Muscle Shortening Research Articles

Gape drives regional variation in temporalis architectural dynamics in tufted capuchins.

Dynamic changes in jaw movements and bite forces depend on muscle architectural and neural factors that have rarely been compared within the same muscle. Here we investigate how regional muscle architecture dynamics-fascicle rotation, shortening, lengthening and architectural gear ratio (AGR)-vary during chewing across a functionally heterogeneous muscle. We evaluate whether timing in architecture dynamics relates to gape, food material properties and/or muscle activation. We also examine whether static estimates of temporalis fibre architecture track variation in dynamic architecture. Fascicle-level architecture dynamics were measured in three regions of the superficial temporalis of three adult tufted capuchins (Sapajus apella) using biplanar videoradiography and the XROMM workflow. Architecture dynamics data were paired with regional fine-wire electromyography data from four adult tufted capuchins. Gape accounted for most architectural change across the temporalis, but architectural dynamics varied between regions. Mechanically challenging foods were associated with lower AGRs in the anterior region. The timing of most dynamic architectural changes did not vary between regions and differed from regional variation in static architecture. Collectively these findings suggest that, when modelling temporalis muscle force production in extant and fossil primates, it is important to account for the effects of gape, regionalization and food material properties. This article is part of the theme issue 'Food processing and nutritional assimilation in animals'.

Beam theory predicts muscle deformation and vertebral curvature during feeding in rainbow trout (Oncorhynchus mykiss).

Muscle shortening underpins most skeletal motion and ultimately animal performance. Most animal muscle generates its greatest mechanical output over a small, homogeneous range of shortening magnitudes and speeds. However, homogeneous muscle shortening is difficult to achieve for swimming fish because the whole body deforms like a bending beam: as the vertebral column flexes laterally, longitudinal muscle strain increases along a medio-lateral gradient. Similar dorsoventral strain gradients have been identified as the vertebral column flexes dorsally during feeding in at least one body location in one fish. If fish bodies also deform like beams during dorsoventral feeding motions, this would suggest the dorsal body (epaxial) muscles must homogenize both dorsoventral and mediolateral strain gradients. We tested this hypothesis by measuring curvature of the anterior vertebral column with XROMM and muscle shortening in 14 epaxial subregions with fluoromicrometry during feeding in rainbow trout (Oncorhynchus mykiss). We compared measured strain to the predicted strain based on beam theory's curvature-strain relationship. Trout flexed the vertebrae dorsally and laterally during feeding strikes, yet when flexion in both planes was included, the strain predicted by beam theory was strongly and significantly correlated with measured strain (p <0.01, R2=0.60). Beam theory accurately predicted strain (slope=1.15, compared to ideal slope=1) across most muscle subregions, confirming that epaxial muscles experience dorsoventral and mediolateral gradients in longitudinal strain. Establishing this deformation-curvature relationship is a crucial step to understanding how these muscles overcome orthogonal strain gradients to produce powerful feeding and swimming behaviours.

Evaluation of stretch reflex synergies in the upper limb using principal component analysis (PCA).

The dynamic nature of movement and muscle activation emphasizes the importance of a sound experimental design. To ensure that an experiment determines what we intend, the design must be carefully evaluated. Before analyzing data, it is imperative to limit the number of outliers, biases, and skewness. In the present study, a simple center-out experiment was performed by 16 healthy volunteers. The experiment included three load conditions, two preparatory delays, two perturbations, and four targets placed along a diagonal path on a 2D plane. While the participants performed the tasks, the activity of seven arm muscles were monitored using surface electromyography (EMG). Principal component analysis (PCA) was used to evaluate the study design, identify muscle synergies, and assess the effects of individual quirks. With PCA, we can identify the trials that trigger stretch reflexes and pinpoint muscle synergies. The posterior deltoid, triceps long head, and brachioradialis were engaged when targets were in the direction of muscle shortening and the perturbation was applied in the opposite direction. Similarly, the pectoralis and anterior deltoid were engaged when the targets were in the direction of muscle shortening and the perturbation was applied in the opposite direction. The stretch reflexes were not triggered when the perturbation brought the hand in the direction of, or into the target, except if the muscle was pre-loaded. The use of PCA was also proven valuable when evaluating participant performance. While individual quirks are to be expected, failure to perform trials as expected can adversely affect the study results.

SAT306 Comparison Of Sodium Nitroprusside And Urapidil In Laparoscopic Adrenalectomy For Pheochromocytoma

Abstract Disclosure: M.G. Rusalenko: None. E. Pispanen: None. M. Wisham: None. I. Savasteeva: None. S. Marchenko: None. D. Borovik: None. D.O. Rusalenko: None. The aim: of the study was to compare the efficacy of Sodium Nitroprusside and Urapidil in management of blood pressure in laparoscopic adrenalectomy for pheochromocytoma. Material and methods : This study includes of 58 cases of pheochromocytoma operated in the Republican Scientific and Practical Center for Radiation Medicine. The mean age of patients was 57.0 years (31 men and 27 women). For preliminary preparations, oral α1-blocker Doxazosin was used. In-operative blood pressure (BP) was recorded via intra-radial artery BP monitoring and via intra-venous BP monitoring from the external jugular vein. Fluid loading was done with colloids and crystalloids. Epidural anesthesia was given with a combination of Ropivacaine 10mg/ml-10ml and Spinal Morphine 1mg/ml-1-2ml was given between T4 - T5 for relaxation of the abdominal cavity. For anesthesia Sevoflurane was used with non-depolarizing short and medium-acting muscle relaxants (rocuronium, atracurium). In the study we included 12 patients who underwent surgery under BP control with Uradipil and 46 patients with Nitroprusside. Results: Long-term administered Doxazosin (more than 14 days) demonstrated lower BP values ​​in the starting phase of the operations (SBP 125.0[110.0; 130.0]; DBP [75.0(60.0; 80.0]) § (SBP 140.0[130.0; 150.0]; DBP [90.0(80.0; 90.0]); p&amp;lt;0.05. Statistically significant differences in BP variability from baseline to maximum values, as well as minimum values were obtained. In both groups (Nitroprusside and Urapidil), using the Wilcoxon criteria, we did not obtain significant differences in the increase in the initial blood pressure in maximum values. In contrast, in the Nitroprusside group, a statistically significant decrease in baseline blood pressure to the minimum values (SBP 90.0[75.0; 100.0]; DBP [50.0(50.0; 55.0]); p&amp;lt;0.004) was obtained, as in the Urapidil group: (SBP 130.0[ 110.0; 140.0]; DBP [80.0(60.0; 90.0]), to minimal values (SBP 95.0[90.0; 110.0]; DBP [60.0(50.0; 60.0]); p&amp;lt;0.008. Comparison of all blood pressure indicators when using Nitroprusside or Urapidil using the Mann-Whitney U test did not show statistically significant differences. However, there was a minor significance in minimum SBP values ​​(N 90.0[75.0; 100.0] § [U 95.0(90.0; 110.0]); z=-1.44; p=0.15) and DBP (N 50.0[50.0; 55.0] § [U 60.0(50.0; 60.0]); z=-1.81; p=0.07. Initial, maximum and final BP values ​​were equivalent in two groups. Conclusion: This data shows that to stabilize patient blood pressure in adrenalectomy for pheochromocytoma, preparation with α1-blockers is significant. The use of Sodium Nitroprusside and Urapidil is equally effective for managing BP during adrenalectomy, however, Urapidil shows to have advantages due to its lower side effects compared to Nitroprusside. Presentation: Saturday, June 17, 2023

Resolving an inconsistency in the estimation of the energy for excitation of cardiac muscle contraction.

In the excitation of muscle contraction, calcium ions interact with transmembrane transporters. This process is accompanied by energy consumption and heat liberation. To quantify this activation energy or heat in the heart or cardiac muscle, two non-pharmacological approaches can be used. In one approach using the "pressure-volume area" concept, the same estimate of activation energy is obtained regardless of the mode of contraction (either isovolumic/isometric or ejecting/shortening). In the other approach, an accurate estimate of activation energy is obtained only when the muscle contracts isometrically. If the contraction involves muscle shortening, then an additional component of heat associated with shortening is liberated, over and above that of activation. The present study thus examines the reconcilability of the two approaches by performing experiments on isolated muscles measuring contractile force and heat output. A framework was devised from the experimental data to allow us to replicate several mechanoenergetics results gleaned from the literature. From these replications, we conclude that the choice of initial muscle length (or ventricular volume) underlies the divergence of the two approaches in the estimation of activation energy when the mode of contraction involves shortening (ejection). At low initial muscle lengths, the heat of shortening is relatively small, which can lead to the misconception that activation energy is contraction mode independent. In fact, because cardiac muscle liberates heat of shortening when allowed to shorten, estimation of activation heat must be performed only under isometric (isovolumic) contractions. We thus recommend caution when estimating activation energy using the "pressure-volume area" concept.

Hip Flexors Shortening among Patients with Low Back Pain

Purpose: Determine the hip flexors shortening in individuals with low back pain.&#x0D; Methodology: It was descriptive cross-sectional study. A total of 255 participants were included according to the selection criteria. Non-probability sampling technique was used to select participants. Inclusion criteria of the study were the patients of age between 18 to 65 years having low back pain from a period of 3 months or more. Exclusion criteria were the individuals with history of spinal trauma, joint dysfunction in past 3 months, any congenital deformity in hip or lumbar region, any history of fracture in related joints in previous 6 months and history of abdominal, hip or lumbar surgery in previous 3 months. Study settings include OPD of DHQ hospital, Gujranwala and Physical therapy department of Gondal hospital, Gujranwala. Study was completed within 4 month. Thomas test was used to assess hip flexors shortening. A structured questionnaire was used to collect participants’ relevant data. Data was analysed by SPSS version 20.&#x0D; Findings: Mean age of the patients was 40.10±12.31 and mean body mass index was 27.44±6.10. Out of 255 patients, 35.7% were male and 64.3% were females. 64.3% participants were housewife, 20.8% were labour and 14.9% were worker. Thomas test was found to be positive in 63.5% patients of low back pain and negative in 36.5% patients. Chi square shows that (p&gt;0.05) there was no significant association between participants’ gender and the results of Thomas test. But a statistically significant association was found between gender and occupation (p&lt;0.05).&#x0D; Recommendations: In conclusion, hip flexor shortening was prevalent in patients of low back pain. The prevalence of hip flexor muscles shortening was found to be 63.5%. There was no statistical significant association of participants’ gender with hip flexor shortening. However, statistical significant association was found between gender and occupation of the participant with low back pain. The relationship of hip flexor shortening with various conditions should be evaluated in future research with a bigger sample size, diverse populations, and different age groups. It is suggested that future research look at the prevalence of hip flexor shortening in those without LBP. To stop people's muscles from shortening in general, several awareness programmes for posture advice and muscle stretching practices should be set up.

The Impact of Tendon Lengthening Following Achilles Tendon Repair on Foot Kinetics, a Finite Element Analysis

Category: Midfoot/Forefoot; Hindfoot Introduction/Purpose: Triceps surae muscle force is transferred through the Achilles tendon to the calcaneus and from the calcaneus to the plantar fascia and then to the metatarsal heads and the toes which exert force on the ground. Achilles tendon ruptures occur in tendons that have reached a critical point of intrasubstance degeneration. The Achilles tendon almost always heals but frequently lengthens during the healing process, leading to an alteration in the triceps surae force production profile. We hypothesized that Achilles tendon overlengthening has implications not only for force generation but likely has many other impacts throughout the foot. The goal of this work was to evaluate the effect of a lengthened Achilles tendon following tendon repair on the kinetics of the foot. Methods: A validated finite element model of the foot was used to compare foot biomechanics between the foot with a functional and non-functional Achilles tendon. The model of the foot constructed from CT scan images of a female cadaveric foot weighing 60 kg included all 28 bones, 72 ligaments, cartilage, and an encapsulating soft tissue. The model was loaded with 0.5 body weight applied at the center of mass and 0.25 body weight applied to the Achilles tendon simulating quiet stance. The tendon forces were applied using force vectors in the direction of their lines of action. The foot with a non-functional Achilles tendon was created by unloading the Achilles tendon since triceps surae muscle shortening due to tendon lengthening significantly decreases force production. The force transmitted through the joints, force in the ligaments, and plantar pressure were determined for both the foot with a functional and non-functional Achilles tendon. Results: We found that the force transmitted through all the joints decreased when the Achilles tendon force was removed (Figure 1a). In addition, removing the Achilles tendon decreased the force within the plantar fascia, long and short plantar ligaments, and deep deltoid ligament, while it increased the force within the spring and superficial deltoid ligaments (Figure 1b). The plantar fascia experienced the greatest reduction in ligament force after unloading of the Achilles tendon (from 93 N to 26 N). Moreover, the maximum plantar pressure in the heel fat pad increased from 164 kPa to 231 kPa when the Achilles tendon was removed. Conclusion: The varying changes in the force in the ligaments and joints due to Achilles lengthening suggest that Achilles tendon rupture with sequent healing with overlengthening can alter the force distribution throughout the entire foot. A major implication of this work is that in treating Achilles ruptures, an extended period of protection with heel wedges beyond the customary six weeks may be needed to prevent over lengthening of the Achilles. Moreover, this study supports the efficiency of surgical lengthening of the Achilles in the treatment of diabetic forefoot foot ulcers by shifting the plantar pressure towards the calcaneus.

Efficacy and Safety of Surgical Procedures for Congenital Moderate and Severe Blepharoptosis: A Network Meta-analysis.

There are various surgical approaches to treat congenital moderate and severe blepharoptosis (CMSBP), but their efficacy and safety remain unclear owing to a lack of high-level evidence. This network meta-analysis aimed to evaluate the efficacy and safety of 3 classical operations: and their modifications frontal muscle flap suspension (FMS), levator palpebrae muscle shortening (LMS), conjoint fascial sheath suspension (CFSS), and modified CFSS. We searched the PubMed, MEDLINE, Cochrane Library, CNKI, and Wanfang databases until March 2022. A Bayesian network meta-analysis was conducted for the 5 most common treatments. Outcome indicators were the number of patients with good correction and adverse events. Twenty-one studies were included, with 2402 eyes in 1863 patients. Five surgical methods were evaluated: FMS, LMS, CFSS, and conjoint fascial sheath suspension combined with levator muscle shortening (CFSS+LMS), or with levator palpebrae muscle composite flap suspension (CFS+L). Meta-analysis indicated that CFSS is more effective than LMS and FMS, but inferior to CFSS+LMS and CFS+L. Efficacy rates of CFSS+LMS and CFS+L were comparable. Frontal muscle flap suspension was more effective than LMS. Safety data meta-analysis found CFSS safer than FMS and LMS but with more complications than CFSS+LMS and CFS+L. Complication rates were comparable between CFS+L and CFSS+LMS, and also for FMS and LMS. When correcting CMSBP, CFSS+LMS, and CFS+L may be better therapeutic strategies for effectiveness and safety. Conjoint fascial sheath suspension also yielded good surgical effects. Plastic surgeons should be cautious about LMS and FMS. Level IV.

Qualidade de vida, capacidade funcional e física de pacientes com fibromialgia

Introduction: Fibromyalgia is a syndrome that manifests itself with the symptomatology of pain spread throughout the body (tender points), directly affecting the patient's quality of life, as it compromises functionality, physical and psychological well-being. Aim: The aim of this study was to assess the quality of life, functional and physical capacity of patients with fibromyalgia. Methodology: This is a quantitative, exploratory and descriptive study, in which 12 patients were interviewed, 3 from the city of Nanuque/MG, 4 from the city of Ecoporanga/ ES, 3 from the city of Ponto Belo/ES and 2 through google forms, from May 18, 2023 to June 7, 2023. Results: When asked about the impact of fibromyalgia on their ability to perform everyday tasks, the following results were obtained in the never category: vacuuming the carpet (83%), walking several blocks (75%) and working outside (58%). The following symptoms were found: intense pain (83.33%), tiredness (83.33%), stiffness (50%), tension (66.67%) and depression (50%), as well as altered sleep quality (33.33% have moderate sleep and 66.67% have very poor sleep). Conclusion: It can be concluded that due to the intense pain caused by fibromyalgia, there are important limitations in patients' lives, as it alters their functionality, interpersonal relationships and psychological state. However, physiotherapy plays a fundamental role, as it aims to treat symptoms such as pain, muscle shortening, muscle weakness, among others, thus promoting a better quality of life.

Методы лечения болезни Осгуда–Шлаттера у детей раннего подросткового возраста в отечественной медицинской практике

Osgood–Schlatter disease is an osteochondropathy of the tibial tuberosity that develops in children aged 12–15 years, more often in boys than in girls (the ratio between them ranges from 3:1 to 7:1), and developes without complications. Recovery occurs in 1–1.5 years from the moment of the first clinical manifestations. It is assumed that the difference is due to the greater participation of boys in sports and risky activities than girls. It was found that the main cause of morbidity is regular exercise and shortening of the rectus femoris muscle in adolescents. For most patients, conservative treatment is effective because painful symptoms stop, but if they persist, surgical treatment is recommended. The study of minimally invasive methods of treating Osgood–Schlatter disease described in the national literature revealed only a few works on various methods of treatment with a description of clinical cases. Objective Review of existing methods of minimally invasive treatment of Osgood–Schlatter disease in children of early adolescence, comparison of their effectiveness from the standpoint of modern evidence requirements. Materials and methods When preparing the review, electronic databases eLibrary, PubMed were used. Results In this review, a comparative analysis of the effectiveness of various minimally invasive methods of treatment is carried out. The main advantages of the methods, as well as their disadvantages, which are due to the complications and difficulties arising from their implementation, are considered. Conclusions The undesirability of surgical treatment of osteochondropathy due to the danger of closing the growth zone is a good reason to develop a new method.

Comparing right and left hamstring flexibility and its association to nonspecific lowr back pain among women of different age groups

Background and objectivesDecreased hamstring flexibility has been associated with LBP (lower back pain). Increased tightness or shortening of hamstring muscle may cause pelvis imbalance or tilt and create instability and increase LBP risk. This study was conducted to pinpoint the differences between right and left hamstring length and their association to LBP in Israeli adult and elderly women. MethodsN = 109 women which were divided into two groups: Adult group, 41 women (aged 45–60) and older group, 68 women (aged 60–75), with LBP that exercise regularly (minimum twice weekly) were selected based on inclusion criteria. Hamstring flexibility was measured using the Passive Straight Leg Raise test and Sit and Reach test, and LBP was measured using the Oswestry Disability Index (OS), the Roland-Morris questionnaire (RM), and a personal information questionnaire. FindingsFindings indicate a statistically significant difference (p < .05) in hamstring flexibility between right and left legs in PSLR test, with the left being shorter than the right. A significant negative correlation was found between hamstring shortening to function in OS and RM questionnaires in the older group, no significant correlation was found between left -right hamstring flexibility differences and reduced function with LBP in the OS and RM questionnaires. Conclusions: Hamstring shortening in adult and elderly women exists despite regular exercise. Future studies must be incorporated to improve hamstring flexibility with emphasis on balance of left and right legs to examine how this will affect LPB reports and compare women who exercise versus women who do not.

Sous vide cooking improved the physicochemical parameters of hot-boned bovine semimembranosus muscles

The physicochemical parameters of hot-boned bovine semimembranosus muscles after sous vide cooking were investigated. Hot-boned or wet-aged steaks were collected, and cooked by different cooking methods, including sous vide (57 °C, 11 h, SV), grilling (at 200 °C to the central temperature of 72 °C, GR) or boiling (100 °C, 2 h, BO). The meat color, tenderness, water-holding capacity, degree of oxidation, myoglobin denaturation and sensory quality traits were determined, as well as the changes in the microstructure. Compared to other cooking methods, SV reduced the degree of oxidation and muscle shortening, and significantly improved the water holding capacity (WHC), tenderness, connective tissue content and overall acceptability for both hot-boned and wet-aged steaks. The oxidation and muscle shortening were reduced in hot-boned SV steaks (P < 0.05), and the water-holding capacity and sensory scores for juiciness, connective tissue content and overall acceptability were increased (P < 0.05) compared to the wet-aged steaks. The combination of hot-boning and SV cooking resulted in an acceptable tenderness, better overall sensory acceptability and higher WHC than other combinations of muscle states and cooking methods. Therefore, it is a good choice to cook hot-boned semimembranosus muscles using SV to improve the eating quality, which can eliminate the need for aging, benefiting the beef industry.

A Multidisciplinary Approach to Swallowing Rehabilitation in Patients with Forward Head Posture.

(1) Background and Objectives: The forward head posture (FHP) is characterized by increased extensions of upper cervical vertebrae and flexion of the lower cervical vertebrae and upper thoracic regions, associated with muscle shortening. The compressive loading on the tissues in the cervical spine negatively impacts suprahyoid and infrahyoid muscles and generates increased tension of the masticatory muscles. The tongue has relations with the suprahyoid and the infrahyoid muscles. The pattern of swallowing evolves gradually from birth to the age of four. If this developmental transition does not occur, the result is persistent infantile or atypical swallowing-an orofacial myofunctional disorder with the tongue in improper position during swallowing, causing strain and stress on the jaw, face, head and neck. In FHP, muscles crucial to swallowing are biomechanically misaligned. The lengthening of the suprahyoid muscles necessitates stronger contractions to achieve proper hyolaryngeal movement during swallowing. This study assesses the added benefits of physiotherapy to the traditional myofunctional swallowing rehabilitation for patients with FHP. The underlying hypothesis is that without addressing FHP, swallowing rehabilitation remains challenged and potentially incomplete. (2) Materials and Methods: A total of 61 participants (12-26 years) meeting the inclusion criteria (FHP and atypical swallowing) were divided into two similar groups. Group A attended one orofacial myofunctional therapy (OMT) and one physiotherapy session per week, group B only one OMT session per week, for 20 weeks. Exclusion criteria were as follows: ankyloglossia, neurological impairment affecting tongue and swallowing, cervical osteoarticular pathology, other previous or ongoing treatments for FHP and atypical swallowing. (3) Results: There is a significant improvement in terms of movement and use of the orofacial structures (tongue, lips, cheeks), as well as in breathing and swallowing in both groups. Group A achieved better outcomes as the CVA angle was directly addressed by manual therapy and GPR techniques. (4) Conclusions: The combined therapy proved to be more effective than single OMT therapy.

The Effect of Q Angle and Hamstring Length on Balance Performance in Gonarthrosis Patients.

Introduction Gonarthrosis (G) is a progressive disease that affects the knee joint and causes pain and limitation of movement in the knee. The determination of the morphometric status of G patients has been a subject of interest recently. The purpose of this study is to determine how hamstring length (HL) and patellofemoral angle (Q angle [QA]) affect the ability of individuals with G to maintain balance. Methods A total of 80 (40 G patients and 40 in the control group [CG]) participants aged 40-65 were included in the study. A goniometer was used to measure the participants' QA. The mean age of the participants was 50.18±7.16 in the G group and 51.40±6.64 in CG. HL was measured using the sit-and-reach test. Participants' dynamic balance state was evaluated using the Y balance test by stepping in the following directions: right-anterior (R-An), right-posteromedial (R-Pm), right-posterolateral (R-Pl), left-anterior (L-An), left-posteromedial (L-Pm), and left-posterolateral (L-Pl). Results According to the results of this research, the balance performance of G patients was significantly lower in all directions (R-An, R-Pm, R-Pl, L-An, L-Pm, L-Pl) compared to the CG. In both groups, R-QA, L-QA, and HL did not change. However, linear regression analysis indicated that in G patients, R-QA, L-QA, and HL affected balance performance. No significant interaction was found between these parameters and balance performance in the CG. Conclusion HL and QA have a significant role in determining body balance. In our study, we found that QA decreased in G patients, leading to genu varum in these individuals. The hamstring muscle shortening observed in G patients significantly negatively affected balance, especially in the R-An, R-Pm, L-An, L-Pm, and L-Pl directions. For healthcare professionals preparing treatment protocols for G patients, we recommend providing exercises to improve balance, especially in these directions.

Dance Around the Fibula with a Twisted Plate: A Technical Note.

Nowadays, there is a better understanding of the role of the posterior malleolar fragment in trimalleolar ankle fractures. Not fragment size, but rather fragment morphology should guide the management of the posterior malleolar fracture (PMF). Anatomical reduction and fixation of the PMF is important, as an intra-articular step-off will eventually lead to osteoarthritis. Incongruency of the incisura fibularis tibia is associated with fibular dislocation, syndesmotic insufficiency, and poor functional outcomes. Open reduction and internal fixation through a posterior approach leads to ankle joint mobility restriction (i.e., dorsal flexion deficiency) due to arthrofibrosis of the ankle joint, fibrous adhesions and secondary shortening of the flexor muscles. In this technical note, we describe a surgical technique to fixate unstable ankle fractures with a combined PMF and a high supra-syndesmotic fibular fracture through two small surgical windows using a twisted one-third tubular plate. By reducing the size of the posterolateral window, fibrous adhesions and secondary flexor muscle shortening are diminished, favoring ankle joint mobility.

Elongating achilloplasty and the original tenorraphy technique for cerebral palsy

BACKGROUND:In cerebral palsy, shortening of the triceps muscle of the lower leg leads to impaired coordination and gait and orthopedic consequences that disrupt the quality of life and complicate rehabilitation. Many surgical techniques are aimed at eliminating contractures and restoring ankle joint movements. However, treatment results are not always satisfactory, and the number of complications remains high, such as recurrence of deformation and failure of the tendon suture after tenotomy.&#x0D; AIM:To analyze the results of calcaneal tendon lengthening plastic surgery with the original tendon suture technique in patients with cerebral palsy complications and consider the features of surgical technique onaclinical example.&#x0D; MATERIALS AND METHODS:This study describes the lengthening plastic surgery of the calcaneal tendon with the original tendon suture technique performed in four patients with complications of cerebral palsy. The clinical observations of the surgical treatment ofa30-year-old patient with spastic paresis of the triceps muscle of the left tibia were presented. The treatment results were followed from 1 to 12 months postoperatively. The amplitude of active and passive movements in the joints, muscle tone, presence and nature of postoperative complications, and functional outcome were evaluated.&#x0D; RESULTS:The results 1 year after the operation were evaluated as good in two initially more severe cases and excellent in two cases. In all patients, decreased pain level, restoration of movements, decreased hypertension, and hypotrophy of the triceps muscle of the lower leg were observed, and no complications were noted.&#x0D; CONCLUSIONS:The results revealed data on the pathogenetic validity of calcaneal tendon elongation in patients with spastic paralysis of the triceps muscle of the lower leg. The proposed original method of surgical treatment ensures the correct anatomical comparison and density of the contact of the tendon ends, reduces the tone of the calf-flounder complex, preserves joint physiological mobility, begins early rehabilitation, and reduces the likelihood of relapse.

Mutant SPART causes defects in mitochondrial protein import and bioenergetics reversed by Coenzyme Q

Pathogenic variants in SPART cause Troyer syndrome, characterized by lower extremity spasticity and weakness, short stature and cognitive impairment, and a severe mitochondrial impairment. Herein, we report the identification of a role of Spartin in nuclear-encoded mitochondrial proteins. SPART biallelic missense variants were detected in a 5-year-old boy with short stature, developmental delay and muscle weakness with impaired walking distance. Patient-derived fibroblasts showed an altered mitochondrial network, decreased mitochondrial respiration, increased mitochondrial reactive oxygen species and altered Ca 2+ versus control cells. We investigated the mitochondrial import of nuclear-encoded proteins in these fibroblasts and in another cell model carrying a SPART loss-of-function mutation. In both cell models the mitochondrial import was impaired, leading to a significant decrease in different proteins, including two key enzymes involved in CoQ10 (CoQ) synthesis, COQ7 and COQ9, with a severe reduction in CoQ content, versus control cells. CoQ supplementation restored cellular ATP levels to the same extent shown by the re-expression of wild-type SPART, suggesting CoQ treatment as a promising therapeutic approach for patients carrying mutations in SPART .

Automatic echocardiographic evaluation of the probability of pulmonary hypertension using machine learning.

Echocardiography, a simple and noninvasive tool, is the first choice for screening pulmonary hypertension (PH). However, accurate assessment of PH, incorporating both the pulmonary artery pressures and additional signs for PH remained unsatisfied. Thus, this study aimed to develop a machine learning (ML) model that can automatically evaluate the probability of PH. This cohort included data from 346 (275 for training set and internal validation set and 71 for external validation set) patients with suspected PH patients and receiving right heart catheterization.Echocardiographic images on parasternal short axis-papillary muscle level (PSAX-PML) view from all patients were collected, labeled, and preprocessed. Local features from each image were extracted and subsequently integrated to build a ML model. By adjusting the parameters of the model, the model with the best prediction effect is finally constructed. We used receiver-operating characteristic analysis to evaluate model performance and compared the ML model with the traditional methods. The accuracy of the ML model for diagnosis of PH was significantly higher than the traditional method (0.945 vs. 0.892, p = 0.027 [area under the curve [AUC]]). Similar findings were observed in subgroup analysis and validated in the external validation set (AUC = 0.950 [95% CI:0.897-1.000]). In summary, MLmethods could automatically extract features from traditional PSAX-PML view and automatically assess the probability of PH, which were found to outperform traditional echocardiographic assessments.

Basic Concepts of Plyometric Training in Soccer Players

Exercises that involve plyometrics are typically broken up into a stretch-shortening cycle with three phases: an eccentric phase (rapid muscle lengthening), an amortization phase (short resting interval), and a concentric phase (explosive muscle shortening). How quickly an athlete transitions from the eccentric to the concentric phase is a measure of his power. Plyometric training (PT) affects the neuromuscular components of the body for maximum contraction of muscle in minimum time. Soccer is a multidimensional sport and requires various strength training, endurance training, power and agility training, and soccer tactical training. Considering all facts, PT has got a strong tendency to develop cardiovascular and neuromuscular fitness. PT improves VO2 max, explosive strength, linear sprint speed, effective kicking, endurance, agility, soccer skills, and vertical jump ability in athletes of any age. PT improves tendon strengthening and increases muscle elasticity, which results in avoiding injuries.

Аналіз ефективності методів корекції пронаційних деформацій стоп у дітей з дитячим церебральним паралічем

Pronation deformities of the feet are one of the most common childhood deformities requiring surgical treatment. For correction subtalar arthroereisis and subtalar arthrodesis according to Grice are used. The use of these methods in combination with the transposition of the gastrocnemius muscle is promising. Purpose - тo study the effectiveness of subtalar arthroereisis and subtalar arthrodesis according to Grice in combination with transposition of the gastrocnemius muscle in the correction of pronation deformity of the feet in children with cerebral palsy. Materials and methods. The results of treatment of 40 patients aged 7 to 16 years with pronation deformity of the feet were analyzed. Patients were divided into 2 groups. The main group (25 patients) was divided into 2 subgroups depending on the method of surgical treatment: the subgroup A - 10 patients who underwent subtalar arthroereisis with transposition of the tendon of the short peroneal muscle; the subgroup B - 15 patients who underwent subtalar arthrodesis according to Grice with transposition of the tendon of the short peroneal muscle. The control group included 15 patients who underwent subtalar arthrodesis according to Grice. Clinical and radiological methods were used to examine patients. Numerical data were compared between groups and processed statistically with the determination of M±m and the coefficient of reliability by Student’s t-test. The level of probability was set at p&lt;0.05. Results. The advantage of subtalar arthroereisis and subtalar arthrodesis according to Grice in combination with transposition of the gastrocnemius muscle is the elimination of its pronation pathological effect on the foot, increased supination effect of the posterior tibialis muscle, as well as reduced compression on the autoimplant when performing subtalar arthrodesis according to Grice. Conclusions. The effectiveness of peroneal tendon transposition in combination with subtalar arthroereisis or arthrodesis in the correction of pronation deformity of the feet in children with cerebral palsy has been proven, which allows improving clinical and radiological parameters after treatment. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committees of all institutions participating in the study. Informed consent was obtained from the patients. No conflict of interests was declared by the authors.