Decreased Muscle Strength Research Articles

Decreased muscle strength in adjuvant-induced rheumatoid arthritis animal model: A relationship to behavioural assessments

Rheumatoid arthritis (RA) is an autoimmune disorder with unknown aetiology. Patients suffering from RA face persistent pain due to joint inflammation, and tissue destruction. Behavioural phenotyping is an approach to target the role of different behavioural traits associated with disease progression. The study aimed to assess behavioural patterns associated with decreased muscle strength in the adjuvant-induced rheumatoid arthritis animal model. The study was conducted on male Albino Wister rats (n = 30) [Control, Vehicle, and Disease groups]. After taking ethical approvals RA was induced by complete Freund's adjuvant (CFA) intradermally base of tail. The weight of animals, macroscopic analysis of inflammatory signs, and arthritic scores were measured weekly. Grip strength, ganglia-based movement, cataleptic activity, and motor-coordination-related behaviours were assessed among the groups. Radiographs and spleen index assay were performed followed by data analysis using one-way and two-way ANOVA (Analysis of Variance). A significant decrease in weight and an increase in arthritic scores among the diseased group was observed. Behavioural analyses confirmed that diseased animals had significantly decreased grip strength and increased cataleptic activity with less motor coordination. Radiographic images and spleen index assay confirmed the pattern of RA. Therefore, it can be suggested that the development of the disease animal model is an effective approach to identifying the disease progression and associated behavioural changes. Moreover, this prepared laboratory animal model may be utilised for pathway analyses to understand the key role of immune regulators and genetic insight into molecular pathways associated with acute and chronic phases of RA.

The relationship between physical activity level and balance parameters, muscle strength, fear of falling in patients with hypertension.

The number of studies investigating the role of physical activity and exercise in hypertension (HT) patients is insufficient in the literature, and reports evaluating the relationship between HT, physical activity, and balance are lacking. This study aims to examine the relationship between physical activity levels and balance parameters, muscle strength, and fear of falling in patients with HT. 78 subjects with HT participated in this study. Demographic and clinical characteristics of all participants were recorded. Blood pressure was evaluated using a sphygmomanometer, physical activity level was assessed using a SenseWear Armband, fear of falling was assessed using the Fall Efficacy Scale, balance was assessed using the Fullerton Advanced Balance Scale, and muscle strength was evaluated using a digital handheld dynamometer. All 78 subjects completed the study as planned. The average age of participants was 57.75 ± 5.82, the mean systolic blood pressure was 133 ± 5.73, and the diastolic blood pressure was 84 ± 6.78. 34.2% of participants used angiotensin-converting enzyme inhibitors, 38% used beta blockers, and 26% used diuretic drugs. A positive correlation between physical activity and balance scores of individuals with HT was found (P < .005). It was also found that low muscle strength was associated with balance and risk of falling (P < .005). There is a positive correlation between decreased physical activity levels and balance in participants with HT. The results suggest that people with HT who have poor balance also have decreased muscle strength against gravity, such as in the quadriceps femoris and gluteus maximus. Overall, we recommend that patients with HT should improve their physical activity levels.

Risk factors of the patellofemoral pain syndrome

Background: Patellofemoral pain syndrome (PFPS) is one of the common injuries to the knee that often occur, causing pain when doing physical activities such as squatting, running or going up and down stairs when the knee is bent. As the joint that supports the body the most, this certainly hinders a person's activities. PFPS is caused by various risk factors ranging from intrinsic factors such as muscle strength to extrinsic factors such as type of activity. This study aimed to determine the risk factors related to PFPS as a preventive effort by doing quadriceps muscle strengthening exercises. Methods: This study used a literature review study design using secondary data from published literature. Literature searches were conducted online through PubMed, ScienceDirect, and Google Scholar, using the keywords “knee injury”, “patellofemoral pain”, “patellofemoral pain syndrome”, and “risk factors”, which selected based on inclusion and exclusion criteria. Results: From the five studies that discussed risk factors related to PFPS, it was found that all journals showed quadriceps muscle strength, type of daily activity, Q-angle, joint laxity, hip tightness, patellar imbalance, overuse, and patellofemoral joint overpressure were associated with PFPS. Conclusion: Based on the literature that has been reviewed and the discussion, the dominant risk factor associated with PFPS was a decrease in hip muscle strength, especially quadriceps. Besides, several other contributing factors include the type of daily activity, Q-angle, joint laxity, hip tightness, patellar imbalance, overuse, and patellofemoral joint overpressure.

The effect of moringa oleifera leaf as an anti-inflammatory: a literature review

Background: Patellofemoral pain syndrome (PFPS) is one of the common injuries to the knee that often occur, causing pain when doing physical activities such as squatting, running or going up and down stairs when the knee is bent. As the joint that supports the body the most, this certainly hinders a person's activities. PFPS is caused by various risk factors ranging from intrinsic factors such as muscle strength to extrinsic factors such as type of activity. This study aimed to determine the risk factors related to PFPS as a preventive effort by doing quadriceps muscle strengthening exercises. Methods: This study used a literature review study design using secondary data from published literature. Literature searches were conducted online through PubMed, ScienceDirect, and Google Scholar, using the keywords “knee injury”, “patellofemoral pain”, “patellofemoral pain syndrome”, and “risk factors”, which selected based on inclusion and exclusion criteria. Results: From the five studies that discussed risk factors related to PFPS, it was found that all journals showed quadriceps muscle strength, type of daily activity, Q-angle, joint laxity, hip tightness, patellar imbalance, overuse, and patellofemoral joint overpressure were associated with PFPS. Conclusion: Based on the literature that has been reviewed and the discussion, the dominant risk factor associated with PFPS was a decrease in hip muscle strength, especially quadriceps. Besides, several other contributing factors include the type of daily activity, Q-angle, joint laxity, hip tightness, patellar imbalance, overuse, and patellofemoral joint overpressure.

Penerapan pijat kaki Terhadap Peningkatan Kekuatan Otot Pada Pasien Stroke

Background Stroke is a central nervous system function disorder in the form of blockage of brain blood vessels or rupture of blood vessels in the brain, symptoms that appear in hemiparesis disease, namely a decrease in muscle strength, one of the independent nursing interventions in dealing with decreased muscle strength by giving foot massage. Research Methods: This study uses a descriptive method with a case study approach. Sample: 1 stroke patient who experienced a decrease in muscle strength. Results: the study found that stroke patients experienced complaints of weakness on the right side of the body, muscle strength on the right 1. Nursing diagnoses were: physical mobility barriers, ineffective cerebral tissue perfusion, and damage to skin integrity. Mobilization support nursing interventions, Improved cerebral perfusion, skin integrity care. Nursing implementation was carried out for 6 days. Evaluation after applying foot massage nursing problems that arise in patients can be resolved. Conclusion: the application of foot massage can increase muscle strength there is a change in the value of muscle strength in stroke patients from a value of 1 to a value of 4 on day 6. Suggestion: it is hoped that it can provide independent nursing interventions as a companion to pharmacological therapy to overcome nursing problems that exist in non hemorrhagic stroke patients.

Foot Massage dan Latihan Range of Motion Dapat Mengatasi Gangguan Mobilitas Fisik pada Lansia dengan Stroke

Introduction: the elderly are part of the growth process. One of the problems that often occur in the elderly with stroke cases is a decrease in physical mobility. This can be overcome by nursing interventions providing food massage and range of motion exercises. Method: with a case study approach. The research sample was one post-stroke patient who experienced a decrease in muscle strength. by giving foot massage and ROM exercises for 15-30 minutes 2 times a day in the morning and evening for 6 days. Results: there were complaints, weakness in the right extremity, selurred speech, difficulty walking asymmetrical mouth. Nursing interventions identify physical tolerance for movemen. Monitor blood pressure before starting mobilization and ambulation. Implementation facilitates changing positions as comfortable as posibble, providing foot massage and range of montion exercises. Evaluation TTV: 120/90 mmHg, N: 90x/minutes, R: 22x/minutes, S:36.0ᵒC efter being given foot massage and range of montion exercises whit a duration of 15-3o minutes 2 tamies a day in the morning dan evening for 6 days showed that the client eperianced an increase in muscle strength from a score of 2 to 3. Conclusion: giving food massage and range of motion can increase muscle strength. It is hoped that nurses can provide this intervention as a companion to non-pharmacological therapy to overcome physical problems in patients with stroke

Assessment of Motor Activity of Patients Undergoing Medical Rehabilitation and Health Resort Treatment

INTRODUCTION. Problem of evaluation of the motor activity patients undergoing medical rehabilitation and sanatorium treatment remains relevant, including obesity.&#x0D; AIM. To study the nature and degree of disorders of muscle strength, motor and coordination functions in patients undergoing medical rehabilitation and sanatorium treatment.&#x0D; MATERIALS AND METHODS. Single cross-sectional study included 160 patients aged 40 to 65 years with normal and overweight. The complex of the study included: functional tests and assess muscle strength and balance.&#x0D; RESULTS. In patients with obesity, compared with persons with normal body weight of the same age, significantly (p 0.05) lower indicators of muscle strength of the right and left arms, strength of the abdominal and back muscles, lower endurance of the abdominal muscles and back muscles and longer time to complete the “Get up and walk” test. Also, in obesity, it turned out to be significantly less time to maintain balance in the “Stand on one leg” tests on the right and left legs with open eyes. A statistically significant direct relationship was found between the level of back muscle strength (γ = −0.82, p = 0.0038) and body weight. A significant relationship was also found between the level of endurance of the back muscles to physical activity and BMI (γ = −0.79, p = 0.01). At the same time, there was no relationship between age and the level of endurance of the back muscles to physical activity (γ = 0.107, p = 0.36).&#x0D; DISCUSSION. In patients undergoing medical rehabilitation and health resort treatment, obesity is associated with a decrease in muscle strength and motor activity.&#x0D; CONCLUSION. In patients with obesity at the age of 40–65 years, compared with persons with normal body weight of the same age and gender, there is a statistically significant decrease in the muscle strength of the arms, abdomen and back, a longer time to complete the “Get up” test and walk”, as well as deterioration in the function of static balance according to the results of the “Stand on one leg” test.

The effect of changing the length of the components of the muscle-tendon unit of the knee joint on its isometric force and torque

Background. A knee contracture developed due to immobilization after extra-articular injuries leads to lameness, impaired walking, and the appearance of pain in other joints of the lower limb. Long-term immobilization of the joint leads to weakening and increasing stiffness of muscles, changes in the length of tendons and myofibrils, loss of cushioning properties of cartilage, inhibition of blood circulation processes in the periarticular tissues. Adequate rehabilitation and recovery of the knee joint function after immobilization is a medical and social problem in terms of reducing disability. The goal of the work: to study the influence of changes in strength, length of muscles and tendons of the knee joint on torque. Materials and methods. The OpenSim Leg39.osim base model was used for simulation. The parameters of the muscles and tendons were changed in accordance with the conditions of immobilization for 45 days at the angle of preferential position of the limb — 15°. Three models were analyzed: a basic model without changes in muscle parameters, a model with a change in the length of the muscle-tendon unit, and a model with an additional change in muscle strength (according to calculations). Results. Changing the length of the components of the muscle-tendon unit of the flexors has little effect on both the isometric strength of the muscles and the knee joint torques produced by these muscles. A decrease in the maximum isometric force of the flexor muscles leads to a decrease in torque. When the length of the extensors changes, there is a sharp increase in the isometric force and torques of the knee joint and a change in the direction of the active torque trajectory. A decrease in muscle strength leads to a decrease in the level of torques approaching normal, but the direction remains unchanged. Conclusions. Mathematical modeling of the effect of changes in the components of the muscle-tendon unit of the muscles responsible for the movement of the knee joint showed that minor alterations in their length lead to noticeable violations of both the torque of the joint and changes in the isometric strength of the muscle during movements. Predicting the change in knee joint torque can be useful in studying specific clinical situations with contractures caused by a long-term immobilization after extra-articular injuries. But it cannot be fully transferred into practice due to the significant conditionality of model parameters. The used modeling method can show trends in the change of muscle functioning parameters when changing their geometry, and can be extended to study of other muscle and joint parameters.

Subcutaneous Infusion of DNA-Aptamer Raised against Advanced Glycation End Products Prevents Loss of Skeletal Muscle Mass and Strength in Accelerated-Aging Mice.

We have developed DNA aptamers that can inhibit the toxic effects of advanced glycation end products (AGE-Apts). We herein evaluated the effects of AGE-Apts on muscle mass and strength in senescence-accelerated mouse prone 8 (SAMP8) mice. Eight-month-old male SAMP8 mice received subcutaneous infusion of control DNA aptamers (CTR-Apts) or AGE-Apts. Mice in an age-matched senescence-accelerated mouse resistant strain 1 (SAMR1) group were treated with CTR-Apts as controls. The soleus muscles were collected after the 8-week intervention for weight measurement and histological, RT-PCR, and immunofluorescence analyses. Grip strength was measured before and after the 8-week intervention. AGE-Apt treatment inhibited the progressive decrease in the grip strength of SAMP8 mice. SAMP8 mice had lower soleus muscle weight and fiber size than SAMR1 mice, which was partly restored by AGE-Apt treatment. Furthermore, AGE-Apt-treated SAMP8 mice had a lower interstitial fibrosis area of the soleus muscle than CTR-Apt-treated SAMP8 mice. The soleus muscle levels of AGEs, oxidative stress, receptor for AGEs, and muscle ring-finger protein-1 were increased in the CTR-Apt-treated mice, all of which, except for AGEs, were inhibited by AGE-Apt treatment. Our present findings suggest that the subcutaneous delivery of AGE-Apts may be a novel therapeutic strategy for aging-related decrease in skeletal muscle mass and strength.

Muscle strength in ostensibly healthy non-diabetic subjects

Background/purposeSarcopenia and decreased muscle strength (dynapenia) are emerging health issues. However, the study exploring muscle strength changes of both upper and lower limbs at the same time among all age groups is rare. This study aims to investigate the muscle strength and to establish a muscle strength norm of an ostensibly healthy non-diabetic Asian population. MethodsFrom 2018 June to 2020 March, subjects (aged from 20 to <80 years old) undergoing health checkup in Good Liver Medical Examination Center and National Taiwan University Hospital Geriatrics and Gerontology Department were enrolled. A battery of muscle power examinations including handgrip strength (HGS), five times sit-to-stand test (5TSTS), and one-leg standing test (OLST) were performed. ResultsA total of 183 participants was enrolled, consisting of 92 females and 91 males. The finding shows the strongest HGS, best 5TSTS, and the longest OLST of both genders appeared in the 20-29-year-old group. Age, gender, and palm length are significantly related to HGS, whereas age is the only factor affecting 5TSTS and OLST. It revealed a progressive decline during ageing process, especially after age 60. Finally, Z-score and T-score norms of these were established. ConclusionThese data will be useful as normal controls for muscle strength of specific disease groups. The application of the cutoffs from these data and their comparisons with the recommended cutoffs from various guidelines worth further exploration.

FUNCTIONAL TRAINING

This work is a review of the literature which used the main databases such as SCIELO and PUBMED, bringing together 7 articles in Portuguese and English from 2013 to 2023, on the benefits of functional training for the elderly, as the Aging is a set of morphological, physiological, biochemical and psychological changes that depend on the individual’s life history and genetics. It is common to observe a reduction in the percentage of lean mass in the elderly, which may be related to a decrease in muscle strength. Functional training is effective in strengthening muscles, improving mobility and balance, ensuring the prevention of falls and, consequently, improving the quality of life for the elderly.

Low extracellular magnesium induces phenotypic and metabolic alterations in C2C12-derived myotubes

Magnesium (Mg) has a pivotal role in upholding skeletal muscle health and optimizing performance. Its deficiency decreases muscle strength, and an association has been reported between Mg intake and sarcopenia. To gain a comprehensive understanding of the repercussions arising from low Mg concentrations on muscle behavior, we employed an in vitro model utilizing C2C12-derived myotubes. Myotubes cultured in low Mg show a significant reduction of thickness and a concomitant down-regulation of myosin heavy chain (MyHC), Myog and Myomixer. In parallel, myotubes shape their metabolism. Glycolysis is inhibited and beta-oxidation increases. These metabolic changes are consistent with the increase of MyHC I (slow) vs. MyHC II (fast) expression. We identified an essential player in these changes, namely nitric oxide (NO), as the increase in NO production appeared to orchestrate the observed modifications in myotube behavior and metabolism under low Mg conditions. Understanding these underlying mechanisms may pave the way for targeted interventions to ameliorate muscle-related conditions associated with Mg deficiency and contribute to enhancing overall muscle health and function.

A prospective feasibility trial exploring novel biomarkers for neurotoxicity after isolated limb perfusion.

Isolated limb perfusion (ILP) is a regional cancer treatment in which high-dose chemotherapy is administered in an isolated extremity. The main side effect is regional toxicity, which occasionally leads to nerve damage. Measuring neuroaxonal biomarkers, might be a method predicting such complications. Therefore, the primary aim of the study is to investigate if neuronal biomarkers are measurable and alters in an isolated extremity during ILP. Secondly, if postoperative regional toxicity, alterations in sensitivity, and/or muscle strength are correlated to the biomarker levels. Eighteen scheduled ILP-patients were included in the study. Glial fibrillary acidic protein (GFAP), neurofilament light (NfL), and tau concentrations were measured in plasma sampled preoperatively, at the start and end of the ILP, on days 3 and 30, using ultrasensitive Single molecule array (Simoa) technology. The patients were assessed by a physiotherapist pre- and postoperatively. At ILP end, significantly higher NfL and tau levels were measured in the extremity than in the corresponding systemic circulation (NfL; 17 vs 6ng/L, p < .01, tau; 1.8 vs 0.6ng/L, p < .01), and the extremity levels were significantly increased at ILP end (NfL; 66 ± 37%, p < .001, tau; 75 ± 45%, p = .001). On days 3 and 30, significantly increased NfL and GFAP levels were measured systemically (NfL day 3: 69 ± 30%, p < .001; day 30: 76 ± 26%, p < .001; GFAP day 3: 33 ± 22%, p < .002; day 30: 33 ± 23%, p ≤ .004). Finally, no significant correlations were found between regional toxicity or between postoperative muscle or sensitivity decrease and biomarker release. During ILP, NfL and tau levels increased significantly. No obvious correlations were observed between biomarker release and regional toxicity or decreased muscle strength or sensitivity, although large-scale studies are warranted.

Effect of Low-Load Blood Flow Restriction Training on Patients With Functional Ankle Instability: A Randomized Controlled Trial.

Decreased muscle strength and balance in patients with functional ankle instability (FAI) can be effectively improved by ankle strength training. Low-load blood flow restriction (LL-BFR) training increases muscle size and strength, but there is limited evidence from studies on muscle strength and balance in FAI patients. To study the effects of LL-BFR training versus high-load training (HLT) on muscle strength and balance in FAI patients. Randomized controlled trial. Forty-six young adults with a history of FAI. Participants in the LL-BFR and HLT groups performed 4 sets (30 × 15 × 15 × 15) of ankle training at 20% to 40% of the one-repetition maximum and 70% to 85% one-repetition maximum, respectively, twice a week for 6weeks. Plantar flexion, dorsiflexion, inversion, and eversion muscle strength, and the Y-balance test scores were assessed at baseline and after 3 and 6weeks; the thickness of the tibialis anterior, triceps surae, and peroneus longus muscles were assessed at baseline and after 6weeks. Inversion, eversion, dorsiflexion, and plantar flexion muscle strength; tibialis anterior, triceps surae, and peroneus longus thickness; and Y-balance test scores were significantly increased in the LL-BFR group after 3 and 6weeks compared with baseline (P < .05), with no significant difference between the LL-BFR and HLT groups after 6weeks (P > .05). However, at the end of 3weeks, eversion muscle strength and Y-balance test scores were significantly higher in the LL-BFR group than in the HLT group (P < .05). Over 6weeks, LL-BFR training was as effective as HLT in improving ankle muscle strength, muscle thickness, and balance in FAI patients, but LL-BFR training improved the ankle eversion muscle strength and dynamic balance more than HLT did in the early stages of the intervention. This finding will provide a new intervention strategy for the clinical rehabilitation of FAI patients.

Effect of TRX Suspension Training on Balance, Mobility, Lower Limb Muscle Strength, and Fear of Falling in Older Men

Background and Aims Decreased muscle strength due to aging can lead to neuromuscular disorders, increased risk of falling, decreased function in daily activities, and reduced independence in the elderly. The present study aims to investigate the effect of eight weeks of TRX suspension training on lower limb muscle strength, balance, mobility, and fear of falling in older men. Methods This is a quasi-experimental. Participants were 30 elderly men with a mean age of 67.9±4.3 years who were assigned into two groups of TRX (n=16) and control (n=14). In the pre-test phase, lower limb strength was measured by the 30-second chair stand test, functional balance by the Berg balance scale, functional mobility by the timed up &amp; go test, and fear of falling by the falls efficacy scale -international. Then, the TRX group performed the functional training for eight weeks, three sessions per week, each for about one hour. After performing the exercises, post-test assessments were performed in two groups. To compare the groups, the analysis of covariance and Bonferroni post hoc test were used in SPSS software, version 19. The significance level was set at 0.05. Results The TRX functional training significantly improved lower limb strength, balance, and functional mobility of the elderly (P≤0.001); however, it had no significant effect on their fear of falling (P&gt;0.05). Conclusion Given the positive effects of TRX functional training on lower limb strength, functional balance, and mobility of elderly men, it seems that this suspension training can be used to improve lower limb muscle strength, functional balance, and mobility of older men.

The impact of the balance beam on early age balance skills at DBL Academy Yogyakarta

The key foundation for a child’s overall development is their early years. As children learn new things and acquire new types of movement, they require continuous and appropriate support for their cognitive development and movement abilities at this stage. Children’s lives revolve around play because it gives them the opportunity to engage with others, explore their surroundings, and acquire new skills. Stability of posture, or postural balance, is important for young children’s development. A child’s general health can suffer as a result of decreased muscle strength, coordination, and cognitive function brought about by accidents, sports injuries, or aging. This increases the risk of a child falling. Children have the opportunity to exercise and enhance their balance while walking on a balance beam, which is a stable board with supports underneath. Open-ended play, such as that involving a balance beam, can foster children’s imagination and creativity. Data for this study were collected through an online survey method. The entire existing population was used as the sample in a targeted sampling strategy. The online survey was given to 11 participants, and the results showed that 84.3% observed an improvement in balance in young children, 66.9% understood the advantages and risks of using a balance beam, and 87.2% of coaches had used a balance beam when they were younger. One of the training methods to enhance balance skills in young children is the balance beam.

The impact of life-long strength versus endurance training on muscle fiber morphology and phenotype composition in older men.

Aging is typically associated with decreased muscle strength and rate of force development (RFD), partly explained by motor unit remodeling due to denervation, and subsequent loss of fast-twitch type II myofibers. Exercise is commonly advocated to counteract this detrimental loss. However, it is unclear how life-long strength versus endurance training may differentially affect markers of denervation and reinnervation of skeletal myofibers and, in turn, affect the proportion and morphology of fast-twitch type II musculature. Thus, we compared fiber type distribution, fiber type grouping, and the prevalence of atrophic myofibers (≤1,494 µm2) in strength-trained (OS) versus endurance-trained (OE) master athletes and compared the results to recreationally active older adults (all >70 yr, OC) and young habitually active references (<30 yr, YC). Immunofluorescent stainings were performed on biopsy samples from vastus lateralis, along with leg press maximal strength and RFD measurements. OS demonstrated similar type II fiber distribution (OS: 52.0 ± 16.4%; YC: 51.1 ± 14.4%), fiber type grouping, maximal strength (OS: 170.0 ± 18.9 kg, YC: 151.0 ± 24.4 kg), and RFD (OS: 3,993 ± 894 N·s-1, YC: 3,470 ± 1,394 N·s-1) as young, and absence of atrophic myofibers (OS: 0.2 ± 0.7%; YC: 0.1 ± 0.4%). In contrast, OE and OC exhibited more atrophic fibers (OE: 1.2 ± 1.0%; OC: 1.1 ± 1.4%), more grouped fibers, and smaller proportion of type II fibers (OE: 39.3 ± 11.9%; OC: 35.0 ± 12.4%) than OS and YC (all P < 0.05). In conclusion, strength-trained master athletes were characterized by similar muscle morphology as young, which was not the case for recreationally active or endurance-trained old. These results indicate that strength training may preserve type II fibers with advancing age in older men, likely as a result of chronic use of high contractile force generation.NEW & NOTEWORTHY Aging is associated with loss of fast-twitch type II myofibers, motor unit remodeling, and grouping of myofibers. This study reveals, for the first time, that strength training preserves neural innervation of type II fibers, resulting in similar myofiber type distribution and grouping in life-long strength-trained master athletes as young moderately active adults. In contrast, life-long endurance-trained master athletes and recreationally active old adults demonstrated higher proportion of type I fibers accompanied by more marked grouping of type I myofibers, and more atrophic fibers compared with strength-trained master athletes and young individuals. Thus, strength training should be utilized as a training modality for preservation of fast-twitch musculature, maximal muscle strength, and rapid force capacity (RFD) with advancing age.

Trunk muscle dysfunction in patients with myotonic dystrophy type 2 and its contribution to chronic low back pain.

Myotonic dystrophy type 2 (MD2) presents with a varied manifestation. Even though the myopathy in these patients is more widespread, axial musculature involvement is one of the most prominent conditions. MD2 patients also often report chronic low back pain (CLBP). The purpose of this study was to evaluate trunk muscle function, including respiratory muscles, in patients with MD2 and to compare it with healthy controls, to determine the occurrence of CLBP in patients with MD2, and to assess whether trunk muscle dysfunction increases the risk of CLBP in these patients. We enrolled 40 MD2 patients (age range 23 to 76 years, 26 women). A comprehensive battery of tests was used to evaluate trunk muscle function. The tests consisted of quantitative muscle strength testing of low back extensor muscles and respiratory muscles and the assessment of trunk muscle endurance. A neurological evaluation contained procedures assessing the distribution of muscle weakness, myotonia, and pain, and used questionnaires focused on these items and on disability, depression, and physical activity. The results of this study suggest that patients with MD2 show significant dysfunction of the trunk muscles, including the respiratory muscles, expressed by decreased muscle strength and endurance. The prevalence of CLBP in patients with MD2 was 52.5%. Based on our analysis, the only independent significant risk factor for CLBP in these patients was maximal isometric lower back extensor strength in a prone position ≤ 15.8 kg (OR = 37.3). Other possible risk factors were severity of myotonia and reduced physical activity. Outcomes of this study highlighted the presence of axial muscle dysfunction, respiratory muscle weakness, and frequent occurrence of CLBP together with its risk factors in patients with MD2. We believe that the findings of this study may help in management and prevention programs for patients with MD2.

A Case Report of Reversible Iatrogenic Compressive Myelopathy

Physical rehabilitation is a proven method of non-specific lower back pain treatment in contrast to manual therapy which has no evidence of clinical effectiveness. But sometimes, in the search for relief, patients develop complications resulting from the actions of unscrupulous healthcare providers in this field. A 35-year-old patient developed unbearable pain, impaired sensitivity, decreased muscle strength, stiffness in both legs, and urinary retention after rough manual-barefoot manipulation. Computed tomography scans of the cervical, thoracic, and lumbar spine regions revealed signs of hematomyelia involving the Th9-Th10, Th10-Th11, and L1-L2 spinal cord segments. After undergoing therapy with nonsteroidal anti-inflammatory drugs and glucocorticosteroids, the patient reported a significant improvement in his condition. The description of this clinical case demonstrates a complication of the manual-barefoot manipulation presenting as compressive myelopathy.

The value of ultrasound measurement of muscle thickness at different sites and shear wave elastography in Parkinson's disease with sarcopenia: a pilot study.

Patients with Parkinson's disease (PD) and sarcopenia often exhibit resilience, frailty, disability, and depression, highlighting the complex and interrelated nature of these conditions. Despite the presence of clinical manifestations of muscle atrophy in both PD and sarcopenia, accurately discerning the coexistence of sarcopenia in PD patients remains a challenging task with significant implications for treatment strategies and prognostic assessments. This study aims to elucidate the specific ultrasonic diagnostic parameters associated with PD accompanied by sarcopenia through a comparative analysis of muscle ultrasound parameters in patients with PD, thereby presenting a novel approach for rapid identification of this condition. A total of 110 participants were enrolled in this study, including patients with PD and control subjects. Demographic data, clinical characteristics, physical performance tests, appendicular skeletal muscle mass index (ASMI), bioelectrical impedance analysis and muscle ultrasound measurements were collected from all participants. The muscle ultrasound measurements encompassed assessments of muscle thickness, pennation angle and shear wave elastography at various anatomical sites. Parkinson's disease patients exhibited decreased muscle strength and physical performance, and increased shear wave elastography value. In PD patients with sarcopenia, body circumference, including calf circumference, mid-arm circumference, Waist-to-Hip Ratio and body mass index (BMI) were all significantly decreased. Biceps brachii muscle thickness (MT) and gastrocnemius MT decreased in PD patients with sarcopenia and low ASMI. Binary logistic regression analysis revealed that male PD patients, BMI and gastrocnemius MT were predictive factors for ASMI in PD patients. Biceps brachii MT and gastrocnemius MT are important indicators for distinguishing whether PD patients have sarcopenia. Male patients, low BMI and gastrocnemius MT were identified as valid predictors of low ASMI in PD patients. The findings of this study provide important insights into the use of muscle ultrasound in the diagnosis of PD with sarcopenia.