Limb Muscle Strength Research Articles

Comparative effects of cognitive and instability resistance training versus instability resistance training on balance and cognition in elderly women

This study investigates the effects of integrated instability resistance training and cognitive training (IRCT) versus isolated instability resistance training (IRT) on balance, gait, muscle strength, and cognitive functions in elderly women.This randomized controlled trial included 36 participants, with 18 in the IRCT group and 18 in the IRT group. The sample size was estimated to achieve a statistical power of 0.95 with a large effect size (0.40; n = 12 each group). The closed-eye single-leg stand test was measured for static balance, the closed-eye stepping test, and the Timed Up and Go Test (TUGT) were measured for dynamic balance. Dual-task balance was assessed by combining the TUGT with cognitive tasks (TUGT-C) and motor tasks (TUGT-M). Gait performance was evaluated using a gait function system. Lower limb muscle strength was measured with the 30-Second Chair Stand Test. Cognitive function was assessed through the Trail Making Test (TMT), Digit Span Test (DST), Stroop Color and Word Test (Stroop), and Digit Symbol Substitution Test (DSST). Results IRCT group showed better improvements in both cognitive (p < 0.001) and motor (p = 0.812 for baseline; p < 0.001 for post-intervention) dual-task abilities, IRCT also experienced better enhancement in certain cognitive functions, particularly in the TMT (p = 0.001) and DSST (p = 0.022) compared to the IRT group. Both groups demonstrated enhancements in walking abilities as shown on selective markers of the gait performance test (p < 0.05) and leg muscle strength via 30-Second Chair (p < 0.001 for time main effect). These results suggest that combining cognitive exercises with physical training more effectively addresses the complex challenges associated with aging in women. The study highlights the potential of comprehensive training approaches in boosting health and quality of life for the elderly, with implications for developing tailored exercise programs focused on reducing fall risks and enhancing quality of life in this population.

Discipline-specific adaptation patterns in respiratory and lower limb musculotendinous structures: cyclists vs. basketball players.

This study aimed at assessing how chronic exposure to specific exercise training (high-intensity intervals vs. endurance), comparing experienced basketball-players (BP, N.=16), cyclists (CY, N.=16), and non-specifically trained individuals (CN, N.=16), influences the structural and functional characteristics of both lower limb and respiratory musculotendinous structures. Vastus lateralis, gastrocnemius lateralis, and medialis, diaphragm muscles, as well as patellar tendon and Achilles tendon, were assessed using B-mode ultrasonography. Maximal voluntary isometric and passive torque measurements were conducted in the knee-extensors and plantar-flexors. Additionally, a subset of participants (N.=10 for each group) underwent a fatigue-inducing exercise-till-exhaustion protocol, and the strength of lower limb and respiratory muscles was evaluated immediately before and after the trial. Athletes had bigger and stronger musculotendinous structures and greater endurance to fatigue than CN (P<0.05). BP had bigger plantar-flexors and diaphragm, greater fascicles length, more explosive plantar-flexors and respiratory muscles and bigger tendons than CY (P<0.05). On the other hand, CY showed greater muscle pennation angle and greater endurance to fatigue for both, lower limb, and respiratory muscles (P<0.05). The present study emphasizes that chronic and specific exercise training leads to distinctive adaptations, not only in lower limb musculotendinous structures but also in other components such as respiratory muscles.

Light Physical Activity Throughout the Day and Physical Function in Older Adults

Abstract Background Light physical activity (LPA) plays a crucial role in preventing muscle loss and disability in older adults. Since LPA makes up a significant portion of daily activity, understanding how the timing of LPA influences physical function is important for designing effective health interventions. Methods This cross-sectional study investigated the association between the timing of LPA and physical function among 200 older adults (mean age 76.3, 55.5% female) attending the geriatric outpatient clinic at National Taiwan University Hospital. LPA was objectively measured using wrist-worn accelerometers for seven consecutive days. Principal component analysis (PCA) was used to identify distinct patterns of LPA timing. Participants underwent assessments of grip strength, basic mobility, walking speed, and lower limb muscle strength. Multivariable linear regression models were adjusted for potential confounders, including gender, age, moderate-to-vigorous physical activity (MVPA), and accelerometer wear time. Results Our findings revealed that higher levels of LPA during the morning to noon period were positively associated with better performance across all four physical function tests. Moreover, after controlling for relevant confounders, increased LPA in the late afternoon and evening was positively associated with enhanced basic mobility, walking speed, and lower limb muscle strength. Conclusions This study highlights the importance of considering LPA timing when promoting physical function in older adults, independent of MVPA participation. Encouraging LPA, particularly during the morning to noon period, could be a valuable strategy for maintaining and improving physical capabilities in this population. These findings provide actionable insights for clinicians and health professionals when tailoring physical activity recommendations for older adults within geriatric care settings. Key messages • Morning LPA boosts physical function in seniors, enhancing grip, mobility, walking speed, and muscle strength. • Timing of light activity crucial for older adults’ physical health, with morning to noon activity showing most benefits.

The Effect of Blood Flow Restriction Exercise Prior to Total Knee Arthroplasty on Postoperative Physical Function, Lower Limb Strength and Patient-Reported Outcomes: ARandomized Controlled Trial.

30-s sit to stand (30STS). Timed Up&Go, 40-m walk test (40mWT), knee range of motion (ROM) 1-repetition maximum (1RM) leg press and knee extensor strength, maximal isometric contraction (MVIC) for the knee extensors and flexors, Knee injury and Osteoarthritis Outcome Score (KOOS), and Euroqol 5-dimensions (EQ-5D-L5) questionnaire. Data were collected at baseline (12 weeks pre-surgery), ~3 days pre-surgery, 3 and 12 months postoperatively. Intention-to-treat analysis revealed no significant between-group differences in the change from baseline to 3 and 12 months postoperatively on 30STS, TUG, or 40mFWT. Significant between-group differences were observed at 3 but not 12 months postoperatively for the corresponding changes in 1RM leg press strength, 1RM knee extensor strength, and MVIC knee extensor favoring BFR-RT. No between-group differences were observed for the delta changes from baseline in knee ROM, KOOS subscales or EQ-5D-L5 at any postoperative time points. These findings suggest that preoperative BFR-RT offered no superior effects compared with usual preoperative care on postoperative physical function or patient-reported outcomes. Preoperative BFR-RT produced amplified gains in lower limb muscle strength at 3 months postoperatively. NCT04081493.

Use of the international classification of functioning, disability and health in a group of older persons with osteoarticular disorders

Objective: to describe the main structural and functional impairments, activity limitations, and social participation restrictions in elderly individuals with myoarticular dysfunctions using the International Classification of Functioning, Disability, and Health (ICF). Methods: a descriptive, cross-sectional, and retrospective study based on the analysis of clinical and functional data of elderly individuals with osteomyoarticular dysfunctions. A questionnaire including components of Functionality and Disability (ICF, 2004), mobility and stability (Timed Up and Go), lower limb muscle strength (Sit-To-Stand Test), and pain (visual analog scale) was used. Results: a total of 11 elderly individuals (70±1.4 years) with at least two comorbidities (100%) were included, with the majority reporting episodes of falls (54.5%). Pain was the primary complaint in "Body functions," reported by all participants. In "Body structures," the lower limbs (45.4%) and upper limbs (18.1%) had the highest prevalence of complaints. In "Activities and Participation," the most frequently mentioned items were performing housework tasks (31.8%), moving around (31.8%), and recreation and leisure (27.3%). Conclusion: among the ICF components, pain sensation was the most common finding in elderly individuals, especially affecting the lower limbs. Regarding activity limitations and social participation restrictions, performing housework tasks, moving around, and recreation/leisure were prevalent.

Analysis of the Effectiveness of a Fall Prevention Program Incorporating an Interprofessional Team Collaboration Model on Reducing Fall Risk in Elderly Living in Long-term Care Facilities

Concurrent with population ageing, falls have become a significantly more challenging public health issue among older adults. Three years of data collected recently from a nursing home in northern Taiwan reveals an increasing trend in fall density that is primarily associated with aging, physiological decline, chronic diseases, polypharmacy, osteoporosis, and lack of exercise. The percentage of nursing home residents at high risk of falls is currently at 12.6%, and the fall rate has been reported as reaching as high as 30% annually. A fall prevention program was implemented to reduce the fall incidence rate to 18%, with secondary goals of improving fall prevention awareness, behavior, self-efficacy, lower limb muscle strength, balance, and gait by 10% on average, respectively, between pre-test and post-test. From September 30, 2023 to February 29, 2024, a health promotion activity and fall prevention exercise course were implemented using an interdisciplinary team collaboration model over a six-week period, providing individualized exercise for the participants. The study included 20 older adults with an average age of 88 years. Most (90%; n = 18) had chronic diseases, 25% (n = 5) were on more than nine medications, 70% (n = 14) had reduced bone mass, and 40% (n = 8) were at high risk of falls, with a fall incidence rate of 30% during the immediately preceding year. Post-intervention, the fall incidence rate dropped to 5%, fall prevention awareness, behavior, and self-efficacy increased by 18.3%, and lower limb muscle strength, balance, and gait improved by 11.7%. The post-test results in fall prevention awareness, behavioral changes, self-efficacy, and lower limb strength, balance, and gait were all significantly better than pre-test results, with all results achieving statistical significance. The project results support the positive effects of the developed intervention effectively on elderly physical fitness and fall risk, providing valuable insights for the implementation of fall prevention strategies in nursing homes.

Predictors Of Handgrip Strength And Its Relationship To Physical Performance In Older Irish Adults

Abstract Background Handgrip strength declines with age and predicts poor physical performance and increased risk of falls and mortality. However, the strength of the relationship between handgrip strength and other physical measures is less well studied. We aimed to explore the predictors of handgrip strength in older Irish adults and its relationship to the Timed and Up and Go (TUG). Methods Study participants were from a longitudinal cohort of Irish adults aged &amp;gt;60 years; Trinity Ulster University Department of Agriculture (TUDA) study. Participants on current or long-term steroids, a history of stroke and with MMSE &amp;lt;24 were excluded. Handgrip strength was assessed with a dynamometer and defined as &amp;lt;27 kg for males and &amp;lt;16 kg for females. Abnormal performance in the TUG was defined as &amp;gt;12 seconds. Predictors of impaired handgrip were explored in multivariate logistic regression. Results There were 748 participants (68.9% female, mean age 70.2 years), of whom 33.4% had abnormal handgrip strength, which was more common in female’s vs males (39.4 vs 20.2%, p&amp;lt;0.001). Both abnormal handgrip strength and TUG was present in 13.6%. Normal handgrip strength had a negative predictive value of 76.0% for ruling out poor TUG, while abnormal handgrip had a positive predictive value of 62% for poor TUG. Predictors of impaired handgrip strength were older age (P&amp;lt;0.0001), female sex (p&amp;lt;0.0001), lower protein intake (P=0.024) and higher waist hip ratio (p=0.014). Conclusion Handgrip strength had a modest correlation with TUG A significant proportion had abnormal TUG but normal handgrip. Changes in lower limb muscle strength (affecting TUG) precede muscle loss in the upper limb. Higher protein intake predicted greater grip strength and supports the recommendation to maintain adequate intakes to prevent sarcopenia. Greater waist hip ratio is associated with reduced lean muscle mass which may explain the negative relationship we identified with handgrip strength.

Prognostic factors for patient-reported satisfaction after percutaneous lumbar endoscopic discectomy at a minimum of two years' follow-Up.

Percutaneous endoscopic lumbar discectomy (PELD) is increasingly used in patients with lumbar disc herniation due to its less invasive nature and faster recovery. In this study, we aimed to investigate the prognostic factors associated with patient satisfaction index (PSI) in PELD. A retrospective study of 337 patients who underwent PELD between November 2015 and October 2020 in our department was conducted. Preoperative data of the enrolled patients were recorded. A logistic regression model was developed to explore the preoperative factors associated with postoperative PSI. After a mean follow-up of 28.7 ± 3.6 months, 310 patients were satisfied (NASS score of 1 or 2) and 27 patients were dissatisfied (NASS score of 3 or 4), resulting in a patient satisfaction rate of 91.99%. Demographic data, clinical symptom characteristics, and neurological physical examinations (including lower limb hypesthesia, muscle strength, and tendon flex) did not show any significant differences between the four groups (NASS1,2,3,4). The satisfactory group showed a higher rate of positive Lasegue sign (P = 0.010) and higher preoperative VAS (P = 0.002). The dissatisfaction group showed a higher rate of contiguous double-level disc herniation (P = 0.003). Our findings indicated that positive Lasegue sign and high preoperative VAS were prognostic factors for patient-reported satisfaction and PELD might not be the first choice for contiguous double-level disc herniation.

Acupuncture in Treating Osteopenia: A Multicenter, Randomized, Controlled Clinical Trial

Introduction: The aim of this study was to analyze the effectiveness of acupuncture as an early intervention in the treatment of osteoporosis and prevention of osteoporosis. Methods: This multicenter, randomized, controlled clinical trial was conducted in 226 patients with osteoporosis for 6 months. Participants were randomized to the control group (n = 110) and the acupuncture group (n = 116), both groups received basic treatment with daily calcium carbonate and vitamin D3 tablet (containing calcium 600 mg/tablet) supplementation (n = 116), and the acupuncture group received additional acupuncture treatment. Bone mineral density (BMD), Berg Balance Scale (BBS), bone metabolism indexes, and lower limb muscle strength and balance indexes were tested to evaluate the therapy outcomes of the two groups. Results: After 6 months of treatment, BBS11 (p = 0.046), BBS12 (p = 0.042), and total BBS scores (p = 0) in the acupuncture group were significantly higher than those before treatment; comparing between groups, BBS8 in the acupuncture group was higher than that in the control group after 3 and 6 months, with statistically significant differences (p = 0.036 and 0.0270). After 6 months of treatment, the total BBS score of the acupuncture group was significantly higher than that of the control group, and the difference was statistically significant (p = 0.039). After 6 months of treatment, the BMD of total bone of femoral neck (p = 0.031) and hip joint (p = 0.013) in the acupuncture group was significantly higher than that before treatment, but there was no statistical difference with the control group. The time of five sit-to-stand test (FTSST) was shortened in the acupuncture group, and the difference was statistically significant (p = 0.023), but there was no significant change in the control group (p > 0.05). In addition, the specific sequences of blood phosphorus (p = 0.007), β-collagen (p = 0.009), and N-osteocalcin (p = 0.007) were significantly lower than before treatment after 3 months of acupuncture treatment, and the blood phosphorus level continued to decrease after 6 months of treatment (p = 0.007). In addition, the levels of N-osteocalcin in the acupuncture group were significantly lower than those in the control group after 3 months of treatment (p = 0.008). Conclusion: Acupuncture can increase hip bone density, improve bone metabolism, reduce bone turnover rate, and improve body balance and lower limb muscle strength in patients with osteoporosis.

Anthropometrical and Physical Performance Profiles of Military Cadets from Angola

Military efforts must include different evaluations to prepare for battles around the world. This study aimed to characterize the body composition and physical performance levels of military cadets from Angola. Ninety military academy participants (males: n=48, females: n=42) aged 18-24 years old performed a battery of physical fitness tests to evaluate upper and lower limbs muscle strength, cardiorespiratory fitness, and body composition. Significant differences between sexes were observed in all variables (p&lt;0.05). Males and females, respectively, showed normal-range values in the body mass index (BMI) (23.32±3.95; 24.75±4.01 Kg/m2), body fat (9.09±6.17; 14.59±8.86 kg), push-ups (36.88±9.81; 20.67±6.62 repetitions), sit-ups (71.04±17.14; 61.95±19.05 repetitions) and medicine ball throwing (5.06±0.89; 4.00±0.84 m). However, countermovement jump (36.14±6.54; 23.53±7.62 cm), 80-meter sprint (13.08±1.90; 14.96±2.01 s), cardiorespiratory fitness (maximal oxygen uptake: 38.02±6.3; 33.18±6.49 ml/kg/min), and fat-free mass values (54.17 ± 8.06; 46.18 ± 6.9 kg) were considered low, specifically in females. Military cadets from Angola, especially females, presented low values of fat-free mass, cardiorespiratory fitness, and neuromuscular maximal performances (countermovement jump and sprint). This highlights a need for body composition and physical condition improvement to perform physical tasks with high military relevance.

Enhancing upper extremity muscle strength in individuals with spinal cord injury using low-intensity blood flow restriction exercise.

This study explores the feasibility and effects of low-intensity blood flow restriction exercise on forearm muscle strength and function in individuals with spinal cord injury. Pilot randomized clinical trial. Ten male and female adult participants with chronic cervical and thoracic spinal cord injury underwent an 8-week low-intensity blood flow restriction exercise programme that targeted forearm muscles. Each participant's contralateral forearm served as the control. Grip strength was the primary outcome measure, and participants also provided qualitative feedback on their experiences. The study revealed a significant increase in participants' forearm muscle strength on the experimental side engaged in low-intensity blood flow restriction training, with an average strength gain of 7.5 ± 0.36 kg after 16 exercise sessions (Cohen's d = -6.32, 95% CI -8.34, -6.68). In comparison, the control side, following a conventional high- intensity exercise regimen without BFR, showed a more modest strength increase of 4.4 ± 0.67 kg. A mean Patient's Global Impression of Change score of 2.2 reflected overall improvements in participants' daily activities and health status. This study highlights the feasibility and effectiveness of low-intensity blood flow restriction exercise as a safe and promising approach to enhancing forearm muscle strength in individuals with spinal cord injury. The observed positive outcomes, coupled with a high level of participant satisfaction, underscore the potential of this innovative method to significantly improve limb muscle strength, thereby contributing to greater functional independence in this population.

Tongue pressure, respiratory muscle and limb strength and functional exercise capacity in oesophageal cancer

ObjectivesPreoperative management of oesophageal cancer requires effective prehabilitation. This study investigates the relationship between tongue pressure, respiratory muscle, handgrip and lower limb muscle strengths, and functional exercise capacity in patients...

Accuracy Validation of a Sensor-Based Inertial Measurement Unit and Motion Capture System for Assessment of Lower Limb Muscle Strength in Older Adults-A Novel and Convenient Measurement Approach.

(1) Background: The aim of this study was to assess lower limb muscle strength in older adults during the transfer from sitting to standing (STS) using an inertial measurement unit (IMU). Muscle weakness in this population can severely impact function and independence in daily living and increase the risk of falls. By using an IMU, we quantified lower limb joint moments in the STS test to support health management and individualized rehabilitation program development for older adults. (2) Methods: This study involved 28 healthy older adults (13 males and 15 females) aged 60-70 years. The lower limb joint angles and moments estimated using the IMU were compared with a motion capture system (Mocap) (pair t-test, ICC, Spearman correlations, Bland-Altman plots) to verify the accuracy of the IMU in estimating lower limb muscle strength in the elderly. (3) Results: There was no significant difference in the lower limb joint angles and moments calculated by the two systems. Joint angles and moments were not significantly different (p > 0.05), and the accuracy and consistency of the IMU system was comparable to that of the Mocap system. For the hip, knee, and ankle joints, the ICCs for joint angles were 0.990, 0.989, and 0.885, and the ICCs for joint moments were 0.94, 0.92, and 0.89, respectively. In addition, the results of the two systems were highly correlated with each other: the r-values for hip, knee, and ankle joint angles were 0.99, 0.99, and 0.96, and the r-values for joint moments were 0.92, 0.96, and 0.85. In the present study, there was no significant difference (p > 0.05) between the IMU system and the Mocap system in calculating lower limb joint angles and moments. (4) Conclusions: This study confirms the accuracy of the IMU in assessing lower limb muscle strength in the elderly. It provides a portable and accurate alternative for the assessment of lower limb muscle strength in the elderly.

A 24-Week Combined Resistance and Balance Training Program Improves Physical Function in Older Adults: A Randomized Controlled Trial

Abstract Jiang, G, Tan, X, Zou, J, and Wu, X. A 24-week combined resistance and balance training program improves physical function in older adults: a randomized controlled trial. J Strength Cond Res XX(X): 000–000, 2024—This randomized controlled trial assessed the feasibility of older adults performing combined resistance and balance training (RBT) and compared the effects of RBT on physical function with those of resistance training (RT) alone and with no exercise training in older adults. In total, 65 community-dwelling adults aged 60–74 years were randomly assigned to an RT (n = 22), RBT (n = 22), or control (n = 21) group. The exercise intervention consisted of RT or RBT for 45 minutes, 3 times per week for 24 weeks. The control group engaged in no exercise training. The compliance rates were 93% in the RT group and 92% in the RBT group. No training-related adverse effect was observed. In the RT and RBT groups, dynamic balance (p = 0.017; p &lt; 0.001, respectively), maximum walking speed (p = 0.014; p &lt; 0.001), upper extremity (p = 0.013; p = 0.009) and lower extremity (p = 0.009; p &lt; 0.001) muscle strength, and spirometry (p = 0.043; p = 0.018) were significantly improved at 24 weeks compared with the control group. Only the RBT group showed significant improvement in normal walking speed (p = 0.002). Compared with the RT group, the RBT group showed additional significant improvements in dynamic balance (p = 0.001) and lower limb muscle strength (p = 0.027). The findings of this randomized controlled trial indicated that RBT was safe and feasible for older adults. Long-term RBT had better effects than either no exercise training or RT alone on improving physical function in older adults. Compared with RT, RBT additionally benefited dynamic balance and lower limb muscle function, which are clinically important factors in preventing falls, frailty, disability, and other geriatric syndromes.

Application of ultrasonic bone scalpel system for laminectomy and posterior longitudinal ligament ossification block release combined with dekyphosis orthopedic surgery in treatment of multisegmental thoracic ossification of posterior longitudinal ligament

To explore the safety and effectiveness of multisegmental thoracic ossification of posterior longitudinal ligament (T-OPLL) treated by laminectomy, posterior longitudinal ligament ossification block release combined with dekyphosis orthopedic surgery using ultrasonic bone scalpel system. The clinical data of 8 patients with multisegmental T-OPLL treated with laminectomy, posterior longitudinal ligament ossification block release combined with dekyphosis orthopedic surgery using ultrasonic bone scalpel system between January 2020 and April 2023 was retrospectively analyzed. There were 3 males and 5 females; the age ranged from 41 to 67 years, with a mean of 57.1 years. The disease duration ranged from 3 to 74 months, with a mean of 33.4 months. Symptoms were progressive numbness and weakness of both lower limbs, unsteady walking, chest and back pain in 3 cases, and urinary and bowel dysfunction in 5 cases; 7 cases showed increased muscle strength of the lower limbs, hyperreflexia of the tendons, and a positive Babinski sign, and 1 case showed decreased muscle strength of the lower limbs, decreased skin sensation, decreased knee and Achilles tendon reflexes, and a negative pathologic sign. Multisegmental posterior longitudinal ligament ossification of thoracic spine was found in 8 cases, with 4-8 segments of ossification, and in 5 cases with multisegmental ossification of the ligamentum flavum. The preoperative Japanese Orthopaedic Association (JOA) thoracic spinal function score was 4.3±0.9, the visual analogue scale (VAS) score was 6.9±1.0, and the the kyphotic Cobb angle of the stenosis segment was (34.62±10.76)°. The operation time, intraoperative blood loss, and complications were recorded. VAS score was used to evaluate the back pain, JOA score was used to evaluate the thoracic spinal cord function and the JOA improvement rate was calculated, and the kyphotic Cobb angle of the stenosis segment was measured and the Cobb angle improvement rate was calculated. The operation time ranged from 210 to 340 minutes, with a mean of 271.62 minutes; intraoperative blood loss ranged from 900 to 2 100 mL, with a mean of 1 458.75 mL; the number of resected vertebral plates ranged from 4 to 8, with a mean of 6.1; dural tears and cerebrospinal fluid leakage occurred in 3 cases, and the incisions healed by first intention. All 8 cases were followed up 12-26 months, with a mean of 18.3 months. There was no complication such as loosening of internal fixator, breakage of screws and rods, and no significant progress of ossification. At last follow-up, the VAS score was 1.4±0.7, the JOA thoracic spinal function score was 9.8±0.7, and the the kyphotic Cobb angle of the stenosis segment was (22.12±8.28)°, all of which significantly improved when compared with preoperative ones ( t=11.887, P<0.001; t=13.015, P<0.001; t=7.395, P<0.001). The JOA improvement rate was 81.06%±10.93%, of which 5 cases were rated as excellent and 3 cases as good; the Cobb angle improvement rate was 36.51%±14.20%. Laminectomy, posterior longitudinal ligament ossification block release combined with dekyphosis orthopedic surgery using ultrasonic bone scalpel system is a safe, effective, and simple method for the treatment of multisegmental T-OPLL, which is a feasible option.

Utilization of condoliase therapy versus surgery for lumbar disc herniation and comparison of post-treatment motor improvement

Study DesignDouble-center retrospective study. PurposeUtilization trends in interventional treatment for lumbar disc herniation (LDH) have not yet been examined. Furthermore, limited information is currently available on motor recovery with condoliase therapy. Therefore, the present study investigated utilization trends in treatment for LDH and the effects of condoliase therapy on muscle weakness. MethodsThis retrospective, double-center study involved patients with leg pain caused by LDH who received interventional treatment between September 2017 and August 2022. LDH patients were divided into two groups: an operative treatment group and condoliase therapy group. The period between September 2017 and August 2022 was divided into 5 equal parts and changes in the percentage of intervention treatment were examined. Motor recovery was also assessed in the two groups. Patients receiving condoliase therapy were divided into two groups: an effective group and non-effective group. Sex, age, the body mass index, duration of symptoms, herniation level, neurological and radiographic findings, a visual analog scale for leg pain, and the Oswestry disability index were examined in the two groups. ResultsSubjects included 226 males and 115 females with a mean age of 49.2 years, mean BMI of 22.8, and mean duration of symptoms of 5.0 months. The utilization of condoliase therapy for LDH surpassed surgery in the third year after its introduction. In the fourth year, condoliase therapy became the main treatment for LDH. Lower limb muscle strength improved in 76 % of cases receiving condoliase therapy. ConclusionsCondoliase therapy has become an intermediate treatment before surgery in our institutions. Motor recovery in patients receiving condoliase therapy was not inferior to that after surgery; however, in cases with severe muscle weakness with manual muscle test ≤3, the improvement rate was approximately 60 %. These results will be useful for clinicians when providing informed consent and selecting condoliase therapy.

Physical fitness components are bone mineral density predictors in adulthood: cross-sectional study

BackgroundHealth-related physical fitness (HRPF) attributes are considered important markers beneficial to various health outcomes. However, the literature is divergent regarding HRPF and bone health in adulthood, especially due to the end of the second and beginning of the third decades of life when the peak bone mass period occurs.ObjectiveTo analyze which HRPF variables are areal bone mineral density (aBMD) predictors in adult males and females.MethodsThis study evaluated 137 healthy young adults aged 18–25 years (50% males). Dual-energy X-ray absorptiometry (DXA) was used to estimate fat mass and lean mass and aBMD, hand grip strength test, sit-ups test, flexibility test, lower limb muscle strength and 20-meter run were used to evaluate physical fitness. Multiple linear regression using the backward method was used to analyze bone mineral density predictors by sex.ResultsHRPF indicators showed correlations from R = 0.28 in the right femoral neck aBMD to R = 0.61 in the upper limbs aBMD in males; in females, correlations from R = 0.27 in total body aBMD to R = 0.68 in the lower limbs aBMD were found. In males, body mass and HRPF indicators were aBMD predictors with HRPF indicators explaining variance from R²=0.214 in the lumbar spine to R²=0.497 in the upper limbs, and in females, with the exception of the lumbar spine, variance from R²=0.237 in the right femoral neck aBMD to R²=0.442 in the lower limbs aBMD was found.ConclusionHealth-related physical fitness components were able to predict aBMD in different anatomical regions in young adults, especially muscle strength and cardiorespiratory fitness indicators for males, while only lean mass and fat mass for females.

Assessment of the Effectiveness of Vibration Therapy and Passive Rest on the Recovery of Muscular Strength and Plasma Lactate Levels in the Upper Limbs after Intense Anaerobic Exercise in Elite Boxers and Kickboxers

Background: High-intensity anaerobic physical training frequently leads to muscle fatigue among boxers and kickboxers. Vibrational therapy (VT) and passive rest (PR) have been employed as methods to enhance muscular recovery and performance. This study evaluates the effectiveness of these two recovery methods on upper limb muscle strength and lactate levels in plasma after high-intensity exertion. Methods: Eighteen elite boxers and kickboxers, aged 19–32 years, underwent tests employing VT and PR as recovery methods in a controlled, crossover study. Muscle performance was assessed via isokinetic dynamometry, and lactate levels were measured pre-exercise, post-exercise, and post-recovery. The study adhered to the Declaration of Helsinki guidelines and was approved by the relevant bioethics committee. Results: The results showed that VT led to a faster recruitment of muscle fibers and improved muscle endurance as indicated by decreased fatigue work indices compared to PR. However, no significant differences were observed in peak torque or lactate levels between the two recovery methods. The VT group exhibited quicker recovery times in torque generation and better performance in fatigue resistance. Conclusions: VT appears to provide superior muscular recovery compared to PR following intense anaerobic effort, particularly in terms of muscle strength endurance and activation speed. These findings support the potential of VT in sports recovery protocols, although similar lactate response suggests that metabolic recovery rates are not significantly affected.

Underweight, dementia, and not being completely independent in bowel management are risk factors for urinary incontinence among older people

Background:Despite the known relationship between frailty and urinary incontinence, the components of frailty that are important in managing urinary incontinence remain unclear. Objectives:This study aimed to investigate physical factors that influenced urinary incontinence. Methods:This prospective observational study included patients admitted to the rehabilitation ward of our hospital from July 2020 to June 2022. Patients’ data were collected during the week before their discharge. Patients who needed diaper changes because of urine contamination were defined as incontinent and others as continent. Univariate and multivariate analyses were used to analyze differences between the two groups by age, sex, medical history, body mass index, serum albumin levels, Mini-Mental State Examination scores, Functional Independence Measure motor items (excluding bladder management), grip strength, gait speed, lower limb muscle strength, posture when seated on the toilet, residual urine volume, medication for lower urinary tract symptoms, and polypharmacy. Results:Of 121 patients, 104 (38 men, 66 women) were included in our analyses. Patients’ median age was 81 years (range 56–101 years). The risk factors for urinary incontinence identified in the multivariate analysis were: history of dementia (odds ratio [OR] 19.80, 95% confidence interval [CI]: 2.31–170.00; p = 0.00646), body mass index < 18.5 kg/m2 (OR 7.09, 95% CI: 1.36–36.90; p = 0.0201), and non-completely independent bowel management (OR 7.19, 95% CI: 1.29–40.16; p = 0.0245). Conclusions:We concluded that dementia, low body mass index, and non-completely independent bowel management are associated with urinary incontinence among older people.

Efficacy of a Virtual Reality Rehabilitation Protocol Based on Art Therapy in Patients with Stroke: A Single-Blind Randomized Controlled Trial.

Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect. After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p = 0.001). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p < 0.01) and reduction in spasticity (Ashworth scale, p = 0.007) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R = 0.41), patient satisfaction (R = 0.60), and the perceived utility of the intervention by the therapist (R = 0.43). These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach.