Muscle Strength Of Upper Limbs Research Articles

Motor imagery therapy on upper limb motor control after stroke

BackgroundStroke is a common neurological disease, the main pathological feature of which is cerebral ischemia or bleeding caused by sudden blockage or rupture of cerebral vessels. Impaired upper limb motor control after stroke severely affects patients’ quality of life and ability to perform daily activities. Traditional rehabilitation methods mainly rely on physical therapy and drug therapy, but there are limited effects.Subjects and MethodsIt is to explore the clinical effect of motor imagery therapy in the study of upper limb motor control after stroke. Fifty patients with stroke and the influence of upper limb movement were selected as experimental subjects, 25 as an experimental group and 25 as a control group. The experimental group received six months of rehabilitation training using motor imagery therapy, and the control group received six months of rehabilitation training using traditional drug alteplase.ResultsThe experimental results were evaluated by SPSS23.0 system. P<0.05 indicated that the difference was statistically significant, and the upper limb motor function and muscle strength of 20 patients in the experimental group were significantly improved after half a year, More than 80 percent have recovered, with significant differences (P<0.05).ConclusionsAfter the motor imagination therapy is integrated into stroke patients, it can promote the reorganization of brain nerves, enhance the motor memory of muscles, improve the patients’ attention and concentration on sports, and help them recover the motor function of the upper limbs.Acknowledgement2021 Shanghai Society of Integrated Traditional Chinese and Western Medicine Community Medicine and Health Management Research Project (No. 2021-117); 2022 Shanghai Jing’an District Medical Research Fund Project (No. 2022QT05).

Physical Fitness and Body Mass Index Status of Hong Kong Primary Schoolchildren across the COVID-19 Pandemic, before and after School Closure

To determine whether health-related physical fitness and body mass index (BMI) status differed before and after school closure from the COVID-19 pandemic in a population-based cohort of Hong Kong primary schoolchildren. We examined the BMI z score, BMI status, and physical fitness z scores including (i) upper limb muscle strength, (ii) 1-minute sit-up test, (iii) sit-and-reach test, and (iv) endurance run tests, among 3 epochs: prepandemic (September 2018-August 2019), before school closure (September 2019-January 2020), and partial school reopening (September 2021-August 2022), using a repeated cross-sectional approach. A total of 137 752 primary schoolchildren aged 6-12 years were recruited over 3 academic years. Obesity increased significantly from 25.9% in 2018/19 to 31.0% in 2021/22, while underweight increased slightly from 6.1% to 6.5%. All tested parameters were adversely affected by the pandemic. The negative trend over time was far more pronounced in all 4 physical fitness scores in the underweight group, although performance in handgrip strength had no significance between 2018/19 and 2021/22. Schoolchildren who are both underweight and overweight/obese are vulnerable to adverse changes in physical fitness during the COVID-19 pandemic. To eliminate the negative health and fitness outcomes, it is urgent to develop strategies for assisting schoolchildren in achieving a healthy weight, especially in the postpandemic era.

Relationship between throwing distance, shoulder joint range of motion, and upper limb muscle strength in boccia athletes

The purpose of this study was to examine the relationship between throwing distance, shoulder joint range of motion and upper limb muscle strength in boccia athletes. Participants were eight boccia athletes (cerebral palsy, cervical spinal cord injury, muscular dystrophy, spinal muscle atrophy) in whom throwing distance, ranges of motion at the shoulder joint, elbow joint and wrist joint and upper limb muscle strength were measured. Throwing distance was measured to the point where the ball landed so to remove any effect of the floor. Upper limb muscle strength was measured by isometric contraction using a handheld dynamometer. No correlation was found between throwing distance and range of motion of the shoulder joint, but correlations were found between throwing distance and strength of shoulder flexors (r = 0.76, p < .05), shoulder abductors (r = 0.84, p < .01), and elbow flexors (r = 0.77, p < .05). Active training to improve muscle strength around the shoulder joint, regardless of the underlying disease, was considered likely to lead to improvements in competitiveness. Due to the severe dysfunction of boccia athletes, training methods are often restricted. Verification of more effective training methods is needed while managing risks according to the physical function of the athlete and the type of disability.

SEMG-controlled forearm bracelet and serious game-based rehabilitation for training manual dexterity in people with multiple sclerosis: a randomised controlled trial

BackgroundMuscle strength and dexterity impairments are common among patients with multiple sclerosis (MS) producing limitations in activities of daily living related to the upper limb (UL). This study aimed to evaluate the effectiveness of serious games specifically developed for the MYO Armband® capture sensor in improving forearm and wrist mobility, UL muscle strength, dexterity, fatigue, functionality, quality of life, satisfaction, adverse effects and compliance.MethodsA double-blinded (allocation concealment was performed by a blinded investigator and by blinding for assessors) randomised controlled trial was conducted. The sample was randomised into two groups: an experimental group that received treatment based on UL serious games designed by the research team and controlled by the MYO Armband® gesture capture sensor, along with conventional rehabilitation and a control group that received the same conventional rehabilitation for the UL. Both groups received two 60-min sessions per week over an eight-week period. Wrist range of motion (goniometry), grip muscle strength (Jamar® dynamometer), coordination and gross UL dexterity (Box and Block Test), fatigue (Fatigue Severity Scale), functionality (ABILHAND), quality of life (Multiple Sclerosis Impact Scale-29), adverse effects (Simulator Sickness Questionnaire, SSQ), perceived workload (NASA-Task load index), satisfaction (Client Satisfaction Questionnaire-8 (CSQ-8), Satisfaction with Technology Scale, System Usability Scale (SUS) and QUEST 2.0) and compliance (attendance) were assessed in both groups pre-treatment, post-treatment and during a follow-up period of 2 weeks without receiving any treatment.ResultsSignificant differences were observed in the experimental group compared to the control group in the assessment of forearm supination (p = .004) and grip strength (p = .004). Adverse effects were minimal (SSQ: 7/100 points) and perceived workload was low (NASA-Task Load Index: 25/100 points) in the experimental group. The MYO Armband® technology proved to be useful for the participants (SUS: 80.66/100) and the satisfaction scales received high scores (QUEST 2.0: 59.4/70 points; Satisfaction with Technology: 84.36/100 points). There were significant differences between the groups in terms of attendance percentage (p = .029).ConclusionsAn experimental protocol using MYO Armband®-based serious games designed for UL rehabilitation showed improvements in active wrist range of motion and handgrip strength in patients with MS, with high satisfaction, minimal adverse effects and workload and excellent compliance.Trial registration number: This randomised controlled trial has been registered at ClinicalTrials.gov Identifier: NCT04171908.

Performance of physical, cardiovascular, and psychological functions in middle-aged women with and without breast cancer

PurposeTo compare the physical performance, including upper-limb motor and cardiovascular functions, and psychological functions, including anxiety and depression, sleep, and fatigue, between women with and without breast cancer. MethodsThirty-two women with breast cancer and 32 healthy counterparts were recruited for the study. Upper-limb muscle strength, shoulder range of motion, and upper-limb function were assessed using a handheld dynamometer, a goniometer, and the short form of the Disabilities of Arm-Shoulder-Hand Questionnaire, respectively. Exercise endurance and cardiovascular functions were assessed using the 6-min walk test and blood pressure and heart rate variability, respectively. The Hospital Anxiety and Depression Scale, the Pittsburgh Sleep Quality Index, and the Fatigue Assessment Scale were used to assess the symptoms of anxiety and depression, sleep quality, and fatigue, respectively. ResultsBreast cancer participants’ body-weight-adjusted upper-limb strength of both the affected and unaffected sides (0.11–0.14) was only 61.1–77.8% of those of the healthy participants (0.18). Their shoulder mobility of the affected side (flexion: 161.64°; abduction: 157.01°) were 94.2% (flexion) and 92.5% (abduction) of those of the healthy participants (flexion: 171.56°; abduction: 169.68°), respectively. Breast cancer participants had higher quickDASH mean score (19.53), HADS-A mean score (6.78), HADS-D mean score (4.72), global PSQI mean score (7.22) and FAS mean score (25.97) as well as shorter mean distance covered by 6 MWT (496.66 m) than those of the healthy participants. ConclusionsRehabilitative interventions, such as mind–body interventions and exercise training, target physical fitness and promote the psychological health of women with breast cancer are necessary.

A 30-Year-Old Pregnant Woman Presented With Altered Consciousness During Vaginal Delivery

<p>懷孕婦女併發腦血管意外是罕見的產科急症，其中重要的危險因素是子癲前症。本文案例是一位 30 歲初次懷孕39週又3天婦女，無特殊疾病史， 入院待產時出現高血壓合併蛋白尿，被診斷為子癲前症，於自然生產時發生嗜睡及意識改變。醫療團隊藉由神經學檢查及電腦斷層掃描診斷為腦梗塞，立即給予血栓溶解劑治療。治療中密切監測覺察病人有新的神經學異常，立即再度執行電腦斷層掃描，發現後續發生的右側大腦出血，緊急行顱骨切開手術清除血塊。術後病人仍有明顯的左側偏癱，經過積極的復健治療，出院時左上肢肌力3分，左下肢肌力4分，可使用拐杖步行移動。對於子癲前症的高危險妊娠，從待產、生產以至產後過程，均應密切監測血壓及神經學變化，如併發嗜睡及意識改變時，應快速及正確做相關腦血管疾病的鑑別診斷，早期診斷發現，預防惡化再發生，期能在中風黃金時間三小時內及早治療，降低病人殘障、失能及死亡的機率。</p> <p> </p><p>Stroke is an uncommon but serious potential complication of pregnancy. A 30-year-old woman was in her 39+3 weeks of first pregnancy without any past medical history . After admission, she was diag­nosed as preeclampsia due to hypertension with p1roteinuria. Drowsiness and changes of conscious­ness occurred during delivery. The neurological examination and brain CT scan revealed cerebral infarction and thrombolysis was performed. During the treatment new neurological abnormalities was found, CT scan was immediately performed again. Right cerebral hemorrhage was confirmed and an emergency craniotomy was performed. After the operation, the patient still suffered from obvious left hemiplegia. After active rehabilitation treatment, the muscle strength of the left upper limb was 3 points and the muscle strength of the left lower limb was 4 points at the time of discharge, and she could walk with crutches. For high-risk pregnancy with preeclampsia, blood pressure and neurological changes should be closely monitored during labor, delivery, and postpartum. If symptoms as drowsi­ness and changes in consciousness are shown, the differential diagnosis of related cerebrovascular dis­eases should be made quickly and correctly. To prevent the recurrence of deterioration, early treatment is expected within three hours of the prime time of stroke. The probability of handicapped, disability and death of patients can be reduced.</p> <p> </p>

NEUROMYELITIS OPTICA. CASE REPORT

Introduction. Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease that causes severe demyelination, especially in the optic nerve and spinal cord with typical clinical manifestations of acute optic neuritis and transverse myelitis. The frequency of occurrence worldwide is estimated at 1-2 people out of every 100,000 people. Case report. Our patient was a 37-year-old woman. She felt a sudden vision loss since May 2022. She related this condition to another case of unknown etiology that she encountered in January of that year - numerous vesicular-type rashes appeared on the abdomen and back and lasted for 3 days, but the traces of those rashes remained for some time in the form of hypopigmentation. In November 2022, she has a sudden vision loss again. "Vitiligo-type" white spots were visible around the eyes and on the hands. In neurological examination: eyeball movements are complete in all directions, photoreaction is preserved (D=S), nose-lip folds are symmetrical (D=S), tongue is on the midline, swallowing is not disturbed. Muscle tone and muscle strength in upper and lower limbs are normal, reflexes have increased (D=S). No changes in gait and sensory disturbances have been observed. The functions of the pelvic organs have not been disturbed. Intellect appears appropriate for age, speech has not changed. Ophthalmologist's examination, both eyes have high degree of myopia, myopic astigmatism. Contrasted Cranial MRI- Angiography revealed increased signal in the intracranial segments of the bilateral optic nerve, chiasm, and bilateral optic tract level. The MRI image was initially evaluated in favor of bilateral optic neuritis. USG of the thyroid gland showed sonographic changes in favor of Hashimoto's thyroiditis, and autoimmune thyroiditis was detected. In chest MRI, a demyelinating lesion of 3 mm at C4 level, a 2 mm broad-based protrusion at C4-5 disc that minimally compresses the spinal cord, an annular swelling at C5-6 disc that compresses the anterior subarachnoid area, Th1 – 6 mm, Th5 – 12 mm, Th9 – 10-38 mm long demyelinating lesions were seen. Discussion. According to the available literature, the detection of AQP-4 protein antibodies in serum, which has a role in the pathogenesis of the disease, can play a decisive role in differential diagnosis. In clinical practice, despite the phenotypic and serological characteristics of this disease, the diagnosis is often difficult. Because there are various autoimmune, infectious and neoplastic etiologies phenotypic, manifestations of diseases can mimic neuromyelitis optica. However, based on the clinical symptoms and the results of instrumental examinations, our patient was diagnosed with neuromyelitis optica. She was treated with hormonal therapy and plasmapheresis, and a significant positive change in neurological symptoms was observed. Conclusion. Despite the difficulties in the differential diagnosis of neuromyelitis optica with other demyelinating diseases, especially with multiple sclerosis, it is possible to correctly assess the diagnostic criteria by understanding the detailed clinical, radiological and prognostic differences.

Design a Four-Bar Mechanism for Specific Upper Limb Muscle Strength Rehabilitation Using Genetic Algorithm

In this study, a novel human-in-the-loop design method using a genetic algorithm (GA) is presented to design a low-cost and easy-to-use four-bar linkage medical device for upper limb muscle rehabilitation. The four-bar linkage can generate a variety of coupler point trajectories by using different link lengths. For this medical device, patients grab the coupler point handle and rotate the arm along the designed coupler point trajectory to exercise upper limb muscles. The design procedures include three basic steps: First, for a set of link lengths, a complete coupler point trajectory is generated from four-bar linkage kinematics; second, optimization-based motion prediction is utilized to predict arm motion (joint angle profiles) subjected to hand grasping and joint angle limit constraints; third, the predicted joint angles and given hand forces are imported into an OpenSim musculoskeletal arm model to calculate the muscle forces and activations by using the OpenSim static optimization. In the GA optimization formulation, the design variables are the four-bar link lengths. The objective function is to maximize a specific muscle’s exertion for a complete arm rotation. Finally, different four-bar configurations are designed for different muscle strength exercises. The proposed human-in-the-loop design approach successfully integrates GA with linkage kinematics, arm motion prediction, and OpenSim static optimization for four-bar linkage design for upper limb muscle strength rehabilitation.

Association between muscle strength and executive function in Tibetan adolescents at high altitude in China: Results from a cross-sectional study at 16-18 years of age.

In recent years, adolescents have shown a trend of decreasing muscle strength, especially in the upper limbs, and it affects the development of executive functions. However, few studies have been conducted on Tibetan adolescents in high-altitude regions of China. To this end, this study investigated upper limb muscle strength and executive function in Tibetan adolescents in Tibetan regions of China and analyzed the association between them. A three-stage stratified whole-group sampling method was used to test and investigate grip strength, executive function, and basic information in 1093 Tibetan adolescents from Tibet, a high-altitude region of China. A chi-square test and one-way ANOVA were used to compare the basic status and executive function of Tibetan adolescents with different muscle strength. Multiple linear regression analysis and logistic regression analysis were used to analyze the correlations that existed between muscle strength and each sub-function of executive function. The differences between the inconsistently and congruent reaction times of Tibetan adolescents with different grip strength levels (<P25 , P25-75 , >P75 ) at high altitude in China were statistically significant (F-values of 32.596 and 31.580, respectively; P-values <.001). The differences between the 1-back and 2-back response times for the refresh memory function were also statistically significant (F-values of 9.055 and 6.610, respectively; P-values <.01). Linear regression analysis showed that after adjusting for the relevant covariates, the 1-back reaction time of Tibetan adolescents in the grip strength < P25 group increased by 91.72 ms (P < .01); the 2-back reaction time of Tibetan adolescents in the grip strength < P25 group increased by 105.25 ms (P < 0.01), using grip strength > P75 as the reference group. Logistic regression analysis showed that, after adjusting for relevant covariates, Tibetan adolescents in the grip strength < P25 group had a higher risk of developing 2-back dysfunction (OR = 1.89, 95% CI: 1.24,2.88), using grip strength >P75 as the reference group (P < .01). The risk of cognitive flexibility dysfunction (OR = 1.86, 95% CI: 1.16, 2.98) was also increased (P < .05). There was a significant correlation between grip strength and executive function of refresh memory function and cognitive flexibility in Tibetan adolescents in high altitude areas of China. Those with higher upper limb muscle strength had shorter reaction time, that is, better executive function. In the future, we should focus on improving the upper limb muscle strength of Tibetan adolescents at high altitude in China to better promote the development of executive function.

Phase II/III Study of Aceneuramic Acid Administration for GNE Myopathy in Japan.

GNE myopathy is an ultra-rare muscle disease characterized by a reduction in the synthesis of sialic acid derived from pathogenic variants in the GNE gene. No treatment has been established so far. We evaluated the safety and efficacy of oral supplementation of aceneuramic acid in patients with GNE myopathy. This multicenter, placebo-controlled, double-blind study comprised genetically confirmed GNE myopathy patients in Japan who were randomly assigned into treatment groups of sialic acid-extended release (SA-ER) tablets (6 g/day for 48 weeks) or placebo groups (4:1). The primary endpoint of effectiveness was set as the change in total upper limb muscle strength (upper extremity composite [UEC] score) from the start of administration to the final evaluation time point. Among the 20 enrolled patients (SA-ER group, 16; placebo group, 4), 19 completed this 48-week study. The mean value of change in UEC score (95% confidence interval [CI]) at 48 weeks was -0.1 kg (-2.1 to 2.0) in the SA-ER group and -5.1 kg (-10.4 to 0.3) in the placebo group. The least squares mean difference (95% CI) between the groups in the covariance analysis was 4.8 kg (-0.3 to 9.9; P = 0.0635). The change in UEC score at 48 weeks was significantly higher in the SA-ER group compared with the placebo group (P = 0.0013) in the generalized estimating equation test repeated measurement analysis. In one patient in the SA-ER group, who was found to be pregnant 2 weeks after drug administration fetal death with tangled umbilical cord occurred at 13 weeks after the discontinuation of treatment. No other serious adverse effects were observed. The present study indicates that oral administration of SA-ER tablets is effective and safe in patients with GNE myopathy in Japan.

#4046 ADVANCED CHRONIC KIDNEY DISEASE, PREOPERATIVE ISOMETRIC EXERCISE AND VASCULAR ACCESS: LET´S CLEAR THE DOUBTS

Abstract Background and Aims Arteriovenous fistula (AVF) is the best vascular access for hemodialysis. However, the role of preoperative isometric exercises in patients with advanced cronic kidney disease (CKD) who are candidates for AVF is unclear and not well reported in the literature. The main objetive of this study was to evaluate the effect of preoperative isometric exercise on vascular territory in advanced CKD prior to AVF creation. Method An 8 months prospective single-center study. We performed an isometric preoperative exercise program for 4 weeks on the non dominant arm (exercise arm) and was compared with the dominant arm (control arm) performing usual activity in our advanced CKD patients. Demographic data, upper limb muscle strength (ULMS), Doppler ultrasound (DUS) measurements (foream and distal cefalic vein (FCV, DCV) diameter, basilic vein (BV) diameter and depth, peak systolic velocities (PSVs) and diameters in the radial artery (RA) and braquial artery (BA), as well as percentage of patients candidates to AVF in both arm (exercise and control arm) according to Spanish Clinical Guidelines of Vascular Access (VA) and possible medical complications were analyzed. Results 27 patients. 67,7%men. Mean age 70,3±10,4years. Main cardiovascular risk factors: HBP (93,5%) and DM (64,5%). Exercise arm was left side in 87,1%. A significant increase was observed in ULMS only in exercise arm at the end of study (23,8±8,7Kg vs 27, 6±9,5Kg, p = 0,001). Related to DUS measurements, there were not diffences between groups on vein caliber. However, a significant increase was observed in RA PSV (57,7±15,3 vs 62,6±17,4cm/seg, p = 0,044), BA diameter (4,6±0,6 vs 4,9±0,9mm, p = 0,029) and percentage of patients who could be candidates to AVF (70,4 vs 92,6%, p = 0,034) in exercise arm at the end of the study. We did not observe any related complications (pain, hypotension or muscle injury). Conclusion Preoperative isometric exercises would increase the percentage of performing a native AVF in those advanced CKD patients candidates for HD. Similarly, our results suggest that preoperative isometric exercise could be a useful tool to improve the vascular territory, mainly arterial, in our patients. However, more studies are required to confirm our results.

Mirror therapy combined with flashcards on the extremity function and stages of self-acceptance of stroke patients

Link of Video Abstract: https://youtu.be/u6GkzKfCplE Background: Psychological changes such as body image are important factors that need to be considered to boost the positive sense of self-acceptance in stroke patients with hemiparesis. One measure that can be taken to minimize the incidence of disability, both physically or psychologically, in stroke patients is mirror therapy (mirror therapy combined with flashcards). This study aims to determine whether mirror therapy combined with flashcards can improve the upper limb muscle strength function and the stages of self-acceptance of stroke patients with hemiparesis. Methods: This study was quantitative, with an experimental research design. The design used was a quasi-experiment with a pre-test-posttest control group design involving 60 respondents with consecutive sampling techniques for 5 months in the Nusa Indah Ward of the Dr. Doris Sylvanus Palangkaraya General Hospital. Upper extremity/arm muscle strength was measured using the muscle strength scale from the Medical Research Council, while self-acceptance stages were measured using a stage questionnaire adapted from Kubler Ross. Data were analyzed using SPSS version 20.0 for Windows. Results: Our results showed there was a significant increase in the mean value of muscle strength and self-acceptance stages of the treatment group from the control group (p&lt;0.05). The results of the Mancova test showed that gender affects the intervention given (p&lt;0.05). Conclusion: Our study provided information for nurses in nursing care to stroke patients with hemiparesis on the upper arm and motivation to improve the patient's self-acceptance stages.

The association of dietary inflammatory potential with sarcopenia in Chinese community-dwelling older adults

BackgroundDietary-induced inflammation is potentially associated with sarcopenia. Nevertheless, few studies have investigated the structure of the inflammatory diet and its correlation with muscle function and performance in both the upper and lower limbs. This study was performed to explore the association of the dietary inflammatory index (DII) with sarcopenia and its diagnostic parameters.MethodsWe conducted a cross-sectional survey on a sample of 515 Chinese community-dwelling older adults selected through multistage cluster sampling from three districts in Shanghai. DII scores were calculated using a validated food frequency questionnaire. Sarcopenia and its diagnostic parameters were determined based on the definition set by the Asian Working Group on Sarcopenia (AWGS).ResultsThe mean age of study participants was 71.31 ± 4.71 years. The prevalence of sarcopenia in the cohort was 12.4%. Older adults in the highest DII quartile had a 3.339 times increased risk of sarcopenia compared to those in the lowest quartile (OR Quartile4vs1:3.339, 95%CI: 1.232, 9.052, p-trend: 0.004) after adjusting for confounding factors. Additionally, a more pro-inflammatory diet was associated with lower appendicular skeletal muscle index (ASMI) (OR Quartile4vs1: 3.005, 95%CI: 1.275, 7.318, p-trend: 0.005), a higher 5-times sit-stand test time score (OR Quartile4vs1: 4.942, 95%CI: 1.745, 13.993, p-trend: 0.005), and lower gait speed (OR Quartile4vs1: 2.392, 95%CI: 1.104, 5.185, p-trend: 0.041) after adjusting for confounding factors. However, there was no significant association between DII, handgrip strength, and Short Physical Performance Battery (SPPB) score in either the unadjusted or adjusted model.ConclusionThis study found that the association between consuming a more pro-inflammatory diet and sarcopenia in Chinese community-dwelling older adults was mainly due to underlying low intakes of dietary energy, protein, and anti-inflammatory foods, and not due to the high intake of pro-inflammatory foods. Meanwhile, DII was more highly correlated with lower limb muscle strength and performance compared to upper limb muscle strength.

Musculoskeletal Fitness for Identifying Low Physical Function in Older Women.

This cross-sectional study aimed to analyze the relevance of musculoskeletal fitness for identifying low physical functioning in community-dwelling older women. Sixty-six older women (73.62 ± 8.23 yrs old) performed a musculoskeletal fitness assessment of the upper and lower limbs. A handheld dynamometer was used to evaluate upper-limb muscle strength through a handgrip (HG) test. Lower-limb power and force were assessed from a two-leg countermovement vertical jump (VJ) on a ground reaction force platform. Physical functioning was assessed subjectively using the Composite Physical Function (CPF) questionnaire and objectively by daily step count measured by accelerometry and gait speed/agility assessed by the 8-Foot Up-and-Go (TUG) test. Logistic regressions and ROC curves were carried out to define odds ratios and ideal cutoff values for discriminatory variables. VJ power showed the ability to identify low physical functioning when evaluated through the CPF (14 W/kg, 1011 W), gait speed/agility (15 W/kg, 800 W), or daily accumulated steps (17 W/kg). Considering that VJ power was normalized for body mass, the increase of 1 W/kg corresponds to a decrease of 21%, 19%, or 16% in the chance of low physical functioning when expressed by these variables, respectively. HG strength and VJ force did not show a capacity to identify low physical functioning. The results suggest that VJ power is the only marker of low physical functioning when considering the three benchmarks: perception of physical ability, capacity for mobility, and daily mobility.

Resistance Training in Wilson Disease: A Case Study

A 15-year-old boy was diagnosed with Wilson disease and referred to a physiotherapy clinic for treatment. He received daily physical therapy exercises with resistance training three times a week for 70 minutes for 8 weeks. The performance of daily activities was evaluated using the Persian version of the disabilities of the arm, shoulder, and hand (DASH) questionnaire. Upper limb muscle strength was assessed using a manual muscle strength test. The DASH questionnaire score decreased from 67.24 before treatment to 46.55 after 4 weeks and 36.20 after 8 weeks. In addition, shoulder flexion and extension are improved. The analysis of resistance exercises to facilitate distal muscles through the use of manual muscle tests showed an improvement in the strength of both hands. The present study suggests that regular physical therapy and exercise may help improve daily activity and muscle strength in Wilson disease.

The Association between a Minimum Amount of Physical Activity and Subsequent Muscle Strength and Balance in Older Adults: A Prospective Study.

This study aimed to investigate the association between 15 min of daily moderate-to-vigorous physical activity (MVPA) and subsequent muscle strength and balance in older adults. Data concerning community-dwelling older Taiwanese adults (mean age, 69.5 years) were collected during the baseline period (2018) and at a 12-month follow-up survey (2019). Time spent performing MVPA was objectively assessed using a triaxial accelerometer (ActiGraph wGT3x-BT) at baseline. Upper and lower limb muscle strength were measured using handgrip strength and a five-times sit-to-stand test, respectively. Balance was assessed using a one-leg standing test. The 12-month variations in muscle strength and balance were calculated through subtracting follow-up data from baseline data. A forced entry-adjusted logistic regression analysis was conducted. In total, 65.2% of participants engaged in at least 15 min of daily MVPA in the baseline survey. After adjusting for confounders, older adults who achieved 15 min of daily MVPA during the baseline period were more likely to maintain or improve balance performance (odds ratio, 8.12). Performing 15 min of daily MVPA was found to benefit older adults' subsequent balance performance but not muscle strength.

The effects of upper body blood flow restriction training on muscles located proximal to the applied occlusive pressure: A systematic review with meta-analysis.

Blood flow restriction combined with low load resistance training (LL-BFRT) is associated with increases in upper limb muscle strength and size. The effect of LL-BFRT on upper limb muscles located proximal to the BFR cuff application is unclear. The aim of this systematic review was to evaluate the effect of LL-BFRT compared to low load, or high load resistance training (LL-RT, HL-RT) on musculature located proximal to cuff placement. Six electronic databases were searched for randomized controlled trials (RCTs). Two reviewers independently evaluated the risk of bias using the PEDro scale. We performed a meta-analysis using a random effects model, or calculated mean differences (fixed-effect) where appropriate. We judged the certainty of evidence using the GRADE approach. The systematic literature searched yielded 346 articles, of which 9 studies were eligible. The evidence for all outcomes was of very low to low certainty. Across all comparisons, a significant increase in bench press and shoulder flexion strength was found in favor of LL-BFRT compared to LL-RT, and in shoulder lean mass and pectoralis major thickness in favor of the LL-BFRT compared to LL-RT and HL-RT, respectively. No significant differences were found between LL-BFRT and HL-RT in muscle strength. With low certainty LL-BFRT appears to be equally effective to HL-RT for improving muscle strength in upper body muscles located proximal to the BFR stimulus in healthy adults. Furthermore, LL-BFRT may induce muscle size increase, but these adaptations are not superior to LL-RT or HL-RT.

Abstract P4-07-10: Effect of acupuncture and exercise therapy on muscular strength, lymphedema and quality of life in breast cancer survivors: randomized clinical trial

Abstract Introduction: The continuous advance in the early detection and treatment of breast cancer has significantly reduced mortality and, consequently, increased the number of survivors with treatment side effects that act on the quality of life, such as lymphedema, loss of upper limb strength, shoulder dysfunction, decreased functional capacity, flexibility, and joint mobility. Exercise therapy is a recognized practice for the rehabilitation of these disorders; however, acupuncture needs to be better evaluated to compare its equivalence with classical therapy. Objective: To compare three distinct rehabilitation treatments (exercise therapy, acupuncture and Stiper®) in women undergoing breast cancer surgery, assessing strength, lymphedema and quality of life. Methods: Seventy-nine women with pain above 3 on the visual analogue pain scale (VAS) and with more than 90 days of surgery were included. They were divided into three groups that received weekly treatment for 10 weeks: group I (G1) treated with standard, pre-defined exercise therapy, based on stretching of the cervical muscles, shoulder girdle and shoulder ROM exercises with a duration of 30 minutes, group II (G2) treated with 30 minutes of acupuncture using predefined points and group III (G3) treated with the same acupuncture points as group II, however, using the Stiper® (silicon oxide micronized quartz pellet) in place of needles. Results: Sixty-seven patients completed the treatment, being 26 from G1, 23 from G2 and 18 from G3. There was an improvement in upper limb muscle strength over time in all groups, except for abduction and internal rotation movements. During treatment, there was no increase in the number of patients with lymphedema and there was no statistical difference between the groups. Regarding the EORTC QLQ-C30 quality of life questionnaire, nine of the fifteen factors analyzed showed significant differences between sessions. The factors that did not have significant differences between the three groups were Social Function, Nausea and Vomiting, Dyspnea, Loss of Appetite, Constipation and Diarrhea. Conclusion: The rehabilitation of physical dysfunctions in women who survived breast cancer through exercise therapy, acupuncture and Stiper® in upper limb muscle strength, lymphedema and quality of life, proved to be effective, without difference between groups, which leads to the conclusion that acupuncture didn’t show superiority of results when compared with exercise therapy, thus being an effective approach for the rehabilitation of these women. Citation Format: Patricia Santolia, Gil Facina, Cinira Haddad, Samantha K. Lopes de Almeida Rizzi, Afonso Nazário, Simone Elias. Effect of acupuncture and exercise therapy on muscular strength, lymphedema and quality of life in breast cancer survivors: randomized clinical trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-10.

Study on the Effect of Bushen Zhuanggu Tablet Combined with Conventional Regimen on Bone Mineral Density Improvement, Functional Recovery and Fracture Risk Prevention in Patients with Postmenopausal Osteoporosis.

This case-control study was to explore the effect of Bushen Zhuanggu tablet combined with routine regimen on bone mineral density (BMD) improvement, functional recovery, and fracture prevention in postmenopausal osteoporosis (PMOP) patients. 180 postmenopausal osteoporosis patients were randomly selected from communities A, B, and C cohorts as research subjects from January to May 2021. The study subjects were divided into three groups. The groups were in a 1 : 1 ratio according to the principles of nonrandomised, concurrent controlled trials, and methods. There were 60 participants in each group (group A, group B, and group C). Group A was treated with Bushen Zhuanggu tablet for antiosteoporosis + basic treatment (calcium supplement and vitamin D). Group C was given Bushen Zhuanggu tablet for antiosteoporosis intervention. Group B was given basic treatment (calcium supplement and vitamin D supplementation) as a control group. The follow-up time was 6 months after treatment. Finally, we compare the differences in calcium and phosphorus metabolism indexes, BMD, bone metabolism indexes, upper and lower limb muscle strength, and quality of life scores. Group A, B, and C's effective rate was 98.33%, 80.00%, and 93.33%, respectively. The group A's effective rate was significantly higher than that in group B and C, and the difference was statistically significant (P < 0.05). After 6 months intervention, the levels of serum Ca2+, serum phosphorus (P), serum creatinine (Cr), and parathyroid hormone (PTH) in 3 groups decreased. Ca, P, Scr, and PTH levels in group A were the lowest among study groups, and the difference was statistically significant (P < 0.05). The increase in the BMD of lumbar spine, the left femoral neck, and Ward's triangle area of the three groups were observed with the highest data in group A. After 6 months of treatment, the levels of serum N-terminal propeptide of type I procollagen, PINP, and serum osteocalcin (OC) increased, while the levels of β-cross-linked C-terminal telopeptide of type I collagen (β-CTX) and alkaline phosphatase (ALP) decreased in the three groups. The improvement of all bone metabolic indexes in group A was significantly better than that in B and C groups, and the difference was statistically significant (P < 0.05). The enhanced upper limb muscle strength and the shorter standing-walking timing test (TUGT) time were observed after 6 months of treatment. The improvement effect of upper and lower limb muscle strength in group A was significantly better than that in B and C groups, and the difference was statistically significant (P < 0.05). There were significant differences in physiological function, life function, general health status, physical pain, mental state, emotional function, vitality, and social function among the three groups after 6 months treatment, and the difference was statistically significant (P < 0.05). The score of quality of life in group A was higher than that in B and C groups, and the difference was statistically significant (P < 0.05). Bushen Zhuanggu tablet combined with conventional therapy is effective in the postmenopausal osteoporosis treatment, which effectively increase the BMD, regulate calcium and phosphorus metabolism, promote the recovery of limb function, prevent the recurrence of fracture, and improve the patients' quality of life. This treatment scheme is worth popularizing.

EFEITOS DO TREINAMENTO VIBRATÓRIO SOBRE OS MEMBROS SUPERIORES DOS JOGADORES DE VOLEIBOL

ABSTRACT Introduction: The research on vibration training has experienced a period of development in many projects, such as badminton, handball, long jump, and volleyball. However, there is still no quantitative research evaluation of its effects on the development of shoulder, elbow, and upper limb muscle strength in volleyball athletes. It is believed that a specific training protocol with vibration may bring benefits to sensory-motor performance and muscle strength implementation in volleyball athletes. Objective: To study the effects of vibration training on upper limb function in volleyball players. Methods: Literature, experimental, and mathematical-statistical research methods were used to explore the relationship between vibration training under the muscle strength of the upper limbs and their joints. Results: The vibration training with an amplitude of 2mm, at a vibration frequency between 30Hz and 45Hz, the frequency of vibration training presented inversely proportional to the effect of vibration training. Conclusion: Vibration training showed the benefits of motor coordination and increased muscle strength in volleyball players. An appropriate vibration training strategy can maximize athletes’ skills, such as body coordination, flexibility, and jumping ability. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.