Muscle Thickness Research Articles

Genome-wide association study of exercise-induced skeletal muscle hypertrophy and the construction of predictive model.

The aim of the current study was to investigate interindividual differences in muscle thickness of the rectus femoris (MTRF) following 12 wk of resistance training (RT) or high-intensity interval training (HIIT) to explore the genetic architecture underlying skeletal muscle hypertrophy and to construct predictive models. We conducted musculoskeletal ultrasound assessments of the MTRF response in 440 physically inactive adults after the 12-wk exercise period. A genome-wide association study was used to identify variants associated with the MTRF response, separately for RT and HIIT. Using the polygenic predictor score (PPS), we estimated the genetic contribution to exercise-induced hypertrophy. Predictive models for the MTRF response were constructed using random forest (RF), support vector mac (SVM), and generalized linear model (GLM) in 10 cross-validated approaches. MTRF increased significantly after both RT (8.8%, P < 0.05) and HIIT (5.3%, P < 0.05), but with considerable interindividual differences (RT: -13.5 to 38.4%, HIIT: -14.2 to 30.7%). Eleven lead single-nucleotide polymorphisms in RT and eight lead single-nucleotide polymorphisms in HIIT were identified at a significance level of P < 1 × 10-5. The PPS was associated with the MTRF response, explaining 47.2% of the variation in response to RT and 38.3% of the variation in response to HIIT. Notably, the GLM and SVM predictive models exhibited superior performance compared with RF models (P < 0.05), and the GLM demonstrated optimal performance with an area under curve of 0.809 (95% confidence interval: 0.669-0.949). Factors such as PPS, baseline MTRF, and exercise protocol exerted influence on the MTRF response to exercise, with PPS being the primary contributor. The GLM and SVM predictive model, incorporating both genetic and phenotypic factors, emerged as promising tools for predicting exercise-induced skeletal muscle hypertrophy.NEW & NOTEWORTHY The interindividual variability induced muscle hypertrophy by resistance training (RT) or high-intensity interval training (HIIT) and the associated genetic architecture remain uncertain. We identified genetic variants that underlie RT- or HIIT-induced muscle hypertrophy and established them as pivotal factors influencing the response regardless of the training type. The genetic-phenotype predictive model developed has the potential to identify nonresponders or individuals with low responsiveness before engaging in exercise training.

Sarcopenia is a prognostic factor in lymphoma patients: a systematic review and meta-analysis

Findings regarding the relationship between sarcopenia and lymphoma have been inconsistent across studies. This study investigated the association between sarcopenia and lymphoma. We systematically searched the Embase, Science Direct, Cochrane Library, and PubMed databases from inception to 31 March 2024 to identify relevant studies. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Twenty-six studies with 3659 participants were included. Sarcopenic lymphoma patients had poor overall survival (OS) (HR = 1.88; 95% CI: 1.47–2.41; p < 0.001). The heterogeneity was high (I2=80%). However, the result of the Egger test indicated a significant publication bias (p < 0.001). After employing the trim and fill method to adjust for this bias, the HR of OS became non-significant (p > 0.05). The progression-free survival (PFS) was worse in sarcopenic patients (HR = 1.77; 95% CI: 1.37–2.29; p < 0.001; I2=70%). There was no significant publication bias (p > 0.05). In the subgroup analyses, sarcopenia was a negative predictor of OS in lymphoma patients who undergo hematopoietic cell transplantation (HCT) (HR = 1.61;95% CI: 1.19–2.18; I2=30%). Male lymphoma patients with sarcopenia had a significantly worse OS (HR = 2.29; 95% CI:1.24–4.24; p = 0.009). Among patients with primary central nervous system lymphoma (PCNSL), those with sarcopenia defined by temporal muscle thickness (TMT) exhibited significantly worse OS (HR = 2.20; 95% CI:1.04–4.65; p = 0.039; I2=68%). Sarcopenia is associated with worse PFS in lymphoma patients. Subgroup analyses indicate that sarcopenia is a negative predictor of OS after HCT, and male lymphoma patients who suffer from sarcopenia have higher mortality. Sarcopenia defined by TMT is also a negative predictor of OS for patients with PCNSL.

HISTOMORPHOLOGICAL ENHANCEMENT OF THE VAGINAL WALL IN DEHYDROEPIANDROSTERONE-TREATED POST-OVARIECTOMIZED WISTAR RATS

Background: Vaginal atrophy has occurred in three quarters of post-menopausal women. The exclusive source of post-menopausal sex hormones is dehydroepiandrosterone (DHEA). Purpose: Observe the impact of orally administered DHEA in the vagina of a rat (Rattus norvegicus) post- bilateral ovariectomy. Method: This experiment utilized 36 wistar rats aged 10 - 12 weeks with a body weight of 180 - 200 grams. The rats were randomly divided into two groups with an equal number of members. The control group was orally administered glycerin via gavage at a dose of 1 mL per day, while the treatment group received 7.2 mg of DHEA dissolved in glycerin, also administered orally via gavage at a daily dose of up to 1 mL. Both groups were maintained for 42 consecutive days. Finally, a histomorphology examination was conducted on the vaginal tissues of the sacrificed rats. Result: The mean of epithelial and smooth muscle thickness of the treatment group was significantly higher than that of the control group (p-value &lt; 0.05). Besides, the number of blood vessels were also significantly higher in the treated group (p-value &lt; 0.05). Conclusion: Administering DHEA orally via gavage enhances epithelial and smooth muscle tissue thickness, and augments the number of blood vessels in the vagina of wistar rats after bilateral ovariectomy.

Muscle structure predictors of vertical jump performance in elite male volleyball players: a cross-sectional study based on ultrasonography.

The objective of this investigation is to examine the contribution of key muscle groups in the lower limbs to vertical jumping performance in elite male volleyball players. Specifically, the study focuses on the rectus femoris (RF), vastus lateralis (VL), and lateral gastrocnemius (LG), as well as exploring differences between attack jump and other vertical jump types. To achieve this, we employed B-mode ultrasound to evaluate the anatomical cross-sectional area (ACSA), muscle thickness (MT), pennation angle (PA), and fascicle length (FL) of the RF, VL, and LG in the participants. Fifteen elite male volleyball players were recruited as participants for this study. Jump heights were measured for four types of vertical jumps: attack jump (AJ), countermovement jump (CMJ), squat jump (SJ), and drop jump (DJ). We conducted regression analyses to assess whether the previously mentioned muscle structures could predict jump performance. Our findings reveal that the muscle structure of the RF does not exhibit any significant correlation with the height of any jump. However, VL-ACSA displays a significant and the most potent predictive effect on jump height for all four jump types (AJ: R 2 = 0.32, p = 0.001; CMJ: R 2 = 0.37, p = 0.005; SJ: R 2 = 0.52, p = 0.001; DJ: R 2 = 0.25, p = 0.021). Conversely, LG-FL only demonstrates a significant and stronger predictive effect on AJ jump height (R 2 = 0.18, p = 0.009). Combining VL-ACSA, LG-FL, and training age through multiple linear regression analysis resulted in a highly significant model for predicting AJ jump height (F = 13.86, R 2 = 0.73). Moreover, the model incorporating VL-ACSA and training age is also important for predicting CMJ, SJ, and DJ jump heights (F = 8.41, R 2 = 0.51; F = 13.14, R 2 = 0.63; F = 5.95, R 2 = 0.41; respectively). The muscle structure indicators in the lower limbs significantly predict jump performance among elite male volleyball players. However, different jump types are influenced by distinct indicators, particularly in the case of AJ, which is associated with LG-FL. This suggests that enhancing LG-FL may positively impact AJ ability, thereby emphasizing the importance of specificity in training. To optimize specialized jump performance in volleyball players, practitioners are advised to assess VL-ACSA and LG-FL and incorporate step-up and eccentric strength training targeting the calf muscles to yield considerable benefits.

Prognostic value of pretreatment temporal muscle thickness after curative surgery for oral cavity squamous cell carcinoma.

Sarcopenia is a poor prognostic factor in various diseases. Temporal muscle thickness (TMT) has been reported to be associated with sarcopenia. We investigated the prognostic value of TMT in patients with oral squamous cell carcinoma. This study included 61 patients with oral squamous cell carcinoma. Two board-certified otolaryngologists measured TMT based on pre-treatment CT. The following sex-specific TMT cut-off values were used in accordance with previous reports: ≤ 6.3mm in men, and ≤ 5.2mm in women. We classified patients into normal TMT group and low TMT group according to the cutoff values. The correlation between the TMT measurements of the two readers was tested using the interclass correlation coefficient (ICC). Cox regression models were used to verify the association between TMT and prognostic factors. The low TMT group had a significantly lower BMI than the normal TMT group. Patients with low TMT at baseline had a significantly higher risk of death than those with normal TMT (hazard ratio 4.51; 95% confidence interval [CI] 1.49-13.61; p = 0.0076). There were no significant differences in disease-specific survival between the two groups. The correlation between the two evaluators' TMT measurements was excellent (ICC 0.988, 95% CI 0.981-0.933). Sex-specific TMT was associated with overall survival in patients with oral squamous cell carcinoma. TMT is easy to assess and its measurement is consistent between evaluators.

Effect of home-based tongue-strengthening exercise using a portable tool on oropharyngeal muscles in older adults with sarcopenic dysphagia: A randomised controlled study.

Tongue-strengthening exercises may be used at home to strengthen swallowing-related oropharyngeal muscles in community-dwelling older adults with sarcopenic dysphagia; however, evidence of their effectiveness remains unclear. This study aimed to investigate the effects of a home-based tongue-strengthening exercise (hTSE) using portable tool on swallowing-related oropharyngeal muscles in community-dwelling older adults with sarcopenic dysphagia. Forth community-dwelling older adults with sarcopenic dysphagia were enrolled in the study. The participants were randomly assigned to the experimental and control groups. 1-Repetition Maximum (1-RM) of tongue muscle was measured in the experimental group using the Iowa Oral Performance Instrument, and hTSE was performed using a portable tool with an intensity corresponding to approximately 70%-80% of the range based on the 1-RM value (90 times/day, 5 days/week, for 8 weeks). The control group did not perform any tongue exercises. The primary outcome measures were tongue strength and thickness. The secondary outcome measure was suprahyoid muscle strength (digastric and mylohyoid muscles). The experimental group showed significantly greater increases in suprahyoid muscle (mylohyoid and digastric) thickness (p = .01 and .011, d = 1.0 and .55), as well as tongue strength and thickness (p < .001 and .029, d = 2.2 and .6) than the control group. This study confirmed that hTSE using a portable tool is effective in increasing swallowing-related oropharyngeal muscle activity in older adults with sarcopenic dysphagia. Therefore, hTSE is recommended as an inexpensive, safe, and easy-to-use therapy for sarcopenic dysphagia in older adults.

Longitudinal changes in Achilles tendon and triceps surae muscle architecture during a 156-km mountain ultramarathon.

This study aimed to assess the longitudinal changes in triceps surae muscle-tendon architecture to an mountain ultramarathon. Experienced trail runners (N=55, 78% men, age: 45.2 [13.5] years) participated in a 156-km trail run (6000m climbing) consisting in six 26-km laps. The resting architectural properties of triceps surae muscle-tendon were measured using ultrasound imaging for Achilles tendon cross-sectional area (AT CSA), medial gastrocnemius muscle pennation angle, thickness, length and fiber length. Measurements were performed the day before the race (Baseline), at 52-km (T1), at 104-km (T2), at 156-km (T3) and 12 hours after the race (H12). Among finishers (n=41), there was a significant biphasic change in AT CSA during the race (P = 0.001). Firstly, a significant decrease in AT CSA occurred between Baseline and T1 (P = 0.006), with greater decrease for participants averaging speed >8 km/h (p = 0.014). Secondary, there was a significant increase in AT CSA especially between T2 and T3 (P = 0.006) that was correlated with a decrease in average speed (P = 0.001) and alteration of spaciotemporal running parameters (p < 0.05). Changes in muscle-tendon architecture was not significantly different between finishers (n=41) and non-finishers (n=14). In 47 participants (85.5%) who completed the follow-up, AT CSA at H12 was greater compared to Baseline (P = 0.010). The main finding is the significant and biphasic modification of the AT CSA during a 156-km mountain ultramarathon with an initial decrease corresponding to mechanical stress followed by a secondary increase suggesting adaptive mechanotransduction persisting after 12 hours.

Handheld Ultrasound Parameters of Lower Limb Muscles versus Bioelectrical Impedance Analysis Parameters for Skeletal Muscle Assessments in Arabic Female Adults.

Ultrasound (US) is a promising tool for skeletal muscle assessment; however, US studies have scarcely focused on Arabic populations. This study examined the association of handheld US indicators and bioelectrical impedance analysis (BIA) parameters in healthy Arabic females. A cross-sectional study was conducted on 60 healthy Arabic females whose muscle thickness (MT) and cross-sectional area (CSA) of the rectus femoris (RF) were measured alongside their MT and pennation angle (PA) of the medial gastrocnemius (MG) muscle (both muscles on the dominant side). Anthropometric and body composition analyses quantified fat-free mass (FFM) and appendicular skeletal muscle mass (ASMM). Muscle strength was assessed using a handgrip dynamometer, and physical activity levels were recorded with the Global Physical Activity Questionnaire (GPAQ). The CSA of the RF and the MT of both the RF and MG correlated significantly with FFM and ASMM. The PA of MG showed no significant correlations with ASMM, FFM, or handgrip strength. The CSA of RF was significantly correlated with handgrip strength (r = 0.313, p = 0.015), while the PA of MG correlated positively with GPAQ score (r = 0.346, p = 0.007). The CSA of RF significantly predicted both ASMM (β = 0.883, p = 0.0002) and FFM (β = 1.935, p = 0.0001). In conclusion, handheld US parameters, especially the RF's CSA, correlate with and can predict BIA-based FFM and ASMM in healthy females.

The Effects of Nordic Hamstring Exercise on Performance and Injury in the Lower Extremities: An Umbrella Review.

Due to their potential positive outcomes, hamstring eccentric exercises are becoming increasingly popular in training regimens. Among the various exercises, the Nordic Hamstring Exercise (NHE) is the most common. Despite its popularity, there are still some doubts about its benefits and risks. So, the aim of this umbrella review was to summarize the effects of NHE on performance and injury prevention. Following the PRISMA guidelines, a comprehensive literature search was conducted across multiple e-databases, according to the P (injured and non-injured athletes or recreationally active or healthy individuals) I (NHE) C (no intervention, placebo, or other interventions) O (performance or injury) S (systematic reviews) model. The quality of the studies was accessed with the AMSTAR-2. From the 916 systematic reviews found, only 10 could be included. They encompassed 125 studies, enrolling 17,260 subjects. The results from the studies indicate that NHE interventions demonstrated positive effects on sprint performance, muscle activation, eccentric strength, and muscle architecture (fascicle length, muscle thickness, and pennation angle). Furthermore, NHE is effective in preventing hamstring injuries (up to 51%). In conclusion, NHE should be integrated in training (especially, in the warm-up phase) for both enhancing athletic performance and preventing hamstring injuries. For achieving more positive results, it is recommended that high-volume is followed by low-volume maintenance, targeting 48 reps/week.

Altered Abdominal Muscle Recruitment and Declined Physical Function in Postpartum Individuals With Pregnancy-Related Pelvic Girdle Pain: A Matched Case-Control Study.

The influence of pregnancy-related pelvic girdle pain (PPGP) on lumbopelvic muscles has not been comprehensively examined in postpartum individuals. Previous research also presented self-reported activity limitations without objective measures. Thirty postpartum individuals with PPGP (PPGP group) and 30 age-, parity-, and postpartum duration-matched asymptomatic individuals (healthy group) were recruited. Transabdominal ultrasonography was used to measure muscle thickness or activation changes of the external oblique (EO), internal oblique (IO), transverse abdominals, lumbar multifidus, and pelvic floor muscles (PFMs) during rest and while performing the active straight leg raise (ASLR). Muscle changes were compared separately in the painful and nonpainful sides between the PPGP and health control group. Physical function was assessed using the ASLR fatigue (ASLRF), timed up-and-go, and 6-m walking (6MW) tests. The PPGP group had greater thickening changes in the bilateral IO during ASLR compared with the healthy group (nonpainful side, 16.34 vs 3.52 mm; P =.010; painful side, 18.83 vs 6.60 mm; P =.02) but became thinner in the EO (nonpainful side, -2.19 vs 19.97 mm; P <.001; painful side, -5.97 vs 21.43 mm; P <.001). Thicker IO and EO on the nonpainful side (IO, 6.60 vs 5.78 mm; P =.004; EO, 5.37 vs 4.54 mm; P =.011) and a lower bladder base (indication of PFMs) (91.87 vs 78.61 mm; P =.002) during rest were also observed in the PPGP group. Furthermore, the performance of the ASLRF and 6MW tests was poorer in the PPGP than in the healthy group (ASLRF nonpainful side, 82.36 vs 59.09 sec; P =.01; painful side, 75.73 vs 59.26 sec; P =.04; 6MW, 3.48 vs 3.17 sec; P =.02). Postpartum individuals with PPGP demonstrated altered abdominal muscle recruitment strategies during loading tasks, with objectively impaired physical functions. These findings are critical for developing effective muscle training interventions for PPGP.

Effects of radial pressure wave irradiation on triceps surae muscle morphology and function

BackgroundRadial pressure wave (RPW) has been introduced to sports sites as an alternative tool to massage, and there have been reports of irradiating muscles. This study aimed to clarify the effects of RPW irradiation on muscles, focusing on muscle morphology and muscle/fascial elasticity. MethodsThe participants were 23 healthy, able-bodied participants. Muscle morphology (muscle thickness, pinnate angle, muscle fascicle length), muscle and fascia elasticity (deep fascia, subfascial, muscle, deep intermuscular fascia) of the gastrocnemius medial head using ultrasound imaging equipment before and after RPW irradiation intervention. The maximum ankle dorsiflexion range of motion and isometric maximum plantarflexion muscle strength were also measured. ResultsBefore and after RPW irradiation to the triceps surae muscle, muscle thickness, decreased pinnate angle, and increase in maximum ankle dorsiflexion range of motion were observed. No significant changes were observed in muscle fascicle length and maximal isometric plantarflexion strength. In addition, a significant decrease in elasticity was observed in deep fascia, subfascial, and muscle, and the change was particularly large in deep fascia and deep intermuscular fascia. ConclusionIt was suggested that RPW irradiation to muscles might improve fascial gliding and reduce muscle elasticity. It was also found to improve joint range of motion while maintaining muscle output.Trial registration number (Japan Registry of Clinical Trials (jRCT))Current Controlled Trials jRCT1032210104, May 21, 2021.

There is no difference between two and five minutes of static stretching training and detraining on gastrocnemius medialis muscle thickness, pennation angle and fascicle length

There is no difference between two and five minutes of static stretching training and detraining on gastrocnemius medialis muscle thickness, pennation angle and fascicle length

Diagnosis of suprascapular nerve entrapment syndrome based on the infraspinatus muscle cross-sectional area on shoulder MRI.

Suprascapular nerve entrapment (SNE) syndrome is a commonly overlooked cause of shoulder weakness and pain. It frequently causes weakness over the posterior and lateral and posterior aspects of the shoulder, as well as pain of infraspinatus muscles. Therefore, we considered that the infraspinatus muscle cross-sectional area (IMCSA) might be a new morphological parameter to analyze SNE syndrome. We assumed that the IMCSA is an important morphologic parameter in SNE syndrome diagnosis. We acquired infraspinatus muscle data from 10 patients with SNE syndrome and from 10 healthy subjects who had undergone magnetic resonance imaging of the shoulder and who revealed no evidence of SNE syndrome. We analyzed the infraspinatus muscle thickness (IMT) and IMCSA at the shoulder on the imaging of the shoulder using our image analysis program. The IMCSA was measured as the whole infraspinatus muscle cross-sectional area that was most atrophied in the sagittal S-MR images. The IMT was measured as the thickest level of infraspinatus muscle. The mean IMT was 29.17 ± 2.81 mm in the healthy subjects and 25.22 ± 3.19 mm in the SNE syndrome group. The mean IMCSA was 1321.95 ± 175.91 mm2 in the healthy group and 1048.38 ± 259.94 mm2 in the SNE syndrome group. SNE syndrome patients had significantly lower IMT (P < .001) and IMCSA (P < .001) than the healthy group. The ROC curve shows that the optimal cutoff point of the IMT was 26.74 mm, with 70.0% sensitivity, 70.0% specificity, and an AUC of 0.83 (95% CI, 0.65-1.00). The best cutoff value of the IMCSA was 1151.02 mm2, with 80.0% sensitivity, 80.0% specificity, and AUC of 0.87 (95% CI, 0.69-1.00). The IMT and IMCSA were both significantly associated with SNE syndrome. And the IMCSA was a highly sensitive diagnostic tool.

Comparison between botulinum toxin type A injection on masseter muscle only and additional injection on anterior belly of digastric muscle in sleep bruxism patients: A clinical trial.

This study aims to evaluate the effects on bite force and muscle thickness of the botulinum toxin (BoNT) injection for patients with sleep bruxism (SB) by comparing injections into the masseter muscle only and both the masseter and the anterior belly of the digastric muscle (ABDM) in a clinical trial. Twelve SB patients received BoNT-A injections using US-guided techniques into the masseter muscle only (Group A), while the remaining 12 SB patients received injections into both the masseter and ABDM (Group B). Bite force and muscle thickness were measured before injection, as well as 1 and 2 months after injection. The bite force and masseter muscle thickness decreased in both Group A and Group B before injection, and at 1 and 2 months after injection. However, there was no significant difference (p > .05, repeated measures analysis of variance) between the two groups, and there was also no significant difference in ABDM thickness (p > .05, repeated measures analysis of variance). This study is the first to assess the short-term effects of BoNT injected into ABDM for SB control. Results show no influence on SB reduction, suggesting the need for further research on BoNT's effectiveness in controlling intense ABDM contractions during sleep and assessing suprahyoid muscle potential impact on rhythmic masticatory muscle activity occurrence.

Can Puborectalis Muscle and Abdominal Subcutaneous Adipose Tissue Thickness Indicate Dyssynergic Defecation?

Introduction: Chronic constipation (CC) is a common issue in primary care and gastroenterology. Defined variably by patients and clinicians, CC per Rome III criteria requires symptoms for six months, present three or more days per month for three months. Dyssynergic defecation (DD), a functional constipation type, involves the failure of pelvic floor muscles to relax during defecation. This study examines the relationship between DD, puborectalis muscle thickness, and subcutaneous adipose tissue thickness via MR defecography. Material and Method: After ethical approval, MR defecography images of 110 patients from Ankara Bilkent City Hospital were analyzed retrospectively. Exclusions included pelvic floor descensus, rectal mass, cystocele, rectocele, or movement artifacts. The study comprised 52 DD patients and 52 matched controls. Measurements of subcutaneous adipose tissue at L5-S1 and puborectalis muscle thickness were performed on T2-weighted images. Results: DD patients had significantly higher abdominal subcutaneous adipose tissue and puborectalis muscle thickness than controls (p=0.021, p=0.001). No significant gender differences were noted. ROC analysis revealed cut-off values of 23 mm for adipose tissue and 4.8 mm for puborectalis muscle thickness. Positive predictive values for DD were 62% for adipose tissue &gt;23 mm, 74% for puborectalis muscle thickness &gt;4.8 mm, and 90% for both criteria. Discussion: MR defecography is essential for diagnosing DD. This study is the first to investigate the link between DD and puborectalis muscle thickness. Increased abdominal subcutaneous adipose tissue suggests a connection between DD and obesity, possibly due to increased intra-abdominal pressure leading to higher puborectalis muscle tone. Conclusion: Puborectalis muscle thickness &gt;4.8 mm and abdominal subcutaneous adipose tissue thickness &gt;23 mm are key parameters for diagnosing DD in MR defecography. These findings underscore the importance of MR defecography in diagnosing and understanding DD, leading to more precise and individualized treatments.

Assessing the Clinical Effectiveness of an Exergame-Based Exercise Training Program Using Ring Fit Adventure to Prevent and Postpone Frailty and Sarcopenia Among Older Adults in Rural Long-Term Care Facilities: Randomized Controlled Trial.

Frailty and sarcopenia are geriatric syndromes of increasing concern and are associated with adverse health outcomes. They are more prevalent among long-term care facility (LTCF) users than among community dwellers. Exercise, especially multicomponent and progressive resistance training, is essential for managing these conditions. However, LTCFs, particularly in rural areas, face challenges in implementing structured exercise programs due to health care professional shortages. Moreover, older adults often become bored with repetitive exercise training and may lose interest over time. The Nintendo Switch Ring Fit Adventure (RFA) exergame is a novel exergame that combines resistance, aerobic, and balance exercises and offers a potential solution by boosting motivation in an immersive manner and reducing staff intervention needs. We aimed to evaluate the clinical effectiveness of an exergame-based exercise training program delivered via RFA (exergame-RFA) in improving muscle mass and functional performance among older adult LTCF users. This was a randomized controlled trial conducted from August 2022 to September 2023 and involved older adult LTCF users (aged ≥60 y) in rural southern Taiwan. Participants were randomized into an intervention group (exergame-RFA plus standard care) or a control group (standard care alone). The intervention, conducted seated with arm fit skills and trunk control exercises using the RFA, lasted 30 minutes twice weekly over 12 weeks. The primary outcomes measured were the Study of Osteoporotic Fractures index (serving as an indicator of frailty status) and the diagnostic criteria for sarcopenia (appendicular skeletal muscle mass index, handgrip strength, and gait speed). The secondary outcomes included functional performance (box and block test as well as maximum voluntary isometric contraction of the dominant upper extremity), muscle condition (muscle thickness measured using ultrasonography), activities of daily living (Kihon checklist), health-related quality of life (Short Form Health Survey-36), and cognitive function (brain health test). We used an intention-to-treat analysis, incorporating a simple imputation technique in statistical analysis. A mixed ANOVA, with time as a within-participant factor and intervention as a between-participant factor, was used to compare the training effects on outcomes. We recruited 96 individuals, of whom 60 (62%) underwent randomization. Of these 60 participants, 55 (92%) completed the study. Significant group×time interactions were observed in the intervention group in all primary outcomes (all P<.001, except P=.01 for handgrip strength) and most secondary outcomes, including maximum voluntary isometric contraction of the biceps (P=.004) and triceps brachii (P<.001) muscles, biceps muscle thickness measured using ultrasonography (P<.001), box and block test (P<.001), Kihon checklist (physical function: P=.01, mood status: P=.003, and total: P=.003), and brain health test (P<.001). The exergame-RFA intervention significantly improved muscle mass, strength, and functional performance among older adult users of rural LTCFs, offering a novel approach to addressing frailty and sarcopenia. ClinicalTrials.gov NCT05360667; https://clinicaltrials.gov/study/NCT05360667. RR2-10.3389/fmed.2022.1071409.

Effect of lung volume preservation during spontaneous breathing trial on successful extubation in patients receiving mechanical ventilation: protocol for a multicenter clinical trial

BackgroundIn standard weaning from mechanical ventilation, a successful spontaneous breathing test (SBT) consisting of 30 min 8 cmH2O pressure-support ventilation (PSV8) without positive end-expiratory pressure (PEEP) is followed by extubation with continuous suctioning; however, these practices might promote derecruitment. Evidence supports the feasibility and safety of extubation without suctioning. Ultrasound can assess lung aeration and respiratory muscles. We hypothesize that weaning aiming to preserve lung volume can yield higher rates of successful extubation.MethodsThis multicenter superiority trial will randomly assign eligible patients to receive either standard weaning [SBT: 30-min PSV8 without PEEP followed by extubation with continuous suctioning] or lung-volume-preservation weaning [SBT: 30-min PSV8 + 5 cmH2O PEEP followed by extubation with positive pressure without suctioning]. We will compare the rates of successful extubation and reintubation, ICU and hospital stays, and ultrasound measurements of the volume of aerated lung (modified lung ultrasound score), diaphragm and intercostal muscle thickness, and thickening fraction before and after successful or failed SBT. Patients will be followed for 90 days after randomization.DiscussionWe aim to recruit a large sample of representative patients (N = 1600). Our study cannot elucidate the specific effects of PEEP during SBT and of positive pressure during extubation; the results will show the joint effects derived from the synergy of these two factors. Although universal ultrasound monitoring of lungs, diaphragm, and intercostal muscles throughout weaning is unfeasible, if derecruitment is a major cause of weaning failure, ultrasound may help clinicians decide about extubation in high-risk and borderline patients.Trial registrationThe Research Ethics Committee (CEIm) of the Fundació Unió Catalana d’Hospitals approved the study (CEI 22/67 and 23/26). Registered at ClinicalTrials.gov in August 2023. Identifier: NCT05526053.

Exercise selection plays an important role in inducing non-uniform acute responses on elbow flexors muscle thickness

The muscle thickness (MT) acutely increases in response to the redirection of blood flow during exercise, with this muscle swelling being a proxy to quantify the degree of muscle stimuli and involvement in an exercise. The present study aims to compare the MT acute variations between the biceps brachii (BB) and brachialis (BRA) muscles in two different unilateral exercises, the dumbbell curl (DC) and dumbbell row (DR). Sixteen well-trained young males performed a 10-repetition maximum (10RM) load test and retest for each exercise. Four sets were performed with the 10RM load for each exercise until the concentric failure. The BB and BRA muscles MT were measured pre and post-intervention with a B-mode ultrasound images. The main finding of this study was that, when DC is performed, the BB presented greater MT changes (18.67% ± 6.23) compared to BRA (12.27% ± 6.20) (p = 0.025), and compared to BB when performed in DR (12.23% ± 6.03) (p = 0.024). It was also found that BB greatest increase from BRA was not observed in DR and the BRA results were similar in both exercises. These results indicate that the structural acute responses can be muscle-specific among the elbow flexors muscles for the single-joint exercise and also exercise-specific. Therefore, either one of these two exercises can be chosen to stimulate BRA, but it would be interesting to use DC to offer greater stimuli for BB.

5'-UMP inhibited muscle atrophy due to detraining: a randomized, double-blinded, placebo-controlled, parallel-group comparative study.

A short period of disuse of 1-2 weeks due to factors such as illness or injury can lead to muscle atrophy, affecting both athletic performance and health. Recent research has shown that uridine 5'-monophosphate (5'-UMP) can counteract disuse-induced muscle atrophy by increasing PGC-1α expression and inhibiting atrogin-1 expression. However, the effect of 5'-UMP on disuse muscle atrophy in humans remains unknown. Therefore, the aimed of this study was to explore the effects of 5'-UMP supplementation during detraining on short-term disuse muscle atrophy in healthy men. Following a 6-week resistance training program on upper arm, healthy men were randomized to either a UMP group (n = 11) or a placebo group (n = 10), taking their respective supplements during the 2-week detraining period. Muscle thickness, an indicator of muscle hypertrophy and atrophy, was measured at 3 positions (MT50, MT60, and MT70) at baseline, 1 week, and 2 weeks after detraining. Both groups showed a significant decrease in muscle thickness at MT70. The relative decrease was greater in the placebo group (2.4 ± 2.8%) than in the UMP group (0.0 ± 2.0%), significantly (p = 0.034) at 1 week. However, no significant difference was observed at MT50 and MT60. After the hypertrophy, 5'-UMP may prevent muscle atrophy due to the detraining within the first week.

Examination of the masseter muscle in patients with hemifacial microsomia using high-frequency ultrasound and shear wave elastography

BackgroundThis study aimed to prospectively investigate the reference values for masseter muscle thickness and hardness using ultrasonography and shear wave elastography, respectively, in patients with hemifacial microsomia (HFM). MethodsWe enrolled 51 patients, aged 5–20 years, with HFM including 31 males and 20 females. The upper-lower, left-right, and anterior-posterior diameters of 102 masseter muscles and stiffness of 98 masseter muscles were determined by examining the unaffected and affected sides of each participant’s face. ResultsThe upper-lower, left-right, and anterior-posterior diameters of the masseter muscle were significantly smaller at rest (4.26 ± 0.83, 2.94 ± 0.75, and- 0.80 ± 0.25 cm, respectively) and during contraction (3.95 ± 0.78, 2.71 ± 0.78, and 0.87 ± 0.29 cm, respectively) in the affected side than those in the healthy side (5.45 ± 0.66, 3.87 ± 0.49, and 0.97 ± 0.20 cm, respectively, at rest and 4.99 ± 0.45, 3.49 ± 0.53, and 1.07 ± 0.23 cm, respectively, during contraction, p < 0.05). In the resting state, the hardness of the masseter muscle on the affected side (0.77 ± 0.66 m/s) was significantly greater than that on the healthy side (0.42 ± 0.41 m/s; p < 0.05). The magnitude of changes in the upper-lower, left-right, and anterior-posterior diameters of the biting muscle in the occlusal state were significantly smaller on the affected side (−0.30 ± 0.27, −0.23 ± 0.17, and 0.08 ± 0.08 cm, respectively) than those in the healthy side (−0.47 ± 0.38, −0.37 ± 0.25, and 0.10 ± 0.12 cm, respectively, p < 0.05). ConclusionsThe knowledge of these values allows for better understanding of the disease characteristics of HFM, which may be used for its diagnosis, treatment, and prognosis. Patients experiencing different severity levels exhibited significant differences in the morphology and function of the masseter muscle on the affected-side (p < 0.05). Evidence levelLevel III.