Lower Limb Muscle Research Articles

Changes in standing stability when wearing different colored glasses cannot be determined by participants’ subjective preference – A crossover randomized single-blinded pilot study

BackgroundThe use of individually preferred colored glasses has gained popularity with the expectation that it may improve balance control and sports performance, however, the results of previous studies remain inconclusive. Aim of the studyIn the present pilot study, we aimed to determine the association between participants’ subjective preference and standing balance performance when wearing five different colored glasses. MethodsThirteen participants stood on one or two legs on a pair of synchronized force platforms for 30 seconds with 60 seconds rest between the five-five randomized stance trials, while wearing red, blue, yellow, green, or transparent colored glasses. In addition to 7 CoP-related variables, we analyzed five features of EMG data from three lower limb muscles on both legs. ResultsNo significant effect of colored glasses was found. Some CoP (velocity: χ²(4, 13) = 10.086; p = 0.039; Kendall’s W = 0.194, root mean square [RMS]: χ²(4, 13) = 12.278; p = 0.015; Kendall’s W = 0.236) and EMG-related (RMS of biceps femoris: χ²(4, 13) = 13.006; p = 0.011; Kendall’s W = 0.250) variables showed differences between the colored glass conditions during dominant-leg stance, however, participants failed to consecutively determine these differences in standing stability. ConclusionsOverall, our results may suggest that lens color preference, irrespective of the color itself, may influence dominant leg standing balance most probably due to psychological factors, however, only subjective determination have no potential to determine the color of the glasses that would support the individual’s standing balance the most.

Effect of double rocking jump rope training on lower limb muscle strength of badminton players.

Double rocking jump rope training can effectively enhance physical recovery, adaptability to exercise load, and lower limb muscle strength of badminton players in sports colleges, thus offering valuable insights for improving training methods in sports colleges and universities. To investigate the effect of double rocking jump rope training on the lower limb muscle strength of badminton players specializing in badminton in sports colleges. An experimental study was conducted through a ten-week teaching intervention experiment with badminton players. Relevant heart rate indexes and badminton related lower limb muscle strength indexes were measured before and after the experiment. The data of the measured relevant indexes were statistically and analytically analyzed. At the end of the experiment, the physical recovery level and the heart's adaptability to the exercise load of the control group were improved, and the lower limb muscle strength test indexes and sports performance were better than before the experiment. In the experimental group, badminton players' physical function, anaerobic metabolism of the body and other aspects also improved. The physical function of the experimental group of badminton players, the energy supply capacity of the body anaerobic metabolism and aerobic work capacity all have an enhancement effect, enabling badminton players to adapt to large exercise loads quickly and improve the recovery rate of physical fitness. The introduction of double rocking jump rope into badminton training classes in sports colleges and universities as a means of lower limb muscle strength training is conducive to improving the level of lower limb muscle strength of special badminton players, enriching the teaching and training means of lower limb muscle strength in sports colleges and universities, and broadening the research field of lower limb muscle strength in badminton in sports colleges and universities.

Effect of a graded running race on lower limb muscle damage, jump performance and muscle soreness in men and women.

Delayed structural and functional recovery after a 20 km graded running race was analyzed with respect to the sex effect. Thirteen female and 14 male recreational runners completed the race and three test sessions: one before (PRE) and two after, once on Day 1 or 2 (D1-2) and then on Day 3 or 4 (D3-4). Muscle damage was assessed indirectly using ultrasonography to quantify changes in cross-sectional area (CSA) of 10 lower-limb muscles. Delayed onset of muscle soreness (DOMS) was assessed for three muscle groups. Functional recovery was quantified by kinetic analysis of a squat jump (SJ) and a drop jump (DJ) test performed on a sledge ergometer. Linear mixed models were used to assess control group reproducibility and recovery patterns according to sex. Regardless of sex, DOMS peaked at D1-2 for all muscle groups and resolved at D3-4. CSA was increased in each muscle group until D3-4, especially in the semimembranosus muscle. A specific increase was found in the short head of the biceps femoris in women. Regardless of sex, SJ and DJ performances declined up to D3-4. Depending on the muscle, positive and/or negative correlations were found between structural and functional changes. Some of these were sex-specific. Structural and functional recovery was incomplete in both sexes up to D3-4, although DOMS had disappeared. More emphasis should be placed on hamstring muscle recovery. Highlighting the intermuscular compensations that can occur during multi-joint testing tasks, the structural-functional relationships were either positive or negative, muscle- and sex-dependent.

Functional and Combined Training Promote Body Recomposition and Lower Limb Strength in Postmenopausal Women: A Randomized Clinical Trial and a Time Course Analysis.

Encouraging healthy aging in postmenopausal women involves advocating for lifestyle modifications, including regular physical exercise like combined training (CT) and functional training (FT). Regarding this population, age-related alterations in body composition, such as decreased muscle mass and heightened adipose tissue, impact health. The aim of this study was to analyze the effects of FT and CT on body recomposition in postmenopausal women. About the methods, we randomly allocated 96 post-menopausal women to the FT, CT, or control group (CG). We measured body composition by bioimpedance and lower limb muscle strength by sit-to-stand test in five repetitions, respectively. The training protocol lasted 16 weeks, and we measured body composition and lower limb muscle strength every 4 weeks, totaling five assessments. Regarding results, we notice that both training groups increased lean mass from the 8th week of training. In addition, a reduction was observed in total fat percentage and an increase in appendicular lean mass from the 12th week of intervention. No differences were found for body mass. Furthermore, only the experimental groups increase muscle strength, starting from the 4th week of training. The conclusion was that FT and CT promote similar adaptations in body recomposition without affecting body mass in postmenopausal women.

Shoe sole impedes leg muscle activation and impairs dynamic balance responding to a standing-slip

The shoe sole is identified as a fall risk factor since it may impede the afferent information about the outside world collected by the plantar sensory units. However, no study has directly quantified how the shoe sole compromises body balance and increases fall risk. This study aimed to inspect how the sole affects human balance after an unexpected standing-slip. It was hypothesized that individuals wearing the sole, relative to their barefoot counterparts, would exhibit 1) more impaired stability and 2) disrupted lower limb muscle activation following a standing-slip. Twenty young adults were evenly randomized into two groups: soled and barefoot. The soled group wore a pair of customized 10-mm thick soles, while the other group was bare-footed. Full-body kinematics and leg muscle electromyography (EMG) were collected during a standardized and unexpected standing-slip. The EMG electrodes were placed on the tibialis anterior, gastrocnemius, rectus femoris, and biceps femoris bilaterally. Dynamic stability, spatiotemporal gait parameters, and the EMG latency of the leg muscles were compared between groups. The sole impeded the initiation of the recovery step possibly because it interfered with the accurate detection of the external perturbation and subsequently activated the leg muscles later in the soled group than in the barefoot group. As a result, individuals in the soled group experienced a longer slip distance and were more unstable than the barefoot group at the recovery foot liftoff. The findings of this study could augment our understanding of how the shoe sole impairs body balance and increases the fall risk.

Fibrotic Fibro-Adipogenic Progenitors Produce an Altered Extracellular Matrix that Impairs Myogenesis

Introduction: Fibrosis is the pathological accumulation of extracellular matrix (ECM) components, impairing tissue function. In skeletal muscle, the main source of ECM deposition are fibro-adipogenic progenitors (FAPs). FAPs can signal to muscle satellite cells (MuSCs) through soluble factors and ECM deposition. FAPs are more highly activated into myofibroblasts in fibrotic conditions, but how this affects their signaling to MuSCs is unknown. Cell-derived matrices (CDMs) can be synthesized from FAPs to investigate their ECM deposition. The goal of this study was to understand how FAPs are signaling to MuSCs through their ECM deposition. We hypothesized that FAPs isolated from mdx mice, a model for skeletal muscle fibrosis, would have increased collagen deposition compared to wt FAPs and would produce a matrix that reduces myogenesis. Methods: FAPs were isolated from the lower limb muscles of wt and mdx mice. FAPs were plated in media containing 50μM ascorbic acid to promote collagen deposition for 2 weeks in order to synthesize CDMs. CDMs were imaged using second harmonic generation (SHG) imaging to visualize collagen organization. Some CDMs were solubilized and replated to create a flat protein coating of matrix. MuSCs were then plated on the CDMs, solubilized matrix, in a transwell co-culture with FAPs, and on plastic in differentiation media for 5 days. Results: There was a significant negative correlation between the level of FAP activation into myofibroblasts and the MuSC differentiation index, independent of if the FAPs were isolated from wt or mdx mice. SHG images revealed CDMs derived from mdx FAPs had less aligned collagen fibrils compared to wt CDMs. Conclusions: High activation into myofibroblasts is often an indicator of a fibrotic FAP phenotype. The negative correlation between myofibroblasts and MuSC differentiation found here indicates this phenotype impairs myogenesis. FAPs in transwell co-culture did not have a significant effect on MuSC differentiation, highlighting the importance of ECM deposition rather than soluble signaling is important in FAP signaling to MuSCs. Targeting FAPs activation into myofibroblasts provides a therapeutic target to attenuate fibrosis and improve regeneration in skeletal muscle. Research reported in this publication was supported by the National Institute Of Arthritis And Musculoskeletal And Skin Diseases of the National Institutes of Health under Award Number F31AR082700. The content is solely the responsibility of the authors and does not necessarily represent the offcial views of the National Institutes of Health. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The effect of aquatherapy on pain intensity and performance in patients with osteoarthritis.

Osteoarthritis (OA) is a noninflammatory joint disease. If OA of the knee causes pain, decreased muscle strength and joint stiffness, exercise therapy is one of the most effective treatments for the disease. The aim of the present study was to evaluate the effect of aquatherapy on pain intensity and performance in women with OA with the assumption that it causes weightlessness. This is a quasiexperimental study. The sample size included 60 people who were randomly divided into experimental and control groups. The visual analogue scale was used to assess pain and timed up and go test (TUG), 30 Second Sit to Stand Test (30-S-CS), and 40-meter fast-paced walk test (40 MW) were used to assess performance. Data analysis was carried out using SPSS ver. 22. The results of the present study showed a decrease in pain intensity from moderate to mild intensity. Also, physical performance dimensions in patients with OA were improved, so that the average TUG increased from 14.06 to 8.8 s. The average S-CS frequency increased from 4.86 to 8.4 s and 90 MW decreased from the average 93.43 to 72.66 s. Lower limb muscle strength, and physical performance can be improved and pain intensity can be reduced in patients with OA by performing aquatherapy three times a week for 8 weeks.

Resistance training in women with myotonic dystrophy type 1: a multisystemic therapeutic avenue

Myotonic dystrophy type 1 (DM1) is a hereditary disease characterized by muscular impairments. Fundamental and clinical positive effects of strength training have been reported in men with DM1, but its impact on women remains unknown. We evaluated the effects of a 12-week supervised strength training on physical and neuropsychiatric health. Women with DM1 performed a twice-weekly supervised resistance training program (3 series of 6–8 repetitions of squat, leg press, plantar flexion, knee extension, and hip abduction). Lower limb muscle strength, physical function, apathy, anxiety and depression, fatigue and excessive somnolence, pain, and patient-reported outcomes were assessed before and after the intervention, as well as three and six months after completion of the training program. Muscle biopsies of the vastus lateralis were also taken before and after the training program to assess muscle fiber growth. Eleven participants completed the program (attendance: 98.5 %). Maximal hip and knee extension strength (p < 0.006), all One-Repetition Maximum strength measures (p < 0.001), apathy (p = 0.0005), depression (p = 0.02), pain interference (p = 0.01) and perception of the lower limb function (p = 0.003) were significantly improved by training. Some of these gains were maintained up to six months after the training program. Strength training is a good therapeutic strategy for women with DM1.

EFFECTS OF DAILY 5-MINUTE ECCENTRIC-BIASED EXERCISES ON PHYSICAL FITNESS, BODY COMPOSITION, CRITICAL HEALTH MARKERS AND WELL-BEING IN SEDENTARY INDIVIDUALS

INTRODUCTION Exercise is fundamental for maintaining and improving health and fitness; however, many individuals do not participate in regular exercise, with perceived lack of time a key barrier. Minimal dose strategies, which reduce weekly exercise volumes to less than recommended guidelines, might improve health outcomes with minimal time investment. However, minimal dose strategies and their effects on health and fitness are still unclear. Therefore, we developed a bodyweight eccentric-biased exercise program consisting of 4 exercises (1 set of 10 repetitions each), which took just 5-min to complete, and investigated the effects of the program performed daily for 4 weeks on health and fitness outcomes in sedentary individuals. METHODS We recruited 22 healthy but sedentary individuals (32 – 69 years) whose daily steps were &amp;lt;5000. Participants completed a two-week control period, followed by a 4-week daily exercise intervention. Muscular strength, physical fitness, body composition and critical health markers were assessed before (PRE-1) and after the control period (PRE-2), as well as after the intervention (POST). RESULTS Participants adhered to the exercise program &amp;gt;90%. No significant changes in any measures were observed from PRE-1 to PRE-2. Following the exercise intervention, no significant changes in body mass, bone mineral density, fat mass, lean mass, heart rate, blood pressure, grip strength, squat jump or countermovement jump were evident. However, isometric mid-thigh pull, representing lower limb muscle strength (13%), push-ups (42%) and sit-ups (44%), representing upper body strength and sit and reach, representing flexibility (12%) increased significantly (P&amp;lt;0.05), and the increase in heart rate from a 3-minute step test was attenuated (8%) from PRE-2 to POST (P&amp;lt;0.05). Finally, mental health assessed by SF-36 significantly improved (15%) (P&amp;lt;0.05). CONCLUSION These results suggest that the 5-min eccentric exercise program was effective for improving physical fitness and mental health of sedentary individuals when performed every day for 4 weeks.

Differences on Thigh Muscles&amp;apos; Activity by Types of Squat

OBJECTIVES Thigh strength has many features in our life. Many people perform vary squat types to stimulate different thigh muscles. However, there is a lack of information on which squat is the most effective on targeted muscles. Therefore, the purpose of this study was to compare thigh muscles’ activity by squat types and suggest the correct squat for strengthening thigh.METHODS Total of 20 men and women (age: 23.9±1.5yrs, height: 173.3±6.6cm, weight: 75.1±13.2kg, BMI: 24.9±3.1kg/m&lt;sup&gt;2&lt;/sup&gt;) who had no musculoskeletal pathologies within last one year, and had weight training experience for more than 1 year were participated. Squat types were classified into standard (SS), narrow (NS), wide (WS), jump (JS), and Smith machine squats (SMS). Surface electromyography was used to collect the muscle activity of the thigh during three repetitions of each squat without weights. Time points during squat are defined as follows: E1 (start), E2 (maximum knee flexion, MKF), E3 (returned), P1 (from start to MKF), and P2 (from MKF to return). Repeated measured ANOVA was used to verify differences in lower limb muscle activity between squat types.RESULTS At the E2, significant differences were found in RF (p=.00) and ST (p=.00). In the P1, significant differences were found in RF (p=.00), VL (p=.00), and BF (p=.02). In the P2, significant differences were found in RF (p=.00), VM (p=.00), and ST (p=.01).CONCLUSIONS For more activity of both quadriceps and hamstrings, plyometric-based JS is the most effective squat, but by considering the performer's lack of exercise experience, postural control may not be performed correctly which may lead to injury. In addition, stable squat using the Smith machine should be considered and the intensity, number of repetitions, and weight should be carefully set according to type of squat.

The Effects of Different Breathing Techniques on Lower Extremity Muscle Function and Postural Stability

OBJECTIVES This study examines the effects of bracing versus hollowing breathing techniques on lower limb muscle function and postural stability, aiming to identify the most effective breathing strategy for functional movement.METHODS Conducted on ten healthy males in their twenties without back or musculoskeletal issues, the study involved pre-experiment training in both breathing techniques. It assessed maximal strength, endurance, and power during knee flexion and extension, alongside postural stability, with both eyes open and closed, using the non-parametric Wilcoxon signed-rank test for analysis.RESULTS Except for certain specific measurements (right flexor muscle peak torque, left flexor muscle total work, and right extensor muscle power), statistical analysis showed significant differences in Knee muscle function favoring the bracing technique (p&lt;.05). While postural stability tests showed no significant overall differences between the techniques, an observable trend emerged: the hollowing group showed superior performance in one-foot balance tasks, whereas the bracing group demonstrated better outcomes in two-footed stances.CONCLUSIONS It is anticipated that bracing breathing will positively influence muscle training, surpassing the effects of hollowing by bolstering the strength, endurance, and power of the lower limbs. However, for postural stability, the hollowing technique may offer advantages in tasks requiring higher balance acuity, like one-legged standing. In contrast, bracing appears more effective for simpler stability tasks. These findings underscore breathing techniques' role in physical performance, highlighting the need for further, detailed research considering posture and musculoskeletal influences.

Effect of 12 weeks of plyometric training on explosive power, agility, and isokinetic lower limb muscle function of Taekwondo freestyle-poomsae players

Effect of 12 weeks of plyometric training on explosive power, agility, and isokinetic lower limb muscle function of Taekwondo freestyle-poomsae players

Weight-Bearing Physical Activity, Lower-Limb Muscle Mass, and Risk of Knee Osteoarthritis.

It has been demonstrated that total physical activity is not associated with risk of osteoarthritis. However, the association of different types of physical activity with incident knee osteoarthritis remains unclear. To determine whether weight-bearing recreational physical activities are associated with increased risk of incident knee osteoarthritis. This prospective cohort study used data from the Rotterdam Study (1996 to 2009), including participants with knee x-ray measurements at baseline and follow-up examinations. Participants with knee osteoarthritis at baseline were excluded. Residents aged 45 years and older of the Ommoord district in the city of Rotterdam in The Netherlands were invited to join the Rotterdam Study (78% response rate). Analysis was conducted in June 2023. Total, weight-bearing, and non-weight-bearing recreational physical activities collected by questionnaires at baseline. Incident radiographic knee osteoarthritis measured by knee x-ray was the primary outcome, and incident symptomatic knee osteoarthritis defined by x-ray and knee pain questionnaire was the secondary outcome. The association of different types of recreational physical activity with radiographic knee osteoarthritis was examined using logistic regression within generalized estimating equation framework after adjusting for potential confounders. A prespecified stratification analysis was planned on the basis of lower-limb muscle mass index (LMI) tertiles, measured by dual-energy x-ray absorptiometry. A total of 5003 individuals (2804 women [56.0%]; mean [SD] age, 64.5 [7.9] years) were included. The knee osteoarthritis incident rate was 8.4% (793 of 9483 knees) for a mean (SD) follow-up time of 6.33 (2.46) years. Higher weight-bearing activity was associated with increased odds of incident knee osteoarthritis (odds ratio [OR], 1.22; 95% CI, 1.10-1.35; P < .001), but non-weight-bearing activity was not (OR, 1.04; 95% CI, 0.95-1.15; P = .37). In the analysis stratified by LMI tertiles, the association of weight-bearing activity with incident osteoarthritis was found only among 431 patients in the lowest LMI tertile (OR, 1.53; 95% CI, 1.15-2.04; P = .003), but not among patients in the middle or high LMI tertile. The findings of this study suggest that weight-bearing activity is associated with incident knee osteoarthritis in people with low levels of lower-limb muscle mass, which might be a promising avenue for tailored advice for physical activity.

The Association of Age, Sex, and BMI on Lower Limb Neuromuscular and Muscle Mechanical Function in People with Multiple Sclerosis.

(1) Background: The countermovement jump (CMJ) on a force plate could be a sensitive assessment for detecting early lower-limb muscle mechanical deficits in the early stages of multiple sclerosis (MS). CMJ performance is known to be influenced by various anthropometric, physiological, and biomechanical factors, mostly investigated in children and adult athletes. Our aim was to investigate the association of age, sex, and BMI with muscle mechanical function using CMJ to provide a comprehensive overview of lower-limb motor function in people with multiple sclerosis (pwMS). (2) Methods: A cross-sectional study was conducted with pwMS (N = 164) and healthy controls (N = 98). All participants performed three maximal CMJs on a force plate. Age, sex, and BMI were collected from all participants. (3) Results: Significant age, sex, and BMI effects were found for all performance parameters, flight time, and negative and positive power for pwMS and HC, but no significant interaction effects with the group (pwMS, HC) were detected. The highest significant effects were found for sex on flight time (η2 = 0.23), jump height (η2 = 0.23), and positive power (η2 = 0.13). PwMS showed significantly lower CMJ performance compared to HC in middle-aged (31-49 years), with normal weight to overweight and in both women and men. (4) Conclusions: This study showed that age, sex, and BMI are associated with muscle mechanical function in pwMS and HC. These results may be useful in developing reference values for CMJ. This is a crucial step in integrating CMJ into the diagnostic assessment of people with early MS and developing individualized and effective neurorehabilitative therapy.

Measuring Surface Electromyography with Textile Electrodes in a Smart Leg Sleeve.

This paper presents the design, development, and validation of a novel e-textile leg sleeve for non-invasive Surface Electromyography (sEMG) monitoring. This wearable device incorporates e-textile sensors for sEMG signal acquisition from the lower limb muscles, specifically the anterior tibialis and lateral gastrocnemius. Validation was conducted by performing a comparative study with eleven healthy volunteers to evaluate the performance of the e-textile sleeve in acquiring sEMG signals compared to traditional Ag/AgCl electrodes. The results demonstrated strong agreement between the e-textile and conventional methods in measuring descriptive metrics of the signals, including area, power, mean, and root mean square. The paired data t-test did not reveal any statistically significant differences, and the Bland-Altman analysis indicated negligible bias between the measures recorded using the two methods. In addition, this study evaluated the wearability and comfort of the e-textile sleeve using the Comfort Rating Scale (CRS). Overall, the scores confirmed that the proposed device is highly wearable and comfortable, highlighting its suitability for everyday use in patient care.

Effects of once- versus twice-weekly eccentric resistance training on muscular function and structure in older adults: a randomised controlled trial

Adherence rates to current twice-weekly strength training guidelines are poor among older adults. Eccentric-only training elicits substantial improvements in muscle function/size so the aim of this study was to compare the effects of once- versus twice-weekly eccentric training programmes on muscle function/size in older adults. Thirty-six participants (69.4 ± 6.0 yr) were randomised into non-active control, once-, or twice-weekly training groups. Lower-limb muscle power, strength, and size were assessed at baseline, mid-, and post-eccentric training. Training was performed for 12 min per session at 50% of maximum eccentric strength. Significant increases in power (13%), isometric (17–36%) and eccentric (40–50%) strength, and VL muscle thickness (9–18%) occurred in both training groups following 12 weeks. Minimal muscle soreness was induced throughout the 12 weeks and perceived exertion was consistently lower in the twice-weekly training group. One weekly submaximal eccentric resistance training session over 12 weeks elicits similar improvements in neuromuscular function compared to the currently recommended twice-weekly training dose. Given the substantial improvements in neuromuscular function and previously reported low adherence to current twice-weekly training guidelines, eccentric training may be pivotal to developing a minimal-dose strategy to counteract neuromuscular decline. The trial was registered retrospectively on 24/01/2024 with ISRCTN (trial registration number: ISRCTN68730580).

Characteristics of motor evoked potentials in patients with peripheral vascular disease.

With an aging population, it is common to encounter people diagnosed with peripheral vascular disease (PVD). Some will undergo surgeries during which the spinal cord may be compromised and intraoperative neuromonitoring with motor evoked potentials (MEPs) is employed to help mitigate paralysis. No data exist on characteristics of MEPs in older, PVD patients, which would be valuable for patients undergoing spinal cord at-risk surgery or participating in neurophysiological research. Transcranial magnetic stimulation, which can be delivered to the awake patient, was used to stimulate the motor cortex of 20 patients (mean (±SD)) age 63.2yrs (±11.5) with confirmed PVD, every 10 minutes for one hour with MEPs recorded from selected upper and lower limb muscles. Data were compared to that from 20 healthy volunteers recruited for a protocol development study (28yrs (±7.6)). MEPs did not differ between patient's symptomatic and asymptomatic legs. MEP amplitudes were not different for a given muscle between patients and healthy participants. Except for vastus lateralis, disease severity did not correlate with MEP amplitude. There were no differences over time in the coefficient of variation of MEP amplitude at each time point for any muscle in patients or in healthy participants. Although latencies of MEPs were not different between patients and healthy participants for a given muscle, they were longer in older participants. The results obtained suggest PVD alone does not impact MEPs; there were no differences between more symptomatic and less symptomatic legs. Further, in general, disease severity did not corelate with MEP characteristics. With an aging population, more patients with PVD and cardiovascular risk factors will be participating in neurophysiological studies or undergoing surgery where spinal cord integrity is monitored. Our data show that MEPs from these patients can be easily evoked and interpreted.

Effect of Training in Water and Training with Thera-Band on the Frequency Spectrum of Electrical Activity of Lower Limb Muscles in People with Pronated Foot During Walking: A Clinical Trial Study

Introduction: The ankle joint is one of the most vulnerable joints in the body due to weight bearing. Pronated foot is one of the most common complications of the lower limbs. Therefore, the aim of the present study was to investigate the effect of training in water and training with thera-band on the frequency spectrum of electrical activity of lower limb muscles in people with pronated foot during walking. Methods: The present research was a clinical trial study that was conducted in a semi-experimental and laboratory. The statistical sample of the present study included 45 students of University of Mohaghegh Ardabili who had pronated foot, were selected purposefully and were randomly and equally placed in three groups: TheraBand, exercise in water, and control. The training protocol used for the water training group was based on the sports prescription guidelines of the American College of Sports Medicine (ACSM), and for the training group with the thera-band, it was performed using an orange thera-band in three sets with repetitions of 14 movements. To measure the frequency spectrum of the electrical activity of the lower limb muscles, it was recorded using a wireless surface electromyography device. Likewise, analysis of variance with repeated measurements and Bonferroni post hoc test were used to analyze the data at a significance level of P≤0.05. Results: The results showed that the interactive effect of time and group on the middle frequency spectrum of electromyography of the vastus medialis muscle in the exercises of the thera-band group during walking had a significant decrease (P=0.02). Other variables from the pre-test stage to the post-test did not show statistically significant differences (P&lt;0.05). Conclusion: It seems that doing exercises in water and thera-band doesn't statistically have much effect on the frequency spectrum of the electrical activity of the lower limb muscles.

Case Report : Physiotherapy management of maternal obstetric palsy in a Nigerian teaching hospital

Introduction Maternal obstetric palsy is a rare nerve injury to all or part of the lumbosacral plexus with signs and symptoms becoming evident during labour or after childbirth. Motor and sensory involvement affect dermatomes and lower limb muscle group(s). Physiotherapy is indicated for the clinical presentations of maternal obstetric palsy, but research in this area is limited. The purpose of this case report was to highlight the application of physiotherapy in the management of the clinical presentations of maternal obstetric palsy. Clinical description A 38-year-old female patient presented with severe pain (verbal pain rating scale [VPRS]: 10/10), intermittent muscle spasm, loss of sensation, weakness of lower limb muscle groups (Oxford Muscle Grading [OMG]: ≤2/5) and loss of lower limb function after childbirth following prolonged obstructed labour. The patient was diagnosed with maternal obstetric palsy after detailed history and physical examinations. Interventions and outcomes Transcutaneous electrical muscle stimulation and muscle strengthening exercises were administered immediately post-delivery. Duration of treatment was eight weeks. The patient’s pain stopped (VPRS= 0/10), muscle spasm reduced, with improved muscle strength (OMG≥ 4/5) and lower limb function. Conclusion Early physiotherapy reduced pain intensity and muscle spasm, and increased muscle strength and function in a patient with maternal obstetric palsy.

Feasibility of Combining Functional Mobilisation with Resistance and Endurance Training for Mechanically Ventilated Patients in Intensive Care Unit Setting-A Pilot Study.

Background: Intensive-care-acquired weakness resulting in functional impairment is common in critical care survivors. This study aims to evaluate the feasibility of a combined early functional training with endurance and resistance training and its effect on the functional outcome. Methods: It is a pilot study performed in a 39-bed Medical and Surgical Intensive Care Unit (ICU). Patients who were premorbidly independent and were mechanically ventilated for ≥24 h were recruited to receive functional mobilisation (sit out of bed, ambulation), endurance (bed cycling), and resistance training (selected upper and lower limb muscle training using weights). The primary outcomes were feasibility of training, muscle strength, handgrip strength, quadricep strength, and Functional Status Score-Intensive Care Unit (FSS-ICU) collected at the first assessment in the ICU, at the ICU discharge, and at hospital discharge. Secondary outcomes were functional capacity (6-Minute Walk Distance) and quality of life measures, EQ-5D, at hospital discharge and at 3 months. Results: Out of the 11 patients, 6 (54.54%) patients achieved level 2 functional mobilisation, 2 (18.18%) patients achieved level 2 resistance training, and 1 (9.09%) patient achieved level 2 endurance training. There were no significant differences in the medical research council (MRC) score, quadricep strength, and handgrip strength between the first assessment in the ICU, at the ICU discharge, and at hospital discharge. However, there was a significant difference in FSS_ICU (p < 0.008) from the first assessment in the ICU up to hospital discharge. EQ-5D visual analogue scale also showed a change of 8.5% at 3-month follow-up. 6MWD showed significant difference (p < 0.043) at 3-month follow-up compared to that at hospital discharge. Conclusions: The study found low compliance to resistance and endurance training in patients with mechanical ventilation. However, functional mobilisation in terms of sit out of bed was possible in more than half of the recruited patients.