Recovery Of Muscular Strength Research Articles

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

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

Recovery of Muscular Strength Following Total Hip Replacement: A Narrative Review.

This narrative review analyzes muscle strength recovery following total hip replacement (THR) and looks at various factors affecting postoperative muscle function restoration. The review synthesizes evidence from various studies regarding the timing and degree of muscular strength recovery, different rehabilitation protocols, and patient-specific variables such as age, preoperative physical condition, and comorbidities, among others. Overall, it appears that THR is associated with improved hip function and quality of life, but this usually takes a long time due to individualized physical therapy interventions. In addition, postoperative rehabilitation has been found not to exist without any personal factors involved such as age or gender whereby for instance senior citizens have no alternative but to go for THR surgery, making their lower limbs weaker than those who are younger. Based on the findings in this review on muscle recovery after THR surgeries, one may conclude that this endeavor should begin as early as possible and include regular resistance training programswith performance-focused functional training after surgery. In addition, more longitudinal studies should be conducted regarding post-surgical outcomes comparing other traditional medical practices.

Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery.

Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries (RCIs). Although this procedure has certain clinical advantages, it requires rehabilitation management interventions to ensure therapeutic efficacy. To investigate the effect of integrated traditional Chinese medicine and Western medicine (TCM-WM) under the multidisciplinary team (MDT) model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs. This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024. They were divided into a control group (n = 48) that received routine rehabilitation treatment and an experimental group (n = 52) that received TCM-WM under the MDT model (e.g., acupuncture, TCM traumatology and orthopedics, and rehabilitation). The results of the Constant-Murley Shoulder Score (CMS), Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), muscular strength evaluation, and shoulder range of motion (ROM) assessments were analyzed. After treatment, the experimental group showed significantly higher CMS scores in terms of pain, functional activity, shoulder joint mobility, and muscular strength than the baseline and those of the control group. The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group. In addition, the experimental group showed significantly enhanced muscular strength (forward flexor and external and internal rotator muscles) and shoulder ROM (forward flexion, abduction, and lateral abduction) after treatment compared with the control group. TCM-WM under the MDT model improved shoulder joint function, relieved postoperative pain, promoted postoperative functional recovery, and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

Effect of Cold vs Temperate Conditions on Physical Performance During Extended Mountain Warfare Training at Moderate Altitude.

The purpose of this study was to investigate the effect of environmental conditions on body composition, upper body power, and lower body power throughout a ∼4-week military mountain training exercise. We hypothesized that countermovement jump and ballistic push-up performance would decrease as a result of extended mountain field training and that winter (cold) conditions would result in greater decrements compared to fall (temperate) conditions. We also expected to observe a strong positive correlation between changes in performance and changes in skeletal muscle mass. Finally, we expected acute changes in performance upon altitude exposure. A total of 111 U.S. Infantry Marines (110 M; 1 F) provided written informed consent to participate in this study according to a protocol approved by the Naval Health Research Center. There were 54 participants in the fall cohort and 57 in the winter cohort. Maximum effort countermovement jump and ballistic push-up performance were assessed at different timepoints: (1) baseline at the sea level, (2) before training at ∼2100 m, (3) midpoint of training at ∼2100 m, (4) end of training at ∼2100 m, and (5) after 3 to 4 weeks of recovery at the sea level. The fall cohort trained at moderate temperatures (average day/night, 20°C/3°C), whereas the winter cohort trained under snowy winter conditions (7°C/-14°C). The results suggested that seasonal conditions did not significantly affect changes in body composition or physical performance. Furthermore, no acute effects of altitude on physical performance were detected. Training exercise did, however, cause performance decrements in countermovement jump height, countermovement jump peak power, and ballistic push-up height. Repeated measure correlation analyses suggested that there was a weak positive correlation between the decrease in skeletal muscle mass and the decrease in countermovement jump peak power throughout the training. The results of our study suggest that explosive movements are negatively affected by extended military training, seemingly independent of environmental training conditions or temperature. Planning and execution of military training should account for the likelihood that warfighter physical power will decline and may not return to pretraining levels within the month following the training event. It may also be advised to consider targeted exercises to aid in recovery of muscular strength and power. Future work should consider additional factors that likely influenced the decrease in physical performance that occurs during extended military training, such as nutrition, sleep, and psychological and cognitive stresses.

Short-Term Effects of Dietary Protein Supplementation on Physical Recovery in Older Patients at Risk of Malnutrition during Inpatient Rehabilitation: A Pilot, Randomized, Controlled Trial.

It is estimated that about 50% of geriatric rehabilitation patients suffer from sarcopenia. Thereby, malnutrition is frequently associated with sarcopenia, and dietary intake is the main modifiable risk factor. During hospitalization, older adults are recommended to consume more dietary protein than the current recommended dietary allowance of 0.8 g/kg body weight per day to optimize the recovery of muscular strength and physical function. This prospective pilot study examined the feasibility and preliminary efficacy of short-term protein supplementation with protein-enriched foods and drinks on the hand-grip strength, nutritional status, and physical function of older patients at risk of malnutrition during a three-week inpatient orthopedic rehabilitation stay. The Mini Nutritional Assessment (MNA) tool was used to assess malnutrition. Patients with an MNA score ≤ 23.5 points were randomly assigned to an intervention group (goal: to consume 1.2-1.5 g protein/kg body weight per day) or a control group (standard care). Both groups carried out the same rehabilitation program. Physical recovery parameters were determined at admission and discharge. A trend was recognized for participants in the intervention group to consume more protein than the control group (p = 0.058): 95.3 (SD 13.2) g/day as compared to 77.2 (SD 24.2) g/day, which corresponds to a mean protein intake of 1.6 (SD 0.3) g/kg/day vs. 1.3 (SD 0.5) g/kg/day. Dietary protein supplementation increased body weight by an average of 0.9 (SD 1.1) kg and fat mass by an average of 0.9 (SD 1.2) kg as compared to the baseline (p = 0.039 and p = 0.050, respectively). No significant change in hand-grip strength, body composition, or physical function was observed. In conclusion, short-term intervention with protein-enriched foods and drinks enabled older patients at risk of malnutrition to increase their protein intake to levels that are higher than their required intake. In these older individuals with appropriate protein intake, dietary protein supplementation did not result in a greater improvement in physical recovery outcomes during short-term inpatient rehabilitation. The intervention improved dietary protein intake, but further research (e.g., a full-scale, randomized, controlled trial with sufficient power) is required to determine the effects on physical function outcomes.

Abstract Number ‐ 270: Assessing Biceps Brachii Functional Recovery after Stroke: Comprehensive Analysis of Two Decades of Patient Data

Introduction Severe loss of muscle strength is common following stroke, and rehabilitation in the form of targeted physical therapy is often needed to recover partial muscular function. Although lower limb weakness is typical in stroke patients, upper body complications presenting as decreased grip strength and hand motor coordination can also occur. The biceps brachii, one of the most frequently used upper body muscles, often shows weakness post‐stroke. Although recent literature has touched on various techniques to help regain biceps brachii function, studies looking at quantifiable recovery of muscular strength are limited.In this review, we summarize strength recordings of the biceps brachii from stroke patients collected over the past 20 years to better characterize upper extremity functional recovery after stroke. Methods Using PRISMA guidelines, we queried 3 databases to identify all studies reporting findings of stroke recovery including isolated strength measurement of the bicep brachii muscle in newtons (N). Results 15 studies describing 384 patients (mean age range: 55.7‐73.6 years) were included for formal analysis. Baseline biceps strength range following stroke was 12.1‐91.23 N. At 4 weeks, strength ranged from 16.3‐85.8N, and this range improved to 85.31‐97.38N and 29–125.04N at 5 and 8 weeks, respectively. Additionally,Folkerts et al. found a significant improvement in biceps function from the 5 week value (97.38N) to the 10 week final follow‐up (108.46N). Over 12 weeks post‐stroke, Donaldson and colleagues observed a significant improvement in bicep strength range (27.1‐61.0N vs. 59.5‐76.1N). Conclusions Our study is the first systematic review assessing the recovery of biceps function with time following stroke in the current literature. Singular timepoint studies showed a significant loss of bicep function post‐stroke. Multiple timepoint studies showed semi‐linear relationships between biceps strength recovery and time within studies but no patterns when comparing between studies. Further research is required to quantify biceps strength recovery in a sex‐specific manner.

Effects of Cold-Water Immersion Compared with Other Recovery Modalities on Athletic Performance Following Acute Strenuous Exercise in Physically Active Participants: A Systematic Review, Meta-Analysis, and Meta-Regression.

Studies investigating the effects of common recovery modalities following acute strenuous exercise have reported mixed results. This systematic review with meta-analysis and meta-regression compared the effects of cold-water immersion (CWI) against other common recovery modalities on recovery of athletic performance, perceptual outcomes, and creatine kinase (CK) following acute strenuous exercise in physically active populations. Systematic review, meta-analysis, and meta-regression. The MEDLINE, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare, and Embase databases were searched up until September 2022. Studies were included if they were peer reviewed, published in English, included participants who were involved in sport or deemed physically active, compared CWI with other recovery modalities following an acute bout of strenuous exercise, and included measures of performance, perceptual measures of recovery, or CK. Twenty-eight studies were meta-analysed. CWI was superior to other recovery methods for recovering from muscle soreness, and similar to other methods for recovery of muscular power and flexibility. CWI was more effective than active recovery, contrast water therapy and warm-water immersion for most recovery outcomes. Air cryotherapy was significantly more effective than CWI for the promotion of recovery of muscular strength and the immediate recovery of muscular power (1-h post-exercise). Meta-regression revealed that water temperature and exposure duration were rarely exposure moderators. CWI is effective for promoting recovery from acute strenuous exercise in physically active populations compared with other common recovery methods. Open Science Framework: https://doi.org/10.17605/OSF.IO/NGP7C.

A state-of-the-art review of tamoxifen as a potential therapeutic for duchenne muscular dystrophy.

Introduction: This systematic review analyzes the state-of-art repurposing of the drug tamoxifen (TAM) in the treatment of Duchenne Muscular Dystrophy (DMD), including its mechanism of action, toxicological findings, and past and ongoing clinical trials. A parallel aim of this work was to explore whether evidence exists to support further funding of investigation on TAM treatment for DMD patients with a pivotal trial in young patients. Bringing evidence and answering the scientific question of whether this treatment could improve the quality-of-life of DMD patients is needed to establish guidelines and accelerate access to promising therapies for DMD patients. Methods: The search was conducted in January 2022 utilizing PubMed. All MeSH terms for "Duchenne Muscular Dystrophy" and "tamoxifen" were used. The inclusion and exclusion criteria were defined according to the PICOS framework. Results: The included publications all explored the use of TAM with promising outcomes in muscular strength recovery and a decrease in pathology biomarkers. Two reviews recognize TAM as a potential treatment for DMD patients and state that drug repurposing plays a crucial role in the quest for a drug candidate to treat this rare disease. Conclusion: According to available data, TAM shows promise as a treatment for DMD, both pharmacologically and clinically. However, published data to date are insufficient to definitively conclude the beneficial effect of TAM on quality-of-life and ultimately survival, particularly in the youngest patients diagnosed with DMD.

Efficacy of passive stretching vs muscle energy technique in Postoperative Elbow stiffness

The elbow, which is the upper limb's intermediate joint, is prone to pathological occurrences and stiffness in particular. As a patient's ability to perform compensatory motions deteriorates, intolerance develops. Individuals frequently suffer from fractures and dislocations. Prior to treatment, a thorough examination is required. Physical therapy is crucial in the recovery of function. The purpose of this research is to examine the benefits of regular stretching vs. PIR in the muscle energy technique on postoperative elbow stiffness, discomfort, and range of motion. A Randomized Control Trial will be used to conduct the research. A total of 20 participants will be chosen from AVBRH and RNPC OPD, Sawangi (Meghe) , based on inclusion and exclusion criteria. Twenty subjects will be divided into two groups, with one group receiving Stretching (static stretching) and other receiving Muscle Energy Technique (Post isometric relaxation). The patient's outcome measurements will be the Visual Analogue Scale for Pain and the Universal Goniometer Range of Motion Assessment. When compared to stretching, this study found that employing muscular energy approach can be more beneficial. It may aid in to the recovery of muscular strength, as well as the patient's ability to conduct compensatory movements in nearby joints. The majority of studies found Muscle energy approach to be more helpful in expanding range of motion, but only a few studies found stretching to be effective.

Dysferlinopathy misdiagnosed with juvenile polymyositis in the pre-symptomatic stage of hyperCKemia: a case report and literature review

BackgroundDysferlinopathy encompasses a group of rare muscular dystrophies caused by recessive mutations in the DYSF gene. The phenotype ranges from asymptomatic elevated serum creatine kinase (hyperCKemia) to selective and progressive involvement of the proximal and/or distal muscles of the limbs. Bohan and Peter criteria are the most widely used for the diagnosis of polymyositis, but they have limitations and can misclassify muscular dystrophies with inflammation as polymyositis. Most dysferlinopathy patients have muscle biopsies with inflammation and thus are vulnerable to misdiagnosis with polymyositis and inappropriate treatment with steroids and immunosuppressors.Case presentationWe describe a 14 years-old male patient who was referred for assessment of asymptomatic hyperCKemia (26,372 IU/L). An X-linked dystrophinopathy initially was ruled out by direct genetic testing. Juvenile polymyositis was considered based on muscle biopsy, creatine kinase levels, and electromyography changes. Corticosteroid treatment triggered proximal lower limb muscular weakness, and no full muscular strength recovery was observed after corticosteroid withdrawal. Based on these observations, a limb-girdle muscular dystrophy (LGMD) was suspected, and LGMDR2 was confirmed by whole exome sequencing.ConclusionWe report a dysferlinopathy patient who was misdiagnosed with juvenile polymyositis and explore in a literature review how common such misdiagnoses are. With diagnosis based only on routine clinicopathological examinations, distinguishing an inflammatory myopathy from dysferlinopathy is quite difficult. We suggest that before establishing a diagnosis of “definite” or “probable” juvenile polymyositis, according to Bohan and Peter or current ACR/EULAR criteria, a muscular dystrophy must first be ruled out.

Comparative Assessment of Robotic versus Classical Physical Therapy Using Muscle Strength and Ranges of Motion Testing in Neurological Diseases.

The use of robotic systems in physical rehabilitation protocols has become increasingly attractive and has been given more focus in the last decade as a result of the high prevalence of motor deficits in the population, which is linked to an overburdened healthcare system. In accordance with current trends, three robotic devices have been designed, called ParReEx Elbow, ParReEx Wrist, and ASPIRE, which were designed to improve upper-limb medical recovery (shoulder, elbow, forearm, and wrist). The three automated systems were tested in a hospital setting with 23 patients (12 men and 11 women) suffering from motor deficits caused by various neurological diseases such as stroke, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). The patients were divided into three groups based on their pathology (vascular, extrapyramidal, and neuromuscular). Objective clinical measures, such as the Medical Research Council (MRC) scale, goniometry, and dynamometry, were used to compare pre- and post-rehabilitation assessments for both robotic-aided and manual physical rehabilitation therapy. The results of these tests showed that, with the exception of a few minor differences in muscular strength recovery, the robotic-assisted rehabilitation methods performed equally as well as the manual techniques, though only minor improvements were validated during short-term rehabilitation. The greatest achievements were obtained in the goniometric analysis where some rehabilitation amplitudes increased by over 40% in the vascular group, but the same analysis returned regressions in the neuromuscular group. The MRC scale analysis returned no significant differences, with most regressions occurring in the neuromuscular group. The dynamometric analysis mostly returned improvements, but the highest value evolution was 19.07%, which also in the vascular group. While the results were encouraging, more research is needed with a larger sample size and a longer study period in order to provide more information regarding the efficacy of both rehabilitation methods in neurological illnesses.

Flavonoid Containing Polyphenol Consumption and Recovery from Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis

Flavonoid polyphenols are bioactive phytochemicals found in fruits and teas among other sources. It has been postulated that foods and supplements containing flavonoid polyphenols may enhance recovery from exercise-induced muscle damage (EIMD) through upregulation of cell signalling stress response pathways, particularly the nuclear factor erythroid 2-related factor 2 (NRF2) pathway. This study aims to investigate the ability of polyphenol treatments containing flavonoids to enhance recovery of skeletal muscle strength, soreness and creatine kinase post EIMD. Medline (Pubmed), Embase and SPORTdiscus were searched from inception to August 2020 for randomised placebo-controlled trials which assessed the impact of 6 or more days of flavonoid containing polyphenol ingestion on skeletal muscle recovery in the 96-h period following a single bout of EIMD. A total of 2983 studies were screened in duplicate resulting in 26 studies included for analysis. All meta-analyses were undertaken using a random-effects model. The pooled results of these meta-analyses show flavonoid polyphenol treatments can enhance recovery of muscle strength by 7.14% (95% CI [5.50-8.78], P < 0.00001) and reduce muscle soreness by 4.12% (95% CI [-5.82 to -2.41] P = 0.00001), no change in the recovery of creatine kinase concentrations was observed. These results indicate that ingestion of polyphenol treatments which contain flavonoids has significant potential to improve recovery of muscular strength and reduce muscle soreness in the 4-day period post EIMD. However, the characterisation of polyphenol dosage and composition of study treatments should be prioritised in future research to facilitate the development of specific guidelines for the inclusion of flavonoid-rich foods in the diet of athletes and active individuals.

Medicinal Plants in Physical Exercise: A Review

Background: The use of medicinal plants may have an effective action on the performance of athletes.&#x0D; Aims: This review aimed to evaluate the effects of the use of medicinal plants and some phytocompounds on physical performance.&#x0D; Methodology: MEDLINE/PUBMED and EMBASE were consulted following the PRISMA guidelines.&#x0D; Results: Panax ginseng increases the anti-fatigue effect, decreases the stress promoted by the physical exercise, and improves muscular function through gene expression enhancement. Arnica montana has a crucial anti-inflammatory action showing relief of muscular pain a. Zingiber officinale has an anti-inflammatory and analgesic role on muscular pain, and it can be used to speed up the recovery of muscular strength after intense activity. Ephedra sinica is related to thermogenic and sympathomimetic effects, being able to increase the energetic state. Capsaicin increases the energetic expenditure due to fat oxidation, promotes the anti-fatigue effect, and enhances the athlete’s resistance. Caffeine has ergogenic importance related to its antioxidant capacity, and it improves mental alertness condition.&#x0D; Conclusion: The nutritional supplementation with products derived from medicinal plants may be an efficient alternative to improve the athlete’s performance, being a natural substitute for synthetic supplements, which usually are forbidden in competitions.

Tart Cherry Supplementation and Recovery From Strenuous Exercise: A Systematic Review and Meta-Analysis.

The aim of this study was to determine the efficacy of tart cherry (TC) supplementation on recovery following strenuous exercise. A systematic review and meta-analysis were conducted using studies investigating TC supplementation on measures of muscle soreness, muscular strength, muscular power, creatine kinase, C-reactive protein, Interleukin-6, and tumor necrosis factor alpha. A literature search ending in July 2020 was conducted in three databases (SPORTDiscus, Web of Science, and PubMed). Data from 14 studies were extracted and pooled for analysis. Tart cherry supplementation had a small beneficial effect in reducing muscle soreness (effect size [ES] = -0.44, 95% confidence interval [CI] [-0.87, -0.02]). A moderate beneficial effect was observed for recovery of muscular strength (ES = -0.78, 95% CI [-1.11, -0.46]). A moderate effect was observed for muscular power (ES = -0.53, 95% CI [-0.77, -0.29]); a further subgroup analysis on this variable indicated a large effect of TC supplementation on recovery of jump height (ES = -0.82, 95% CI [-1.18, -0.45]) and a small significant effect of supplementation on sprint time (ES = -0.32, 95% CI [-0.60, -0.04]). A small effect was observed for both C-reactive protein (ES = -0.46, 95% CI [-0.93, -0.00]) and Interleukin-6 (ES = -0.35, 95% CI [-0.68, -0.02]. No significant effects were observed for creatine kinase and tumor necrosis factor alpha. These results indicate that the consumption of a TC supplement can aid aspects of recovery from strenuous exercise.

EFFECT OF WHOLE BODY VIBRATION TRAINING ON SELECTED HEALTH RELATED COMPONENTS AMONG AMATEUR PLAYERS IN THE POLYTECHNIC, IBADAN FOOTBALL TEAM, IBADAN, NIGERIA

Numerous studies have made attempt at identifying adequate recovery stratagem for amateur athletes. But little or no study has assessed the prolonged effects of whole-body vibration (WBV) as a recovery technique on selected health components after performance. This study investigated the effects of whole body vibration training on some selected health related fitness components among amateur players in The Polytechnic, Ibadan football team, Ibadan, Nigeria. The study was carried out using pretest posttest control group experimental research design. Twenty (20) participants partook in the research; they were placed into two groups; the experimental group (A) who undertook eight weeks of whole body vibration training while the participants in group B form the control group. Pretest and posttest values were elicited and then subjected to empirical analysis. Numerous studies have made attempt at identifying adequate recovery stratagem for amateur athletes. But little or no study has assessed the prolonged effects of whole-body vibration (WBV) as a recovery technique after performance. This study therefore investigated the effects of whole body vibration training on some selected health related health fitness components among amateur players among The Polytechnic, Ibadan football team, Ibadan, Nigeria. Descriptive statistics of mean, percentages, chats and inferential statistics of analysis of covariance (ANCOVA) were used to test all hypotheses at 0.05 alpha level of significance. The results revealed a significant difference in the pretest and posttest scores of players with muscular endurance (F(1, 18) =10.047; p&lt;0.05; ƞ2=.137) and muscular strength (F(1, 18) =19.317; p&lt;0.05; ƞ2=.327). However, the effect of WBV was not significant on flexibility (F(1, 18) =1.006; p&gt;0.05; ƞ2=.062). So, the hypothesis was not rejected. It was concluded that whole body vibration training significantly improved the muscular endurance and muscular strength recovery of the participants, but was not significant on flexibility. It was therefore recommended that football coaches should incorporate whole body vibration training more into their training programme as muscular endurance and muscular strength are essential health fitness components needed to play football game.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0721/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Clinical outcomes of contralateral 7th cervical nerve transfer in the treatment of total brachial plexus root avulsion in Xinjiang Autonomous Region

Objective To evaluate the long-term functional recovery after contralateral 7th cervical nerve(C7) transfer with brachial plexus root avulsion and the effect on the contralateral limbs after operation. Methods A total of 83 patients with injory of brachial plexus avulsion were underwent contralateral C7 transfer from September, 2004 to December, 2014. Among them, contralateral C7 were transferred to the median nerve in 33 cases, to radial nerve in 14 cases, to musculocutaneous nerve in 22 cases, and simultaneous transfer to median and musculocutaneous nerve in 14 cases. The followed-up contents included recovery of muscular strength and sensory innervated by the recipient nerve, bilateral limbs synergistic activity and the effect on the contralateral limbs after the surgery. Results All 83 cases were successfully followed-up for 3.2-6.2 years (average, 4.5 years), and found no significant effect on function of the contralateral limbs. In the group of C7 transferred to the median nerve group, 10 cases had muscle strength recovered≥M3, and 26 cases had sensory recovered≥S3; In the group of C7 transferred to the radial nerve, 6 cases had muscle strength recovered≥M3, and 9 cases had sensory recovered ≥S3; In the group of C7 transferred to the musculocutaneous nerve, 12 cases had muscle strength recovered≥M3, and 17 cases had sensory recovered≥S3. In the group of C7 simultaneous transferred to the median and musculocutaneous nerve, 6 cases had muscle strength of wrist and digital flexion recovered≥M3, 5 cases had elbow flexion recovered≥M3, 9 and 10 cases had sensory of innervated area and lateral forearm region recovered≥S3, respectively. Conclusion Contralateral C7 transfer is an ideal procedure for the treatment of total brachial plexus root avulsion with definitive clinical outcomes. Key words: Brachial plexus root avulsion; Seventh cervical nerve; Nerve transfer; Limb coordination

Clinical diagnosis and surgical treatment of cervical spondylosis with distal upper extremity amyotrophy

Objective To summarize the clinical features of cervical spondylosis with distal upper extremity amyotrophy; and further analyze the clinical efficacy of cervical anterior decompression and fusion on cervical spondylosis with distal upper extremity amyotrophy. Methods Thirty cases of cervical spondylosis with distal upper extremity amyotrophy were analyzed retrospectively from June 2006 to June 2015. nineteen males and eleven females with an average age of 55.20±9.08 years (41 to 72 years) were included. The preoperative course was 1 to 108 months with a median of 6 months. The muscle extent of the affected group, the segmentation and location of spinal canal stenosis, and the results of neurophysiological examination were analyzed. The muscular strength recovery of atrophic muscles was evaluated by Manual Muscle Testing (MMT), and the clinical satisfaction was assessed at the last followed up. Results The muscles involved in patients of cervical spondylosis with distal upper extremity amyotrophy are mainly the thenar muscle (17 cases, 56.7%), interosseous muscle (15 cases, 50.0%), and shypothenar muscles (13 cases, 43.3%). Most cases of imaging findings showed multi-segmental degeneration, of which C5, 6 (24 cases, 80.0%), C6,7 (21 cases, 70.0%) segments were most common, and the types of anterior compression: 23 segments (33.5%) of the central type, 37 segments (54.4%) of the lateral-central type, and 8 segments (11.8%) of the foramen type. Neuroelectrophysiological examination showed that cervical spinal cord anterior horn cells or nerve root damage, the most commonly involved segments of C7, C8, T1(18 cases, 60.0%). The average follow-up time was 36.8 months. At the last follow-up, MMT assessment showed that thirteen patients (43.3%) in this group had muscle strength recovery for more than one grade at the last follow-up. The average clinical satisfaction was 73.4%. Conclusion The clinical diagnosis of cervical spondylosis with distal upper extremity amyotrophy requires a combination of clinical symptoms, imaging findings and neurophysiological examination results for comprehensive judgment. Cervical anterior decompression and fusion can effectively prevent the progression of cervical spondylosis in distal upper extremity amyotrophy patients, and some patients can get a good muscle recovery. Key words: Cervical vertebrae; Spinal cord compression; Muscular atrophy; Spinal fusion

Muscle recovery at 1year after the anterior cruciate ligament reconstruction surgery is associated with preoperative and early postoperative muscular strength of the knee extension.

The anterior cruciate ligament (ACL) injury often occurs in young athletes, but it also occurs in middle-aged individuals and the elderly during recreational sports activities. Clinical outcomes after the ACL reconstruction depend on postoperative recovery of muscular strength. The current study aimed to evaluate the recovery of knee extension and flexion strength after ACL reconstruction surgery and to examine the relationship between preoperative and postoperative muscle strength by age and the type of graft used. From 2007 to 2010, 32 patients (17 men, 15 women; average age, 31years; range, 14-66years) who underwent two-bundle ACL reconstruction surgery using hamstrings, i.e., semitendinous and gracilis tendon (STG) graft, and 25 patients (15 men, 10 women; average age, 28years; range, 15-59years) who underwent the ACL reconstruction surgery using bone-patellar tendon-bone (BTB) graft were included in this study. The muscular strength of the knee extension and flexion compared to non-injury side was measured by an isokinetic dynamometer at a velocity at 60°/s preoperatively, and postoperative measurements were performed at 6, 9months, and 1 year after the ACL reconstruction surgery. Covariates that influenced the outcome of the force of knee extension at 12months were the preoperative muscular strength [p = 0.045, odds ratio (OR): 1.105, 95% confidence interval (CI): 1.002-1.219] and muscular strength at 6months after surgery (p = 0.040, OR: 1.155, 95% CI: 1.006-1.326). Only muscle strength at 6months after surgery influenced the outcome of the force of the knee flexion at 1 year after surgery. In sub-analysis, muscular strength of the knee extension and flexion was greater in the STG group than in the BTB group at 6months after surgery although there was no difference between muscular strength of the knee extension in the STG group and that in BTB group at 1 year. Recovery of knee extension strength at a year after ACL reconstruction was significantly associated with preoperative muscular strength and muscle recovery at 6months. Age and graft type might be related to the muscle strength recovery. Preoperative and early postoperative strength training could improve the recovery of knee extension strength, which would support an earlier return to sports after ACL reconstruction.

The implementation of laser biostimulation at the early treatment stage of facial nerve palsy in children

Introduction: Peripheral-type facial nerve palsy (FNP) is called "Bell's paralysis". This is the most common type of damage to the facial nerve among children. Treatment includes the use of various types of pharmacologically assisted physical treatments. Study aim: The aim of the study is to evaluate the effectiveness of laser biostimulation in the treatment of peripheral FNP as well as the speed and sequence at which the disease symptoms subside. In addition, the relationship between the progress in physiotherapy and the patient's age were determined. Material and methods: The study included 50 patients (27 girls and 23 boys) aged 6 to 18 with FNP symptoms. Left-sided paralysis was noted in 22 of them, and right-sided in 28. All of the subjects included in the study were divided into two equal groups. In group A, treat-ment with the use of magnetic fields and electrostimulation was applied, while in group B, laser biostimulation was additionally applied. The speed and sequence of regression of symp-toms and the recovery of muscular strength were assessed. Results: In group A, in 17 of the treated children, symptoms subsided after 3 weeks. In group B, symptom relief occurred in 18 of them after 2 weeks. Due to one of the symptoms main-taining, although the symptom was not intense, 8 patients from group B continued ambulatory treatment, while 14 continued from group A. Conclusions: The early application of laser biostimulation in FNP patients leads to the rapid regression of symptoms and shortens the time of hospital treatment. Not fully shutting the eye and Bell’s symptoms were the quickest to subside. The age of the child with FNP does not affect the duration of treatment.

Bilateral Simultaneous Rupture of the Quadriceps Tendon in a Healthy Elderly Woman: A Case Report

Background: Quadriceps tendon ruptures are uncommon injury that affects middle-aged women, predominantly it affects middle aged men. However, the bilateral quadriceps tendon rupture is extremely rare in the absence of systemic disease. Subjects and Method: We reported a case of bilateral quadriceps tendon rupture in a healthy 65 year old female. She felt pain in both knees since 4 months before entering the hospital. Local physical examination on both knees reveal the loss of normal contour of rectus femoris, tenderness at superior pole patella the ruptur site, and palpable defect within 2 cm of superior pole patella. Patient unable to extend knee against resistance, and unable to perform straight leg raise. The patient was carried out a surgical repair with consent. Results: After the surgery both knees were immobilized with knee extension splint for 6 weeks. Patient evaluation revealed no pain and progressive recovery of muscular strength after four months and could be able to walk and returned to normal activity. Conclusion: Surgery is needed to repair quadriceps rupture. Keywords : Quadriceps tendon, quadriceps rupture, repair tendon. Correspondence: Pamudji Utomo. Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: utomodr@yahoo.com. Indonesian Journal of Medicine (2019), 4(1): 54-58 https://doi.org/10.26911/theijmed.2019.04.01.09