Reduced Muscle Power Research Articles

Comparing Sarcopenia Definitions and Muscle Power Reduction: Associations with Health Outcomes in Spanish Community-Dwelling Older Adults.

Objectives: To analyze the associations between the different operational definitions of sarcopenia published in the last decade and reduced muscle power with a set of adverse health-related outcomes, such as comorbidities, depression, polypharmacy, self-perceived health, educational attainment, socioeconomic status, falls, and hospitalizations in Spanish community-dwelling older adults. Methods: A total of 686 community-dwelling older adults (median age: 72; women: 59.2%; physically active: 84%) were included in this cross-sectional analysis (ClinicalTrials.gov: NCT05148351). Sarcopenia was assessed using the FNIH, EWGSOP2, AWGS, and SDOC algorithms. Reduced muscle power was defined as the lowest sex-specific tertile and measured during the rising phase of the sit-to-stand test using a validated mobile application. Unadjusted and adjusted logistic regressions by potential confounders were performed to identify the association between sarcopenia and reduced muscle power with health-related outcomes. Results: Sarcopenia prevalence was 3.4%, 3.8%, 12.4%, and 21.3% according to the SDOC, FNIH, EWGSOP2, and AWGS, respectively. Among these definitions, moderate and large associations with health-related outcomes were observed for EWGSOP2 and SDOC, respectively, but few associations were found for FNIH and AWGS criteria. Reduced muscle power was associated more frequently and moderately with health-related outcomes compared to sarcopenia definitions. These associations remained constant after adjusting for confounders. Conclusions: The prevalence and impact of sarcopenia varied depending on the definitions used. Among the sarcopenia definitions, the SDOC exhibited the strongest associations, while reduced muscle power was the variable most frequently associated with health-related outcomes compared to any of the four sarcopenia definitions in well-functioning and physically active community-dwelling older adults.

A CRITICAL REVIEW OF THE APPLIED ASPECT OF SHADVIDHUPAKRAMA

Different kinds of chikitsa have been recommended for disease therapy by the timeless science of life known as Ayurveda. Shadvidha upakrama is a very important chikitsa among those given. Upakrama expertise is critical in this situation. According to the Ayurvedic system, only two upakramas, bruhana (vruddhikara) and langhana (hrasakara), are primarily discussed. Specifically, santarpana and apatarpana. Satarpana is defined as an excessive intake of overly nutrient-dense food and a lack of physical activity. Apatarpaan is defined as consuming fewer, less nutrient-dense meals while engaging in more physical activity. Ayurveda has the potential to transform the current healthcare industry and create a more sustainable healthcare system in the future. Its prevention is better than cure philosophy, is to offer guidance for a healthy lifestyle that will promote general wellbeing. In Ayurveda, mandagni results in aamsanchiti, which causes santarpanjanya vyadhis like diabetes, kustha, jwar, libido, sthoulya, etc., and undernutrition results in apatarpan, which causes vyadhis like decreased physical strength, oja, varna, shukra, and reduced muscle power. Shadvidh upakrama is used to prevent and treat various diseases.

A single-set functional training program increases muscle power, improves functional fitness, and reduces pro-inflammatory cytokines in postmenopausal women: A randomized clinical trial.

Introduction: Aging can be associated with reduced muscle power, functional decline, and increased plasma concentrations of proinflammatory cytokines. Functional training (FT) can improve muscle power, functional fitness and reduce plasma cytokines. However, the functional training optimal volume required to produce these adaptations must be clarified. Our study analyzed the effects of multiple-set functional training (MSFT) and single-set functional training (SSFT) on postmenopausal women's muscle power, functional fitness, and inflammatory profile. Methods: Forty-three women were randomly allocated into three groups: multiple-set functional training (n = 16, age 64.13 ± 5.17), single-set functional training (n = 14, age 63.79 ± 4.88), and control group (CG, n = 13, age 64.62 ± 5.44). The bench press and squat exercises evaluated upper and lower limb muscle power. The following tests assessed functional fitness: putting on and taking off a T-shirt, gallon-jug shelf-transfer, standing up and walking around the house, five times sit-to-stand, and 400-m walk. Plasma cytokine (TNF-α, IL-6, and IL 10) concentrations were measured by flow cytometry. Results: Single-set functional training and multiple-set functional training increased upper and lower limbs muscle power and improved functional fitness, except for the putting on and taking off a T-shirt test. Multiple-set functional training reduced TNF-α and IL-6, while single-set functional training reduced only TNF-α. IL-10 was unaffected by exercise. Discussion: Single-set functional training and multiple-set functional training, therefore, promoted similar muscle power and functional fitness improvements over 24weeks. Multiple-set functional training was more effective than single-set functional training, reducing both TNF and IL-6, while single-set functional training only decreased TNF-α.

Hyperhomocysteinemia due to Vitamin B12 Deficiency with MTHFR Gene Mutation, an Atypical Metabolic Cause of Young Ischemic Stroke: A Case Report

Background: Vitamin B12 deficiency can impair the metabolism of homocysteine, leading to hyperhomocysteinemia that can cause thrombosis in the intracranial blood vessels resulting in a stroke. Case Presentation: A 15-year-old Muslim young boy initially presented with pallor, slurred speech, right facial weakness, and right-sided hemiplegia. On examination, he was found moderately anemic, nonicteric, and with right-sided stroke evidenced by hypertonia, reduced muscle power jerk exaggerated with extensor plantar response. There was no lymphadenopathy, bony tenderness, intellectual impairment, or organomegaly, and normal vital parameters with the unremarkable cardiovascular examination. Laboratory investigations revealed pancytopenia, with reduced Vit B12, folic acid, and moderately increased homocysteine level. Bone marrow study suggestive of megaloblastic anemia. Immunological, infectious screens; and prothrombotic markers were found negative. CT scan of the head revealed a hypodense lesion in the left parieto-occipital region, DWI sequence on MRI Brain revealed diffusion restriction in the same area while an MR angiogram of the Brain revealed occlusion of the left middle cerebral artery due to thrombus sparing a small segment after its origin. In addition, he had MTHFR c677 C>T (Methyl tetrahydrofolate reductase) gene mutation and responded both clinically and biochemically after vitamin B12, folic supplementation along with aspirin in 5 months. Conclusion: Vitamin B12 deficiency along with MTHFR c677 C>T gene mutation has increased the chance of thrombotic stroke. Vitamin B12 supplementation might be beneficial for patients with an MTHFR gene mutation positive. J MEDICINE 2023; 24: 51-55

“EFFECT OF WIPPRACER TRAINING TO IMPROVE BALANCE IN STROKE PARTICIPANTS:A RANDOMIZED CONTROL TRIAL”

Background: Balance capacity was dened as maintaining, achieving, or restoring a state of balance during any posture. Stroke can be ischemic and haemorrhagic and can be acute or chronic. Mainly causes altered sensations reduced muscle power and tone, reduced joint mobility and stability, balance and gait impairment. this causes paralysis of the whole body or partial body, i.e., quadriplegia, hemiplegic, hemiparesis, paraplegia, paraparesis. increase in muscle tone is responsible for the relative failure of muscle growth and may produce functional problems. deformities of the whole body affect ambulation, bed positioning, sitting, chair level activities, transfers, and standing up. The study aims to nd out the effects of wippracer training on stroke participants for benet of participants. Methods: In a 6-week intervention study, a total of 30 participants of the middle age group were diagnosed with hemiparesis. The participants were divided into two groups; group A, who received a wippracer training with a conventional exercise program and group B received a convectional exercise program. Pre and post-treatment data were collected and analysed using SPSS 22.0. Paired t-test and unpaired t-test were used to nd out the signicance of the treatment. Results: Wippracer training can be employed along with conventional exercise programs in the effective management with stroke participants in improving functional activity and balance. A signicant improvement in balance and functional activity (p<0.05) after the treatment was found in the intervention group. Conclusion: The study concluded that wippracer training can be employed along with conventional exercise programs in the effective management of participants with stroke participants in improving functional activity and balance.

Metabolic Flexibility and Mechanical Efficiency in Women Over-60.

Purpose: Aging deteriorates metabolic flexibility (MF). Moreover, recent studies show that glycolysis is barely increased despite impoverished lipid metabolism, in addition to increased relevance of muscle power in older adults. This study aims to analyze MF, i.e., fat and carbohydrates oxidation rates (FATox and CHOox), and the point of maximal fat oxidation (MFO), in a group of active women over-60. It also aims to delve into the role of power production and mechanical efficiency regarding MF. This will help to decipher their metabolic behavior in response to increasing intensity. Methods: Twenty-nine women (66.13 ± 5.62 years) performed a submaximal graded cycling test, increasing 10 W each 3-min15-s, from 30 W to the second ventilatory threshold (VT2). Muscle power was adjusted with a Saris-H3 roller, together with a continuous gas analysis by indirect calorimetry (Cosmed K4b2). Pre and post-test blood lactate (BLa) samples were included. Frayn’s equations, MFO and CHOoxpeak (mg/min/kg FFM) were considered for MF analysis (accounting for average VO2 and VCO2 in each last 60-s), whilst delta and gross efficiencies (DE%, GE%), and exercise economy (EC), were added for Mechanical Efficiency. Mean comparisons regarding intensities 60, 80 and 100% at VT2, completed the study together with correlation analysis among the main variables. Results: MFO and CHOoxpeak were small (6.35 ± 3.59 and 72.79 ± 34.76 g/min/kgFFM respectively) for a reduced muscle power (78.21 ± 15.84 W). Notwithstanding, GE% and EC increased significantly (p < 0.01) with exercise intensity. Importantly, coefficients of variation were very large confirming heterogeneity. Whilst muscle power outcomes correlated significantly (p < 0.01) with MFO (r = 0.66) and age (r = −0.62), these latter failed to be associated. Only GE% correlated to CHOoxpeak (r = −0.61, p < 0.01) regarding mechanical efficiency. Conclusions: Despite being active, women over-60 confirmed impaired substrates switching in response to exercise, from both FAT and CHO pathways. This limits their power production affecting exercise capacity. Our data suggest that decreased power with age has a key role above age per se in this metabolic inflexibility. Vice versa, increasing power seems to protect from mitochondrial dysfunction with aging. New studies will confirm if this higher efficiency when coming close to VT2, where GE is the more informative variable, might be a protective compensatory mechanism.

“EFFECT OF MYOFASCIAL RELEASE ON SPASTIC MUSCLES AND FUNCTIONAL OUTCOME IN CHRONIC STROKE SUBJECT”- A RANDOMIZED CONTROL TRIAL

Background: Stroke is damage to the brain from interruption of blood supply causing altered sensations, reduced muscle power and tone, reduced joint mobility and stability, balance, gait impairment leading to plegia or paresis. Hemiplegia causes paralysis of one side of the body leading to inactivity, impaired movements, posture and gait pattern. Spasticity is increase in tonic stretch reexes with exaggerated tendon jerks. Myofascial release is a manipulative treatment that helps reduce fascial tension. Purpose:The aim of study was to nd out the effectiveness of Myofascial Release on spasticity of hamstrings, calf, adductors and biceps muscles in spastic hemiplegic subject. Methodology:Atotal 30 participants of middle aged group were diagnosed with chronic spastic hemiplegia. They were divided in two groups by randomized sampling, of which 15 (controlled group) and 15 (experimental group) who were treated with MFR and conventional treatment. Pre and Post treatment measures of Modied Ashworth Scale, Modied Tardieu Scale, Functional Independence Measure and Berg Balance Scale were evaluated. MFR was given to hamstrings, calf, adductors and biceps muscles for 5 days a week for 12 weeks. Result: MFR and conventional physiotherapy treatment had an excellent effect on the experimental group as compared to the controlled group. Conclusion: The current study concludes that MFR along with conventional treatment has signicant effect in reducing spasticity and improving the functional activities

Comparative Study Of Foam Rolling And Vibration Therapy On Blood Creatinine Level, Pain Sprint Speed, Lower Limb Power And Hip Range Of Motion In Delayed Onset Muscle Soreness

Muscle soreness appears after high-intensity unaccustomed exercise, especially eccentric exercise and it peaks between 24 and 72 hours post-exercise. It can result in reduced muscle power, range of motion hence impacting athletic performance. Different treatment strategies are available to alleviate symptoms of Delayed Onset Muscle Soreness (DOMS). The present study was done to draw a comparison between the effects of foam rolling and vibration therapy on pain, hip range of motion, sprint speed and lower limb power in subjects with exercise-induced muscle damage. It was a comparative Experimental Study design. The sample consisted of 30 Male students who were randomly allocated to 2 groups, i.e. Group A (Foam Rolling) and Group B (Vibration Therapy) with 15 participants in each group. Participants performed ten sets of 10 repetitions of back squats at 60% of their 1-repetition maximum, followed by either foam rolling or vibration therapy 24 and 48 hours post-DOMS protocol. Blood Creatinine level was measured before inducing DOMS(day 1) and after 24 hrs(day2) and 48 hrs(day 3) of recovery. Increase in serum levels of CK is used as an indirect marker of the microtrauma associated with DOMS. Pain, lower limb power, sprint speed and Hip range of motion were measured using Numeric Pain Rating Scale, Vertical Jump test, Sprint speed 30-meter test and goniometer respectively after 24 and 48 hours of recovery. Results showed both groups showed improvement on Day 2 and 3. However, Vibration therapy showed statistically better improvement compared to Foam Rolling group.

Effect of a Blend of Zingiber officinale Roscoe and Bixa orellana L. Herbal Supplement on the Recovery of Delayed-Onset Muscle Soreness Induced by Unaccustomed Eccentric Resistance Training: A Randomized, Triple-Blind, Placebo-Controlled Trial.

BackgroundThere is an increasing interest in the use of eccentric muscle exercise to improve physical condition, especially with regards to its health-related benefits. However, it is known that unaccustomed eccentric exercise causes muscle damage and delayed pain, commonly defined as “delayed onset muscle soreness” (DOMS). The efficacy of herbal preparations in subjects suffering from DOMS has been reported in a few previous studies with small or moderate outcome measures related to muscle recovery. The present study aimed to evaluate the effects of a polyherbal mixture containing whole Zingiber officinale Roscoe and Bixa orellana L., powders called ReWin(d), in young male athletes suffering from DOMS induced by a 1 h session of plyometric exercises.MethodsThirty-three young male athletes participated in this randomized, Triple-blind, placebo-controlled trial: 17 of them assigned to the ReWin(d) group and 16 of them to the placebo group. Creatine kinase (CK) was measured as a muscle damage marker, pain was assessed using the Visual Analog Scale (VAS), muscle performance was measured through half-squat exercise (HS) monitored with an accelerometer (Encoder), and heart rate variability (HRV) was monitored for 5 min with the subjects in the supine position. All determinations were performed before and after the eccentric session and 24, 48, and 72 h after the session.ResultsThe eccentric exercise session caused an increase in CK at 24 and 48 h after exercise intervention in both groups (p < 0.001). There was no interaction between groups regarding muscle damage. The pain increased after the training session in both groups (p < 0.001), and a significant interaction was observed between groups at 48 h after exercise (p = 0.004). Lower limb muscular power showed a significant interaction between groups 24 h after exercise (p = 0.049); the placebo group showed a reduction in muscle power compared to the ReWin(d) group. The LF/HF ratio decreased significantly at 72 h after exercise in the herbal group but not in the placebo group.ConclusionThe herbal supplement maintained the maximum power of the lower limbs and attenuated muscle pain.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT03961022.

Molecular and Cellular Aspects of Sarcopenia, Muscle Healthy Aging and Physical Conditioning in the Elderly

During aging, the skeletal muscle tissue is one of the most affected, undergoing loss of mass and function, a process defined as sarcopenia. This age-related muscle mass and function decline, dependent on many factors, predispose individuals to decreased mobility, reduced muscle power and increased risk of falls. Several factors at the cellular and molecular level affect muscle aging, synergizing with each other. At present, it is broadly accepted that Reactive Oxygen Species (ROS) play a primary role in the aging process, especially in those tissues like skeletal muscle, where the generation of free radicals is more pronounced as a consequence of the high consumption of oxygen. Recently, several studies have highlighted the involvement of muscle stem cells (satellite cells, SCs) in the progression of sarcopenia, showing a concomitant regression of activity and number of these cells. At a sub-cellular level, the main processes correlated with sarcopenia are the alteration of protein synthesis and mitochondrial dysfunction. Attempts to slow down or revert sarcopenia are essentially based on three approaches: use of supplements, pharmaceutical therapies and physical activity. In brief, it seems that appropriate physical exercise training protocols could be capable of slowing down and sometimes reversing the sarcopenic process. This finding is the consequence of a beneficial action of physical exercise on mitochondria and/or on the regenerative process led by SCs with different effects on the basis of training characteristics. Furthermore, according to a recent hypothesis, early strength training should be considered as public health advice.

PARKINSON’S DISEASE

The risk of Parkinson’s Disease (PD) increases with age as over 90% of individuals are diagnosed after the age of 50. Older individuals with PD face a compounding burden of reduced muscle power, decreased muscular endurance, and weakness related to disease specific processes such as an altered pattern of motor unit activation, rigidity and bradykinesia. Individuals with PD demonstrate a tendency towards type I fiber hypertrophy, and a greater heterogeneity for type II fibers. Despite the disease specific burden of PD, exercise results in improved mobility, balance, and movement initiation. Interventions like resistance training have resulted in strength gains, and other interventions, such as tango dancing may be particularly useful for balance improvements, as the movement involves multi-directional perturbations and whole-body coordination. Here, we will discuss the use of novel exercise interventions, such as resistance training and tango, to improve the muscle and mobility function of older adults with PD.

Impact of driving duration on hand muscle strength in people who commute for work

Background: Urbanization has brought a lot of health issues in the citizens. Commuting for work has become more common. People around the world use different means of commute like public transport or driving a car to work. The increase in time of commute may be associated with many health hazards. In this study we try to study the impact of driving duration on hand muscle power.Methods: A prospective cross sectional study was conducted in a tertiary care hospital. About 32 persons who drive car for their work participated in this study after giving their consent. Subjects grouped in to two categories long commuters, who drive for greater or equal to one hour and short commuters less than one hour. Muscle power tested on two occasions immediately after driving and four hour after driving with a help of hand grip dynamometer. Demographic details were collected. The two groups compared for muscle power and body mass index (BMI).Results: The long commuters had less muscle power in comparison with short commuters and it was significant. The average BMI of long commuters was in obesity range were as the average BMI of short commuter is less and it was statistically significant.Conclusions: Driving for greater than one hour is associated with obesity and reduced muscle power immediately after driving.

Inorganic phosphate, protons and diprotonated phosphate may contribute to the exacerbated muscle fatigue in older adults

Inorganic phosphate, protons and diprotonated phosphate may contribute to the exacerbated muscle fatigue in older adults

Positional relationship between several performance tests and physical profile of Brazilian football athletes

The purpose of this study was to investigate the association between anthropometric (height and weight) and physical parameters in Brazilian football athletes and to determine if the relationship between various anaerobic indices of running anaerobic sprint test (RAST) and physical performance are dependent upon position. The present study is an observational, randomized cross-sectional research, where thirty-eight players (24.7 ± 3.9 years) performed a series of tests that consisted of physical fitness (horizontal jump, abdominal curl, push up, 10, 20 and 30 m sprint speed), anthropometric and RAST assessments. The players were classified into three groups: skill players (n = 14), big skill players (n = 10), and linemen (n = 14). One-way ANOVA followed by Bonferroni test presented no difference between groups for anthropometric, horizontal jump, push up, T agility, 10, 20, and 30 m sprint speed tests and all anaerobic indices computed (p &gt; 0.05). However, higher abdominal curl performance was noted under skill player versus big skill player group (p = 0.045). In big skill players group, the relationship between 10, 20 and 30 m sprint speed and muscle power reduction index was great. In conclusion, the results of the current study indicated that only agility and sprint tests presented an association with the anaerobic performance for all group analyzed.

Primary progressive multiple sclerosis in a 10-year-old Nigerian boy

Multiple sclerosis (MS) is generally believed to be extremely rare in black African children, and the primary progressive form is the rarest type. We describe a case of primary progressive multiple sclerosis (PPMS) in a 10-year-old Nigerian boy and highlight the challenges of management in a resource-limited setting. He presented with 2 years history of inability to neither walk nor use the left upper limb, and a year history of progressive loss of vision. The symptoms were insidious in onset and associated with nasal and slurred speech, hesitancy, incomplete voiding, and occasional jerky movement of the lower limbs. Examination revealed a cheerful child with good memory and intelligence. There were reduced muscle power and lead-pipe rigidity in all the limbs except the right upper limb which was normal. Fundoscopy revealed bilateral optic atrophy. The diagnosis of PPMS was made by the typical clinical presentation, and brain and spinal cord magnetic resonance imaging (MRI). We had no facilities for cerebrospinal uid monoclonal IgG. This case highlights the need for pediatricians in the tropics to have a high index of suspicion and for healthcare systems to be equipped with facilities to accurately diagnose pediatric MS.

Around the concept of classification in para sport: Involvement of physical and rehabilitation medecine (close-up on athletics)

The Para-sport Movement aims to offset the restriction of sport participation by offering fair competition and rules. As such, the classification process is fundamental and unavoidable. It determines who can compete. Following the International Classification of Functioning Disability and Health, classification groups athletes with similar activity limitations in classes depending on how their impairments impact their ability to produce the core activities in each sport. Ten physical, sensory, or intellectual impairments, are recognised and minimum impairment criteria are defined. Certain diseases or health conditions are excluded. (Ehlers Danlos, conversion disorders, fibromyalgia, pain…). Physical impairments taken into consideration are reduced muscle power, reduced passive range of movement, loss of limb or limb deficiency, leg-length difference, short stature, hypertonia, ataxia or athetosis. Physicians and Physiotherapists form panels with technical experts evaluating athletes and assigning classes following a specific procedure. The medical diagnosis has to be sent prior to the competition. Then, classifiers assess the impairment and its impact on the activity in three steps, physical and technical assessments, and if needed observation during the competition. Different issues are developed in the presentation: – evidence-based classification: most valid, reliable and reproducible tests are needed to make the decisions; – ethical aspects and controversies with potential cheating called Intentional Misrepresentation. (I.M.); – specific cases of dysautonomia for high level of Spinal Cord Injuries and Maximum Allowed Standard Height for bilateral lower limbs amputees; – training to improve expertise and develop classifiers’ skills; – problems of data protection; – status (New, Confirmed, Review, Classification Not Completed…); – non-eligible and borderline cases.

Associations between muscle myotonometry (a)symmetry and functional movement performance in young women and men

Asymmetry of body parts refers to absence of symmetry and unevenly developed body parts in terms of the axis and plane. It has been long ago noticed that no perfectly correct human body exists, and bodies are to a greater or lesser extent asymmetric. A passive way of life, insufficient movement and inappropriate ergonomics of the workplace have a negative impact on the skeletal muscle system, usually resulting in reduced muscle power, static and dynamic muscle endurance, and altered muscle tone. The aim is to determine whether muscle myotonometry parameters are informative in early risk diagnostics to predict the likelihood of skeletal muscle system trauma. The study involved 382 people aged 18-24. Participants were devided into two groups: according to the accumulated composite score. Testing was made one time. The study consisted of functional movement and myotonometry evaluation. The study analyses and presents comparisons of the results depending on the trauma likelihood and sex. In addition, asymmetry of the left and the right body side is investigated. The analysis of the asymmetries (delta) in the frequency of damped oscillations of trapezius, biceps femoris, gastrocnemius (inner and outer part) on the left and right sides of the body demonstrated greater asymmetries between the left and the right sides of the body in the groups of both men and women with a lower chance of trauma. The assessment of asymmetries in femoris rectus and tibialis anterior between the left and the right sides of the body showed differences in the frequency of damped oscillations in all groups. Muscle myotonometry parameters are informative and may be used in early risk diagnostics to predict skeletal muscle system trauma. The asymmetry in tibialis muscle tone between the left and the right leg causes poorer parameters of functional movement performance in women. No associations were found to exist with the ability to perform functional movements in men. The asymmetry in femoris muscle tone between the left and right leg demonstrates the ability of young subjects to perform functional movements. It is characteristic of men and, to a lower extent, of women.

Force-velocity profiling in older adults: An adequate tool for the management of functional trajectories with aging.

The actual mechanisms leading to a reduced muscle power and functional ability in older adults are poorly understood. We investigated the association between different force-velocity (F-V) profiles and impaired muscle power, physical and cognitive function, frailty, and health-related quality of life (HRQoL) in older people. Physical function (habitual gait speed, timed up-and-go test, sit-to-stand and stair-climbing ability), cognitive function, HRQoL and frailty were evaluated in 31 older subjects (70-85 years). The F-V relationship and maximal muscle power (Pmax) were assessed in the leg press exercise. The skeletal muscle index (SMI) and fat index, moderate-to-vigorous physical activity (MVPA) and sedentary time were obtained from DXA scans and accelerometry, respectively. While some subjects showed a force deficit (FDEF), others presented a velocity deficit (VDEF), both leading to an impaired muscle power [Effect size (ES) = 1.30-1.44], and to a likely-very likely moderate harmful effect in their physical and cognitive function, HRQoL and frailty levels (except the VDEF group for cognitive function) [ES = 0.76-1.05]. Leg muscle mass and specific force were similarly associated with force at Pmax, while MVPA but not sedentary time was related to fat index, force at Pmax, and power values (all p < 0.05). A trend was found for the negative association between fat index and relative Pmax (p = 0.075). Older subjects exhibited different mechanisms (force vs. velocity deficits) leading to impaired muscle power. Both deficits were associated with a lower physical function and quality of life, and a higher frailty, whereas only a force deficit was associated with a lower cognitive function. Interventions aimed at reversing age- and/or disuse-related impairments of muscle power might evaluate the specific responsible mechanism and act accordingly.

Chiari malformation type 1 presenting as unilateral progressive foot drop: a case report and review of literature

BackgroundFoot drop is a disabling clinical condition with multiplicity of causes, which requires detailed evaluation to identify the exact aetiology. Here, we report an extremely rare cause of foot drop in a child, which if not recognized early, could lead to multiple complications.Case presentationA 6-year-old girl presented with difficulty in walking and left sided foot droop for1-month duration. On examination she had reduced muscle power in dorsiflexors and plantar flexors and diminished knee and absent ankle jerk in the left side. Sensory loss was noted in L4 and L5 dermatomes on the left side. Superficial abdominal reflex was absent on the left side while preserved in the right. Nerve conduction and electromyography revealed nerve root or spinal cord cause for the foot drop. These results prompted ordering MRI spine and brain which revealed Chiari malformation type-1 with holocord syrinx extending from the cervicomedullary junction to conus medullaris.ConclusionsThis case highlights the importance of considering broad differential diagnosis for foot drop and value of the complete neurological examination including superficial reflexes in arriving at a diagnosis. Prompt diagnosis helped to early neurosurgical referral and intervention which is an important prognostic factor.

Effect of Botulinum Toxin A on Muscle Healing and its Implications in Aesthetic and Reconstructive Surgery.

Muscle activity contributes to the enhancement of facial aging deformity, blepharospasm, cerebral palsy spasticity, trismus, torticollis, and other conditions. Myotomy of the involved muscles in order to reduce the deformity has variable success rates due to muscle healing and regeneration of activity. The goal of this study was to investigate whether blocking striated muscle activity with Botulinum toxin (BtxA) during the healing time after myotomy alters the healing process and reduces long-term muscle activity. Eighteen Sprague Dawley rats where divided into 3 groups: group A (n = 7) underwent myotomy of their Latisimus Dorsi muscle; group B (n = 7) underwent myotomy and injection of BtxA into their severed muscle; group C (n = 4) injection of BtxA only. Muscle strength was tested periodically using a grip test. Starting at week 16 and until the termination of study at week 22, group B (Myotomy + BtxA) showed significant reduction in muscle power compared to the two control groups. Addition of BtxA injection into a muscle immediately after myotomy may interfere with muscle healing and contribute to a more successful long-term result.