Short Period Of Immobilization Research Articles

The therapeutic potential of red beetroot (Beta vulgaris L.) intake on muscle atrophy in immobilized mouse skeletal muscles

AbstractSkeletal muscle atrophy is the reduction in muscle mass and function caused by an imbalance in protein synthesis and degradation. Inflammation has been shown to accelerate protein degradation during periods of muscle inactivity. We investigated the potential therapeutic effects of beetroot extract (BRE) in reducing inflammation and oxidative stress to prevent muscular atrophy after a short period of immobilization. We divided 36 male BALB/c mice into three groups: control, muscular atrophy mice, and muscular atrophy mice treated with BRE (n = 12). Each group was further divided into two subgroups: (1) 7‐day immobilization and (2) 10‐day recovery. BRE was administered orally at a dose of 300 mg/kg for 17 days. We assessed the anti‐inflammatory and antioxidative effects of BRE using ELISA and RT‐PCR assays. Hematoxylin–eosin staining was used to measure the cross‐sectional area (CSA) of muscle fibers, and grip strength tests were performed to assess muscle strength. BRE administration increased muscle weight, CSA, and grip strength in mice with immobilization‐induced muscle atrophy. It also suppressed inflammation and oxidative stress biomarkers in atrophic muscle fibers. Higher nitrate levels and lower Troponin I (TnI) concentrations were observed in the BRE‐treated group, indicating improved muscle function and structure. These findings suggest that BRE may have therapeutic benefits in improving muscle mass and function and warrant further studies in humans, particularly in individuals with low physical activity levels.

Surgical Intervention of a Fibular Stress Fracture in a Male Basketball Player: A Case Report

This is a case of a 21-year-old male, African American Division I basketball player with a fibula stress fracture. The athlete initially reported pain, without distinct injury and was diagnosed with a stress fracture. After a short period of immobilization in a walking boot, this individual opted to undergo surgical intervention consisting of an intramedullary screw inserted in his left fibula. This was in consultation with the orthopedic team physician and orthopedic trauma surgeon. After a brief period of rest and continued immobilization in a walking boot, weight bearing as tolerated, the patient was able to start rehabilitation. He continued rehabilitation and progressive return to activity and was able to return to limited practice approximately 4 weeks. He played 13 min of a game in under 5 weeks (31 days). Stress fractures are not uncommon in basketball players, but a fibula stress fracture is one not often seen, and there is a paucity of data in the literature regarding this injury. A nonoperative approach to treatment of a fibula stress fracture typically yields good results but may lead to longer return than a surgical intervention. Providing athletes options for treatment may result in a quicker recovery. This case demonstrates a novel treatment option resulting in a quicker return to play.

The Natural History of Non-operatively Treated Traumatic Triangular Fibrocartilage Complex Tears: A Systematic Review

Abstract Purpose Operative treatment of triangular fibrocartilage complex (TFCC) tears has been well researched; however, data regarding nonoperative management is mixed and scarce. Our review aimed to utilize available data to formulate conclusions regarding treatment algorithms for this heterogeneous injury group. Methods A thorough literature review was performed in Medline (OVID), Embase, Cochrane Library, and PubMed databases with search terms including “triangular fibrocartilage complex” and variations on the full term including “triangular fibrocartilage” or “TFCC,” alongside “non-operative” and “conservative.” Results were then subject to inclusion criteria, ultimately identifying eight studies. Results The studies involved a total of 425 patients and 427 wrists for analysis. The mean age ranged from 30.7 years to 60.4 years. 53.6% of patients were male. The mean follow-up ranged from 12 months to 7 years, with an overall mean follow-up period of 27 months. Primary endpoints focused on various functional outcome scores, range of motion, grip strength, and pain. The nonoperative management of TFCC tears resulted in noninferior and comparable outcomes to operative management. Conclusion Our review identified that the nonoperative management of Palmer-type IB tears with a short period of above-elbow immobilization was an effective treatment option with good functional outcome scores. The nonoperative management of general TFCC tears resulted in comparable functional outcomes when viewed alongside results from other systematic reviews. Risk factors for developing a poor functional outcome or requiring operative management included distal radioulnar joint subluxation, short-arm immobilization, and full tears of the foveal attachment. However, further randomized controlled trials with homogenous data collection are required to make further conclusions regarding the management of this condition.

Immobilizing Second-Instar Drosophila Larvae for Imaging and Surgery Using the Larva Chip.

The simple body plan and semitranslucent cuticle of the Drosophila larva allow for imaging of structures close to the body wall within intact animals. These include sensory neurons, muscles, neuromuscular junctions, and some regions of the segmental nerve. However, imaging within an intact larva requires a strategy to immobilize the animal in a position that presents the structures within the working distance of the microscope objective. Although various methods have been implemented for Drosophila larvae, this protocol describes a simple and noninvasive method that makes use of the polydimethylsiloxane (PDMS) larva chip. This larva chip immobilizes animals without the use of anesthetics or changes in temperature, which alter neuronal physiology, making it suitable for calcium imaging of endogenous activity in live animals. The membrane is air-permeable. Animals robustly survive short periods of immobilization (up to 30 min) and can even survive longer time periods. Since animals recover well after the procedure, the same animal can be reimaged multiple times. This makes the method amenable to manipulations such as laser microsurgery, photobleaching, and photoconversion followed by imaging of outcomes of these manipulations over time.

Short Versus Regular Periods of Cast Immobilization for Distal Radial Fractures: A Systematic Review and Meta-Analysis.

The current research on the recommended durations for cast immobilization in adults with distal radial fractures (DRFs) lacks a clear consensus or definitive conclusion. The standard practice involves casting immobilization for five to six weeks. The debate revolves around the potential benefits of shorter periods (three to four weeks) without compromising patient outcomes. While previous research has delved into this subject through systematic reviews, our study stands out by conducting a meta-analysis, aiming for a more precise understanding of whether short or regular cast immobilization duration proves more effective for treating DRFs. A systematic search was conducted across PubMed, Embase, and the Cochrane Library databases to identify relevant studies. The focus was on comparing the outcomes of DRFs between short (three to four weeks) and regular (five to six weeks) periods of cast immobilization. The evaluated parameters include the shortened disabilities of the arm, shoulder, and hand questionnaire (quick (q) DASH); patient-rated wrist evaluation (PRWE); visual analog scale (VAS) score after cast removal; total complications; and the occurrence of complex regional pain syndrome (CRPS). Data synthesis employed the random-effects models, presenting the results as mean difference (MD) and weighted odds ratio (OR) with corresponding 95% confidence intervals (CI). We included three randomized controlled trials (RCTs) with 252 patients, of whom 125 (49.6%) were immobilized in a cast for three to four weeks. The average age of participants was 61.20 years, and the follow-up duration was one year. The QDASH scores were significantly lower at 12 weeks (MD -6.72; 95% CI -10.76 to -2.69; p = 0.001), six months (MD -4.46; 95% CI -7.42 to -1.50; p = 0.003), and one year (MD -4.89; 95% CI -7.45 to -2.33; p = 0.0002) in patients treated with short periods compared to those with regular periods. The PRWE scores at six months (MD -2.33; 95% CI -8.10 to 3.43; p=0.43) did not significantly differ between groups. Also, the PRWE scores were significantly lower at one year (MD -4.93; 95% CI -9.03 to -0.82; p = 0.02) in the shorter cast-immobilization-period group. There were no significant differences in VAS score after cast removal, total complications, or CRPS. The meta-analysis of RCTs on DRFs reveals that shorter periods of cast immobilization lead to better patient-reported functional outcomes (qDASH and PRWE). This suggests a potential benefit of reducing the immobilization duration for DRF patients, offering clinicians valuable insights for improved patient care and informed decision-making in clinical practice.

Injuries of the ankle ligaments

Lateral ligament injuries are the most common injuries of the ankle joint and are usually treated with early weight bearing after a short period of immobilization. If the clinical presentation is suspicious, additional injuries to the deltoid ligament complex and the syndesmosis should be considered. The indications for additional diagnostics should be generously applied. Injuries to the deltoid ligament usually occur as part of acomplex ankle injury and should also be addressed in the surgical treatment of accompanying injuries. Chronic instability in this area necessitates complex bony and soft tissue procedures. Syndesmotic injuries with insufficiency of the capsule-ligament apparatus are frequent in ankle fractures and are stabilized during fracture treatment. Isolated syndesmotic instability should also be surgically treated as chronic injuries are usually associated with poor clinical results and early osteoarthritis.

Management of de Quervain Tenosynovitis

There is a plethora of treatment options for patients with de Quervain tenosynovitis (DQT), but there are limited data on their effectiveness and no definitive management guidelines. To assess and compare the effectiveness associated with available treatment options for DQT to guide musculoskeletal practitioners and inform guidelines. Medline, Embase, PubMed, Cochrane Central, Scopus, OpenGrey.eu, and WorldCat.org were searched for published studies, and the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, The European Union Clinical Trials Register, and the ISRCTN registry were searched for unpublished and ongoing studies from inception to August 2022. All randomized clinical trials assessing the effectiveness of any intervention for the management of DQT. This study was prospectively registered on PROSPERO and conducted and reported per Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions (PRISMA-NMA) and PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science (PERSIST) guidance. The Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluations tool were used for risk of bias and certainty of evidence assessment for each outcome. Pairwise and network meta-analyses were performed for patient-reported pain using a visual analogue scale (VAS) and for function using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale. Mean differences (MD) with their 95% CIs were calculated for the pairwise meta-analyses. A total of 30 studies with 1663 patients (mean [SD] age, 46 [7] years; 80% female) were included, of which 19 studies were included in quantitative analyses. From the pairwise meta-analyses, based on evidence of moderate certainty, adding thumb spica immobilization for 3 to 4 weeks to a corticosteroid injection (CSI) was associated with statistically but not clinically significant functional benefits in the short-term (MD, 10.5 [95% CI, 6.8-14.1] points) and mid-term (MD, 9.4 [95% CI, 7.0-11.9] points). In the network meta-analysis, interventions that included ultrasonography-guided CSI ranked at the top for pain. CSI with thumb spica immobilization had the highest probability of being the most effective intervention for short- and mid-term function. This network meta-analysis found that adding a short period of thumb spica immobilization to CSI was associated with statistically but not clinically significant short- and mid-term benefits. These findings suggest that administration of CSI followed by 3 to 4 weeks immobilization should be considered as a first-line treatment for patients with DQT.

The past, present and future of the conservative treatment of distal radius fractures

The distal radius fracture is a common fracture with a prevalence of 17% on the emergency departments. The conservative treatment of distal radius fractures usually consists of three to six weeks of plaster immobilization. Several studies show that one week of plaster immobilization is safe for non- or minimally displaced distal radius fractures that do not need reduction. A shorter period of immobilization may lead to a better functional outcome, faster reintegration and participation in daily activities. Due to upcoming innovations such as three-dimensional printed splints for distal radius fractures, a patient specific splint can be produced which may offer more comfort. Furthermore, these three-dimensional printed splints are expected to be more environmental friendly in comparison with traditional plaster casts.

Stabilization of the Distal Radioulnar Joint Using the TightRope Implant: A Distal Oblique Bundle Augmentation.

Background Triangular fibrocartilage complex (TFCC) injury often results in distal radioulnar joint (DRUJ) instability. However, not all patients with a ruptured TFCC have an unstable DRUJ as in these patients a distal oblique bundle (DOB) may be present. We assumed that augmentation of the DOB leads to a more stable situation following reinsertion of the TFCC. We present the clinical results of a new surgical technique using the TightRope system as a DOB augmentation. Description of Technique All cases were treated under regional anesthesia with the TightRope implant for which a tunnel was drilled from the distal ulna through the radius along the path of the DOB. The TightRope was passed through the tunnel and secured with buttons on either side. X-rays were made during surgery to confirm correct positioning. Methods A retrospective study was performed analyzing 21 cases treated with a TightRope augmentation of the DOB. The primary outcome was measured using the patient-rated wrist evaluation (PRWE) score at least 12 months after surgery. Results Postoperatively, the DRUJ was stable in all patients. The median PRWE score was 16 for the injured side compared to zero for the uninjured side ( p -value: < 0.001). The median pronation and supination were not statistically significant when we compared the injured side to the uninjured side. The median grip strength was 31 kg for the injured side compared to 38 kg for the uninjured side ( p -value: 0.015). There were two minor postoperative complications (10%). Conclusion This technique is capable of restoring DRUJ stability with a short immobilization period resulting in good patient-related outcomes and a low complication rate.

Vicia faba Peptide Network Supplementation Does Not Differ From Milk Protein in Modulating Changes in Muscle Size During Short-Term Immobilization and Subsequent Remobilization, but Increases Muscle Protein Synthesis Rates During Remobilization in Healthy Young Men

BackgroundMuscle mass and strength decrease during short periods of immobilization and slowly recover during remobilization. Recent artificial intelligence applications have identified peptides that appear to possess anabolic properties in in vitro assays and murine models. ObjectivesThis study aimed to compare the impact of Vicia faba peptide network compared with milk protein supplementation on muscle mass and strength loss during limb immobilization and regain during remobilization. MethodsThirty young (24 ± 5 y) men were subjected to 7 d of one-legged knee immobilization followed by 14 d of ambulant recovery. Participants were randomly allocated to ingest either 10 g of the Vicia faba peptide network (NPN_1; n = 15) or an isonitrogenous control (milk protein concentrate; MPC; n = 15) twice daily throughout the study. Single-slice computed tomography scans were performed to assess quadriceps cross-sectional area (CSA). Deuterium oxide ingestion and muscle biopsy sampling were applied to measure myofibrillar protein synthesis rates. ResultsLeg immobilization decreased quadriceps CSA (primary outcome) from 81.9 ± 10.6 to 76.5 ± 9.2 cm2 and from 74.8 ± 10.6 to 71.5 ± 9.8 cm2 in the NPN_1 and MPC groups, respectively (P < 0.001). Remobilization partially recovered quadriceps CSA (77.3 ± 9.3 and 72.6 ± 10.0 cm2, respectively; P = 0.009), with no differences between the groups (P > 0.05). During immobilization, myofibrillar protein synthesis rates (secondary outcome) were lower in the immobilized leg (1.07% ± 0.24% and 1.10% ± 0.24%/d, respectively) than in the non-immobilized leg (1.55% ± 0.27% and 1.52% ± 0.20%/d, respectively; P < 0.001), with no differences between the groups (P > 0.05). During remobilization, myofibrillar protein synthesis rates in the immobilized leg were greater with NPN_1 than those with MPC (1.53% ± 0.38% vs. 1.23% ± 0.36%/d, respectively; P = 0.027). ConclusionNPN_1 supplementation does not differ from milk protein in modulating the loss of muscle size during short-term immobilization and the regain during remobilization in young men. NPN_1 supplementation does not differ from milk protein supplementation in modulating the myofibrillar protein synthesis rates during immobilization but further increases myofibrillar protein synthesis rates during remobilization.

Hystostructure Features of the Sacra-Caudal (Coccygeal) Dorsal Lateral Muscle when Modeling Posterior Arthodesis of the Ileosacral Joint

Paravertebral muscles play an important role in the development of deformities and degenerative diseases of the spine. The impact of posterior arthrodesis of the ileosacral articulation (sacrum-iliac joint) on the morphological characteristics of the m. sacrocaudalis (coccygeus) dorsalis lateralis of mongrel dogs was studied in animal experiments. Titanium cages were used, followed by stabilization with an external fixation device for 30 days. The advantages of posterior arthrodesis include a small incision, minimal blood loss, preservation of the integrity of most ligaments, and a short immobilization period. Nevertheless, when modeling arthrodesis experimentally in animals, fibrosis of the interstitial space and fatty infiltration in the adjacent muscle were revealed at the end of the experiment, which amounted to 240% and 310% of the intact parameters, respectively. In addition, fibrosis of the vessel membranes of the arterial link was observed. When performing surgical interventions on the spine, traumatization of the muscles should be reduced in order to minimize fibrogenesis and fatty involution of the paravertebral muscles.

SUBTALAR DISLOCATION OF LATERAL VARIETY WITH OR WITHOUT ASSOCIATED INJURIES OF FOOT -A CASE SERIES.

Introduction- Of all the injuries encountered around foot and ankle joint, subtalar dislocations are of rare occurrence. Most common mode of dislocation is high energy trauma( fall from height, road trafc accident and sports injuries). We conducted a prospective study from 1st MethodsJanuary 2017- 31st December 2020 including four patients ( 3 males and one female) with closed lateral subtalar dislocations with (one) or without fractures (three). In our study, closed reduction was performed in all cases. At  Results- nal follow-up functional score was evaluated using AOFAS-AHFS score and radiological assessment.All four patients had good functional outcome at nal follow-up and none of them had difculty in daily routine activities. Closed lateral subtalar dislocations are pure Conclusion- ly ligamentous injuries and has good functional outcome if managed properly( short period of immobilization followed by early mobilization).

Ankle instability and intra-articular injuries in children

Ankle instability is a common problem in children and adolescents. What may seem like an initial, relatively benign ankle injury for a child may lead to chronic pain, chronic instability and gradual loss of the ability to participate in certain activities. The complications of an ankle injury can include osteochondral defects, which may require urgent surgical attention and may be associated with an increased long-term risk of osteoarthritis. This article aims to provide trainees and general orthopaedic surgeons with a systematic approach to the assessment, diagnosis and management of ankle instability in the paediatric population. We explore the mechanisms of the initial injury together with factors that may increase the risk of injury to the child. Guidance on clinical examination and of the ankle joint is provided. Though short periods of immobilization and proprioceptive activities are the mainstay of treatment, there is a small subset of these patients who will benefit from further imaging and surgical intervention to prevent the chronic sequelae of ankle instability.

The Effects of Early Range of Motion Versus Immobilization Following Acute First-Time Lateral Patellar Instability Episode: Randomized Control Trial

Background:The acute management of lateral patellar dislocations (LPD) typically consists of placing the patient in a knee immobilizer for 2 to 6 weeks, but it is not clear on how long these patients should be immobilized, if at all.Hypothesis/Purpose:The purpose of this study is to compare outcomes for patients following a rehabilitation protocol that is initiated with or without a short period of immobilization after sustaining a LPD.Methods:An IRB-approved prospective study was performed at a children’s hospital which included patients <18 years of age (mean = 14.22) diagnosed with LPD (<10 days). A total of 18 (14 females, 4 males) patients diagnosed with LPD were consented and enrolled in the study (Early ROM group = 11, Immobilization group = 7). Inclusion criteria for the study was history of knee instability, effusion or history of effusion, and (+) apprehension. Subjects were followed for 4 weeks and the following outcomes were assessed: knee ROM, isokinetic strength, Kujala, Pedi-IKDC, and Y balance scores. Split-plot (2x2) ANOVAs were conducted for each of the dependent variables with an alpha level set at .05 for the global tests and independent t-tests were run at baseline and 4 weeks.Results:There were no significant differences between groups at baseline. Knee flexion ROM showed a significant main effect of time (p≤.0005) and group (p=.012). Pedi-IKDC showed a significant main effect of time (p≤.0005) and group (p=.026). When comparing groups at 4 weeks, the early ROM group had significantly better scores in both the Kujala (means for both groups: 76.78 and 52.67), p=.049)), and the Pedi-IKDC (means for both groups: 68.85 and 40.88), p=.025)). There were no significant differences in isokinetic strength measures between the groups except for affected side knee flexion at 60 degrees/sec (p=.039) with the early ROM demonstrating higher strength. In addition, the affected side composite Y-balance scores were significantly better for the early ROM group (as compared to the immobilization group) at p=.031.Conclusion:Patients that underwent early ROM following LPD scored significantly better across patient derived outcome measures and functional outcomes at 4 weeks following the initial physical therapy evaluation when compared to a group that underwent a 2 week period of immobilization. Future studies should analyze longer term comparisons between groups to determine if this short term difference leads to long term differences or improved re-injury rates.

Rotura bilateral do tendão rotuliano (clínica case)

Simultaneous bilateral rupture of the patellar tendon is a rare entity. In this paper we describe the case of a bilateral rupture of the patellar tendon because of an indirect trauma to both knees. He was a healthy individual with no important identifiable risk factors. Surgical treatment consisted of tendon reinsertion through longitudinal bone tunnels in the patella, temporarily protected with discharge cerclage in the form of a tension band. He maintained a short period of immobilization with articulated knee braces, with a progressive increase in the allowed flexion. Ten weeks after the operation, the discharge cerclage was removed. The return to sports activity was allowed six months after surgery. In this work, we also make a brief review of the etiopathogenic factors identified in the literature.

Short term clinical and radiological results of volar locking plating in volar barton fractures

Introduction: Volar Barton's fracture is fracture-dislocation of radiocarpal joint with the intra-articular fracture involving the volar lip. Open reduction and internal fixation is the preferred method as this allows reduction under direct vision, stable internal fixation, shorter period of immobilization, and fast return of function. Materials and Methods: The study consisted a total of 20 patients who were operated in the Department of Orthopaedics, Government Medical College Srinagar during the period of 2019-2021. All the patients were managed by volar locking plating. Inclusion criteria were: age 18-60 years, both sexes, patient consenting for surgery and patients fit for anaesthesia. Exclusion Criteria were: associated factures of ipsilateral limb, delayed presentation more than 2 weeks, pathological fractures and open fractures. Results: Mean age of our patients was 27.3 years. The average palmar flexion was 72.5 degrees and the average dorsiflexion was 80.4 degrees. The mean supination was 82 degree and mean pronation at final follow up was 78 degrees. In the present study, the average radial inclination at final follow up was 17 degrees. All the 20 patients in this study had less than 5 mm radial shortening. Average palmar tilt at final follow up was around 7.5 degrees. 75% of the patient had excellent outcome based on Gartland and Werley score. Conclusion: Anatomical reduction of volar barton fractures is important to achieve good procedural outcomes. Volar locking plates have shown promising results in volar barton fractures.

The Toddler's Fracture.

The tibial toddler's fracture is an important diagnosis in both emergency and urgent care, presenting as acute onset lower extremity pain or limping in a young child. Diagnosis and management may be challenging because of an extensive differential diagnosis. The objectives of this study were to provide an overview of the toddler's fracture and to guide clinicians by summarizing up to date literature for both diagnosis and management this common condition. This study analyzed literature from the PubMed database from the years of 1964 to 2018. The main focus was on the diagnosis and management of the toddler's fracture. This review demonstrates that diagnosis is primarily made through history and physical examination, as radiographs are often negative at initial presentation. Treatment involves a short period of immobilization, which can be facilitated through the use of a cast, a splint, or no external support. Successful healing and a full return to normal activities and development are near universal. Although a stable fracture with an excellent prognosis, opportunities exist to improve toddler's fractures diagnosis and treatment protocols, to optimize clinical management.

How Long Should We Immobilize the Shoulder in Patients with Proximal Humeral Fractures

A short period of shoulder immobilization is standard practice for patients with proximal humeral fractures that don't require surgery, but the optimal

Isolated Closed Medial Subtalar Dislocation Without Ankle Fracture: A Rare Case Report

Subtalar dislocation is an unusual clinical case with very little mention in literature constituting nearly 1% of all traumatic dislocations. Here a 40 year old male who sustained fall over inverted foot was diagnosed as closed isolated medial subtalar dislocation with no associated fractures. This is an even more rare entity. Immediate closed reduction was done and immobilised for 4 weeks with below knee cast. This case report describes the mechanism of injury, ligaments involved, manoeuvre of closed reduction. This case report highlights the importance of prompt and urgent reduction and short period of immobilisation to avoid complications and better prognosis. Keywords: Subtalar dislocation, Basketball foot, Isolated, Medial, Arthritis.

Effects of resistance training at different intensities of load on cross-education of muscle strength.

The objectives of this study were to 1) compare the extent of cross-transfer of muscle strength of high- versus low-load unilateral resistance training performed with external pacing of the movement (URTEP) and 2) compare the time course of the 2 approaches. Fifty subjects were randomized to 1 of the following 3 groups: G80 [2 sets at 80% and 2 sets at 40% of 1 repetition maximum (1RM), 1 concentric second and 3 eccentric seconds controlled by a metronome]; G40 (4 sets at 40% of 1RM, 1s and 3s controlled by a metronome); or control group. At week 1, the G80 increased the elbow flexion 1RM (P< 0.05) in contralateral arm. At week 4, both G80 and G40 increased the elbow flexion 1RM (P< 0.05) in contralateral arm. However, a greater 1RM gain was observed in the G80 than in the G40 (P< 0.05). Thus, although higher-load URTEP seems to enhance the cross-education effect when compared with lower-load URTEP, the cross-education of dynamic strength can be achieved in the 2 approaches after 4 weeks. Many patients would benefit from cross-education of muscle strength through URPEP, even those who are unable to exercise with high loads and in short periods of immobilization. Novelty: Unilateral resistance training promotes cross-education of dynamic muscle strength. However, higher-load resistance training enhances the effects of cross-education of muscle strength.