Muscles Of Upper Limb Research Articles

Association of Physical Fitness with Leisure Time Physical Activity in Individuals with Spinal Cord Injury

Abstract Background: Physical fitness of persons with spinal cord injury (SCI) is related to their upper limb strength and range of motion. A change in these factors may impact their participation in physical fitness, and consequently leisure time activities. The objective of the study was to examine an association of physical fitness with leisure time physical activity (LTPA) in people with SCI. Materials and Methods: This was a cross-sectional observational study conducted among 30 male and female participants with SCI. Physical fitness and LTPA were assessed using a 6-min push test and physical activity recall assessment for people with SCI, respectively. Spearman’s Rank correlation coefficient was used to estimate the correlation between physical fitness and LTPA in persons with SCI. Results: The mean age of the participants was 33.6 ± 7.73) years. This study found a positive weak to no correlation between physical fitness and LTPA in individuals with SCI (r s = 0.1008) that was statistically nonsignificant (P > 0.596). In this study, 28 (93.33%) participants had good physical fitness, and 19 (63.33%) participants performed LTPA for 20 min or more in a day, whereas 11 (36.67%) performed less than 20 min per day. Conclusion: Though most of the participants had good physical fitness, they performed only exercise-based activities such as walking with orthosis, pushups exercises, and resistance training exercises for upper limb muscles in their leisure time. They did not participate in LTPA such as sports, gardening, swimming, and other recreational activities. Furthermore, studies can be done to understand the perception of physiotherapists and SCI individuals toward the participation of LTPAs.

Online and Face-to-Face Mat Pilates Training for Long COVID-19 Patients: A Randomized Controlled Trial on Health Outcomes

This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: online Mat Pilates training (n = 16), face-to-face Mat Pilates training (n = 15), and a control group (n = 18) without training. Mat Pilates training was conducted three times a week for 12 weeks. Fatigue, functional capacity, anthropometrics, body composition, and cardiometabolic markers were assessed before and after the interventions. Two-factor Generalized Estimating Equation analyses identified significant differences with Bonferroni post hoc testing (p < 0.05). After the intervention, only the face-to-face Mat Pilates training group had an improved total, physical and mental fatigue, trunk isometric strength, upper limb muscle endurance strength, and aerobic capacity (p < 0.05). No changes were found in fat mass, muscle mass, free fat mass, % of fat, body mass, body mass index, or waist and hip circumferences. No significant changes were observed in blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, or blood pressure (p > 0.05). Our results highlight the potential of face-to-face Mat Pilates training as an effective intervention to mitigate persistent symptoms of long COVID related to fatigue and functional capacities.

Relationship between Upper Limb Muscle Power and Shooting Velocity in Elite Male Youth Rink Hockey Players

Relationship between Upper Limb Muscle Power and Shooting Velocity in Elite Male Youth Rink Hockey Players

Corticospinal Inhibition Is Greater In Males Than Females In An Upper And Lower Limb Muscle

Corticospinal Inhibition Is Greater In Males Than Females In An Upper And Lower Limb Muscle

Role of biomarkers of inflammation and MRI technique for the early detection of cystinosis-associated myopathy

BackgroundCystinosis is an autosomal recessive lysosomal storage disorder caused by cystine crystals accumulation within lysosomes resulting in multi-organ dysfunction. Infantile nephropathic cystinosis is the most common phenotype of the disease. Cystinosis distal myopathy was first described in 1994 with a 24% prevalence in cystinosis adult patients.MethodsWe prospectively evaluated the clinical, biochemical, and radiological data of 22 nephropathic cystinosis pediatric patients from 19 unrelated families (17 males and 5 females, their ages 105.7 ± 41.5 months) recruited at the cystinosis clinic at Cairo University Children’s Hospital. Biochemical assessment included several inflammatory biomarkers, such as CRP, ESR, chitotriosidase, and galectin-3. We further performed conventional MRI for the muscles of both upper and lower limbs for potential detection of early myopathic involvement. We compared these findings with 44 CKD children as pathological controls and 22 healthy pediatric controls.ResultsClinically, no evidence of neuromuscular involvement was detected in our cystinosis pediatric cohort. Chitotriosidase was elevated significantly in cystinosis patients compared to CKD controls. Regarding MRI, morphologically, there were no significant differences between the muscles of cystinosis patients and healthy controls.ConclusionA significantly higher chitotriosidase activity in cystinosis patients seems to better represent the overall disease burden and cannot be linked to neuromuscular involvement. MRI findings in muscles of the cystinosis cohort are not striking and indicate no early changes at a younger age. Follow-up and further studies for higher age groups are required to accurately elucidate the MRI’s role in assessing cystinosis myopathy.

Efficacy of REAC Neurobiological Optimization Treatments in Post-Polio Syndrome: A Manual Muscle Testing Evaluation.

Background: This study evaluated the effectiveness of radio electric asymmetric conveyer (REAC) neurobiological optimization treatments on muscle strength (MS) in individuals with post-polio syndrome (PPS), a condition causing new muscle weakness in polio survivors. Traditional treatments focus on symptom management, whereas REAC technology uses radio electric symmetric conveyed fields to modulate neurotransmission and cellular function. Methods: This open-label study involved 17 PPS patients who maintained their existing medications. The participants underwent four REAC treatment protocols: neuro-postural optimization (NPO), neuro-psycho-physical optimization (NPPO), neuro-psycho-physical optimization-cervical brachial (NPPO-CB), and neuromuscular optimization (NMO). MS was assessed using manual muscular tests (MMT) before and after each protocol. Results: A statistical analysis via repeated measures ANOVA showed significant MS improvements, particularly in the proximal muscles of the left lower limb (LLL), distal muscles of both lower limbs (LLs), and distal muscles of the left upper limb. The LLL, the most severely affected limb at this study's start, exhibited the greatest improvement. Conclusions: These results suggest REAC treatments could enhance MS in PPS patients, potentially reorganizing motor patterns and reducing functional overload on less affected limbs.

EXPLORING FACTORS FOR PRESCRIPTION AND VALIDATION OF ACTUATED UPPER LIMB DEVICES: A CROSS-SECTIONAL SURVEY OF ALLIED HEALTH PROFESSIONALS

BACKGROUND: Actuated devices can be beneficial for individuals with upper limb muscle weakness, offering extra force and grip. Utilising this type of assistive device can facilitate daily activities, thereby enhancing independence and overall quality of life. The development of actuated assistive devices has been growing, and current literature shows promise in their clinical use. However, they are not yet medically recommended by global guidelines and councils. Studies have suggested why assistive devices have barriers to access, but actuated devices have not been a focus in these discussions. OBJECTIVE(S): To address this issue, a survey was conducted among professionals who prescribe and assess upper limb assistive devices. The survey aimed to gather their opinions and quantify the factors that might contribute to the limited use of actuated devices in the field. METHODOLOGY: A web-based cross-sectional study was designed using Qualtrics, contained 25 items and was conducted between October 2023 and January 2024. The survey was piloted, validated, and ethically approved. Results were statistically analysed, and open questions underwent thematic analysis. FINDINGS: 87 Allied Health Professionals (AHPs) contributed to the survey, with a completion rate of 69% (60/87). Survey respondents predominately worked from the USA (72%). The survey revealed that 66% of respondents felt they did not have sufficient access to assistive devices and 58% indicated that outcome measures could be improved. They also noted that actuated devices needed to better meet user-centric needs. Barriers to prescribing these devices included a lack of awareness, experience and standardised prescription methods. In addition, the limited time with patients made decision-making and validation of an actuated device difficult. CONCLUSION: AHP’s have experience prescribing assistive devices but do not have access, knowledge, or clinical methods to assess the use of actuated devices. Future designs for actuated devices should focus on wearability, comfort, user satisfaction, safety and ease of use. Layman's Abstract Powered support devices can be helpful for persons with muscle weakness in their arms. These devices can provide support by giving additional strength to the hands. This helps with everyday tasks such as self-care, which in turn also improves quality of life. The development of powered and motorized assistive devices has been growing and current research shows promise in their clinical use. Yet they are not medically recommended by global guidelines and councils. Studies have suggested why all assistive devices have barriers to access, but powered devices have not been a focus in these discussions. This study aims to explore which devices medical professionals use, their opinions on them and how they test them using outcome measures. The survey included 25 questions which were assessed by external researchers and clinicians. The survey was also ethically approved. Overall, 60 people completed the survey. Occupational therapists and hand therapists responded the most and tended to be from the USA. Factors such as lack of awareness, access, and prescription methods were described as barriers to providing powered devices. In addition, the design of the device, function and relevance were concerns. 58% of respondents voted that outcome measures could also be improved. Therefore, prescribers and assessors of assistive devices do not have access to and awareness of current powered devices. Results also showed the function of these devices did not match respondents' opinions on the wearer's needs. The priority should be to make devices that are comfortable and easy to use. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/43790/33062 How To Cite: Galbert A, Buis A. Exploring factors for prescription and validation of actuated upper limb devices: A cross-sectional survey of allied health professionals. Canadian Prosthetics & Orthotics Journal. 2024; Volume 7, Issue 1, No.4. https://doi.org/10.33137/cpoj.v7i1.43790 Corresponding Author: Professor Arjan Buis, PhDDepartment of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, Scotland.E-Mail: arjan.buis@strath.ac.ukORCID ID: https://orcid.org/0000-0003-3947-293X

Unsupervised, piecewise linear decoding enables an accurate prediction of muscle activity in a multi-task brain computer interface.

Creating an intracortical brain-computer interface (iBCI) capable of seamless transitions between tasks and contexts would greatly enhance user experience. However, the nonlinearity in neural activity presents challenges to computing a global iBCI decoder. We aimed to develop a method that differs from a globally optimized decoder to address this issue. We devised an unsupervised approach that relies on the structure of a low-dimensional neural manifold to implement a piecewise linear decoder. We created a distinctive dataset in which monkeys performed a diverse set of tasks, some trained, others innate, while we recorded neural signals from the motor cortex (M1) and electromyographs (EMGs) from upper limb muscles. We used both linear and nonlinear dimensionality reduction techniques to discover neural manifolds and applied unsupervised algorithms to identify clusters within those spaces. Finally, we fit a linear decoder of EMG for each cluster. A specific decoder was activated corresponding to the cluster each new neural data point belonged to. We found clusters in the neural manifolds corresponding with the different tasks or task sub-phases. The performance of piecewise decoding improved as the number of clusters increased and plateaued gradually. With only two clusters it already outperformed a global linear decoder, and unexpectedly, it outperformed even a global recurrent neural network (RNN) decoder with 10-12 clusters. This study introduced a computationally lightweight solution for creating iBCI decoders that can function effectively across a broad range of tasks. EMG decoding is particularly challenging, as muscle activity is used, under varying contexts, to control interaction forces and limb stiffness, as well as motion. The results suggest that a piecewise linear decoder can provide a good approximation to the nonlinearity between neural activity and motor outputs, a result of our increased understanding of the structure of neural manifolds in motor cortex.

Analysis of the Laboratory and In-Competition Characteristics of Adolescent Motocross (MX) Riders: An In Situ Case Study

Motocross is one of the most popular high-speed motorcycle races, which takes place on a naturally closed track with significant challenges. This study aimed to characterize anthropometric, circulatory, and lower and upper limb muscle properties based on laboratory and race-recorded characteristics. Male competitors (n = 3) aged 14 years (MX) were included in the study. All three boys have national and international experience. Metabolic characteristics (ventilation, oxygen consumption, and carbon dioxide production) and heart rate (HR) were measured in the laboratory while HR and speed were measured while racing. No significant difference was found between the three competitors in terms of HR during the race. In terms of number of sprints (No. sprint) and maximum speed (Speedmax), we found the most successful runner (highest finisher) to have the most sprints and maximum speed. Comparing the metabolic characteristics, it was found that racing was between the respiratory breakpoint (VT1) and the respiratory compensation point (RCP), but, in several cases, crossed the anaerobic threshold. While motocross riders are exposed to extreme conditions and high physical demands, in motorsport, victories depend not only on the athlete’s physical abilities but also on several factors such as driving technique, mental effort, equipment efficiency and resistance, race strategy, and team competence.

Mind the gap: treating post-surgical scar tissue in post-mastectomy patients – a randomized clinical trial

IntroductionPost-mastectomy physiotherapy typically includes massage, exercise, and stretching, but often fails to treat post-surgical scar tissue, a significant contributor to long-term disability. This study aimed to compare conventional therapy with myofascial manual therapy for treating post-surgical scar tissue in post-mastectomy patients and to determine the effectiveness of these treatments.MethodsThe study was an experimental controlled study with pre- and post-testing of two parallel groups. Forty-eight women experiencing shoulder and/or upper torso impairment following mastectomy were randomly allocated to either a control group (<i>n</i> = 21) or a myofascial therapy group (<i>n</i> = 27). Conventional physiotherapy involving exercise and massage or myofascial therapy was used. Pre- and post-therapy measurements included muscle length, pain intensity, range of motion (ROM), and scar mobility.ResultsMyofascial therapy was superior to conventional physiotherapy in reducing the percentage of patients with below-normal muscle lengths at several sites. Significant decreases from baseline were observed in the treatment group for the pars clavicularis, descending trapezius, pars sternocostalis, latissimus dorsi, and levator scapulae muscles. Myofascial therapy also improved mobility in the scar area, with increases of 3 mm relative to the xiphoid process and 4 mm relative to the coracoid.ConclusionsOur study indicates that myofascial interventions improve upper limb ROM and muscle elasticity in the upper limb girdle of post-mastectomy patients. These findings provide empirical evidence supporting the benefits of myofascial intervention over conventional physiotherapy in the treatment of post-surgical scar tissue in this patient group.

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.

Muscle synergies in upper limb stroke rehabilitation: a scoping review.

Upper limb impairment is a common consequence of stroke, significantly affecting the quality of life and independence of survivors. This scoping review assesses the emerging field of muscle synergy analysis in enhancing upper limb rehabilitation, focusing on the comparison of various methodologies and their outcomes. It aims to standardize these approaches to improve the effectiveness of rehabilitation interventions and drive future research in the domain. Studies included in this scoping review focused on the analysis of muscle synergies during longitudinal rehabilitation of stroke survivors' upper limbs. A systematic literature search was conducted using PubMed, Scopus, and Web of Science databases, until September 2023, and was guided by the PRISMA for scoping review framework. Fourteen studies involving a total of 247 stroke patients were reviewed, featuring varied patient populations and rehabilitative interventions. Protocols differed among studies, with some utilizing robotic assistance and others relying on traditional therapy methods. Muscle synergy extraction was predominantly conducted using Non-Negative Matrix Factorization from electromyography data, focusing on key upper limb muscles essential for shoulder, elbow, and wrist rehabilitation. A notable observation across the studies was the heterogeneity in findings, particularly in the changes observed in the number, weightings, and temporal coefficients of muscle synergies. The studies indicated varied and complex relationships between muscle synergy variations and clinical outcomes. This diversity underscored the complexity involved in interpreting muscle coordination in the stroke population. The variability in results was also influenced by differing methodologies in muscle synergy analysis, highlighting a need for more standardized approaches to improve future research comparability and consistency. The synthesis of evidence presented in this scoping review highlights the promising role of muscle synergy analysis as an indicator of motor control recovery in stroke rehabilitation. By offering a comprehensive overview of the current state of research and advocating for harmonized methodological practices in future longitudinal studies, this scoping review aspires to advance the field of upper limb rehabilitation, ensuring that post-stroke interventions are both scientifically grounded and optimally beneficial for patients.

The reliability and validity of rapid transcranial magnetic stimulation mapping for muscles under active contraction

Rapid mapping is a transcranial magnetic stimulation (TMS) mapping method which can significantly reduce data collection time compared to traditional approaches. However, its validity and reliability has only been established for upper-limb muscles during resting-state activity. Here, we determined the validity and reliability of rapid mapping for non-upper limb muscles that require active contraction during TMS: the masseter and quadriceps muscles. Eleven healthy participants attended two sessions, spaced two hours apart, each involving rapid and ‘traditional’ mapping of the masseter muscle and three quadriceps muscles (rectus femoris, vastus medialis, vastus lateralis). Map parameters included map volume, map area and centre of gravity (CoG) in the medial-lateral and anterior-posterior directions. Low to moderate measurement errors (%SEMeas = 10–32) were observed across muscles. Relative reliability varied from good-to-excellent (ICC = 0.63–0.99) for map volume, poor-to-excellent (ICC = 0.11–0.86) for map area, and fair-to-excellent for CoG (ICC = 0.25–0.8) across muscles. There was Bayesian evidence of equivalence (BF’s > 3) in most map outcomes between rapid and traditional maps across all muscles, supporting the validity of the rapid mapping method. Overall, rapid TMS mapping produced similar estimates of map parameters to the traditional method, however the reliability results were mixed. As mapping of non-upper limb muscles is relatively challenging, rapid mapping is a promising substitute for traditional mapping, however further work is required to refine this method.

Efficacy of a Virtual Reality Rehabilitation Protocol Based on Art Therapy in Patients with Stroke: A Single-Blind Randomized Controlled Trial.

Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect. After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p = 0.001). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p < 0.01) and reduction in spasticity (Ashworth scale, p = 0.007) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R = 0.41), patient satisfaction (R = 0.60), and the perceived utility of the intervention by the therapist (R = 0.43). These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach.

Recreational beach tennis training reduces ambulatory blood pressure in adults with hypertension: a randomized clinical trial.

To determine the effect of 12 weeks of beach tennis training on 24-h ambulatory blood pressure in adults with essential hypertension. This was a randomized, single-blinded, two-arm, parallel superiority trial. Forty-two participants aged 35-65 years with a previous diagnosis of hypertension were randomized into 12 weeks of beach tennis training group (two sessions per week lasting 45-60 min) or a nonexercising control group. Ambulatory 24 h (primary outcome) and office blood pressure, heart rate at rest, cardiorespiratory fitness, and muscle strength were assessed at baseline and after the intervention period. Generalized estimating equation analyses were employed to examine the main effects of the interventions. In the beach tennis group, night-time systolic (-9 mmHg, P = 0.023), diastolic (-4 mmHg, P = 0.026), and mean arterial pressure (-7 mmHg, P = 0.023) decreased after 12 weeks of training. The office SBP/DBP (-6 mmHg, P = 0.016/-6 mmHg, P = 0.001) also decreased in the beach tennis group. Heart rate at rest decreased in the beach tennis group (-4 bpm, P = 0.012) but increased in the control group (6 bpm, P = 0.005). The lower and upper limb muscle strength increased in the beach tennis group after training. However, no such changes were observed in the control group. A 12-week recreational beach tennis training significantly reduced office and ambulatory BP among untrained adults with essential hypertension. Additionally, participation in this sport has led to improvements in physical fitness and overall cardiovascular risk profiles.This clinical trial was registered at Clinicaltrials.gov (NCT03909321).

Rapid integration of face detection and task set in visually guided reaching.

The superior colliculus (SC) has been increasingly implicated in the rapid processing of evolutionarily relevant stimuli like faces, but the behavioural relevance of such processing is unclear. The SC has also been implicated in the generation of express visuomotor responses (EVR), which are very short-latency (~80 ms) bursts of muscle activity time-locked to visual target presentation. These observations led us to investigate the influence of faces on EVRs. We recorded upper limb muscle activity from healthy participants as they reached toward targets in the presence of a distractor. In some experiments, faces were used as stimuli. Across blocks of trials, we varied the instruction as to which stimulus served as the target or distractor. Doing so allowed us to assess the impact of instruction on muscle recruitment given identical visual stimuli. We found that responses were uniquely modulated in tasks involving high-contrast faces, promoting reaches toward or away from a face depending on instruction. Follow-up experiments confirmed that the phenomenon required highly salient repeated faces and was not observed to non-facial stimuli nor to faces expressing different affects. This study extends the hypothesis that the SC mediates the EVR by demonstrating that faces impact muscle recruitment at short latencies that precede cortical activity for face perception. Our results constitute direct evidence for the behavioural relevance of face detection in the brainstem, and also implicate a role for top-down cortical pre-setting of the EVR depending on task context.

Superiority of High-Load vs. Low-Load Resistance Training in Military Cadets.

Øfsteng, SF, Hammarström, D, Knox, S, Jøsok, Ø, Helkala, K, Koll, L, Hanestadhaugen, M, Raastad, T, Rønnestad, BR, and Ellefsen, S. Superiority of high-load vs. low-load resistance training in military cadets. J Strength Cond Res 38(9): 1584-1595, 2024-Muscle strength and power are important determinants of soldiers' performance in modern warfare. Here, we compare the efficacy of 22 weeks of whole-body resistance training with high load (HL, 10 repetitions maximum/RM) and low load (LL, 30RM) for developing maximal muscle strength and power, performance, and muscle mass in moderately trained cadets (20 ± 1 year, f; n = 5, m; n = 22). Outcome measures were assessed at baseline and at week 22, in addition to a mid-intervention assessment at week 10. Twenty-two weeks of HL led to greater increases in muscle strength (upper limb, Δ 10%, 95% CI [2.8, 17.1], p = 0.01; lower limb, Δ 9.9%, CI [1.1, 18.6], p = 0.029), jump height (Δ 5.5%, CI [1.4, 9.6], p = 0.011), and upper limb lean mass (Δ 5.2%, CI [1, 9.4], p = 0.018) compared with LL. HL and LL led to similar changes in agility, muscle endurance performance, lower limb muscle mass, and cross-sectional area in m. vastus lateralis. For all variables, training-associated changes occurred primarily during the initial 10 weeks of the intervention, including the differential responses to HL and LL. In conclusion, although 22 weeks of HL led to greater increases in lower and upper limb muscle strength, power, and upper limb lean mass than LL, the 2 load conditions led to similar improvements in agility performance and lower limb muscle mass. Our results thus indicate that both loading regimes elicit multifaceted physiological improvements important for military readiness.

Effects of a tailor-made yoga program on upper limb function and sleep quality in women with breast cancer: A pilot randomized controlled trial

PurposeUpper limb dysfunction and sleep disturbance are common and serious health problems in women with breast cancer. Yoga is a mind-body intervention which is shown to improve physical and psychological health. The aim of this study is to evaluate the effectiveness of a tailor-made yoga program on upper limb function and sleep quality in women with breast cancer. MethodsA pilot randomized controlled trial (RCT) study design was used. Participants were randomly allocated to either the yoga intervention group (YG; eight weekly 60-min group-based yoga sessions) or the wait-list control group (CG). The primary outcome measures were upper limb function and sleep quality, which were assessed by the self-reported questionnaires – the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and the Pittsburgh Sleep Quality Index (PSQI), respectively. The secondary outcome measures were upper limb muscle strength and mobility, heart rate variability (HRV), anxiety and depression, fatigue, and health-related quality of life. All participants underwent assessment at four time-points (baseline, mid-intervention, post-intervention, and 1-month follow-up). The effectiveness of the intervention was tested by two-way mixed-design repeated-measures analysis of covariance. ResultsFor the primary outcomes, there was no significant between-group difference in the upper limb function. The YG demonstrated significantly shorter sleep latency and higher HRV, and less sleep disturbance than the CG at post-intervention, and 1-month follow-up, respectively. For the secondary outcomes, the YG demonstrated significantly improved shoulder muscle strength and arm symptoms compared to the CG from mid-intervention until the 1-month follow-up. ConclusionThis pilot trial revealed that the yoga program was feasible to be implemented for women with primary stage breast cancer. Although yoga was not found to be effective in improving the upper limb function, it improved sleep latency, HRV, shoulder muscle strength and arm symptoms of women with breast cancer.

Vitamin B12 status and skeletal muscle function among elderly: A literature review and pilot study on the effect of oral vitamin B12 supplementation in improving muscle function.

The objective of this study is to understand the role of vitamin B12 supplementation in improving skeletal muscle function among the elderly. A literature review in the Medline database was conducted to understand the association between vitamin B12 and muscle function in Section A. In Section B, 28 healthy elderly participants aged ≥60 years were recruited in a cross-sectional design for estimation of plasma vitamin B12 status and assessment of upper limb muscle strength Maximal voluntary contraction (MVC) and muscle quality (expressed as MVC/total muscle mass). Participants were grouped based on vitamin B12 status into vitamin B12-depleted (<148 pmol/L) and replete (≥148 pmol/L) groups. In a quasi-experimental study design, the vitamin B12-depleted group (n = 14) received daily oral vitamin B12 supplementation of 100 μg for 3 months. All the study measures were repeated post-supplementation. Vitamin B12 deficiency was identified to contribute adversely to muscle strength, quality, and physical performance among older people in the extensive literature review. The pilot intervention study showed significant improvement in MVC and muscle quality (p < 0.050) post-vitamin B12 supplementation, comparable to the vitamin B12-replete group. Vitamin B12 may have a crucial role in the maintenance of muscle function. 3-month oral vitamin B12 supplementation among subclinical vitamin B12 deficient elderly improved muscle strength and quality and reached levels similar to the vitamin B12 replete group.

Causal pathways of potential factors affecting participation level of individuals with unilateral cerebral palsy

Introduction: Although most children with unilateral cerebral palsy can achieve independent mobility levels with or without assistive devices, they remain susceptible to decreased participation. This study aimed to explore the potential factors affecting participation of children with unilateral cerebral palsy. Method: Fifty children with unilateral cerebral palsy were enrolled. The degree of spasticity in the upper limb muscles was assessed using the Modified Ashworth Scale, active range of motion of the upper limb joints was assessed using a universal goniometer, and activity performance was measured using the ABILHAND-Kids and Gross Motor Function Measure. Environmental factors and mental health were evaluated using the European Child Environment Questionnaire and Strength and Difficulties Questionnaire. The Child and Adolescent Scale of Participation was used to assess participation. Results: Path analysis showed that upper limb impairment had both direct (β = −0.41; p &lt; 0.05) and indirect (β = 0.64; p &lt; 0.001) effects on participation. Most importantly, it was found that the participation of children with unilateral cerebral palsy was notably influenced by environmental factors and mental health (β2 = −0.42; p &lt; 0.05, and β2 = −0.36; p &lt; 0.05). Conclusion: Participation of children with unilateral cerebral palsy is affected by a combination of functioning and contextual factors.