Muscles Of Upper Limb Research Articles

Predisposing factors for incomplete spontaneous recovery after Parsonage-Turner Syndrome.

Parsonage-Turner Syndrome (PTS) is a rare idiopathic brachial neuritis that classically presents with sudden onset upper extremity pain followed by upper limb weakness, sensory disruption, and muscle atrophy. We hypothesized that the type of antecedent event before symptom onset would determine the degree of spontaneous recovery after PTS. We retrospectively reviewed all patients who presented with PTS to a single tertiary referral center from January 2002 to December 2021. Each medical record was reviewed to exclude patients with any other identifiable neurologic etiology. The primary outcome was improved muscle strength measured by a modified British Medical Research Council (mBMRC) grading system. The spontaneous recovery cohort included patients with appreciable or full recovery (mBMRC 4 and 5). In contrast, patients with little to no recovery (mBMRC 0 to 3) were included in the incomplete recovery group. Antecedent events, demographic variables, affected upper extremity region, time between symptom onset and final visit, and presence of nerve surgery were analyzed. Two-tailed T-test and Fisher exact tests were used to compare continuous and categorical variables. Multivariable logistic regression was modeled to identify variables associated with spontaneous recovery. 100 patients with 144 extremities met the inclusion criteria. The average time from symptom onset to the final clinic visit was 3.5 years. 65 extremities (57.0%) spontaneously recovered without surgical intervention, whereas 49 extremities (43.0%) incompletely recovered. The spontaneous recovery cohort was younger (mean [SD] age, 47.4 [18.1] vs. 56.5 [18.7]; p = 0.02) and had fewer bilateral cases (count[%], 4 [6.5%] vs. 10 [26.3%]; p = 0.008). Multivariable logistic regression revealed that each year of increased age was associated with a 3% decreased chance of spontaneous recovery (OR[95%CI] 0.97[0.95, 0.99], p = 0.046). Bilateral involvement was associated with 93% decreased chance of recovery (OR[95%CI] 0.07[0.01, 0.39], p = 0.002), each additional muscle affected was associated with 10% decreased chance of recovery (OR[95%CI] 0.90[0.83, 0.97], p = 0.01), and traumatic antecedent events were associated with increased chance of recovery (OR[95%CI] 27.3[2.59, 287.5], p = 0.006). Younger patients with unilateral symptoms and fewer muscle involvement have a greater chance of spontaneous recovery after PTS. PTS precipitated by trauma may have better spontaneous recovery than those precipitated by other causes.

Long-Term Physiological Adaptations Induced by Short-Interval High-Intensity Exercises: An RCT Comparing Active and Passive Recovery

Background: High-intensity interval training (HIIT) is one of the most debated methods involving several parameters that could be modulated, but the long-term adaptations it induces are still unclear. This investigation aimed to evaluate the efficacy of running and whole-body exercises with high-intensity (>80% heart rate) short intervals (30 s) in body composition and physical performance and compare the effects between groups with active (AR) or passive recovery (PR), both in males and females. Methods: Eighteen trained young adults (55.56% ♀) were randomly allocated to the PR (n = 9, 23.09 ± 2.56 years, 163.69 ± 9.88 cm, 68.96 ± 14.62 kg) or AR (n = 9, 22.05 ± 1.54 years, 170.61 ± 11.5 cm, 68.78 ± 12.45 kg) group. Both groups performed eight weeks of HIIT, with an equal progression, training, and volume load (TL: F = 1.55, p = 0.214; VL: F = 0.81, p = 0.505). Body fat (BF), fat-free mass (FFM), upper and lower limb fat (UFI, LFI) and muscle areas (UMA, LMA), handgrip strength (HGS), power (countermovement jump, CMJ), agility (5-0-5), and maximal oxygen consumption (V˙O2p) were tested before and after treatments. Results: The proposed HIIT reduced BF by 9.57% and increased FFM by 2.09%. Females reported better adaptations in LMA (8.34 times higher than males), while both sexes’ upper limb mass distribution was better affected by PR (♀: UFI g = 1.851, 95% CI: 0.51, 3.14; ♂: UFI g = 2.456, 95% CI: 0.336, 4.487). Concerning conditioning, the protocol increased V˙O2p by 6.47%. Females showed better adaptations in CMJ (RR = 1.8), while males showed better adaptations in agility (RR = 3.76). The interaction effects were significant for PR females (right = +6.28%; left = +9.28%) and for AR males (right = +19.21%; left = +19.04%) in HGS. Conclusions: Short-interval HIIT with different exercise recovery types may be a practical solution in training where several physiological improvements are needed. Coaches and trainers can take advantage of the versatile nature of HIIT, relying on desired movement patterns and long-term responses in both male and female individuals.

The strength of associations between ultrasound measures of upper limb muscle morphology and isometric muscle strength: An exploratory study.

Assessing upper limb muscle strength is important for understanding health outcomes, such as daily function and mortality. Ultrasound (US) is increasingly used to evaluate muscle health, but the relationship between its measures of morphology and isometric strength has not been thoroughly explored in upper limb muscles. The aim of this study was to evaluate the associations between US morphological measures and isometric strength in functionally relevant upper limb muscles in healthy adults. Twenty-four healthy volunteers (30.0 ± 10.8 years) underwent B-mode, axial US scans of the first dorsal interosseus (FDI), flexor pollicis longus (FPL), biceps brachii (BB), brachialis (BR), and triceps brachii lateral head (TB). Participants performed corresponding maximal voluntary contractions (MVC), including first digit distal phalanx flexion, second digit abduction, and elbow flexion and extension. US images were segmented to obtain maximal muscle thickness (MT) and cross-sectional area (CSA). Strong positive correlations were found between muscle strength and BB MT (r = .83; p < .001), BR CSA (r = .84; p < .001), and TB MT (r = .70; p < .001). Moderate positive correlations were found for strength and FDI CSA (r = .67; p < .001), FDI MT (r = .47; p < .05), FPL CSA (r = .54; p < .01), and FPL MT (r = .42; p < .05). No significant correlation was found between strength and BR MT (r = .16; p > .05). Our data showed moderate-to-strong associations between US muscle morphology and strength, suggesting that US is likely a good biomarker for strength. However, its use is not "one size fits all." Future investigations should continue to assess this relationship in different muscles and expand the generalizability to clinical populations.

Mazor X robot-assisted upper and lower cervical pedicle screw fixation: a case report and literature review

BackgroundManual placement of cervical pedicle screws is risky, and robot-assisted placement of atlantoaxial pedicle screws has not been reported.Case reportWe describe a 74-year-old female patient with atlantoaxial fracture and dislocation combined with spinal cord injury caused by a car accident. The left lower limb muscle strength was grade 0, the right upper limb muscle strength was grade 1, and the right lower limb muscle strength was grade 2. Loss of sensation below the clavicle level, decreased superficial sensation in the extremities, loss of deep sensation in the left lower extremity, and incontinence were observed. We successfully placed atlas pedicle screws with the assistance of the Mazor X robot. One week after the operation, radiological imaging revealed that the reduction effect was good, the placement of the pedicle screws was satisfactory, the left upper limb and left lower limb muscle strength was level 2, the right upper limb and the muscle strength of the right lower limb were grade 3, and the sensory function was partially restored. No complications related to screw placement were found at the 3-month postoperative follow-up.ConclusionsMazor X robot-assisted descending pedicle screw fixation of the atlas is feasible and safe.

Electromyographic analysis of upper limb muscles for automatic wheelchair propulsion control

Electromyographic analysis of upper limb muscles for automatic wheelchair propulsion control

Surface electromyography character of upper limb muscle after open reduction combine with ulnar osteotomy in children with neglected Monteggia fracture

ObjectiveThis study aims to investigate the surface electromyography (sEMG) characteristics of upper limb muscles in children with neglected Monteggia fracture after open reduction of radial head dislocation and ulna osteotomy and bone grafting internal fixation, and to understand the recovery of muscle activity in children after operation, provide reference for clinical rehabilitation.MethodsA retrospective analysis was conducted on sixteen children with neglected Monteggia fracture who underwent ulna osteotomy at our hospital from January 2021 to August 2022. The biceps brachii, triceps brachii, flexor carpi radialis, and extensor carpi ulnaris muscle activities were recorded during grip strength tests, flexion and extension of elbow joint while holding a 1 kg dumbbell, as well as gripping tasks. The root mean square (RMS) values of sEMG signals, co-contraction ratio, and elbow joint function scores were compared between pre- and post-operation periods as well as between the affected side and unaffected side.ResultsThe preoperative maximum grip strength, as well as the average RMS values of flexor carpi radialis and average RMS value of extensor carpi ulnaris on the affected side were significantly lower. After surgery, both the maximum RMS value of biceps brachii and maximum and average RMS value of extensor carpi ulnaris on the affected side remained lower. Prior to surgery, when performing elbow flexion and extension tests while holding a 1 kg dumbbell, both mean RMS values of biceps brachii and flexor carpi radialis on the affected side were smaller. However, after surgery, there was an increase in mean RMS values of biceps brachii on the affected side. Furthermore, postoperative elbow function scores were significantly higher than preoperative scores.ConclusionOpen reduction of radial head dislocation combined with ulna osteotomy and bone grafting can achieve good functional activities in the treatment of neglected Monteggia fractures in children. The EMG activity of the extensor carnosus ulnalis muscle on the affected side related to grip strength was low, and the desired effect was not achieved within the expected time.

Frequency-dependent effects of superimposed NMES on spinal excitability in upper and lower limb muscles

Superimposing neuromuscular electrical stimulation (NMES) on voluntary contractions has proven to be highly effective for improving muscle strength and performance. These improvements might involve specific adaptations occurring at cortical and spinal level. The effects of NMES on corticospinal activation seem to be frequency dependent and differ between upper and lower limb muscles. The aim of this study was to investigate acute responses in spinal excitability, as measured by H-reflex amplitude of flexor carpi radialis (FCR) and soleus (SOL) muscles, after NMES superimposed on voluntary contractions (NMES + ISO) at two different pulse frequencies (40 and 80 Hz). Conditions involved fifteen intermittent contractions at submaximal level. Before and after each condition, H-reflexes were elicited in FCR and SOL muscles.H-reflex amplitudes increased in FCR and SOL following both NMES + ISO at 40 and 80 Hz. The potentiation of the H-reflex was greater following the 40 Hz condition compared to 80 Hz, although no differences between muscles emerged.These findings indicated that superimposing NMES has an excitatory effect on spinal motoneurons in both upper and lower limb muscles with an overall greater response after low frequency NMES. Such facilitation could be associated to enhanced somatosensory stimuli conjunctly with higher supraspinal downward commands.

Effects of Kitchen Cooking Height on Upper Limb Muscle Activation, Posture, and Perceived Discomfort of Chinese Older and Young Women.

Inappropriate kitchen cooking height may lead to uncomfortable and muscle fatigue. This study aims to compare the effects of kitchen cooking height on upper limb muscle activation, posture, and perceived discomfort among different age groups. Fifteen older women and fifteen young Chinese women each completed three consecutive 20 s simulated cooking tasks at five different heights. Surface electromyography, motion capture, and Borg CR10 scale were used to measure muscle loading. Results showed that the main power muscles of the cooking task were the anterior deltoid, brachioradialis, and biceps brachii. The higher muscle contribution rate of biceps brachii and triceps brachii was found in the younger group compared to the older group (p < 0.05). Muscle activation of the anterior deltoid (different in 1.28-2.87%), pectoralis major (different in 1.43-1.69%), and erector spinae (different in 0.6-1.21%), as well as right shoulder abduction (different in 5.91°-7.96°), were significantly higher in older group than in young group (p < 0.05). Muscle activation of the anterior deltoid and right shoulder abduction decreased significantly with decreasing height (p < 0.05). A height of 200-250 mm below the elbow was considered a more comfortable cooking height for both age groups. This provides data to support the design of cabinet sizes.

Hirayama Disease in a Young Male: A Case Report

Hirayama disease is a rare benign neurological disease that affects the anterior horn of the spinal cord at C5 to T1, mainly at C7 and C8 due to imbalance growth between the vertebral column and the dura mater leading to microcirculatory disturbances in the anterior portion of the spinal cord due to overstretched cord, especially during flexion of the neck causing unilateral or rarely asymmetrically bilateral upper limb weakness and muscle wasting.It is a case of a 21-year-old boy presented with weaknesses in his left hand and forearm for 2 years which aggravates during cold weather and flexion of the neck. A plain x-ray of the neck and MRI of the cervical spine were conducted which show the features of Hirayama disease.

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 &gt; 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 &lt; 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 &lt; 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 &gt; 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 &amp; 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 (&lt;i&gt;n&lt;/i&gt; = 21) or a myofascial therapy group (&lt;i&gt;n&lt;/i&gt; = 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.