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INTRODUCTION: Sarcopenia is common in children after liver transplantation (LTx). Resistance training (RT) may be effective in combating sarcopenia. OBJECTIVES: The purpose of the study was to test the feasibility and impact of a 12-week RT program on skeletal muscle mass (SMM), muscle strength, physical performance (PP), and child-parent perspectives about RT. METHODS: Children (6-18 years) post-LTx and healthy controls (HC) underwent progressive RT using resistance bands. SMM and adipose tissue (MRI: abdomen and thigh), muscle strength (handgrip, push-ups, sit-to-stand), and PP (6-minute walk test [6MWT], timed-up-and-down-stair test [TUDS]) were measured before and after 12-weeks of RT. RESULTS: Ten children post-LTx (11.9 ± 3.5 years) and 13 HC (11.7 ± 3.9 years) participated. LTx children significantly increased abdominal SM-index (+4.6% LTx vs. a -2.7% HC; p = 0.01) and decreased visceral adipose tissue-index (-18% LTx vs. -0.8% HC; p = 0.04) compared to HC. No thigh SMI changes were noted. Significant increases in 6MWT distance (LTx; p = 0.04), number of push-ups (p = 0.04), and greater reduction times for TUDS (-10.6% vs. +1.7%; p = 0.05) occurred after 12 weeks. Higher thigh muscle-fat content was associated with worse physical performance. These results were impacted by adherence (≥75% vs. <75%) and family engagement. CONCLUSIONS: RT in children post-LTx is feasible and effective. RT in children post-LTx may alleviate adverse outcomes associated with sarcopenia.
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Trasplante de Hígado , Fuerza Muscular , Entrenamiento de Fuerza , Sarcopenia , Humanos , Masculino , Trasplante de Hígado/efectos adversos , Proyectos Piloto , Sarcopenia/etiología , Niño , Femenino , Adolescente , Pronóstico , Estudios de Casos y Controles , Estudios de Seguimiento , Entrenamiento de Fuerza/métodos , Músculo Esquelético/fisiopatología , Complicaciones Posoperatorias , Servicios de Atención de Salud a DomicilioRESUMEN
OBJECTIVE: Selective neurotomy has been suggested as a permanent treatment for focal spasticity. A systematic literature review was performed to investigate the efficacy of selective neurotomy regarding focal lower limb spasticity. METHODS: A systematic search in PubMed, Medline, Cochrane, and Embase databases was carried out. Studies were included if they reported on the following outcomes: muscle tone, muscle strength, pain, ankle range of motion and/or walking speed, after selective lower limb neurotomy in any type of upper motor neuron syndrome. RESULTS: A total of 25 non-randomized and/or uncontrolled studies and 1 randomized controlled study were selected. The included studies reported improvements in terms of leg muscle tone, pain, passive range of ankle motion, and walking speed. CONCLUSION: The results suggest that selective neurotomy is effective for reducing lower limb spasticity, without any negative effects on walking speed. However, this conclusion is primarily based on uncontrolled case series, whereas conclusions on clinical efficacy should preferably be based on comparison with a reference treatment through (randomized) controlled trials. Future studies should also include quantitative, validated functional assessment tools to further establish the efficacy of selective neurotomy as long-lasting treatment for patients with focal lower limb spasticity.
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Extremidad Inferior , Espasticidad Muscular , Humanos , Espasticidad Muscular/cirugía , Espasticidad Muscular/etiología , Espasticidad Muscular/fisiopatología , Extremidad Inferior/cirugía , Resultado del Tratamiento , Rango del Movimiento Articular/fisiología , Enfermedad de la Neurona Motora/cirugía , Enfermedad de la Neurona Motora/rehabilitación , Enfermedad de la Neurona Motora/fisiopatología , Fuerza Muscular/fisiologíaRESUMEN
BACKGROUND AND PURPOSE: Diabetic polyneuropathy is a long-standing microvascular complication of diabetes that affects the postural control and functional mobility of patients. There are other microvascular complications, including pulmonary complications that reduce lung function. Multifactorial Inspiratory Muscle Training (IMT) can act as a home-based technique targeted to affect both these complications. This study aims to determine the effects of IMT on respiratory and functional parameters in diabetic polyneuropathy patients. METHODS: This is a Pre-Test Post-Test Randomized Controlled Trial (NCT#04947163) with 62 diabetic polyneuropathy patients. Each was randomly assigned to the IMT or sham-IMT group. Both the groups performed OTAGO exercises , with the sham-IMT group performing IMT at 15% of baseline maximal inspiratory pressure (MIP), whereas IMT were trained at 50% of baseline MIP as an initial intensity, which was increased as per the tolerance of patients. Both groups performed training for 12 weeks. The study investigated diaphragmatic strength, pulmonary function, functional capacity through 6MWT, 30s sit to stand test and anterior trunk muscle endurance tested through sit up test as outcome variables. Data was analysed on SPSS v26 at the significance level of 0.0.5. RESULTS: The IMT group significantly improved diaphragmatic strength, pulmonary function, 6MWT and anterior trunk muscle endurance when compared to the sham-IMT group. CONCLUSION: The study concluded that home-based IMT can improve pulmonary parameters including diaphragmatic strength and lung function as well as functional parameters including functional capacity in patients with diabetic polyneuropathy. The study was registered at ClinicalTrials.gov, NCT#04947163.
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Ejercicios Respiratorios , Neuropatías Diabéticas , Fuerza Muscular , Músculos Respiratorios , Humanos , Masculino , Femenino , Neuropatías Diabéticas/rehabilitación , Neuropatías Diabéticas/fisiopatología , Persona de Mediana Edad , Fuerza Muscular/fisiología , Músculos Respiratorios/fisiopatología , Pruebas de Función Respiratoria , Diafragma/fisiopatología , Anciano , AdultoRESUMEN
Estradiol (E2) deficiency arising from menopause is closely related to changes in body composition and declines of muscle mass and strength in elderly women. Whole-body vibration training (WBV) is an emerging approach expected to improve muscle mass and strength of older person, but the underlying mechanisms remain unclear. The balance between protein synthesis and degradation is a determining factor for muscle mass and strength, which is regulated by Akt-mTOR and FoxO1 signal pathway, respectively. In the present study, we firstly determined whether the effects of WBV on muscle mass and strength in ovariectomized female mice was affected by estrogen level, then investigated whether this was associated with Akt-mTOR and FoxO1 signal pathways. We found that (1) WBV, E2 supplementation (E) and WBV combined with E2 supplementation (WBV+E) significantly increased serum estradiol content, quadriceps muscle mass and grip strength in ovariectomized mice, accompanied with alterations of body composition (reducing fat content, increasing lean body mass and lean percent), furthermore, the altered degrees of these indicators by WBV+E were greater than WBV alone; (2) WBV, E and WBV+E remarkably increased the activities of Akt and mTOR and decreased FoxO1 activity, and the changed degrees by WBV+E were greater than WBV alone; (3) Pearson correlation coefficient revealed that serum estradiol content was positively correlated with Akt and mTOR activities, while inversely associated with FoxO1 activity. We concluded that WBV could significantly increase muscle mass and strength in ovariectomized mice, which might achieve through activating Akt-mTOR and suppressing FoxO1 signal pathways, and the improving effect of WBV on muscle mass and strength was better when in the presence of estrogen.
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Estradiol , Estrógenos , Proteína Forkhead Box O1 , Fuerza Muscular , Ovariectomía , Serina-Treonina Quinasas TOR , Vibración , Animales , Femenino , Vibración/uso terapéutico , Ratones , Fuerza Muscular/fisiología , Serina-Treonina Quinasas TOR/metabolismo , Estradiol/sangre , Proteína Forkhead Box O1/metabolismo , Estrógenos/sangre , Estrógenos/metabolismo , Transducción de Señal , Composición Corporal/fisiología , Humanos , Proteínas Proto-Oncogénicas c-akt/metabolismo , Músculo Esquelético/metabolismo , Músculo Esquelético/fisiología , Condicionamiento Físico Animal/fisiología , Condicionamiento Físico Animal/métodosRESUMEN
OBJECTIVE: To establish age and gender-specific paediatric and adult reference data for muscle function parameters assessed using Jumping Mechanography in the Indian population. METHODS: 2056 healthy individuals (1068 males), aged 5 to 60 years, performed 2 tests on a force platform (Leonardo Mechanograph, Novotec). Maximum power (Pmax) was assessed by single two legged jump and maximum force (Fmax) by multiple one legged hopping. LMS method was used to generate age and gender-specific reference curves for 5 - 20y group and mean ± SD and median ± IQR are presented for 21 - 60y group. RESULTS: In 5 - 20y group, Pmax and Fmax increased with age while in 21 - 60y group, the parameters declined with age. Females had lower Pmax values than males, consistently through all age groups. In children <15y, there were no intergender differences in Fmax, however, in further age groups, females had lower Fmax (p<0.001). Our participants showed lower Pmax and Fmax when compared with machine reference data based on German population (p<0.001). CONCLUSION: We present ethnicity-specific reference values for muscle function by Jumping Mechanography. These values are intended to help in clinical assessment of muscle function of Indian population and to identify those at risk of poor muscle function.
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Músculo Esquelético , Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Adulto Joven , India , Músculo Esquelético/fisiología , Persona de Mediana Edad , Valores de Referencia , Preescolar , Fuerza Muscular/fisiología , Caracteres Sexuales , Miografía/métodosRESUMEN
OBJECTIVES: Inspiratory muscle training is used in rehabilitation to exercise respiratory muscles in various conditions associated with limited ventilatory reserve. In this review, we investigated inspiratory muscle training in lung transplant candidates and recipients. MATERIALS AND METHODS: We searched 5 primary databases from inception through April 2024. Two key word entries, "lung transplantation" and "inspiratory muscle training," were matched using the Boolean operator AND. No filters were applied for document type, age, sex, publication date, language, and subject. RESULTS AND CONCLUSIONS: The searched databases returned 119 citations. Seven articles that considered 64 patients (47% female) were included in the final analysis, with 1 study involving a pediatric patient. Lung transplant recipients used a threshold trainer at 15% to 60% of maximal inspiratory pressure and mostly exercised twice daily for 10 to 15 minutes per session. Lung transplant candidates exercised at 30% to >50% of maximal inspiratory pressure twice daily, performing 30 to 60 inspirations or for 15 minutes. The highest inspiratory muscle strength was observed in a series of adult lung transplant recipients whose mean value improved by 31.8 ± 14.6 cmH2O versus baseline after treatment. To the same extent, the highest value of maximal inspiratory pressure was detected in a pediatric patient who scored 180 cmH2O after training. Overall, participants obtained improvements in lung function (forced expiratory volume in 1 second, forced vital capacity), functional performance, dyspnea intensity, and exercise tolerance. Inspiratory muscle training is easy to perform and can be done at home without specific supervision (in adults) before or after a lung transplant. Nevertheless, additional rigorous investigations should aim to replicate the positive effects reported in the present review.
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Ejercicios Respiratorios , Trasplante de Pulmón , Pulmón , Fuerza Muscular , Recuperación de la Función , Músculos Respiratorios , Humanos , Músculos Respiratorios/fisiopatología , Femenino , Resultado del Tratamiento , Masculino , Pulmón/fisiopatología , Adulto , Niño , Persona de Mediana Edad , Adolescente , Adulto Joven , Inhalación , Factores de Tiempo , Tolerancia al Ejercicio , AncianoRESUMEN
This study examined the effects of birth weight on body composition, physical fitness, and sarcopenia in adulthood among young Japanese women. Seventy young adult women (birth weight <2500 g classified as low-birth-weight group [L-BW, n = 13] and ≥2500 g classified as not low-birth-weight group [NL-BW, n = 57]) were evaluated for body composition, physical fitness, and sarcopenia. Skeletal muscle mass was significantly greater (p<0.05) in the NL-BW group than in the L-BW group for all body sites. Effect sizes for the differences in skeletal muscle mass between the two groups were all larger in the NL-BW group than in the L-BW group (0.86-1.44). Knee extension muscle strength was higher in the NL-BW group than in the L-BW group (p = 0.04), but there were no differences between groups with respect to other physical fitness indicators (p>0.05). Except for SMI (p<0.05), other sarcopenia diagnostic evaluations did not differ between the two groups (p>0.05). In conclusion, L-BW female infants were shorter in standing height and smaller in skeletal muscle mass in terms of morphology at the time of young adulthood compared to NL-BW female infants. In addition, in terms of physical fitness, those with L-BW also had a lower-limb power score and a higher proportion of low skeletal muscle mass. Thus, it was suggested that low birth weight infants may be at risk of needing nursing care in old age (i.e., a high predicted incidence of sarcopenia) as well as thinness problems in the fertile generation.
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Peso al Nacer , Composición Corporal , Aptitud Física , Sarcopenia , Humanos , Femenino , Sarcopenia/fisiopatología , Sarcopenia/epidemiología , Sarcopenia/diagnóstico , Aptitud Física/fisiología , Japón/epidemiología , Adulto , Adulto Joven , Músculo Esquelético/fisiología , Músculo Esquelético/fisiopatología , Fuerza Muscular/fisiología , Recién Nacido , Pueblos del Este de AsiaRESUMEN
Sedentary behaviours in adults with intellectual disabilities (ID) negatively impact health-related determinants and increase the risk of physical dysfunction or chronic health issues. Inclusive sport practice can enhance social inclusion and fitness, benefiting overall person development and life quality. This study aimed to assess fitness level variation in athletes with and without ID before and after a 9-month inclusive (INC) and non-inclusive (N_INC) basketball training. 38 athletes with ID and 14 athletes without ID belonged to INC group, 38 athletes with ID belonged to N_INC group and 23 participants with ID belonged to the control group (CG). Before and after the intervention period, all participants performed anthropometric (body weight, body mass index, body fat percentage) and fitness tests (muscle strength and power, cardiovascular endurance, balance, flexibility, agility, movement speed, and coordination). ID and non-ID athletes of both INC and N_INC groups significantly improved in most of the tests (weight, balance, flexibility, muscle strength, endurance, agility, movement speed and coordination) while CG group significantly worsened weight, muscle endurance, flexibility, agility, movement speed and coordination, after the intervention (p < 0.05). These findings showed that sport training improved fitness in athletes with ID, decreasing health risks. Moreover, involving in the same training group persons with and without disabilities, does not limit the beneficial effects that training induce on persons without ID and could be a valid way to promote both social inclusion and physical health of persons with ID.
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Atletas , Discapacidad Intelectual , Aptitud Física , Humanos , Masculino , Aptitud Física/fisiología , Adulto , Femenino , Adulto Joven , Fuerza Muscular/fisiología , Baloncesto , AdolescenteRESUMEN
BACKGROUND: Total knee arthroplasty (TKA) successfully alleviates pain from knee osteoarthritis, but muscle strength and function are reduced for a long period postoperatively. Postoperative active resistance exercise may play a relevant role. PURPOSE: To systematically evaluate effects of lower-limb active resistance exercise (ARE) on mobility, physical function, muscle strength and pain intensity in patients with TKA. METHODS: A search was conducted in PubMed, EMBASE, and Cochrane Library databases from inception to September 2023. Only randomized controlled trials (RCTs) that compared the effects of ARE and no intervention or other rehabilitation program without PRE were included. The outcome variables were mobility (Maximal walking speed [MWS]/6-Minute Walk Test[6MWT]), physical function (Stair Climb Test [SCT]/Timed Up and Go [TUG]), knee extension/ flexion power(KEP/KFP), joint range of motion (ROM) and pain. Standardized Mean Differences (SMD) or Mean Differences (MD) and 95% confidence intervals (CI) were calculated and combined in meta-analyses. The Cochrane Collaboration's Handbook were used for the methodological quality assessments. GRADE was used to assess the quality of evidence. The meta-analysis was performed using the RevMan 5.4 software. RESULTS: A total of 14 randomized controlled trials, involving 880 patients, were finally included. The lower-limb ARE exhibited significantly greater improvement in MWS (MD 0.13, 95%CI 0.08-0.18, P < 0.00001), TUG(MD -0.92, 95%CI -1.55- -0.28, P = 0.005), KEP (SMD 0.58, 95%CI 0.20-0.96, P = 0.003), KFP (SMD 0.38, 95%CI 0.13-0.63, P = 0.003), ROM-flexion (MD 2.74, 95%CI 1.82-3.67, P < 0.00001) and VAS (MD - 4.65, 95% CI - 7.86- -1.44, p = 0.005) compared to conventional exercise(CE) immediately post-intervention. However, there were no statistically significant differences between both groups in regard to 6MWT (MD 7.98, 95%CI -4.60-20.56, P = 0.21), SCT (MD -0.79, 95%CI -1.69-0.10, P = 0.08) and ROM-extension (MD -0.60, 95%CI -1.23-0.03, P = 0.06). CONCLUSIONS: According to the results of meta-analysis, patients undergoing TKA who receive the lower extremity ARE show better clinical effects in terms of pain relief, strength recovery and knee ROM. Simultaneously, it may be beneficial to improve mobility and physical function of patients after TKA.
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Artroplastia de Reemplazo de Rodilla , Articulación de la Rodilla , Fuerza Muscular , Osteoartritis de la Rodilla , Rango del Movimiento Articular , Entrenamiento de Fuerza , Humanos , Artroplastia de Reemplazo de Rodilla/rehabilitación , Artroplastia de Reemplazo de Rodilla/efectos adversos , Articulación de la Rodilla/fisiopatología , Articulación de la Rodilla/cirugía , Fuerza Muscular/fisiología , Osteoartritis de la Rodilla/cirugía , Dimensión del Dolor , Dolor Postoperatorio/etiología , Dolor Postoperatorio/diagnóstico , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Entrenamiento de Fuerza/métodos , Resultado del TratamientoRESUMEN
Prematurity is associated with lower exercise capacity, which relies on the integrity of the cardiovascular, pulmonary, and skeletal muscle systems. Our animal model mimicking prematurity-associated conditions showed altered muscle composition and atrophy in adulthood. This study aimed to compare muscle composition and strength in adults born preterm versus full-term controls. This observational cohort study recruited 55 adults born preterm, ≤ 29 weeks' of gestation and 53 full-term controls who underwent musculoskeletal ultrasound imaging to assess morphology of the rectus femoris at rest and during a maximal voluntary contraction. Maximal voluntary contraction of the hands and legs were measured by manual dynamometry. In adults born preterm, there was lower muscle strength (handgrip: - 4.8 kg, 95% CI - 9.1, - 0.6; knee extensor: - 44.6 N/m, 95% CI - 63.4, - 25.8) and smaller muscle area (- 130 mm2, 95% CI - 207, - 53), which was more pronounced with a history of bronchopulmonary dysplasia. Muscle stiffness was increased in the preterm versus term group (0.4 m/s, 95% CI 0.04, 0.7). Prematurity is associated with alterations in skeletal muscle composition, area, and function in adulthood. These findings highlight the necessity to implement preventive and/or curative approaches to improve muscle development and function following preterm birth to enhance overall health in this population.
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Fuerza Muscular , Músculo Esquelético , Humanos , Femenino , Adulto , Masculino , Músculo Esquelético/fisiología , Músculo Esquelético/diagnóstico por imagen , Fuerza Muscular/fisiología , Recien Nacido Prematuro/fisiología , Recién Nacido , Nacimiento Prematuro , Fuerza de la Mano/fisiología , Ultrasonografía , Contracción Muscular/fisiología , Músculo Cuádriceps/diagnóstico por imagen , Músculo Cuádriceps/fisiología , Estudios de CohortesRESUMEN
BACKGROUND: Paraspinal muscle degeneration occurs with age; however, it is unknown whether strength and endurance change with muscle cross-sectional area (CSA) and fatty infiltration (FI) parameters in Chinese healthy individuals. METHODS: A total of 94 asymptomatic Chinese volunteers were enrolled in this study. The participants were divided into three groups: young (20-39 years old, n = 27), middle-aged (40-59 years old, n = 49), and elderly (≥ 60 years old, n = 18). CSA and FI of the psoas (PS), quadratus lumborum (QL), multifidus (MF), and erector spinae (ES) were measured using magnetic resonance imaging. The Bionix Sim3 Pro was used to evaluate the maximum isometric torque and the Ito test to evaluate endurance. RESULTS: The CSA of the PS and ES in the elderly group was smaller than those in the other groups, while the CSA of QL in the young group was larger than that in the other groups. There were differences in the MF and ES FI among the three groups. The maximum isometric torque and endurance test time decreased with increasing age; however, these differences were not statistically significant. Maximum isometric torque positively correlated with the average paraspinal muscle CSA and negatively correlated with the torque and FI of the MF and ES muscles. The endurance test was found to be positively correlated with the FCSA of the MF and to be negatively correlated with the FI of the MF and ES. PS and QL can predict the maximum isometric torque, and MF and PS can predict the endurance time. CONCLUSION: MF and ES showed earlier degeneration than PS and QL. MF is the first paraspinal muscle to undergo functional area atrophy, and it plays an important role in the endurance test. The maximum moment of equal length in all directions of the lumbar spine is not completely symmetrical, but it is correlated with the imaging parameters of the paraspinal muscles. QL and PS were more activated in the lumbar activity. TRIAL REGISTRATION: The study was registered in Chinese Clinical Trial Registry and the registration number is ChiCTR2000039073 on 15/10/2020 ( https://www.chictr.org.cn/showproj.html?proj=62785 ). Ethical Approval was obtained from the Peking University Third Hospital Medical Science Research Ethics Committee (IRB00006761-M2020305).
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Imagen por Resonancia Magnética , Músculos Paraespinales , Humanos , Músculos Paraespinales/diagnóstico por imagen , Músculos Paraespinales/fisiología , Estudios Transversales , Adulto , Masculino , Persona de Mediana Edad , Femenino , Anciano , Adulto Joven , Fuerza Muscular/fisiología , Voluntarios Sanos , Factores de Edad , Pueblo Asiatico , China , Envejecimiento/fisiología , Envejecimiento/patología , Contracción Isométrica/fisiología , Resistencia Física/fisiología , TorqueRESUMEN
OBJECTIVE: To compare the effects between telerehabilitation and in-person rehabilitation on physical function, pain and quality of life in patients with breast cancer after surgery. DESIGN: Randomized, controlled, and parallel study that involved post-surgical oncological breast surgery patients who were female and aged between 18 and 70 years. The study was conducted in an outpatient environment, and the participants were randomized using a computer system. Population was divided into 2 groups: G1 (n = 20), who received face-to-face care, and G2 (n = 24), who received telerehabilitation. Participants were followed for 15 and 45 days postoperatively. The study's primary outcomes were based on 44 patients (n = 44). Values of changes in quality of life, range of motion (ROM), muscle strength, and upper limb functionality were compared for both groups during the 15 to 45 day postoperative. RESULTS: Both groups exhibited progressive improvements in range of motion, muscle strength, functionality, and quality of life over time (15- and 45-days post-operatively [PO]), indicating a positive response to treatment. Patients in G2 demonstrated more significant improvements in range of motion and muscle strength, as well as better functionality and quality of life compared to G1, particularly after 45 days PO. Additionally, G2 exhibited a more significant reduction in fatigue after 45 days PO. CONCLUSIONS: Telerehabilitation is a viable option with good usability, and has been shown to produce results similar to in-person physiotherapy in most cases, and even superior in some. Long-term intervention studies are needed for the development of telerehabilitation.
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Neoplasias de la Mama , Calidad de Vida , Rango del Movimiento Articular , Telerrehabilitación , Humanos , Femenino , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/rehabilitación , Persona de Mediana Edad , Adulto , Rango del Movimiento Articular/fisiología , Anciano , Fuerza Muscular/fisiología , Adolescente , Adulto JovenRESUMEN
This scoping review aims to summarize the literature on photobiomodulation (PBM) therapy as an adjunct to resistance exercise among older adults, focusing on its effects on muscle metrics, functional balance, capacity, and physical performance. The participants included were older adults aged ≥ 60 years and either gender. The concept was the application of PBM and resistance exercises with no limits on the context parameters. The databases Medline, Embase, Scopus and Web of Science were searched from inception till February 2024. Methodological quality was assessed using the Cochrane risk of bias 2.0. A total of 10 studies were included in the review. PBM, along with resistance training, was reported in six studies, whereas four reported PBM with isometric fatigue protocol. PBM with a wavelength of 808 nm was given on the belly of the rectus femoris muscle in most of the studies. The common dosimetry parameters used were- power density 35.7 W/cm2, energy density 250 J/cm2, 8 sites, energy per site 7 J, duration of 70 s per site, spot size per diode of 0.028 cm2, and stationary contact of application. The application of PBM therapy alongside resistance exercise has been found to improve muscle metrics, functional capacity, and functional performance and reduce fatigability when compared with the control group in most of the studies. When incorporating PBM therapy as an adjunct to resistance training, it is crucial to consider the dosimetry parameters involved-to achieve the intended therapeutic effect. Adjusting treatment parameters with this information can optimize the effectiveness of PBM therapy and improve treatment outcomes for patients.
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Terapia por Luz de Baja Intensidad , Equilibrio Postural , Entrenamiento de Fuerza , Humanos , Terapia por Luz de Baja Intensidad/métodos , Entrenamiento de Fuerza/métodos , Anciano , Equilibrio Postural/fisiología , Músculo Esquelético/efectos de la radiación , Músculo Esquelético/fisiología , Rendimiento Físico Funcional , Fuerza Muscular/fisiología , Fuerza Muscular/efectos de la radiación , Femenino , Persona de Mediana EdadRESUMEN
BACKGROUND: To establish and validate the criterion-referenced standards of functional fitness in predicting physical independence in 80 + years. METHODS: A group of 2,749 older community dwellers (60-84 years) were recruited, and 2,050 were identified with moderate-to-high independent living ability according to the proposed minimum composite physical function score. The Senior Fitness Test battery was applied to measure functional fitness at five-year intervals. The declining rate for each fitness dimension was calculated based on the differences between any two adjacent age groups and was adjusted according to the reported degradation rate differences between the cross-sectional and longitudinal studies. RESULTS: The age-and-sex-specific criterion-referenced standards were identified for muscle strength, cardiovascular endurance, and dynamic balance that older adults should possess at 60-79 to maintain independent living abilities. Moderate to high consistency (k = 0.622-0.650) and associations (φ = 0.641-0.694) were found between the predicted physical independence by criterion-referenced standards of functional fitness and the results from the composite physical function scale. Moreover, the predicted independent living abilities in later years from the criterion-referenced standards of functional fitness showed high test-retest reliability (Pa = 0.90-0.96). CONCLUSION: The criterion-referenced standards for functional fitness are valid and reliable to predict independent living abilities in later years, and provide the threshold to identify the limitations in physical fitness and detect the risks of functional disabilities among older adults in an early stage.
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Evaluación Geriátrica , Vida Independiente , Aptitud Física , Humanos , Anciano , Masculino , Femenino , Anciano de 80 o más Años , Aptitud Física/fisiología , Persona de Mediana Edad , Vida Independiente/tendencias , Evaluación Geriátrica/métodos , Estudios Transversales , Estudios Longitudinales , Reproducibilidad de los Resultados , Fuerza Muscular/fisiologíaRESUMEN
INTRODUCTION: Cirrhosis is the main cause of morbidity and mortality globally, accounting for approximately 1.2 million deaths annually. Impaired aerobic capacity, muscle wasting and reduced muscle strength are significant complications in patients with cirrhosis. Preoperative exercise intervention "prehabilitation" has been recognised as a potential approach to optimise muscle strength, aerobic capacity and body composition as well as quality of life in patients awaiting abdominal surgery. However, there is little evidence on the effects of preoperative exercise on older adults with cirrhosis and awaiting liver transplant. Thus, the primary objective of this systematic review and meta-analysis will be to assess the effects of exercise interventions in improving aerobic capacity, muscle strength and body composition of older adults with cirrhosis and awaiting liver transplant. METHODS AND ANALYSIS: This systematic review and metaanalysis protocol was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This systematic review will include all peer-reviewed randomised controlled trials (RCTs), including cluster RCTs, controlled (non-controlled), complex clinical trials (CCTs) or cluster trials, cohort, observational studies published in English from inception until July 2024. The following electronic databases will be searched: MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO) and Scopus (Elsevier) and supplemented by a secondary screening of the reference lists of all included articles. Searches will involve studies with both male and female participants aged ≥ 18 years with cirrhosis and awaiting liver transplant. Primary outcomes will include muscle strength, and aerobic capacity. The secondary outcomes include body composition (e.g. body mass index, and thigh circumference). The Cochrane Collaboration Risk of Bias Tool will be used to evaluate quality of the studies and Review Manager (RevMan) V.5.3 (Copenhagen, Denmark: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). Effect sizes will be expressed as a standardised mean difference, and their 95% confidence intervals will be calculated and presented as a forest plot. The standard χ2 and I2 tests will be used to test heterogeneity. CONCLUSION: This systematic review and meta-analysis is anticipated to provide meaningful and contemporary evidence on the effects of preoperative exercise in older adults living with cirrhosis and awaiting liver transplant. In addition, the findings will help clinicians with developing safe and effective preoperative exercise regimens for these patients.
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Composición Corporal , Cirrosis Hepática , Trasplante de Hígado , Metaanálisis como Asunto , Fuerza Muscular , Ejercicio Preoperatorio , Revisiones Sistemáticas como Asunto , Humanos , Fuerza Muscular/fisiología , Cirrosis Hepática/complicaciones , Cirrosis Hepática/cirugía , Tolerancia al Ejercicio/fisiología , Calidad de Vida , Terapia por Ejercicio/métodosRESUMEN
The aim of this study was to compare the acute effects of compression contrast therapy (CT) and dry needling therapy (DN) on muscle tension (MT), muscle strength (Fmax), pressure pain threshold (PPT), and perfusion (PU) following fatigue of forearm muscles (e.g., flexor carpi radialis) in combat sports athletes. A single-blind randomized controlled trial was employed. Participants first underwent muscle fatigue induction, which involved sustaining an isometric handgrip at 60% of their maximum voluntary contraction in 5-second cycles. This was followed by exposure to one of the regenerative therapies. Forty-five participants were randomly assigned to one of three groups: CT/DN (n = 15), CT/ShDN (n = 15), and ShCT/DN (n = 15). The sham condition (Sh) involved a simulated version of the technique. Measurements were taken at four time points: (i) at rest; (ii) immediately after exercise that led to a state of fatigue; (iii) 5 minutes after therapy (PostTh5min); and (iv) 24 hours after therapy (PostTh24h). Each participant was exposed to one experimental condition and one control condition, thereby undergoing evaluation in two sessions. Significant differences between groups were found in MT during the PostTh5min (p = 0.005), as well as in PU during the PostTh5min (p < 0.001) and PU during the PostTh24h (p < 0.001). All groups showed significant improvements at 5 minutes post-therapy compared to immediately post-muscle fatigue. As conclusions, CT/DN seems to be significantly better for enhancing MT and PU after 5 minutes of muscle fatigue induction. Using either CT, DN, or both combined is recommended to enhance the recovery of muscle functionality and properties, favoring recovery and potentially speeding up performance enhancement.
Asunto(s)
Punción Seca , Antebrazo , Contracción Isométrica , Fatiga Muscular , Músculo Esquelético , Umbral del Dolor , Humanos , Método Simple Ciego , Fatiga Muscular/fisiología , Adulto Joven , Masculino , Músculo Esquelético/fisiología , Umbral del Dolor/fisiología , Punción Seca/métodos , Adulto , Fuerza de la Mano/fisiología , Fuerza Muscular/fisiología , Artes Marciales/fisiología , FemeninoRESUMEN
The aim of this study was to compare the effects of 8 weeks of small-sided basketball games (SSG) training using baskets (SSGbk) and ball possession games without baskets (SSGbpg) on various neuromuscular parameters in young male basketball players. Specifically, the study examined unilateral isometric knee flexor strength (KFS), unilateral isometric knee extensor strength (KES), bilateral countermovement jump peak power and peak landing force (CMJ), and leg land and hold test (LHT) peak landing force. This randomized controlled study included two experimental groups (SSGbk and SSGbpg) and one control group. Fifty regional competitive-level male youth basketball players (16.7 ± 0.5 years) were assigned to the groups. The experimental groups participated in two additional SSG weekly training sessions over 8 weeks. Both experimental groups were exposed to the same 2v2 to 4v4 formats of play and training volume, with the only difference being that one group performed ball possession games while the other participated in games targeting to score in the basket. Players were evaluated twice: once at baseline in the week prior to the intervention period, and again in the week post-intervention. The neuromuscular tests were conducted using force platforms. Significant interactions between time and groups were observed in KES (p < 0.001; η p 2 = 0.902), KFS (p < 0.001; η p 2 = 0.880), and CMJ peak power (p < 0.001; η p 2 = 0.630). Significant differences between groups were found post-intervention for the variables of KES (p = 0.017; η p 2 = 0.159), KFS (p = 0.011; η p 2 = 0.174), CMJ peak power (p = 0.017; η p 2 = 0.160), CMJ peak landing force (p = 0.020; η p 2 = 0.154), and LHT peak power (p = 0.012; η p 2 = 0.171). In conclusion, our study highlights that the SSGbk significantly increases neuromuscular adaptations in young male basketball players. Conversely, our findings do not support the efficacy of SSGbpg in targeting these specific physical fitness variables. Therefore, the use of SSGs must be carefully considered, particularly in selecting task conditions, to ensure efficacy in interventions.
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Rendimiento Atlético , Baloncesto , Fuerza Muscular , Humanos , Baloncesto/fisiología , Masculino , Adolescente , Fuerza Muscular/fisiología , Rendimiento Atlético/fisiología , Rodilla/fisiología , Acondicionamiento Físico Humano/métodos , Acondicionamiento Físico Humano/fisiología , Músculo Esquelético/fisiología , Prueba de EsfuerzoRESUMEN
Fibroblast growth factor 21 (FGF-21) has been suggested as a potential therapeutic target for insulin resistance in health-related metabolic disorders such as type 2 diabetes. Despite the metabolic effects of resistance (RT) and aerobic training (AT) on diabetes symptoms, uncertainty exists regarding the superiority of effects manifested through these training approaches on FGF-21 and biochemical and physiological variables associated with metabolic disorders in men diagnosed with type 2 diabetes. This study aimed to investigate the impact of a 12-week RT and AT on FGF-21 levels and symptoms associated with metabolic disorders in male individuals diagnosed with type 2 diabetes. Thirty-six sedentary obese diabetic men (40 to 45 years old) were matched based on the level of FGF-1. They and were randomly divided into two training groups (RT, n = 12 and AT, n = 12) performing three days per week of moderate-intensity RT or AT for 12 weeks and an inactive control group (n = 12). Both training interventions significantly improved FGF-21, glucose metabolism, lipid profile, hormonal changes, strength, and aerobic capacity. Subgroup analysis revealed that RT had greater adaptive responses (p < 0.01) in fasting blood sugar (ES = -0.52), HOMA-IR (ES = -0.87), testosterone (ES = 0.52), cortisol (ES = -0.82), FGF-21 (ES = 0.61), and maximal strength (ES = 1.19) compared to AT. Conversely, AT showed greater changes (p < 0.01) in cholesterol (ES = -0.28), triglyceride (ES = -0.64), HDL (ES = 0.46), LDL (ES = -0.73), and aerobic capacity (ES = 1.18) compared to RT. Overall, both RT and AT interventions yielded significant moderate to large ES in FGF-21 levels and enhanced the management of biochemical variables. RT is an effective method for controlling FGF-21 levels and glucose balance, as well as for inducing hormonal changes. On the other hand, AT is more suitable for improving lipid profiles in overweight men with type 2 diabetes mellitus.
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Glucemia , Diabetes Mellitus Tipo 2 , Factores de Crecimiento de Fibroblastos , Resistencia a la Insulina , Obesidad , Entrenamiento de Fuerza , Humanos , Masculino , Factores de Crecimiento de Fibroblastos/sangre , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/sangre , Entrenamiento de Fuerza/métodos , Obesidad/terapia , Persona de Mediana Edad , Glucemia/metabolismo , Adulto , Ejercicio Físico/fisiología , Fuerza Muscular/fisiología , Lípidos/sangreRESUMEN
We aimed to implement strength and balance training for elite adolescent male soccer players with functional ankle instability (FAI) to assess kinesiophobia, ankle instability, ankle function, and performance. This cluster randomized controlled trial comprised 51 elite adolescent male soccer players with FAI recruited from six different teams, divided into strength, balance, and control groups (SG, n = 17; BG, n = 17; and CG, n = 17, respectively). The SG and BG underwent strength and balance training sessions three times per week for 6 weeks. Primary outcomes were the Tampa scale for kinesiophobia-17 (TSK) and Cumberland ankle instability tool (CAIT) scores to assess kinesiophobia and FAI, respectively. Secondary outcomes were ankle strength (four directions), dynamic balance, static balance (ellipse, displacement, velocity), and performance (figure 8 and side-hop tests). A significant interaction effect was observed for both TSK and CAIT post-intervention (both, P < 0.01). In post hoc analyses, the BG had significantly better outcomes in reducing TSK. The SG and BG showed greater improvements in CAIT scores. Regression analysis indicated that CAIT severity correlated significantly with TSK (P = 0.039, R = 0.289). For secondary outcomes, the SG and BG were superior in terms of ankle dorsiflexion/inversion strength, static balance displacement, and figure-8 and side-hop tests (all, P < 0.05). The BG showed significantly better static balance ellipse results (P < 0.05). The 6-week intervention significantly enhanced kinesiophobia management, ankle stability, and performance. Balance training effectively mitigated kinesiophobia and improved balance, compared with strength training alone. Even small variations in CAIT severity can influence kinesiophobia, highlighting the potential benefits of balance training. Integrating balance training into training programs can address both physical and psychological aspects of ankle instability. Research is recommended to explore the longitudinal effects of these interventions and their potential to prevent injury recurrence.
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Inestabilidad de la Articulación , Trastornos Fóbicos , Equilibrio Postural , Entrenamiento de Fuerza , Fútbol , Humanos , Fútbol/psicología , Fútbol/fisiología , Masculino , Adolescente , Equilibrio Postural/fisiología , Inestabilidad de la Articulación/psicología , Inestabilidad de la Articulación/fisiopatología , Estudios Prospectivos , Entrenamiento de Fuerza/métodos , Trastornos Fóbicos/psicología , Trastornos Fóbicos/terapia , Rendimiento Atlético/psicología , Rendimiento Atlético/fisiología , Articulación del Tobillo/fisiopatología , Traumatismos del Tobillo/psicología , Fuerza Muscular/fisiología , Miedo , KinesiofobiaRESUMEN
This study aimed to explore the impact of functional training on the physical fitness of young elite field hockey players. The study comprised 40 young elite male field hockey players with the following characteristics (mean ± SD age: 21.5 ± 0.8 years; height: 176.9 ± 2.6 cm; weight: 68.4 ± 5.1 kg; BMI: 21.8 ± 1.3; training experience: 51.2 ± 5.4 months). Twenty participants were allocated to two groups: the functional training group (FTG) and the control training group (CG). Each group received 60-minute training sessions three times per week for 12 weeks. Generalized estimating equation analysis and a Bonferroni test for pairwise comparisons were used to assess the intervention's efficacy. Before the start of the exercise program, no statistically significant differences were observed in physical fitness measures between the FTG and CG (p > 0.05). However, by the sixth week, a significant difference appeared in both the T-Agility test (p < 0.001) and endurance (p = 0.024) between the two groups, while no notable distinctions were detected in other fitness parameters (p > 0.05). After a 12-week training program, the FTG demonstrated improvements in all physical fitness measures [flexibility (p < 0.001); Illinois agility test (p < 0.001); T-agility test (p = 0.020); endurance (p < 0.001)] except speed, which exhibited no significant impact (p = 0.175). Notable enhancements in T-agility and endurance were evident after just six weeks of functional training, and a 12-week functional training regimen showed superiority over standard training approaches in young elite male field hockey players. These findings encourage the efficacy of functional training exercises over traditional methods in enhancing athletes' fitness parameters.