1
|
Bellofatto M, Bertini A, Tramacere I, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Grandis M, Previtali SC, Falzone Y, Allegri I, Padua L, Pazzaglia C, Calabrese D, Saveri P, Quattrone A, Valentino P, Tozza S, Gentile L, Russo M, Mazzeo A, Vita G, Piacentini S, Pisciotta C, Pareyson D. Frequency, entity and determinants of fatigue in Charcot-Marie-Tooth disease. Eur J Neurol 2023; 30:710-718. [PMID: 36458502 PMCID: PMC10107642 DOI: 10.1111/ene.15643] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND PURPOSE Fatigue, a disabling symptom in many neuromuscular disorders, has been reported also in Charcot-Marie-Tooth disease (CMT). The presence of fatigue and its correlations in CMT was investigated. METHODS The Modified Fatigue Impact Scale (MFIS) was administered to CMT patients from the Italian Registry and a control group. An MFIS score >38 indicated abnormal fatigue. The correlation with disease severity and clinical characteristics, the Hospital Anxiety and Depression Scale and Epworth Sleepiness Scale scores, and drug use was analysed. RESULTS Data were collected from 251 CMT patients (136 women) and 57 controls. MFIS total (mean ± standard deviation 32 ± 18.3, median 33), physical (18.9 ± 9.7, 20) and psychosocial (2.9 ± 2.4, 3) scores in CMT patients were significantly higher than controls. Abnormal fatigue occurred in 36% of the patients who, compared to patients with normal scores, had more severe disease (median CMT Examination Score 9 vs. 7), more frequent use of foot orthotics (22% vs. 11%), need of support for walking (21% vs. 8%), hand disability (70% vs. 52%) and positive sensory symptoms (56% vs. 36%). Patients with abnormal fatigue had significantly increased frequency of anxiety/depression/general distress (Hospital Anxiety and Depression Scale), somnolence (Epworth Sleepiness Scale), obesity (body mass index ≥ 30) and use of anxiolytic/antidepressant or anti-inflammatory/analgesic drugs. CONCLUSIONS Fatigue is a relevant symptom in CMT as 36% of our series had scores indicating abnormal fatigue. It correlated with disease severity but also with anxiety, depression, sleepiness and obesity, indicating different components in the generation of fatigue. CMT patients' management must include treatment of fatigue and of its different generators, including general distress, sleepiness and obesity.
Collapse
Affiliation(s)
- Marta Bellofatto
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessandro Bertini
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Irene Tramacere
- Dipartimento Gestionale di Ricerca e Sviluppo Clinico, Direzione Scientifica, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Fiore Manganelli
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Naples, Italy
| | - Gian Maria Fabrizi
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
| | - Angelo Schenone
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze materno-infantili, Università di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucio Santoro
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Naples, Italy
| | - Tiziana Cavallaro
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
| | - Marina Grandis
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze materno-infantili, Università di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefano C Previtali
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Yuri Falzone
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Luca Padua
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Daniela Calabrese
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Paola Saveri
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Paola Valentino
- Dipartimento di Scienze Mediche, Università Magna Grecia, Catanzaro, Italy
| | - Stefano Tozza
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Naples, Italy
| | - Luca Gentile
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Massimo Russo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Anna Mazzeo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Giuseppe Vita
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Sylvie Piacentini
- Unità di Neuropsicologia, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta di Milano, Milan, Italy
| | - Chiara Pisciotta
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Pareyson
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | |
Collapse
|
2
|
Physiological profile comparison between high intensity functional training, endurance and power athletes. Eur J Appl Physiol 2021; 122:531-539. [PMID: 34853894 DOI: 10.1007/s00421-021-04858-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION High intensity functional trainings (HIFT), a recent development of high intensity trainings, includes in the same training session components of endurance exercises, elements of Olympic weightlifting and powerlifting, gymnastics, plyometrics and calisthenics exercises. Therefore, subjects practicing this type of activity are supposed to show physiological features that represent a combination of both endurance and power athletes. The aim of this study was to compare the physiological profile of three groups of age-matched endurance, HIFT and power athletes. METHODS A total of 30 participants, 18 to 38-year-old men were enrolled in the study. Participants were divided in three groups: HIFT (n = 10), endurance (END, n = 10), and power (POW, weightlifters, n = 10) athletes. All were evaluated for anthropometric characteristics, VO2peak, handgrip, lower limb maximal isometric and isokinetic strength, countermovement vertical jump and anaerobic power through a shuttle run test on the field. RESULTS VO2peak/kg was higher in END and HIFT than POW athletes (p = 0.001 and p = 0.007, respectively), but there were no significant differences between the first two. POW and HIFT athletes showed significant greater strength at the handgrip, countermovement jump and leg extension/flexion tests than END athletes. HIFT athletes showed highest results at the dynamic isokinetic test, while there were no significant differences at the shuttle run test among groups. CONCLUSIONS As HIFT reach aerobic levels similar to END athletes and power and strength output similar to POW athletes, it appears that HIFT programs are effective to improve both endurance-related and power-related physical fitness components.
Collapse
|
3
|
Peterson DS, Moore A, Ofori E. Performance fatigability during gait in adults with Charcot-Marie-Tooth disease. Gait Posture 2021; 85:232-237. [PMID: 33618167 DOI: 10.1016/j.gaitpost.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Fatigue is common in people with Charcot-Marie-Tooth (pwCMT) disease. However, no studies have characterized performance fatigability during gait in this population. Characterizing performance fatigability during gait, and assessing its relation to life satisfaction could improve understanding and treatment of mobility challenges in pwCMT. RESEARCH QUESTIONS How do gait outcomes change with fatigue in pwCMT? Do these changes relate to life satisfaction? METHODS 31 pwCMT completed a 6-minute, fast-as-possible walk while gait outcomes were captured via inertial sensors. Gait outcomes were separated into six sequential bins of equal size. The mean value, variability, and asymmetry (step time only) of outcomes were calculated for each bin. Perceived fatigue and general life satisfaction were assessed via questionnaire. RESULTS Of the five mean gait outcomes measured, four showed statistically significant changes over the 6-minute fast-as-possible walk: velocity (reduced; p = 0.008); cadence (reduced; p < 0.001), step time (increased; p < 0.001), and trunk ROM (increased; p = 0.032). Of the four variability and one asymmetry outcomes, only stride length variability changed during the walking task (p = 0.015), decreasing from bins 1-2, and remaining stable for bins 2-6. Changes in velocity, cadence, step time were related to general life satisfaction (0.038 < ps<0.04), but not perceived fatigue (ps>0.343). SIGNIFICANCE pwCMT exhibit statistically significant changes in mean gait outcomes, but not variability outcomes, across a 6-minute, fast-as-possible walking bout. Changes correlated to life satisfaction, suggesting performance fatigability during gait could be a target for rehabilitation for pwCMT. Perceived fatigue did not correlate to gait fatigue, underscoring the differentiation between perceived fatigue and performance fatigability.
Collapse
Affiliation(s)
- Daniel S Peterson
- Arizona State University, College of Health Solutions, 425 N 5th St., Phoenix, AZ, 85004, USA; Phoenix VA Medical Center, 650 Indian School Rd, Phoenix, AZ, 85012, USA.
| | - Allison Moore
- Hereditary Neuropathy Foundation, New York, NY, 10016, USA
| | - Edward Ofori
- Arizona State University, College of Health Solutions, 425 N 5th St., Phoenix, AZ, 85004, USA
| |
Collapse
|
4
|
Ranavolo A, Serrao M, Draicchio F. Critical Issues and Imminent Challenges in the Use of sEMG in Return-To-Work Rehabilitation of Patients Affected by Neurological Disorders in the Epoch of Human–Robot Collaborative Technologies. Front Neurol 2020; 11:572069. [PMID: 33414754 PMCID: PMC7783040 DOI: 10.3389/fneur.2020.572069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/30/2020] [Indexed: 01/07/2023] Open
Abstract
Patients affected by neurological pathologies with motor disorders when they are of working age have to cope with problems related to employability, difficulties in working, and premature work interruption. It has been demonstrated that suitable job accommodation plans play a beneficial role in the overall quality of life of pathological subjects. A well-designed return-to-work program should consider several recent innovations in the clinical and ergonomic fields. One of the instrument-based methods used to monitor the effectiveness of ergonomic interventions is surface electromyography (sEMG), a multi-channel, non-invasive, wireless, wearable tool, which allows in-depth analysis of motor coordination mechanisms. Although the scientific literature in this field is extensive, its use remains significantly underexploited and the state-of-the-art technology lags expectations. This is mainly attributable to technical and methodological (electrode-skin impedance, noise, electrode location, size, configuration and distance, presence of crosstalk signals, comfort issues, selection of appropriate sensor setup, sEMG amplitude normalization, definition of correct sEMG-related outcomes and normative data) and cultural limitations. The technical and methodological problems are being resolved or minimized also thanks to the possibility of using reference books and tutorials. Cultural limitations are identified in the traditional use of qualitative approaches at the expense of quantitative measurement-based monitoring methods to design and assess ergonomic interventions and train operators. To bridge the gap between the return-to-work rehabilitation and other disciplines, several teaching courses, accompanied by further electrodes and instrumentations development, should be designed at all Bachelor, Master and PhD of Science levels to enhance the best skills available among physiotherapists, occupational health and safety technicians and ergonomists.
Collapse
Affiliation(s)
- Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
- *Correspondence: Alberto Ranavolo
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
- Movement Analysis LAB, Policlinico Italia, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| |
Collapse
|
5
|
Bazzucchi I, Patrizio F, Ceci R, Duranti G, Sabatini S, Sgrò P, Di Luigi L, Sacchetti M. Quercetin Supplementation Improves Neuromuscular Function Recovery from Muscle Damage. Nutrients 2020; 12:nu12092850. [PMID: 32957571 PMCID: PMC7551500 DOI: 10.3390/nu12092850] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 12/21/2022] Open
Abstract
This study was aimed at investigating whether quercetin (Q) may improve the recovery of neuromuscular function and biochemical parameters in the 7 days following an eccentric exercise-induced muscle damage (EEIMD). Sixteen men (25.9 ± 3.3 y) ingested Q (1000 mg/day) or placebo (PLA) for 14 days following a double-blind crossover study design. A neuromuscular (NM) test was performed pre–post, 24 h, 48 h, 72 h, 96 h and 7 days after an intense eccentric exercise. The force–velocity relationship of the elbow flexor muscles and their maximal voluntary isometric contraction (MVIC) were recorded simultaneously to the electromyographic signals (EMG). Pain, joint angle, arm circumference, plasma creatine kinase (CK) and lactate-dehydrogenase (LDH) were also assessed. The results showed that Q supplementation significantly attenuated the strength loss compared to PLA. During the recovery, force–velocity relationship and mean fibers conduction velocity (MFCV) persisted significantly less when participants consumed PLA rather than Q, especially at the highest angular velocities (p < 0.02). A greater increase in biomarkers of damage was also evident in PLA with respect to Q. Q supplementation for 14 days seems able to ameliorate the recovery of eccentric exercise-induced weakness, neuromuscular function impairment and biochemical parameters increase probably due to its strong anti-inflammatory and antioxidant action.
Collapse
Affiliation(s)
- Ilenia Bazzucchi
- Laboratory of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Roma, Italy; (F.P.); (M.S.)
- Correspondence: ; Tel.: +39-06-36-733-291
| | - Federica Patrizio
- Laboratory of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Roma, Italy; (F.P.); (M.S.)
| | - Roberta Ceci
- Laboratory of Biochemistry of Movement, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Roma, Italy; (R.C.); (G.D.); (S.S.)
| | - Guglielmo Duranti
- Laboratory of Biochemistry of Movement, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Roma, Italy; (R.C.); (G.D.); (S.S.)
| | - Stefania Sabatini
- Laboratory of Biochemistry of Movement, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Roma, Italy; (R.C.); (G.D.); (S.S.)
| | - Paolo Sgrò
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Roma, Italy; (P.S.); (L.D.L.)
| | - Luigi Di Luigi
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Roma, Italy; (P.S.); (L.D.L.)
| | - Massimo Sacchetti
- Laboratory of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Roma, Italy; (F.P.); (M.S.)
| |
Collapse
|
6
|
Brauers L, Rameckers E, Severijns D, Feys P, Smeets R, Klingels K. Measuring Motor Fatigability in the Upper Limbs in Individuals With Neurologic Disorders: A Systematic Review. Arch Phys Med Rehabil 2020; 101:907-916. [DOI: 10.1016/j.apmr.2019.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/22/2019] [Accepted: 11/28/2019] [Indexed: 01/21/2023]
|
7
|
Labanca L, Laudani L, Mariani PP, Macaluso A. Quadriceps muscle compensatory activations are delayed following anterior cruciate ligament reconstruction using hamstring tendon graft. Knee 2020; 27:300-307. [PMID: 31911081 DOI: 10.1016/j.knee.2019.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/12/2019] [Accepted: 09/18/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Compensatory and anticipatory quadriceps activation (CQA and AQA) in response to postural perturbations are essential for functional stability of the knee. This study aimed at investigating CQA and AQA before and after anterior cruciate ligament reconstruction (ACLR) using hamstrings graft. METHODS Twelve participants with ACLR and 12 healthy controls were exposed to 10 either unpredictable or predictable perturbations of the knee before ACLR (T1), two months (T2) and six months (T3) after surgery. Latencies of CQA and AQA in vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM) were measured. RESULTS Latency of CQA was delayed in ACLR compared to controls at T1 for VL (105 ± 25 vs. 57 ± 9 ms; P < .001), RF (102 ± 23 vs. 56 ± 9 ms; P < .001) and VM (107 ± 24 vs. 66 ± 16 ms; P < .001), at T2 for VL (68 ± 14 vs. 55 ± 10 ms; P < .01) and at T3 for VL (105 ± 22 vs. 58 ± 7 ms; P < .001), RF (102 ± 22 vs. 58 ± 12 ms; P < .001) and VM (106 ± 20 vs. 63 ± 8 ms; P < .001). AQA occurred earlier in ACLR than in controls at T1 for VL (-82 ± 64 vs. -14 ± 11 ms; P < .05) and VM (-105 ± 68 vs. -9 ± 12 ms; P < .05). CONCLUSION CQA are delayed following ACLR with hamstring graft and should be addressd by post-surgical rehabilitation.
Collapse
Affiliation(s)
- Luciana Labanca
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy.
| | - Luca Laudani
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy; Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Pier Paolo Mariani
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy; Villa Stuart Sport Clinic-FIFA Medical Centre of Excellence, Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy; Villa Stuart Sport Clinic-FIFA Medical Centre of Excellence, Rome, Italy
| |
Collapse
|
8
|
Quinzi F, Scalia M, Giombini A, Di Cagno A, Pigozzi F, Casasco M, Macaluso A. The Effect of an Orthotic Device for Balancing Neck Muscles During Daily Office Tasks. HUMAN FACTORS 2019; 61:722-735. [PMID: 30608175 DOI: 10.1177/0018720818814957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This study aimed at evaluating the acute effect of the combined and single use of two orthotic devices (neck balance system [NBS] and lumbar support [LS]) on muscle activity of neck and back muscles during typical computer working tasks. BACKGROUND An excessive activation of neck muscles could threaten the balance between agonist and antagonist muscles, resulting in a lower stability of the head and possibly leading to neck pain. At present, no study evaluated the effect of a specific orthotic device in reducing neck muscles activation. METHODS Surface electromyography (sEMG) from neck flexor (sternocleidomastoid [SCMD]) and extensor muscles (semispinalis capitis [SPC]) and back extensor muscles (erector spinae [ERS]) of 20 healthy individuals was recorded during three computer working tasks performed with the NBS, with NBS and LS, with the LS, and without devices (ND). RESULTS In the NBS condition, the SPC showed a reduced activation (NBS = 3.97%; NBS + LS = 4.49%; LS = 4.48%; ND = 4.61% of the maximal voluntary contraction) compared to the other conditions. CONCLUSIONS The use of the NBS promotes a reduction of neck extensor muscles, possibly due to the inertial mass added in the occipital part of the head, producing an external neck extensor moment that cooperates with that produced by neck extensor muscles. APPLICATION Orthotic devices such as the NBS may be used by computer workers to reduce the activation of their neck extensor muscles and possible risks of developing neck pain.
Collapse
|
9
|
Vita G, La Foresta S, Russo M, Vita GL, Messina S, Lunetta C, Mazzeo A. Sport activity in Charcot-Marie-Tooth disease: A case study of a Paralympic swimmer. Neuromuscul Disord 2016; 26:614-8. [PMID: 27460291 PMCID: PMC5026044 DOI: 10.1016/j.nmd.2016.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/01/2016] [Indexed: 12/02/2022]
Abstract
The paper reports a wheelchair-bound CMT 4A patient who became a Paralympic swimmer. She regularly performed intensive aerobic workout and competed in sprint distance events. She became a backstroke and freestyle gold medalist in the Italian Championships. Sport activity increased proximal muscle strength of upper limbs and improved QoL. Sport activity reduced anxiety, annulled depression and increased self-esteem and self-efficacy.
This study reports the positive physical, emotional and psychosocial changes induced by sport activity in a Paralympic swimmer with Charcot–Marie–Tooth (CMT) type 4A. When we compared evaluations before initiating sport activity with those after five years of competitive activity, we found: i) increased proximal muscles strength of upper limbs; ii) augmented ability to propel wheelchair independently; iii) improved quality of life; iv) reduced trait anxiety and striking improvement of depression; v) enhanced self-esteem. Longitudinal studies in large cohorts to evaluate the positive effects of sport activity are needed to support provision of evidence-based advice to patients and families.
Collapse
Affiliation(s)
- Giuseppe Vita
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; Nemo Sud Clinical Centre, Aurora Onlus Foundation, AOU Policlinico, Messina, Italy.
| | - Stefania La Foresta
- Nemo Sud Clinical Centre, Aurora Onlus Foundation, AOU Policlinico, Messina, Italy
| | - Massimo Russo
- Nemo Sud Clinical Centre, Aurora Onlus Foundation, AOU Policlinico, Messina, Italy
| | - Gian Luca Vita
- Nemo Sud Clinical Centre, Aurora Onlus Foundation, AOU Policlinico, Messina, Italy
| | - Sonia Messina
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; Nemo Sud Clinical Centre, Aurora Onlus Foundation, AOU Policlinico, Messina, Italy
| | - Christian Lunetta
- Nemo Sud Clinical Centre, Aurora Onlus Foundation, AOU Policlinico, Messina, Italy
| | - Anna Mazzeo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| |
Collapse
|
10
|
Kuciel NM, Konieczny GK, Oleksy Ł, Wrzosek Z. Lower extremity muscles activity in standing and sitting position with use of sEMG in patients suffering from Charcot-Marie-Tooth syndrome. Neurol Neurochir Pol 2016; 50:195-9. [PMID: 27154447 DOI: 10.1016/j.pjnns.2016.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/12/2015] [Accepted: 01/18/2016] [Indexed: 11/18/2022]
Abstract
There is very limited, evidenced data about movement possibilities in patients with high level of lower limb muscles atrophy and fatigue in patients suffering from Charcot-Marie-Tooth syndrome. Patient (age 46) suffering from Charcot-Marie-Tooth disease for 30 years with multiple movement restrictions and muscles atrophy above knees took part into the study. Tests were performed for 8 muscles of the lower limb and pelvis. Muscles electrical activity was tested in sitting and standing position (for knees extended and hyperextended). In the right leg rectus femoris, vastus lateralis obliquus, gluteus medius and semitendinosus muscles activated at first and were working the longest time. The highest activity was observed in standing position with knees extended. In the left leg rectus femoris and biceps femoris muscles activated at first and biceps femoris was working the longest time. Activity level in left lower limb is much lower than in the right one. Muscles weakness is asymmetric. Left leg is much weaker and engages antagonists and synergists muscles to compensate weaker rectus femoris, vastus medialis obliquus and vastus lateralis obliquus.
Collapse
Affiliation(s)
- Natalia Maria Kuciel
- Department and Division of Medical Rehabilitation, Wroclaw Medical University, Wroclaw, Poland.
| | - Grzegorz Krzysztof Konieczny
- Faculty of Health Sciences and Physical Education, Witelon State University of Applied Sciences in Legnica, Poland
| | - Łukasz Oleksy
- Department of Clinical Rehabilitation, University School of Physical Education in Krakow, Poland
| | - Zdzisława Wrzosek
- Faculty of Health Sciences and Physical Education, Witelon State University of Applied Sciences in Legnica, Poland
| |
Collapse
|
11
|
Menotti F, Laudani L, Damiani A, Mignogna T, Macaluso A. An anterior ankle-foot orthosis improves walking economy in Charcot-Marie-Tooth type 1A patients. Prosthet Orthot Int 2014; 38:387-92. [PMID: 24100074 DOI: 10.1177/0309364613506250] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ankle-foot orthoses are commonly prescribed in Charcot-Marie-Tooth type 1A disease to improve quality of walking and reduce the risk of falling due to the foot drop. OBJECTIVES This study aimed at assessing the effect of an anterior ankle-foot orthosis on walking economy in a group of Charcot-Marie-Tooth type 1A patients. STUDY DESIGN Within-group comparisons. METHODS 7 Charcot-Marie-Tooth type 1A patients (four women and three men; 37 ± 11 years; age range = 22-53 years) were asked to walk on a circuit at their self-selected speeds ('slow', 'comfortable' and 'fast') in two walking conditions: (1) with shoes only and (2) with Taloelast(®) anterior elastic ankle-foot orthoses. Speed of walking and metabolic cost of walking energy cost per unit of distance were assessed at the three self-selected speeds of walking for both walking conditions. RESULTS Speed of walking at the three self-selected speeds did not differ between shoes only and anterior elastic ankle-foot orthoses, whereas walking energy cost per unit of distance at comfortable speed was lower in patients using anterior elastic ankle-foot orthoses with respect to shoes only (2.39 ± 0.22 vs 2.70 ± 0.19 J kg(-1) m(-1); P < 0.05). CONCLUSIONS In Charcot-Marie-Tooth type 1A patients, the use of anterior elastic ankle-foot orthoses improved walking economy by reducing the energy cost of walking per unit of distance, thus reflecting a lower level of metabolic effort and improved mechanical efficiency in comparison with shoes only. CLINICAL RELEVANCE From a practical perspective, Charcot-Marie-Tooth type 1A patients with anterior elastic ankle-foot orthoses can walk for a longer duration with a lower level of physical effort. Improvements in walking economy due to ankle-foot orthoses are likely a consequence of the reduction in steppage gait.
Collapse
Affiliation(s)
- Federica Menotti
- Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Luca Laudani
- Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Antonello Damiani
- Unione Italiana Lotta alla Distrofia Muscolare (UILDM), Sezione Laziale, Rome, Italy
| | | | - Andrea Macaluso
- Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico, Rome, Italy
| |
Collapse
|
12
|
Menotti F, Berchicci M, Di Russo F, Damiani A, Vitelli S, Macaluso A. The role of the prefrontal cortex in the development of muscle fatigue in Charcot–Marie–Tooth 1A patients. Neuromuscul Disord 2014; 24:516-23. [DOI: 10.1016/j.nmd.2014.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 03/19/2014] [Indexed: 02/02/2023]
|
13
|
Bachasson D, Temesi J, Bankole C, Lagrange E, Boutte C, Millet G, Verges S, Levy P, Feasson L, Wuyam B. Assessement of quadriceps strength, endurance and fatigue in FSHD and CMT: Benefits and limits of femoral nerve magnetic stimulation. Clin Neurophysiol 2014; 125:396-405. [DOI: 10.1016/j.clinph.2013.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 07/30/2013] [Accepted: 08/01/2013] [Indexed: 12/30/2022]
|
14
|
Menotti F, Laudani L, Damiani A, Macaluso A. Amount and intensity of daily living activities in Charcot-Marie-Tooth 1A patients. Brain Behav 2014; 4:14-20. [PMID: 24653950 PMCID: PMC3937702 DOI: 10.1002/brb3.187] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/25/2013] [Accepted: 09/29/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Charcot-Marie-Tooth 1A (CMT1A) patients show a reduction of spontaneous activities of daily living measured by means of questionnaires or pedometers, which are quite inaccurate compared to recent measurement techniques. AIM The study aimed at quantifying daily living activities in CMT1A patients by means of inertial sensors, which give information not only on the amount but also on the intensity of these activities. MATERIALS AND METHODS Time and count (amount), and velocity and power (intensity) of 24 h daily living activities were measured in eight patients (20-48 years; Barthel >90; Tinetti >20) and eight healthy individuals, matched for age and gender, by means of a wearable inertial sensor device. RESULTS There were no differences between patients and controls in the 24-h distance covered and count of steps. However, count of step climbing and sit to stand were lower in patients than in controls (139.93 ± 141.66 vs. 341.06 ± 164.07 n and 58.23 ± 7.82 vs. 65.81 ± 4.75 n, respectively; P < 0.05) as well as mean daily step-climbing and walking velocities (1.07 ± 0.17 vs. 1.21 ± 0.10 m/sec and 1.16 ± 0.31 vs. 1.87 ± 0.50 m/sec, respectively; P < 0.05). In CMT1A patients there was a positive correlation between strength of the knee extensor muscles and both count of steps climbed (R = 0.80) and sit to stand (R = 0.79). DISCUSSION AND CONCLUSION The reduced ability of CMT1A patients to carry out activities at high intensity, which was correlated with strength, suggests that strength training might be a rehabilitation tool for improving the 1 ability to carry out these activities.
Collapse
Affiliation(s)
- Federica Menotti
- Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico Rome, Italy
| | - Luca Laudani
- Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico Rome, Italy
| | - Antonello Damiani
- Sezione Laziale, Unione Italiana Lotta alla Distrofia Muscolare (UILDM) Rome, Italy
| | - Andrea Macaluso
- Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico Rome, Italy
| |
Collapse
|
15
|
Berchicci M, Menotti F, Macaluso A, Di Russo F. The neurophysiology of central and peripheral fatigue during sub-maximal lower limb isometric contractions. Front Hum Neurosci 2013; 7:135. [PMID: 23596408 PMCID: PMC3625743 DOI: 10.3389/fnhum.2013.00135] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/26/2013] [Indexed: 01/10/2023] Open
Abstract
Fatigue has been defined as an exercise-induced decline in force generation capacity because of changes at both the peripheral and central levels. Movement is preceded and accompanied by brain activities related to the preparation and execution of movement (movement related cortical potentials, MRCP), which have been correlated with the perception of effort (RPE). We combined force measurements, surface electromyography (sEMG), peripheral electrical stimulation (maximal twitch, MT) and MRCP analysis to further our understanding of the neural correlates of peripheral and central changes during a fatiguing task involving the lower limbs. Eighteen healthy volunteers performed 4 blocks of isometric knee extensions at 40% of the maximal voluntary contraction (MVC) for a total of 240 2-s contractions. At the baseline and after each block, we measured RPE, MT and MVC. We simultaneously recorded the force of the knee extensor muscles, root mean square (RMS) of the sEMG of the vastus lateralis muscle, and electroencephalography (EEG) from 64 channels. The MRCPs were extracted from the EEG recordings and averaged in the early (Block 1-2) and late (Block 3-4) blocks. Two cohorts were obtained by cluster analysis based on the RPE (i.e., perception of effort) and MT (i.e., peripheral fatigue). We observed a significant decline in both the MVC (-13%) and RMS (-25%) of the sEMG signal over the course of the task; thus, muscle fatigue had occurred in all of the participants regardless of the cohort. The MRCP amplitude was larger in the fatigued than the non-fatigued MT cohort in the supplementary and premotor areas, whereas the MRCP amplitude was larger in the fatigued than the non-fatigued RPE cohort in the aforementioned areas, and also in the primary motor and prefrontal cortices (PFC). The increase in the positive activity of the PFC, along with the perception of effort, represents a novel result, suggesting that it is modulated more by the perception of effort than peripheral fatigue.
Collapse
Affiliation(s)
- Marika Berchicci
- Department of Human Movement, Social and Health Sciences, University of Rome “Foro Italico”Rome, Italy
| | - Federica Menotti
- Department of Human Movement, Social and Health Sciences, University of Rome “Foro Italico”Rome, Italy
| | - Andrea Macaluso
- Department of Human Movement, Social and Health Sciences, University of Rome “Foro Italico”Rome, Italy
| | - Francesco Di Russo
- Department of Human Movement, Social and Health Sciences, University of Rome “Foro Italico”Rome, Italy
- Neuropsychological Unit, Santa Lucia Foundation IRCCSRome, Italy
| |
Collapse
|
16
|
Lee SM, Sha D, Mohammed AA, Asress S, Glass JD, Chin LS, Li L. Motor and sensory neuropathy due to myelin infolding and paranodal damage in a transgenic mouse model of Charcot-Marie-Tooth disease type 1C. Hum Mol Genet 2013; 22:1755-70. [PMID: 23359569 DOI: 10.1093/hmg/ddt022] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Charcot-Marie-Tooth disease type 1C (CMT1C) is a dominantly inherited motor and sensory neuropathy. Despite human genetic evidence linking missense mutations in SIMPLE to CMT1C, the in vivo role of CMT1C-linked SIMPLE mutations remains undetermined. To investigate the molecular mechanism underlying CMT1C pathogenesis, we generated transgenic mice expressing either wild-type or CMT1C-linked W116G human SIMPLE. Mice expressing mutant, but not wild type, SIMPLE develop a late-onset motor and sensory neuropathy that recapitulates key clinical features of CMT1C disease. SIMPLE mutant mice exhibit motor and sensory behavioral impairments accompanied by decreased motor and sensory nerve conduction velocity and reduced compound muscle action potential amplitude. This neuropathy phenotype is associated with focally infolded myelin loops that protrude into the axons at paranodal regions and near Schmidt-Lanterman incisures of peripheral nerves. We find that myelin infolding is often linked to constricted axons with signs of impaired axonal transport and to paranodal defects and abnormal organization of the node of Ranvier. Our findings support that SIMPLE mutation disrupts myelin homeostasis and causes peripheral neuropathy via a combination of toxic gain-of-function and dominant-negative mechanisms. The results from this study suggest that myelin infolding and paranodal damage may represent pathogenic precursors preceding demyelination and axonal degeneration in CMT1C patients.
Collapse
Affiliation(s)
- Samuel M Lee
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | | | | | | | | | | | | |
Collapse
|