High intensity resistance training as intervention method to knee osteoarthritis

Reliability of a Custom Device Used to Measure Isometric Knee Flexor and Extensor Strength in Standing Position

Background: Assessing lower limb strength in the field is problematic, as the "gold standard assessment" with isokinetic strength is cumbersome, and the device is costly and not transportable and keeps the angle of the hip at around 90°. Methods: We evaluated isometric muscle strength in a standing position with the help of an exoskeleton that holds the subject and makes the test easily repeatable. Results: The optimal device angles for hip and knee were, respectively, 20° and 80° for flexor tests and 30° and 40° for extensor tests. Test-retest reliability was very high for the right knee extensor (ICC 0.96-0.98), left knee extensor (ICC 0.96-0.97), right knee flexor (ICC 0.91-0.96), and left knee flexor (ICC 0.96-0.97). Furthermore, the typical error in percent (T.E.%) ranged from 2.50 to 5.50%, and the change in the mean in percent ranged from 0.84 to 7.72%, making it possible to determine even a slight variation in force. Conclusions: this new method could represent a valid alternative for assessing strength, due to the high reliability and the favorable joint position, particularly in football.

Effect of lateral wedge-shaped orthopedic insole on patients with genu varus: A protocol for systematic review and meta-analysis

Background

Genu varus (GV) is a common deformity characterized by leg bending, which seriously threatens human health. At present, there is no definite conclusion to explain the cause of genu varus. The purpose of this study is to systematically review and meta-analysis the effectiveness and scientific basis of the clinical efficacy of customized orthopedic insoles on genu varus and hope to provide a reference for future research in this field.

Methods

The following electronic databases will be searched from inception to January 2022: Pubmed, Cochrane Library, MEDLINE, EMBASE, Web of Science, Weipu, Wanfang Data, and CNKI. Randomized controlled trials (RCTs) were collected to examine the effect of lateral wedge-shaped orthopedic insole on patients with genu varus. We will consider inclusion, select high-quality articles for data extraction and analysis, and summarize the intervention effect of lateral wedge orthotic insoles on patients with genu varus. Two reviewers will screen titles, abstracts, and full texts independently according to inclusion criteria; Data extraction and risk of bias assessment were performed in the included studies. We will use a hierarchy of recommended assessment, development, and assessment methods to assess the overall certainty of the evidence and report findings accordingly. Endnote X8 will be applied in selecting the study, Review Manager 5.3 will be applied in analyzing and synthesizing.

Results

The results will provide evidence for judging the effect of lateral wedge-shaped orthopedic insole on patients with genu varus.

Conclusion

Our study will provide reliable evidence for the effect of lateral wedge-shaped orthopedic insole on patients with genu varus.

Trail registration

INPLASY registration number: INPLASY202190002 https://www.google.com/search?client=firefox-b-d&q=INPLASY202190002.

Atomic Simulation of the Binding of JAK1 and JAK2 with the Selective Inhibitor Ruxolitinib

Rheumatoid arthritis belongs to the group of chronic systemic autoimmune diseases characterized by the development of destructive synovitis and extra-articular manifestations. Cytokines regulate a wide range of inflammatory processes involved in the pathogenesis of rheumatoid arthritis and contribute to the induction of autoimmunity and chronic inflammation. Janus-associated kinase (JAK) and signal transducer and activator of transcription (STAT) proteins mediate cell signaling from cytokine receptors, and are involved in the pathogenesis of autoimmune and inflammatory diseases. Targeted small-molecule drugs that inhibit the functional activity of JAK proteins are used in clinical practice for the treatment of rheumatoid arthritis. In our study, we modeled the interactions of the small-molecule drug ruxolitinib with JAK1 and JAK2 isoforms and determined the binding selectivity using molecular docking. Molecular modeling data show that ruxolitinib selectively binds the JAK1 and JAK2 isoforms with a binding affinity of −8.3 and −8.0 kcal/mol, respectively. The stabilization of ligands in the cavity of kinases occurs primarily through hydrophobic interactions. The amino acid residues of the protein globules of kinases that are responsible for the correct positioning of the drug ruxolitinib and its retention have been determined.

Strength training in elderly: An useful tool against sarcopenia

The loss of muscle mass and strength in elderly population (especially after the age of 65–70) represents a public health problem. Due to the high prevalence of frailty in older adults, cardiovascular or low-intensity exercise is implemented as first choice option. Although beneficial these training schemes are not as effective as strength-based resistance training for increasing muscle strength and hypertrophy. In fact, when performed progressively and under professional supervision, strength-based training has been proposed as an important and valid methodology to reduce sarcopenia-related problems. In this mini-review, we not only summarize the benefits of weight resistance training but also highlight practical recommendations and other non-conventional methods (e.g., suspension training) as part of an integral anti-sarcopenia strategy. Future directions including cluster set configurations and high-speed resistance training are also outlined.

Therapeutic Treatments for Osteoporosis-Which Combination of Pills Is the Best among the Bad?

Osteoporosis is a chronical, systemic skeletal disorder characterized by an increase in bone resorption, which leads to reduced bone density. The reduction in bone mineral density and therefore low bone mass results in an increased risk of fractures. Osteoporosis is caused by an imbalance in the normally strictly regulated bone homeostasis. This imbalance is caused by overactive bone-resorbing osteoclasts, while bone-synthesizing osteoblasts do not compensate for this. In this review, the mechanism is presented, underlined by in vitro and animal models to investigate this imbalance as well as the current status of clinical trials. Furthermore, new therapeutic strategies for osteoporosis are presented, such as anabolic treatments and catabolic treatments and treatments using biomaterials and biomolecules. Another focus is on new combination therapies with multiple drugs which are currently considered more beneficial for the treatment of osteoporosis than monotherapies. Taken together, this review starts with an overview and ends with the newest approaches for osteoporosis therapies and a future perspective not presented so far.

Sarcopenia: Etiology, Nutritional Approaches, and miRNAs

Sarcopenia, an age-related decline in skeletal muscle mass and function, dramatically affects the quality of life. Although there is a consensus that sarcopenia is a multifactorial syndrome, the etiology and underlying mechanisms are not yet delineated. Moreover, research about nutritional interventions to prevent the development of sarcopenia is mainly focused on the amount and quality of protein intake. The impact of several nutrition strategies that consider timing of food intake, anti-inflammatory nutrients, metabolic control, and the role of mitochondrial function on the progression of sarcopenia is not fully understood. This narrative review summarizes the metabolic background of this phenomenon and proposes an integral nutritional approach (including dietary supplements such as creatine monohydrate) to target potential molecular pathways that may affect reduce or ameliorate the adverse effects of sarcopenia. Lastly, miRNAs, in particular those produced by skeletal muscle (MyomiR), might represent a valid tool to evaluate sarcopenia progression as a potential rapid and early biomarker for diagnosis and characterization.

Cytokines and Chemokines Involved in Osteoarthritis Pathogenesis

Osteoarthritis is a common cause of disability worldwide. Although commonly referred to as a disease of the joint cartilage, osteoarthritis affects all joint tissues equally. The pathogenesis of this degenerative process is not completely understood; however, a low-grade inflammation leading to an imbalance between anabolic and katabolic processes is a well-established factor. The complex network of cytokines regulating these processes and cell communication has a central role in the development and progression of osteoarthritis. Concentrations of both proinflammatory and anti-inflammatory cytokines were found to be altered depending on the osteoarthritis stage and activity. In this review, we analyzed individual cytokines involved in the immune processes with an emphasis on their function in osteoarthritis.

Spondyloarthritis and Strength Training: A 4-Year Report

Peripheral spondyloarthritis (SpA) has predominant peripheral (arthritis, enthesitis, or dactylitis) involvement. The severity of the symptoms can have a significant impact on the quality of life. There is no therapeutic gold standard, and physical exercise, with the opposition of resistance, remains controversial. Herein, we report the case of a woman who, at the age of 50, comes to our center with evident motor difficulties. She was previously diagnosed with SpA and was in therapy with a biological drug (adalimumab) for over one year. The training program and the nutritional intervention plan improved her condition, as pointed out by WOMAC, SQS, RAD-36 questionnaire, and BIA analysis, suspending biological therapy for almost two years. During this period, she achieved in sequence: (i) the Italian master deadlift championship, and (ii) the Italian master powerlifting championship, both for two consecutive years.