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Ryskalin L, Fulceri F, Morucci G, Busoni F, Soldani P, Gesi M. Ultrasonographic measurements of gastro-soleus fascia thickness in midportion Achilles tendinopathy: A case-control study. Ann Anat 2024; 256:152321. [PMID: 39186962 DOI: 10.1016/j.aanat.2024.152321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 07/25/2024] [Accepted: 08/19/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND The Achilles tendon is one of the thickest, largest, and strongest tendons in the human body. Biomechanically, the AT represents the conjoint tendon of the triceps surae muscle, placed in series with the plantar fascia (PF) to ensure force transmission from the triceps surae toward the toes during walking, running, and jumping. Commonly encountered in the diagnostic evaluation of heel pain, Achilles tendinopathy (AT) refers to a combination of pathological changes affecting the tendon itself often resulting from excessive repetitive stress and overuse. Nevertheless, increasing evidence demonstrates that structural alterations due to overuse or abnormal patterns of skeletal muscle activity are not necessarily restricted to the muscles or tendons but can also affect the fascial tissue. At the same time, there has been recent discussion regarding the role of the fascial tissue as a potential contributor to the pathophysiological mechanisms of the development of several musculoskeletal disorders including tendinopathies. To the best of our knowledge, ultrasound (US) imaging studies on the fascial structures related to the triceps surae complex, as well as their possible correlation with Achillodynia have never been presented in the current literature. METHODS In the present study, a comparative US imaging evaluation of textural features of the suro-Achilleo-plantar complex was performed in 14 healthy controls and 14 symptomatic subjects complaining of midportion AT. The thickness of the Achilles tendon, paratenon, intermuscular fascia, and PF has been assessed with US. In addition, both groups underwent the Victorian Institute of Sport Assessment-Achilles (VISA-A), a disease-specific questionnaire that measures the severity of symptoms of AT. Correlations between quantitative ultrasound measures and VISA-A scores were determined through Pearson or Spearman's rho correlations. RESULTS Our ultrasonographic findings revealed statistically significant differences (p<0.05) in Achilles tendon and paratenon thicknesses between AT patients and controls. No significant differences were observed between groups in PF at the calcaneal insertion as all mean measures were within the expected range of a normal PF on US imaging. In contrast, in tendinopathic subjects, the deep intermuscular fascia between medial gastrocnemius (MG) and soleus (SOL) muscles is significantly (p<0.01) and considerably thickened compared to those of healthy subjects. Moderate correlations exist between tendon and paratenon thicknesses (r= 0.54, p= 0.04) and between MG-SOL fascia and tendon thicknesses (r= 0.58, p= 0.03). Regarding symptom severity and US morphological findings, the Spearman ρ test showed no correlation. CONCLUSIONS Our data demonstrate that, in symptomatic subjects, US alterations are not restricted to paratenon and intratendinous areas, but also affect upstream structures along the myofascial chain, resulting in thickening of the fascia interposed between MG and SOL muscles. Moreover, positive correlations were found between MG-SOL fascia thickening and abnormalities in AT, paratenon, and symptom severity. Thus, US alterations in the fascial system should be interpreted within the clinical context of patients with AT as they may in turn represent important predictors of subsequent clinical outcomes and could help healthcare professionals and clinicians to refine non-operative treatment strategies and rehabilitation protocols for this disease.
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Affiliation(s)
- Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, Pisa 56126, Italy; Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa 56121, Italy.
| | - Federica Fulceri
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, Pisa 56126, Italy.
| | - Gabriele Morucci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, Pisa 56126, Italy; Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa 56121, Italy.
| | | | - Paola Soldani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, Pisa 56126, Italy; Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa 56121, Italy.
| | - Marco Gesi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, Pisa 56126, Italy; Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa 56121, Italy.
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Warneke K, Rabitsch T, Dobert P, Wilke J. The effects of static and dynamic stretching on deep fascia stiffness: a randomized, controlled cross-over study. Eur J Appl Physiol 2024; 124:2809-2818. [PMID: 38689040 PMCID: PMC11365840 DOI: 10.1007/s00421-024-05495-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
AIM Previous stretching studies mostly investigated effects on the skeletal muscle but comprehensive explorations regarding the role of the connective tissue are scarce. Since the deep fascia has been demonstrated to be sensitive to mechanical tension, it was hypothesized that the fascia would also respond to stretching, contributing to enhanced range of motion (ROM). METHODS Forty (40) recreationally active participants (male: n = 25, female: n = 15) were included in the randomized controlled cross-over trial and allocated to different groups performing 5 min static (STAT) or dynamic (DYN) plantar flexor stretching or control condition (CC) in a random order. Pre- and immediately post-intervention, muscle and fascia stiffness, as well as muscle and fascia thickness were measured using high-resolution ultrasound and strain elastography. ROM was assessed in the ankle joint via the knee to wall test (KtW) and goniometer. RESULTS STAT reduced both, muscle and fascia stiffness (d = 0.78 and 0.42, p < 0.001, respectively), while DYN did not reduce stiffness compared to the control condition (p = 0.11-0.41). While both conditions showed significant increases in the KtW (d = 0.43-0.46, p = 0.02-0.04), no significant differences to the CC were observed for the isolated ROM testing (p = 0.09 and 0.77). There was a small correlation between fascia stiffness decreases and ROM increases (r = - 0.25, p = 0.006) but no association was found between muscle stiffness decreases and ROM increases (p = 0.13-0.40). CONCLUSION Our study is the first to reveal stretch-induced changes in fascia stiffness. Changes of fascia`s but not muscle`s mechanical properties may contribute to increased ROM following stretching.
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Affiliation(s)
- Konstantin Warneke
- Institute of Human Movement Science, Sport and Health, University of Graz, 8020, Graz, Austria.
- Institute of Sport Science, Alpen-Adria University Klagenfurt, 9020, Klagenfurt am Wörthersee, Austria.
| | - Thomas Rabitsch
- Institute of Sport Science, Alpen-Adria University Klagenfurt, 9020, Klagenfurt am Wörthersee, Austria
| | - Patrik Dobert
- Institute of Sport Science, Alpen-Adria University Klagenfurt, 9020, Klagenfurt am Wörthersee, Austria
| | - Jan Wilke
- Institute of Sport Science, Alpen-Adria University Klagenfurt, 9020, Klagenfurt am Wörthersee, Austria
- Department of Neuromotorics and Movement, University of Bayreuth, 95447, Bayreuth, Germany
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Štěpánková T, Quittková A, Čech Z, Machač S. Sonographic measurement of deep fascia parameters - Interrater reliability. Surg Radiol Anat 2024; 46:1481-1489. [PMID: 39014213 DOI: 10.1007/s00276-024-03423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 06/17/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE The deep fascia has recently been a current topic in many medical fields, including rehabilitation. Some research has already focused on assessing deep fascia, however results of individual authors differ in certain aspects. This study focuses on the inter-rater reliability of ultrasound (US) measurement of the thickness of deep fascia and loose connective tissue (LCT). The aim was to define the causes of any discrepancies in measurement that could contribute to the unification of management of evaluating fascia. METHODS An observational study was performed including 20 healthy individuals in whom fascia lata of the anterior thigh was examined by US imaging and then measured in Image J software. Three raters participated in this study: the first with 6 years of US imaging experience, other two were newly trained. The measurement of fascial parameters was conducted in two phases with special consultation between them resulting in an agreement of the research team on the more precise way of measurement. RESULTS Results revealed the value of inter-rater reliability ICC3,1 = 0.454 for deep fascia thickness and ICC3,1 = 0.265 for LCT thickness in the first phase and any significant difference in the second phase. This poor inter-rater reliability led to a search for possible causes of discrepancies, which authors subsequently highlighted. CONCLUSION The findings of the study show the main pitfalls of deep fascia measurement that should contribute to the unification of evaluation.
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Affiliation(s)
- Tereza Štěpánková
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
| | - Adéla Quittková
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Zdeněk Čech
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Stanislav Machač
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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Lin Y, Dai R, Vogelaar G, Rinkevich Y. Organ dependency on fascia connective tissue. Am J Physiol Cell Physiol 2024; 327:C357-C361. [PMID: 38912738 DOI: 10.1152/ajpcell.00350.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/17/2024] [Accepted: 06/17/2024] [Indexed: 06/25/2024]
Abstract
Fascia is a specialized connective tissue system that encapsulates and interconnects between tissues and organs throughout the body. The fascia system regulates pain sensation, organ inflammation, trauma, and fibrotic diseases. This mini-review summarizes recent findings from animal models, which reveal the inter-dependency between tissues/organs and the fascia system. Special mechanisms are explored of fascia response to skin inflammatory processes and fibrotic microenvironments in trauma models. We highlight the functionally diverse communities of its fascia-born fibroblasts and the significance of their stage-specific differentiation and communication to disease progression. Understanding the molecular mechanisms and cellular processes within the fascia microenvironment may serve as a basis for future clinical translation.
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Affiliation(s)
- Yue Lin
- Institute of Regenerative Biology and Medicine (IRBM), Helmholtz Zentrum München, Munich, Germany
| | - Ruoxuan Dai
- Institute of Regenerative Biology and Medicine (IRBM), Helmholtz Zentrum München, Munich, Germany
| | - George Vogelaar
- Institute of Regenerative Biology and Medicine (IRBM), Helmholtz Zentrum München, Munich, Germany
| | - Yuval Rinkevich
- Institute of Regenerative Biology and Medicine (IRBM), Helmholtz Zentrum München, Munich, Germany
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Kwon J, Eom S, Kong JS, Cho DW, Kim DS, Kim J. Engineered Regenerative Isolated Peripheral Nerve Interface for Targeted Reinnervation. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2406652. [PMID: 39051516 DOI: 10.1002/adma.202406652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/24/2024] [Indexed: 07/27/2024]
Abstract
A regenerative peripheral nerve interface (RPNI) offers a therapeutic solution for nerve injury through reconstruction of the target muscle. However, implanting a transected peripheral nerve into an autologous skeletal muscle graft in RPNI causes donor-site morbidity, highlighting the need for tissue-engineered skeletal muscle constructs. Here, an engineered regenerative isolated peripheral nerve interface (eRIPEN) is developed using 3D skeletal cell printing combined with direct electrospinning to create a nanofiber membrane envelop for host nerve implantation. In this in vivo study, after over 8 months of RPNI surgery, the eRIPEN exhibits a minimum Feret diameter of 15-20 µm with a cross-sectional area of 100-500 µm2, representing the largest distribution of myofibers. Furthermore, neuromuscular junction formation and muscle contraction with a force of ≈28 N are observed. Notably, the decreased hypersensitivity to mechanical/thermal stimuli and an improved tibial functional index from -77 to -56 are found in the eRIPEN group. The present novel concept of eRIPEN paves the way for the utilization and application of tissue-engineered constructs in RPNI, ultimately realizing neuroprosthesis control through synaptic connections.
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Affiliation(s)
- Jinju Kwon
- Department of Health Science, Graduate School, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Seongsu Eom
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Jeong Sik Kong
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
- POSTECH-Catholic Biomedical Engineering Institute, POSTECH, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
- POSTECH-Catholic Biomedical Engineering Institute, POSTECH, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Dong Sung Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
- Department of Chemical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
- Institute for Convergence Research and Education in Advanced Technology, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Junesun Kim
- Department of Health Science, Graduate School, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- Department of Health and Environmental Science, Undergraduate School, College of Health Science, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
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Yerli S, Yinanç SB, Yağcı G, Erbahçeci F, Özçakar L. Thoracolumbar fascia and chronic low back pain in idiopathic lumbar scoliosis: an ultrasonographic study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:2469-2475. [PMID: 38653872 DOI: 10.1007/s00586-024-08266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/29/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The role of thoracolumbar fascia (TLF) in the development of chronic low back pain (CLBP) has growing evidence in the literature. Although CLBP is reported in individuals with idiopathic scoliosis (IS), its relationship with the TLF has yet not been established. This study aims to evaluate the TLF and its relationship with CLBP in IS. METHODS A total of 60 individuals were included in the study. They were divided into three groups as follows: painful scoliosis (n = 20, age: 17.1 ± 3.7 years, Cobb angle: 15-43°), non-painful scoliosis (n = 20, age: 16.4 ± 3.4 years, Cobb angle: 15-45°), and healthy group (n = 20, age: 16.4 ± 4.7 years). Pain was evaluated using the short form of the McGill Pain Questionnaire. TLF thickness was evaluated on the lumbar region using ultrasonography. Trunk range of motion was assessed using a universal goniometer, and flexibility was assessed with sit-and-reach test. RESULTS The thickness of the right TLF was greatest in the painful group, followed by non-painful (p = 0.007) and healthy (p < 0.001) groups. The thickness of the left TLF in the non-painful and painful groups was greater compared to the healthy group (p < 0.001). In the painful group, right TLF thickness was negatively correlated with trunk flexion/extension (r = -0.540, p = 0.014/r = -0.514, p = 0.020) and left rotation (r = -0.499, p = 0.025) but positively correlated with pain (r = 0.562, p = 0.01). CONCLUSIONS Thickening of the TLF was observed in IS, whereby, in the presence of CLBP, it was further intensified. We suggest considering fascial thickening as a potential contributing factor to both pain and limited motion in relevant patients.
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Affiliation(s)
- Sibel Yerli
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Satuk Buğrahan Yinanç
- Yozgat Bozok University Sarıkaya School of Physiotherapy and Rehabilitation, Yozgat, Turkey
| | - Gözde Yağcı
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Fatih Erbahçeci
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical Medicine and Rehabilitation, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Tapanya W, Sangkarit N, Amput P, Konsanit S. Lower extremity muscle strength equation of older adults assessed by Five Time Sit to Stand Test (FTSST). Hong Kong Physiother J 2024; 44:1-10. [PMID: 38577394 PMCID: PMC10988272 DOI: 10.1142/s1013702523500099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/16/2023] [Indexed: 04/06/2024] Open
Abstract
Background The decline in lower limb muscle strength, one of the risk factors for falling in the older adults, puts older persons at an increased risk of falling. The assessment of the lower limb muscle strength is very important. Objective The purpose of this study was to construct the equation for predicting knee extensor muscle strength based on demographic data and the results of the Five-Time Sit-to-Stand Test (FTSST). Methods A total of 121 healthy elders (mean age 68 . 00 ± 7 . 26 ) were asked to complete the FTSST and submit the demographic information. By using a stationary push-pull dynamometer, the knee extensor strength of each participant was assessed. The multiple regression analysis was used to explore knee extensor strength prediction equation. Results The findings demonstrated that the knee extensor strength equation was developed using variables obtained from gender, weight, and time to complete the FTSST. The equation was found to have a high correlation (r = 0 . 838 ) and 70.1% estimation power. Its formula was as follows: Knee extensor strength = 32 . 735 + 3 . 688 (gender; female = 0 or male = 1 ) + 0.189 (weight) - 2.617 (time to complete the FTSST). However, there was an estimating error in this equation of 4.72 kg. Conclusion The determining factors influencing knee extensor strength, which can be utilized to estimate the strength in elderly individuals, are demographic variables including gender, weight, and the time taken to complete the FTSST.
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Affiliation(s)
- Weerasak Tapanya
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Noppharath Sangkarit
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Patchareeya Amput
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Saisunee Konsanit
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
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Kellis E, Kekelekis A, Drakonaki EE. Thoracolumbar Fascia and Lumbar Muscle Stiffness in Athletes with A History of Hamstring Injury. J Sports Sci Med 2024; 23:436-444. [PMID: 38841644 PMCID: PMC11149066 DOI: 10.52082/jssm.2024.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024]
Abstract
The purpose of this study was to examine the differences in thoracolumbar fascia (TLF) and lumbar muscle modulus in individuals with and without hamstring injury using shear wave elastography (SWE). Thirteen male soccer players without a previous hamstring injury and eleven players with a history of hamstring injury performed passive and active (submaximal) knee flexion efforts from 0°, 45° and 90° angle of knee flexion as well as an active prone trunk extension test. The elastic modulus of the TLF, the erector spinae (ES) and the multifidus (MF) was measured using ultrasound SWE simultaneously with the surface electromyography (EMG) signal of the ES and MF. The TLF SWE modulus was significantly (p < 0.05) higher in the injured group (range: 29.86 ± 8.58 to 66.57 ± 11.71 kPa) than in the uninjured group (range: 17.47 ± 9.37 to 47.03 ± 16.04 kPa). The ES and MF modulus ranged from 14.97 ± 4.10 to 66.57 ± 11.71 kPa in the injured group and it was significantly (p < .05) greater compared to the uninjured group (range: 11.65 ± 5.99 to 40.49 ± 12.35 kPa). TLF modulus was greater than ES and MF modulus (p < 0.05). Active modulus was greater during the prone trunk extension test compared to the knee flexion tests and it was greater in the knee flexion test at 0° than at 90° (p < 0.05). The muscle EMG was greater in the injured compared to the uninjured group in the passive tests only (p < 0.05). SWE modulus of the TLF and ES and MF was greater in soccer players with previous hamstring injury than uninjured players. Further research could establish whether exercises that target the paraspinal muscles and the lumbar fascia can assist in preventing individuals with a history of hamstring injury from sustaining a new injury.
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Affiliation(s)
- Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Afxentios Kekelekis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Eleni E Drakonaki
- Department of Anatomy, Medical School, University of Crete, Heraklion Crete, Greece
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Antohe BA, Alshana O, Uysal HŞ, Rață M, Iacob GS, Panaet EA. Effects of Myofascial Release Techniques on Joint Range of Motion of Athletes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports (Basel) 2024; 12:132. [PMID: 38787001 PMCID: PMC11125680 DOI: 10.3390/sports12050132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Although myofascial release techniques (MRTs) are commonly used to improve athletes' range of motion (ROM), the effectiveness of MRTs may vary depending on the specific method performed. This systematic review and meta-analysis aimed to evaluate the effects of MRTs on the ROM performance of athletes. (2) Methods: The electronic databases of Cochrane Library, PubMed, Scopus, and Web of Science were searched to identify relevant articles published up to June 2023. This study utilized the PRISMA guidelines, and four databases were searched. The methodological quality of the studies was assessed using the PEDro scale, and the certainty of evidence was reported using the GRADE scale. The overall effect size was calculated using the robust variance estimator, and subgroup analyses were conducted using the Hotelling Zhang test. (3) Ten studies met the inclusion criteria. The overall effect size results indicated that the myofascial release intervention had a moderate effect on ROM performance in athletes when compared to the active or passive control groups. (4) Conclusions: Alternative MRTs, such as myofascial trigger point therapy, can further improve the ROM performance of athletes. Gender, duration of intervention, and joint type may have a moderating effect on the effectiveness of MRTs.
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Affiliation(s)
- Bogdan Alexandru Antohe
- Departament of Physical Therapy and Ocupational Therapy, “Vasile Alecsandri” University of Bacău, 600011 Bacău, Romania; (B.A.A.); (E.A.P.)
| | - Osama Alshana
- Department of Physiotherapy, University College of Applied Sciences, Gaza Strip P6160675, Palestine;
| | - Hüseyin Şahin Uysal
- Faculty of Sport Sciences, Burdur Mehmet Akif Ersoy University, 15030 Burdur, Turkey
| | - Marinela Rață
- Departament of Physical Therapy and Ocupational Therapy, “Vasile Alecsandri” University of Bacău, 600011 Bacău, Romania; (B.A.A.); (E.A.P.)
| | - George Sebastian Iacob
- Department of Physical Education and Sports Science, Faculty of Physical Education and Sport, “Alexandru Ioan Cuza” University of Iași, 700506 Iași, Romania;
| | - Elena Adelina Panaet
- Departament of Physical Therapy and Ocupational Therapy, “Vasile Alecsandri” University of Bacău, 600011 Bacău, Romania; (B.A.A.); (E.A.P.)
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Hu C, Xia Y, Zeng D, Ye M, Mei T. Effect of resistance circuit training on comprehensive health indicators in older adults: a systematic review and meta-analysis. Sci Rep 2024; 14:8823. [PMID: 38627495 PMCID: PMC11021536 DOI: 10.1038/s41598-024-59386-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
The aging process leads to the degeneration of body structure and function. The objective of this study is to conduct a systematic review and meta-analysis of the effects of resistance circuit training (RCT) on comprehensive health indicators of older adults. PubMed, Embase, and Web of Science were searched until August 2023. Primary outcomes were body composition, muscle strength, cardiorespiratory endurance, blood pressure, and functional autonomy. Muscle function and exercise intensity subgroups were analyzed. RCT reduces body fat (MD = - 5.39 kg, 95% CI - 10.48 to - 0.29), BMI (MD = - 1.22, 95% CI - 2.17 to - 0.26), and body weight (MD = - 1.28 kg, 95% CI - 1.78 to - 0.78), and increases lean body mass (MD = 1.42 kg, 95% CI 0.83-2.01) in older adults. It improves upper limb strength (SMD = 2.09, 95% CI 1.7-2.48), lower limb strength (SMD = 2.03, 95% CI 1.56-2.51), cardiorespiratory endurance (MD = 94 m, 95% CI 25.69-162.67), and functional autonomy (MD = - 1.35, 95% CI - 1.73 to - 0.96). High-intensity RCT benefits BMI and body weight, while low-intensity exercise reduces blood pressure. RCT improves muscle function in push, pull, hip, and knee movements in older adults. RCT improves body composition, muscle strength, cardiorespiratory endurance, blood pressure, and functional autonomy in older adults. High-intensity training is superior for body composition, while moderate to low intensity training is more effective for lowering blood pressure.
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Affiliation(s)
- Chenxi Hu
- Institute of Artificial Intelligence in Sports, Capital University of Physical Education and Sports, Beijing, 100191, China
- Department of Chinese Academy of Sport and Health, Beijing Sport University, Beijing, 100084, China
| | - Yunpeng Xia
- Department of Chinese Academy of Sport and Health, Beijing Sport University, Beijing, 100084, China
| | - Dongye Zeng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China
| | - Mingyi Ye
- Department of Chinese Academy of Sport and Health, Beijing Sport University, Beijing, 100084, China
| | - Tao Mei
- Department of Chinese Academy of Sport and Health, Beijing Sport University, Beijing, 100084, China.
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Lee MC, Hsu YJ, Ho CS, Tsai YS, Chen CC, Huang CC. Supplementation with Lactiplantibacillus brevis GKEX Combined with Resistance Exercise Training Improves Muscle Mass, Strength Performance, and Body Fat Condition in Healthy Humans. Foods 2024; 13:1030. [PMID: 38611334 PMCID: PMC11011920 DOI: 10.3390/foods13071030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
In addition to maintaining good exercise and dietary habits, recent studies have shown that probiotics may have potential benefits for muscle mass and strength. It is worth noting that the effects may vary depending on the specific strains used. To date, no studies have analyzed the effects of Lactiplantibacillus brevis in this context. Here, we combine the L. brevis strain GKEX with resistance training to further understand its effects on muscle mass, thickness, performance, and fat loss. In a six-week intervention for a double-blind randomized trial, 52 healthy subjects were divided into two groups (10 male and 16 female participants in each group): a placebo group (two capsules/day, containing 0 CFU of GKEX per capsule) and a GKEX group (two capsules/day, containing 1 × 1010 CFU of GKEX per capsule). Before the intervention, no differences were observed between the two groups in any of the tests (body composition, muscle thickness, exercise performance, and blood parameters). However, supplementation with GKEX significantly improved muscle mass and thickness, as well as grip strength, muscle strength, and explosive performance, when compared to the associated parameters before the intervention. Additionally, GKEX supplementation promoted a reduction in the body fat percentage (p < 0.05). Through analysis of the change amount, we observed that GKEX supplementation yielded significantly improved benefits when compared to the placebo group (p < 0.05). In summary, our findings support the notion that a six-week resistance exercise training program combined with L. brevis GKEX supplementation has superior additive effects that enhance muscle mass and strength performance, while also reducing body fat percentage. This intervention can promote muscle gain and fat loss.
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Affiliation(s)
- Mon-Chien Lee
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 333325, Taiwan; (M.-C.L.); (Y.-J.H.); (C.-S.H.)
- Center for General Education, Taipei Medical University, Taipei 110301, Taiwan
| | - Yi-Ju Hsu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 333325, Taiwan; (M.-C.L.); (Y.-J.H.); (C.-S.H.)
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 333325, Taiwan; (M.-C.L.); (Y.-J.H.); (C.-S.H.)
| | - You-Shan Tsai
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan 325002, Taiwan; (Y.-S.T.); (C.-C.C.)
| | - Chin-Chu Chen
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan 325002, Taiwan; (Y.-S.T.); (C.-C.C.)
- Institute of Food Science and Technology, National Taiwan University, Taipei 106319, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 333325, Taiwan; (M.-C.L.); (Y.-J.H.); (C.-S.H.)
- Tajen University, Pingtung 907101, Taiwan
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12
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Hirata K, Akagi R. Acute effect of static stretching on non-muscular tissue stiffness and joint flexibility: a comparative study between older and young men. Eur J Appl Physiol 2024; 124:793-803. [PMID: 37702788 DOI: 10.1007/s00421-023-05307-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE Non-muscular tissue stiffness is assumed to have a negative impact on joint flexibility, and a reduction in non-muscular tissue stiffness may be important, especially in older adults. The present study aimed to compare the acute effects of static stretching on non-muscular tissue stiffness between older and young adults and to investigate whether a decrease in tissue stiffness improves joint flexibility. METHODS Twenty older (62-83 years) and 20 young (21-24 years) males participated. Ankle dorsiflexion static stretching (five sets of 90 s each) was performed, and before and after stretching, the ankle dorsiflexion range of motion (RoM), passive ankle joint stiffness, and shear wave speed (SWS) (an index of stiffness) of the sciatic nerve, tibial nerve, and posterior thigh fascia were measured. RESULTS Stretching led to an increase in RoM and a decrease in passive joint stiffness in both groups (P < 0.001) with no significant between-group differences (P ≥ 0.055). The between-group difference in the effect of stretching on SWS was evident only for the sciatic nerve, and a decline in sciatic nerve SWS was only observed in the older adult group (pre-stretching: 2.5 ± 0.3 m/s; post-stretching: 2.3 ± 0.4 m/s; P = 0.027). A significant positive repeated-measures correlation was observed between the sciatic nerve SWS and passive joint stiffness (P = 0.014, rrm = 0.540). CONCLUSION The reduction in sciatic nerve stiffness by stretching was noticeable in older men and led to improved joint flexibility. These findings may provide insight into tissue adaptation by stretching and may be used to explore effective exercises for improving joint flexibility in older adults.
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Affiliation(s)
- Kosuke Hirata
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.
| | - Ryota Akagi
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, Japan.
- College of Systems Engineering and Science, Shibaura Institute of Technology, 307 Fukasaku, Minuma-ku, Saitama-shi, Saitama, 337-8570, Japan.
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13
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Brandl A, Wilke J, Egner C, Schmidt T, Schilder A, Schleip R. Pain quality patterns in delayed onset muscle soreness of the lower back suggest sensitization of fascia rather than muscle afferents: a secondary analysis study. Pflugers Arch 2024; 476:395-405. [PMID: 38102488 PMCID: PMC10847203 DOI: 10.1007/s00424-023-02896-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
Delayed onset muscle soreness (DOMS) of the lower back is considered a surrogate for acute low back pain (aLBP) in experimental studies. Of note, it is often unquestioningly assumed to be muscle pain. To date, there has not been a study analyzing lumbar DOMS in terms of its pain origin, which was the aim of this study. Sixteen healthy individuals (L-DOMS) were enrolled for the present study and matched to participants from a previous study (n = 16, L-PAIN) who had undergone selective electrical stimulation of the thoracolumbar fascia and the multifidus muscle. DOMS was induced in the lower back of the L-DOMS group using eccentric trunk extensions performed until exhaustion. On subsequent days, pain on palpation (100-mm analogue scale), pressure pain threshold (PPT), and the Pain Sensation Scale (SES) were used to examine the sensory characteristics of DOMS. Pain on palpation showed a significant increase 24 and 48 h after eccentric training, whereas PPT was not affected (p > 0.05). Factor analysis of L-DOMS and L-PAIN sensory descriptors (SES) yielded a stable three-factor solution distinguishing superficial thermal ("heat pain ") from superficial mechanical pain ("sharp pain") and "deep pain." "Heat pain " and "deep pain" in L-DOMS were almost identical to sensory descriptors from electrical stimulation of fascial tissue (L-PAIN, all p > 0.679) but significantly different from muscle pain (all p < 0.029). The differences in sensory description patterns as well as in PPT and self-reported DOMS for palpation pain scores suggest that DOMS has a fascial rather than a muscular origin.
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Affiliation(s)
- Andreas Brandl
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, 20148, Hamburg, Germany.
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80992, Munich, Germany.
- Vienna School of Osteopathy, 1130, Vienna, Austria.
| | - Jan Wilke
- Department of Movement Sciences, University of Klagenfurt, 9020, Klagenfurt, Austria
| | - Christoph Egner
- Department for Medical Professions, Diploma Hochschule, 37242, Bad Sooden-Allendorf, Germany
| | - Tobias Schmidt
- Osteopathic Research Institute, Osteopathie Schule Deutschland, 22297, Hamburg, Germany
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, 20457, Hamburg, Germany
| | - Andreas Schilder
- Department of Orthopaedics and Trauma Surgery, Medical Faculty Mannheim, Heidelberg University, 68167, Mannheim, Germany
| | - Robert Schleip
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80992, Munich, Germany
- Department of Movement Sciences, University of Klagenfurt, 9020, Klagenfurt, Austria
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14
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Nakanishi S, Watanabe K, Ouchi K, Hakozaki M, Oi N, Konno S. Reference values of lumbar spine range of motion by sex and age based on the assessment of supine trunk lateral bending-A preliminary study. Fukushima J Med Sci 2024; 70:25-33. [PMID: 38123298 PMCID: PMC10867432 DOI: 10.5387/fms.2023-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023] Open
Abstract
[Purpose] The purpose of this study was to clarify the preliminary reference values for the lumbar spine range of motion associated with lateral bending exercises by gender and age group. [Methods] Subjects were 82 volunteers without low back pain, including five males and five females in each age group from 16-19 to 80-89 years. All subjects underwent radiographs of the lumbar spine with lateral flexion; the range of lateral flexion of the vertebrae from T12 to the sacrum (ROLB) was measured twice by three observers. [Results] The ROLB of the entire T12-S1 of all subjects showed a significant negative correlation with age in both sexes (p < 0.01). The ROLB of the lumbar spine tended to be greater in females, with a statistically significant difference between those aged 16-19 and 70-79 (p < 0.05). Lateral flexion angles for each intervertebral segment were largest at L3-L4 and smallest at L5-S1 (0.7°). [Conclusion] Lumbar ROLB reference values were examined by gender and age group; ROLB was greatest in L3-L4, and ROLB tended to be lower in older age groups.
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Affiliation(s)
- Shigetaka Nakanishi
- Department of Rehabilitation Medicine, Fukushima Medical University School of Medicine
| | - Kazuyuki Watanabe
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
| | - Kazuo Ouchi
- Department of Rehabilitation Medicine, Fukushima Medical University School of Medicine
| | - Michiyuki Hakozaki
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
| | - Naoyuki Oi
- Department of Rehabilitation Medicine, Fukushima Medical University School of Medicine
| | - Shinichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
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15
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Newell E, Chorney H, Tiegs-Heiden CA, Benson JC, Ouellet J, Driscoll M. Augmentation of musculoskeletal soft tissue morphology within low back pain patients may suggest the presence of physiological stress shielding: An in vivo study. J Biomech 2024; 162:111894. [PMID: 38070295 DOI: 10.1016/j.jbiomech.2023.111894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/19/2023] [Accepted: 11/28/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION The pathomechanism of low back pain (LBP) remains unknown. However, changes to mechanical properties of soft tissues affected by LBP may indicate the presence of stress shielding, which may manifest via tissue remodeling. This study investigates the potential for physiological stress shielding within the lumbar spine by examining differences within lumbar soft tissue morphology between control and LBP subjects. METHODS Through MRI, the total and functional cross-sectional area (tCSA, fCSA) and fatty infiltration (FI) of the lumbar multifidus (MF), erector spinae (ES), quadratus lumborum (QL), psoas major (PM), and thoracolumbar fascia (TLF) were measured from the L1/L2 to L5/S1 intervertebral disc levels of 69 subjects (36 LBP and 33 control subjects). Statistical analysis was conducted using Mann-Whitney U. P < 0.05 denoted significance. RESULTS Comparison of male LBP patients and male healthy controls yielded an increase in tCSA and fCSA within the L4/L5 PM (p < 0.01), and the L4/L5 ES (p = 0.02) and PM (p < 0.01), respectively, of LBP patients. Female LBP patients' FI compared to female controls increased within the L1/L2 MF (p = 0.03), L3/L4 MF (p = 0.04) and ES (p = 0.02), and L4/L5 QL (p = 0.01). The L3/L4 TLF also demonstrated an 8% increase in LBP subjects. CONCLUSION Male patients' results suggest elevated tissue loading during motion yielding hypertrophy in the L4/L5 ES and PM fCSA, and PM tCSA. Female LBP patients' MF, ES, and PM at L3/L4 demonstrating elevated FI coupled with TLF tCSA hypertrophy may suggest irregular stress distributions and lay the foundation for stress shielding within musculoskeletal soft tissues.
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Affiliation(s)
- Emily Newell
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada; Orthopaedic Research Laboratory, Montreal General Hospital, Montreal, Quebec, Canada.
| | - Harriet Chorney
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada; Orthopaedic Research Laboratory, Montreal General Hospital, Montreal, Quebec, Canada.
| | | | - John C Benson
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
| | - Jean Ouellet
- Department of Paediatric Surgery, McGill University, Montreal, Quebec, Canada; Department of Pediatric Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
| | - Mark Driscoll
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada; Orthopaedic Research Laboratory, Montreal General Hospital, Montreal, Quebec, Canada.
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16
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Unalmis Y, Muniroglu S. Examination of the effect of fascial therapy on some physical fitness parameters in taekwondo athletes. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:299-307. [PMID: 38314051 PMCID: PMC10831376 DOI: 10.1016/j.smhs.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/09/2023] [Accepted: 09/21/2023] [Indexed: 02/06/2024] Open
Abstract
One of the objectives of this study is to determine the effect of the eight-week fascial therapy program on flexibility, vertical jump, standing long jump, speed and anaerobic strength parameters in taekwondo athletes. Another aim of the research is to create a therapy protocol that can be used in athletes related to performance development through the relaxation of the fascial system, which is considered an indicator of physical fitness and has numerous functions in the body. This study included 32 taekwondo players who were licensed, actively attending taekwondo training. In the study, two groups were formed as fascial therapy group (FTG) (n = 16) and control group (CG) (n = 16). After the groups were randomized, fascial relaxation techniques were applied to the fascial therapy group for eight weeks, up to twice a week, and for 30 min. According to the findings obtained as a result of the research, FTG ([-0.36 ± 0.17] seconds [s]) for the 20 m (m) Sprint (T2-T1) had a lower mean time than CG (0.00 ± 0.07) s, FTG (0.06 ± 1.95) for the Flamingo Balance Test (T2-T1) had a lower mean fall than CG (1.25 ± 1.13), FTG ([3.56 ± 2.37] centimeters [cm]) for the Sit & Reach Test (T2-T1) had a lower mean fall than CG ([-0.19 ± 1.28] cm), FTG ([5.75 ± 2.54] cm) had a higher jump distance than CG ([1.88 ± 8.11] cm) according to the results of Vertical Jump Test (T2-T1) and finally FTG ([9.13 ± 5.56] cm) had a longer distance than CG ([-0.31 ± 1.85] cm) according to the results of Standing Long Jump Test (T2-T1). The result of our study has shown that fascial techniques can be used safely by experienced physiotherapists and can be included in the training program. It is recommended that coaches of sports disciplines work with experienced physiotherapists on this subject and include fascial methods in their training programs.
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Affiliation(s)
- Yagmur Unalmis
- Ankara University, Faculty of Sport Sciences, Dögol Caddesi 06100 Beşevler, Ankara, Turkey
| | - Surhat Muniroglu
- Ankara University, Faculty of Sport Sciences, Dögol Caddesi 06100 Beşevler, Ankara, Turkey
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17
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Song MX, Yang H, Yang HQ, Li SS, Qin J, Xiao Q. MR Imaging Radiomics Analysis Based on Lumbar Soft Tissue to Evaluate Lumbar Fascia Changes in Patients with Low Back Pain. Acad Radiol 2023; 30:2450-2457. [PMID: 37003877 DOI: 10.1016/j.acra.2023.02.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/21/2022] [Accepted: 02/27/2023] [Indexed: 04/03/2023]
Abstract
RATIONALE AND OBJECTIVES Clinicians must precisely pinpoint the etiology of low back pain as the number of people suffering from it increases to provide targeted care. The purpose of this paper was to use MR imaging radiomics based on lumbar soft tissue to analyze changes in the lumbar fascia of patients with low back pain. MATERIALS AND METHODS We retrospectively analyzed the lumbar MRI of 197 patients with low back pain. Patients were randomly assigned to either the training (n = 138) or validation (n = 59) cohorts. Multivariate logistic regression analysis was used to create radiomics model and combined nomogram model and their predictive performance were evaluated using receiver operating characteristic curves. RESULTS Seven radiomics features based on lumbar soft tissue MRI images were established, which performed well in distinguishing between low back pain patients with fascial changes and normal individuals demonstrated an excellent ability to identify differences, with an Area Under Curve (AUC) of 0.92 (95% CI, 0.88-0.96) in the training cohort and 0.84 (95% CI, 0.73-0.96) in the validation cohort, which performed better than the clinical model significantly only. CONCLUSION The nomogram based on clinical features and radiomics features of MR images had a good predictive ability to differentiate fascial alterations in patients with low back pain from normal subjects. It had the potential to be used as a decision support tool to assist clinicians in determining the etiology of patients with lower back pain and managing patients promptly, particularly in the early stage of the fasciitis when significant abnormalities on imaging were difficult to detect.
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Affiliation(s)
- Ming-Xin Song
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - Hui Yang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - He-Qi Yang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - Shan-Shan Li
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - Jian Qin
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, China
| | - Qiang Xiao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Shandong First Medical University, No.366 Taishan Street, Tai'an 271000, China.
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18
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Wadhokar OC, Kulkarni CA, Joshi M. Changing Trends in Publication Regarding Temporomandibular Joint Dysfunction From 1975 to 2021: A Bibliometric Analysis. Cureus 2023; 15:e46179. [PMID: 37905263 PMCID: PMC10613334 DOI: 10.7759/cureus.46179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 09/28/2023] [Indexed: 11/02/2023] Open
Abstract
Temporomandibular joint (TMJ) is a bicondylar joint. Various conditions have the same clinical presentation as TMJ dysfunction, which requires a thorough assessment of active and passive movements and palpation of the joints surrounding the joint. Many times, TMJ dysfunction occurs due to an alteration in the cervical spine. The patient complains of clicking or popping sound at the jaw and a reduced maximum mouth opening. The conditions that lead to TMJ dysfunction include bruxism, arthritis, stress, injury to the jaw, and overuse. The trend of the available literature has changed from 1972 to 2021 to assess changing trends in the publication on TMJ about authors, country, collaboration of the institutes, and the journal. We have done this bibliometric assessment. The articles were collected from the PubMed database; the keywords used were temporomandibular dysfunction (TMD), neck pain, physiotherapy, and rehabilitation. A total of 437 articles were found from 1975 to 2021, which were then converted into pictorial forms using the CiteSapce R software, and the data were interpreted. The analysis of the bibliometrics of publications on TMD, neck pain, and functional disability between the years 1975 and 2021 shows a total of 437 articles were published. The articles were from 196 sources; the highest number of publications were seen from 2014 until 2021, with the highest number of published papers by author Yoo WG and the highest number of articles published by the Journal of Physical Therapy Science. This bibliometric analysis depicts that the quantity of literature on TMD and the forward head has increased, as has the effectiveness of physical therapy interventions on the forward head in terms of correcting temporomandibular dysfunction.
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Affiliation(s)
- Om C Wadhokar
- Musculoskeletal Physiotherapy, Dr. D.Y Patil College of Physiotherapy, Pune, IND
- Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Chaitanya A Kulkarni
- Community Health Physiotherapy, Dr. D.Y Patil College of Physiotherapy, Pune, IND
- Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Medhavi Joshi
- Musculoskeletal Physiotherapy, Dr. D.Y Patil College of Physiotherapy, Pune, IND
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Llewellyn J, Fede C, Loneker AE, Friday CS, Hast MW, Theise ND, Furth EE, Guido M, Stecco C, Wells RG. Glisson's capsule matrix structure and function is altered in patients with cirrhosis irrespective of aetiology. JHEP Rep 2023; 5:100760. [PMID: 37534230 PMCID: PMC10393548 DOI: 10.1016/j.jhepr.2023.100760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/14/2023] [Accepted: 03/31/2023] [Indexed: 08/04/2023] Open
Abstract
Background & Aims Glisson's capsule is the interstitial connective tissue that surrounds the liver. As part of its normal physiology, it withstands significant daily changes in liver size. The pathophysiology of the capsule in disease is not well understood. The aim of this study was to characterise the changes in capsule matrix, cellular composition, and mechanical properties that occur in liver disease and to determine whether these correlate with disease severity or aetiology. Methods Samples from ten control patients, and six with steatosis, seven with moderate fibrosis, and 37 with cirrhosis were collected from autopsies, intraoperative biopsies, and liver explants. Matrix proteins and cell markers were assessed by staining and second harmonic generation imaging. Mechanical tensile testing was performed on a test frame. Results Capsule thickness was significantly increased in cirrhotic samples compared with normal controls irrespective of disease aetiology (70.12 ± 14.16 μm and 231.58 ± 21.82 μm, respectively), whereas steatosis and moderate fibrosis had no effect on thickness (90.91 ± 11.40 μm). Changes in cirrhosis included an increase in cell number (fibroblasts, vascular cells, infiltrating immune cells, and biliary epithelial cells). Key matrix components (collagens 1 and 3, hyaluronan, versican, and elastin) were all deposited in the lower capsule, although only the relative amounts per area of hyaluronan and versican were increased. Organisational features, including crimping and alignment of collagen fibres, were also altered in cirrhosis. Unexpectedly, capsules from cirrhotic livers had decreased resistance to loading compared with controls. Conclusions The liver capsule, similar to the parenchyma, is an active site of disease, demonstrating changes in matrix and cell composition as well as mechanical properties. Impact and implications We assessed the changes in composition and response to stretching of the liver outer sheath, the capsule, in human liver disease. We found an increase in key structural components and numbers of cells as well as a change in matrix organisation of the capsule during the later stages of disease. This allows the diseased capsule to stretch more under any given force, suggesting that it is less stiff than healthy tissue.
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Affiliation(s)
- Jessica Llewellyn
- Department of Gastroenterology and Hepatology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Engineering MechanoBiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Caterina Fede
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Abigail E. Loneker
- Center for Engineering MechanoBiology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Chet S. Friday
- Department of Orthopaedic Surgery, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael W. Hast
- Department of Orthopaedic Surgery, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Neil D. Theise
- Department of Pathology, New York University, School of Medicine, New York, NY, USA
| | - Emma E. Furth
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Maria Guido
- Department of Pathology, University of Padova, Italy
| | - Carla Stecco
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Rebecca G. Wells
- Department of Gastroenterology and Hepatology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Engineering MechanoBiology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
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20
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Du Y, Cai X, Xu B, Wu Y, Chen M, Wang J, Yuan B, Zhang W, Zhu J, Yang C. Global Status and Future Trends of Fascia and Pain Research in 2013-2022: Bibliometric Analysis Based on CiteSpace and VOSviewer. J Pain Res 2023; 16:2633-2653. [PMID: 37538250 PMCID: PMC10394092 DOI: 10.2147/jpr.s412161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 07/19/2023] [Indexed: 08/05/2023] Open
Abstract
Background Fascial pathological pain is the main type of chronic pain in older adults today, and studying the relationship between fascia and pain can help in the clinical search for effective treatments. However, in the face of the vast amount of research findings, there is no systematic assessment of the relationship between fascia and pain in a bibliometric analysis. Therefore, the purpose of this study is to analyze studies on fascia and pain using CiteSpace and VOSviewer to identify research hotspots and future directions. Materials and Methods A total of 744 papers related to fascia and pain from 2013 to 2022 were collected from the core collection database of Web of Science, and the authors, countries, institutions, keyword co-occurrence, keyword clustering, and keyword emergence were analyzed by CiteSpace and VOSviewer to construct a knowledge map. Results Literature publication has shown an overall upward trend over the past decade, but there have been some fluctuations. Carmelo Pirri, Caterina Fede, and Raffaele De Caro are the top three authors with the most articles. The United States, China, and Spain are major contributors to fascial and pain research. The University of Padua, Universidad Complutense and Harvard Medical School are leading institutions in this field. However, it is noteworthy that the collaboration between authors, countries and institutions is not active. Keyword analysis showed that hot spots and trends in research on fascia and pain focused on hot diseases, major interventions, and mechanism exploration. Conclusion This analysis identifies the most influential authors, institutions, and countries in the field of fascial and pain research and provides a reference for assessing their academic impact. The analysis of keywords and co-cited literature is useful for analyzing research hotspots and their evolution, as well as for predicting future trends.
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Affiliation(s)
- Yikuan Du
- Central Laboratory, The Tenth Affiliated Hospital of Southern Medical University, Dongguan, 523059, People’s Republic of China
| | - Xiaolin Cai
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
| | - Bijun Xu
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
| | - Yuqing Wu
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
| | - Mianhai Chen
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
| | - Jinjin Wang
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
| | - Bing Yuan
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
| | - Weichui Zhang
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
| | - Jinfeng Zhu
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
| | - Chun Yang
- Dongguan Key Laboratory of Chronic Inflammatory Diseases, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Guangdong Medical University, Dongguan, 523808, People’s Republic of China
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Muanjai P, Namsawang J. Hamstrings fascicle length and physical performance changes after a single bout of dynamic stretching or neurodynamic gliding in healthy young and older adults. J Bodyw Mov Ther 2023; 35:99-107. [PMID: 37330810 DOI: 10.1016/j.jbmt.2023.04.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/28/2023] [Accepted: 04/15/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The physiological and structural alterations have been less reported in response to dynamic stretching (DS) or neurodynamic nerve gliding (NG). Accordingly, this study investigated the changes in fascicle lengths (FL), popliteal artery velocity, and physical fitness in response to a single bout of DS or NG. METHODS The study included 15 healthy young adults (20.9 ± 0.7 yrs) and 15 older adults (66.6 ± 4.2 yrs) who randomly performed three different interventions (DS, NG, and rest control) for 10 min and 3 days apart. The biceps femoris and semitendinosus FL, popliteal artery velocity, sit and reach (S&R), straight leg raise (SLR), and fast walking speed were measured before and immediately after the intervention. RESULTS After NG intervention, S&R was largely greater by 2 cm (1.2, 2.8 cm) and 3.4 cm (2.1, 4.7 cm) with largely increased SLR angles of 4.9° (3.7°, 6.1°) and 4.6° (3.0°, 6.2°) with all p < 0.001 for the older adults and young groups, respectively. A similar magnitude improvement in the S&R and SLR testing was also seen for both groups after DS (p < 0.05). Moreover, no changes were seen in FL, popliteal artery velocity, fast gait speed, and age effect following all three intervention occasions. CONCLUSION Stretching with DS or NG immediately increased flexibility, which appeared to be largely due to changes in stretch tolerance rather than an increase in fascicle length. Furthermore, age dependency in response to stretching exercise was not seen in the present study.
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Affiliation(s)
- Pornpimol Muanjai
- Department of Physical Therapy, Allied Health Sciences Faculty, Burapha University, Chonburi, Thailand; Exercise and Nutrition Innovation and Sciences Research Unit, Burapha University, Chonburi, Thailand.
| | - Juntip Namsawang
- Department of Physical Therapy, Allied Health Sciences Faculty, Burapha University, Chonburi, Thailand; Exercise and Nutrition Innovation and Sciences Research Unit, Burapha University, Chonburi, Thailand
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22
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Brandl A, Wilke J, Egner C, Reer R, Schmidt T, Schleip R. Thoracolumbar fascia deformation during deadlifting and trunk extension in individuals with and without back pain. Front Med (Lausanne) 2023; 10:1177146. [PMID: 37342497 PMCID: PMC10278943 DOI: 10.3389/fmed.2023.1177146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/19/2023] [Indexed: 06/23/2023] Open
Abstract
Background Alterations in posture, lumbopelvic kinematics, and movement patterns are commonly seen in patients with low back pain. Therefore, strengthening the posterior muscle chain has been shown to result in significant improvement in pain and disability status. Recent studies suggest that thoracolumbar fascia (TLF) has a major impact on the maintenance of spinal stability and paraspinal muscle activity, and thus is likely to have an equal impact on deadlift performance. Objective Aim of the study was to evaluate the role of thoracolumbar fascia deformation (TFLD) during spinal movement in track and field athletes (TF) as well as individuals with and without acute low back pain (aLBP). Methods A case-control study was performed with n = 16 aLBP patients (cases) and two control groups: untrained healthy individuals (UH, n = 16) and TF (n = 16). Participants performed a trunk extension task (TET) and a deadlift, being assessed for erector spinae muscle thickness (EST) and TLFD using high-resolution ultrasound imaging. Mean deadlift velocity (VEL) and deviation of barbell path (DEV) were measured by means of a three-axis gyroscope. Group differences for TLFD during the TET were examined using ANOVA. Partial Spearman rank correlations were calculated between TLFD and VEL adjusting for baseline covariates, EST, and DEV. TLFD during deadlifting was compared between groups using ANCOVA adjusting for EST, DEV, and VEL. Results TLFD during the TET differed significantly between groups. TF had the largest TLFD (-37.6%), followed by UH (-26.4%), while aLBP patients had almost no TLFD (-2.7%). There was a strong negative correlation between TLFD and deadlift VEL in all groups (r = -0.65 to -0.89) which was highest for TF (r = -0.89). TLFD during deadlift, corrected for VEL, also differed significantly between groups. TF exhibited the smallest TLFD (-11.9%), followed by aLBP patients (-21.4%), and UH (-31.9%). Conclusion TFLD maybe a suitable parameter to distinguish LBP patients and healthy individuals during lifting tasks. The cause-effect triangle between spinal movement, TFLD and movement velocity needs to be further clarified. Clinical trial registration https://drks.de/register/de/trial/DRKS00027074/, German Clinical Trials Register DRKS00027074.
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Affiliation(s)
- Andreas Brandl
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany
- Department for Medical Professions, Diploma Hochschule, Bad Sooden-Allendorf, Germany
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
| | - Jan Wilke
- Department of Movement Sciences, University of Klagenfurt, Klagenfurt, Austria
| | - Christoph Egner
- Department for Medical Professions, Diploma Hochschule, Bad Sooden-Allendorf, Germany
| | - Rüdiger Reer
- Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Tobias Schmidt
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Medical School Hamburg (MSH), Hamburg, Germany
| | - Robert Schleip
- Department for Medical Professions, Diploma Hochschule, Bad Sooden-Allendorf, Germany
- Department of Sport and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany
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23
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Escamilla-Martínez E, Sánchez Martín F, Ramos-Ortega J, González-García P, Cortés-Vega MD, Fernández-Seguín LM. Age related changes in the Q angle of non-professional football players. Heliyon 2023; 9:e16781. [PMID: 37292358 PMCID: PMC10245054 DOI: 10.1016/j.heliyon.2023.e16781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023] Open
Abstract
Background Football practice involves a great muscular demand, leading to the development of the lower limbs that, on occasions, can cause deviations from the normal anthropometric values. The quadriceps angle (Q angle) is a value often taken as a reference for the alignment of the lower limbs. Objective To observe the changes of the Q angle in young football players, because of muscular effort, analyzing the differences between four groups of different ages and to determine whether the playing position might influence these variations. Methods A cross sectional study was carried out with 104 male subjects divided into four groups according to age: under 8 years-old, 8-17 years-old, 17-21 years-old and over 21 years-old. A photograph was taken in standing position and the Q angle was plotted with KINOVEA® software. As for the reliability of the measurements, intraclass intra and interobserver coefficient were 0.958 and 0.860 respectively. The study was conducted in mid-season. Results Q angle value is greater in those under 8 years of age and decreases gradually and significantly (p < 0.005) until 17-21 years of age, where it stabilizes at values of 5.73° ± 2.78 for right Q angle and 5.88° ± 2.55 for left Q angle. Two way ANOVA demonstrated a significant group*position interaction for goalkeepers with a medium effect size in both angles (p < 0.001) with a medium effect (η2 Right Q angle = 0.31; η2 Left Q angle = 0.37). The values remain unchanged in subjects over 21 years of age (p > 0.005), except for goalkeepers, who suffered a difference in the evolution of the angle within their age category (p < 0.005) and with a high effect size with the other positions (value > 0.8) except forward (value < 0.5). Conclusion This study determines that the Q angle in football players decreases with growth, reaching values below 15° at the end of development. Playing positions only influence players over the age of 21, and the Q-angle of goalkeepers is greater than that of other players.
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Affiliation(s)
| | | | | | - Paula González-García
- Physiotherapy Department, University of Seville, Spain
- Institute of Biomedicine of Seville (IBIS), Spain
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Kodama Y, Masuda S, Ohmori T, Kanamaru A, Tanaka M, Sakaguchi T, Nakagawa M. Response to Mechanical Properties and Physiological Challenges of Fascia: Diagnosis and Rehabilitative Therapeutic Intervention for Myofascial System Disorders. Bioengineering (Basel) 2023; 10:bioengineering10040474. [PMID: 37106661 PMCID: PMC10135675 DOI: 10.3390/bioengineering10040474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Damage to the fascia can cause significant performance deficits in high-performance sports and recreational exercise and may contribute to the development of musculoskeletal disorders and persistent potential pain. The fascia is widely distributed from head to toe, encompassing muscles, bones, blood vessels, nerves, and internal organs and comprising various layers of different depths, indicating the complexity of its pathogenesis. It is a connective tissue composed of irregularly arranged collagen fibers, distinctly different from the regularly arranged collagen fibers found in tendons, ligaments, or periosteum, and mechanical changes in the fascia (stiffness or tension) can produce changes in its connective tissue that can cause pain. While these mechanical changes induce inflammation associated with mechanical loading, they are also affected by biochemical influences such as aging, sex hormones, and obesity. Therefore, this paper will review the current state of knowledge on the molecular level response to the mechanical properties of the fascia and its response to other physiological challenges, including mechanical changes, innervation, injury, and aging; imaging techniques available to study the fascial system; and therapeutic interventions targeting fascial tissue in sports medicine. This article aims to summarize contemporary views.
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Affiliation(s)
- Yuya Kodama
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Shin Masuda
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Toshinori Ohmori
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Akihiro Kanamaru
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Masato Tanaka
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Tomoyoshi Sakaguchi
- Department of Central Rehabilitation, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Masami Nakagawa
- Department of Central Rehabilitation, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
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Antequera-Vique JA, Oliva-Lozano JM, Muyor JM. Effects of cycling on the morphology and spinal posture in professional and recreational cyclists: a systematic review. Sports Biomech 2023; 22:567-596. [PMID: 35440291 DOI: 10.1080/14763141.2022.2058990] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The aim was to know if cycling affects spinal morphology in postures off the bicycle, such as adapting the spinal curvatures on the bicycle depending on the handlebar type and position on the handlebars. A systematic review was conducted following the PRISMA guidelines. The studies selected met the following criteria: a) the study design was cross-sectional or longitudinal (experimental or cohorts); b) the study evaluated the sagittal morphology of the spine on the bicycle; c) the study included healthy and trained participants without injuries or cyclists reporting low back pain. Fifteen studies reported that a greater pelvic tilt was observed that when the handlebar was in a lower position. Sixteen studies found that lumbar kyphosis was greater when the handlebar grip was lower and farther from the saddle. Twelve studies reported that a tendency towards greater thoracic flexion as the time spent pedalling on the bicycle increased. In conclusion, the practice of cycling produces adaptations in the morphology of the spine of the cyclist compared to non-cyclists, such as an increase in pelvic tilt and a greater capacity for lumbar flexion in trunk flexion positions, and a greater thoracic kyphosis in the standing position.
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Affiliation(s)
| | | | - José M Muyor
- Health Research Centre, University of Almería, Almería, Spain.,Laboratory of Kinesiology, Biomechanics and Ergonomics (KIBIOMER Lab). University of Almería, Almería, Spain
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Immediate Effects of Myofascial Release Treatment on Lumbar Microcirculation: A Randomized, Placebo-Controlled Trial. J Clin Med 2023; 12:jcm12041248. [PMID: 36835784 PMCID: PMC9959802 DOI: 10.3390/jcm12041248] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
(1) Background: Inflammatory processes in the thoracolumbar fascia (TLF) lead to thickening, compaction, and fibrosis and are thought to contribute to the development of nonspecific low back pain (nLBP). The blood flow (BF) of fascial tissue may play a critical role in this process, as it may promote hypoxia-induced inflammation. The primary objective of the study was to examine the immediate effects of a set of myofascial release (MFR) techniques on the BF of lumbar myofascial tissue. The secondary objectives were to evaluate the influence of TLF morphology (TLFM), physical activity (PA), and body mass index (BMI) on these parameters and their correlations with each other. (2) Methods: This study was a single-blind, randomized, placebo-controlled trial. Thirty pain-free subjects (40.5 ± 14.1 years) were randomly assigned to two groups treated with MFR or a placebo intervention. Correlations between PA, BMI, and TLFM were calculated at baseline. The effects of MFR and TLFM on BF (measured with white light and laser Doppler spectroscopy) were determined. (3) Results: The MFR group had a significant increase in BF after treatment (31.6%) and at follow-up (48.7%) compared with the placebo group. BF was significantly different between disorganized and organized TLFM (p < 0.0001). There were strong correlations between PA (r = -0.648), PA (d = 0.681), BMI (r = -0.798), and TLFM. (4) Conclusions: Impaired blood flow could lead to hypoxia-induced inflammation, possibly resulting in pain and impaired proprioceptive function, thereby likely contributing to the development of nLBP. Fascial restrictions of blood vessels and free nerve endings, which are likely associated with TLFM, could be positively affected by the intervention in this study.
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Hopen SR. Intrafasciomembranal Fluid Pressure: A Novel Approach to the Etiology of Myalgias, Part II. Cureus 2023; 15:e35163. [PMID: 36949992 PMCID: PMC10028401 DOI: 10.7759/cureus.35163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 02/21/2023] Open
Abstract
The fascia forms a hierarchy of spaces (small and large compartments) that contain and enclose muscle fibers, fiber bundles, skeletal muscles, and compartments of several skeletal muscles. Solid fascia serves as a membrane that enables an increased volume and fluid pressure within such a fasciomembrane, an intrafasciomembrial fluid pressure (IFMFP). Increased IFMFP provides a theoretical model and a common explanation for the etiology of the myalgias: trigger point (TrP), chronic exertional compartment syndrome (CECS), overtraining syndrome (OTS), and delayed onset muscle soreness (DOMS). Many myalgias and their symptoms are poorly understood, and this review aims to provide an extension to this theoretical model and novel approach. This review suggests that the swelling from elevated IFMFP also likely leads to a longitudinal shortening of the same affected tissue. This model of swelling and shortening provides additional explanations for the changes in the lines of force through the body that can lead to changes in the body's posture and, thus, to compensatory movements. This new approximation also provides a biomechanical explanation for the thickening of the fascia and referred pain, and also suggests that IFMFP is a factor in weather-related pain.
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Vo MHT, Lin CJ, Chieh HF, Kuo LC, An KN, Wang YL, Su FC. Behavior of medial gastrocnemius muscle beneath kinesio taping during isometric contraction and badminton lunge performance after fatigue induction. Sci Rep 2023; 13:1779. [PMID: 36720990 PMCID: PMC9889375 DOI: 10.1038/s41598-023-28818-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 01/25/2023] [Indexed: 02/02/2023] Open
Abstract
Kinesio taping (KT) is widely used in sports for performance improvement and injury prevention. However, little is known of the behavior of the muscle region beneath the KT with movement, particularly when the muscle is fatigued. Accordingly, this study investigated the changes in the medial gastrocnemius muscle architecture and fascia thickness when using KT during maximum isometric plantar flexion (MVIC) and badminton lunges following heel rise exercises performed to exhaustion. Eleven healthy collegiate badminton players (4 males and 7 females) were recruited. All of the participants performed two tasks (MVIC and badminton lunge) with a randomized sequence of no taping, KT and sham taping and repeated following exhaustive repetitive heel rise exercise. In the MVIC task, the fascia thickness with the medial gastrocnemius muscle at rest significantly decreased following fatigue induction both without taping and with KT and sham taping (p = 0.036, p = 0.028 and p = 0.025, respectively). In the lunge task, the fascia thickness reduced after fatigue induction in the no taping and sham taping trials; however, no significant change in the fascia thickness occurred in the KT trials. Overall, the results indicate that KT provides a better effect during dynamic movement than in isometric contraction.
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Affiliation(s)
- Minh Hoang-Thuc Vo
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Ju Lin
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Feng Chieh
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Kai-Nan An
- Division of Orthopedic Research, Mayo Clinic, Rochester, USA
| | - Yu-Lin Wang
- Department of Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan
| | - Fong-Chin Su
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
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Brandl A, Egner C, Schwarze M, Reer R, Schmidt T, Schleip R. Immediate Effects of Instrument-Assisted Soft Tissue Mobilization on Hydration Content in Lumbar Myofascial Tissues: A Quasi-Experiment. J Clin Med 2023; 12:jcm12031009. [PMID: 36769657 PMCID: PMC9917932 DOI: 10.3390/jcm12031009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/14/2022] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Instrument-assisted soft tissue mobilization (IASTM) is thought to alter fluid dynamics in human soft tissue. The aim of this study was to investigate the influence of IASTM on the thoracolumbar fascia (TLF) on the water content of the lumbar myofascial tissue. METHODS In total, 21 healthy volunteers were treated with IASTM. Before and after the procedure and 5 and 10 min later, lumbar bioimpedance was measured by bioimpedance analysis (BIA) and TLF stiffness was measured by indentometry. Tissue temperature was recorded at the measurement time points using an infrared thermometer. RESULTS Bioimpedance increased significantly from 58.3 to 60.4 Ω (p < 0.001) at 10-min follow-up after the treatment. Temperature increased significantly from 36.3 to 36.6 °C from 5 to 10 min after treatment (p = 0.029), while lumbar myofascial stiffness did not change significantly (p = 0.84). CONCLUSIONS After the IASTM intervention, there was a significant increase in bioimpedance, which was likely due to a decrease in water content in myofascial lumbar tissue. Further studies in a randomized control trial design are needed to extrapolate the results in healthy subjects to a symptomatic population as well and to confirm the reliability of BIA in myofascial tissue.
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Affiliation(s)
- Andreas Brandl
- Department of Sports Medicine, Faculty for Psychology and Human Movement Science, Institute for Human Movement Science, University of Hamburg, 20148 Hamburg, Germany
- Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
- Osteopathic Research Institute, Osteopathie Schule Deutschland, 22297 Hamburg, Germany
| | - Christoph Egner
- Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
| | - Monique Schwarze
- Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
| | - Rüdiger Reer
- Department of Sports Medicine, Faculty for Psychology and Human Movement Science, Institute for Human Movement Science, University of Hamburg, 20148 Hamburg, Germany
| | - Tobias Schmidt
- Osteopathic Research Institute, Osteopathie Schule Deutschland, 22297 Hamburg, Germany
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, 20457 Hamburg, Germany
| | - Robert Schleip
- Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80333 Munich, Germany
- Correspondence: ; Tel.: +49-89-289-24561
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Yang C, Huang X, Li Y, Sucharit W, Sirasaporn P, Eungpinichpong W. Acute Effects of Percussive Massage Therapy on Thoracolumbar Fascia Thickness and Ultrasound Echo Intensity in Healthy Male Individuals: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1073. [PMID: 36673829 PMCID: PMC9859515 DOI: 10.3390/ijerph20021073] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 05/13/2023]
Abstract
Percussive massage therapy (PT) has been widely used by therapists and the fitness population to treat myofascial-related conditions. However, there is no evidence to confirm the effects of PT on the fascia. This study aimed to investigate the effects of PT on thoracolumbar fascia (TLF) morphology and other related outcomes. METHODS Sixty-six healthy males participated and were randomly allocated into a percussive massage group (PT group) and a control group. The PT group received 15 min of back percussion massage, while the control group rested prone lying in the same environment for 15 min. Thoracolumbar fascia (TLF) thickness and echo intensity, perceived stiffness, lumbar flexibility, and skin temperature were measured in both groups before and immediately after the intervention. RESULT TLF thickness and lumbar flexibility did not change when compared in the two groups. However, the echo intensity (left side, difference -3.36, 95% CI -5.1 to -1.6; right side, difference -4.39, 95% CI -6.1 to -2.7) and perceived stiffness (difference, -1.18, 95% CI -1.84 to -0.52) in the TLF region were significantly lower in the PT group than in the control group and were accompanied by increased skin temperature (difference 0.29, 95% CI 0.11 to 0.48). CONCLUSION We suggest that a 15 min PT with 30 Hz on the back region could reduce TLF echo intensity and perceived stiffness and increase skin temperature in healthy men individual.
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Affiliation(s)
- Chao Yang
- Department of Exercise and Sport Sciences, Faculty of Graduate School, Khon Kaen University, Khon Kaen 40002, Thailand
- Research and Training Center for Enhancing Quality of Life of Working-Age People, Khon Kaen 40002, Thailand
| | - Xingyu Huang
- Department of Human Movement Sciences, Faculty of Physical Education, Gan Nan Normal University, Ganzhou 341000, China
| | - Ying Li
- School of Rehabilitation Medicine, Gan Nan Medical University, Ganzhou 341000, China
| | - Wiraphong Sucharit
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Division of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Patpiya Sirasaporn
- Department of Rehabilitation Medicine Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Wichai Eungpinichpong
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Division of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
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Tamartash H, Bahrpeyma F, Mokhtari Dizaji M. Ultrasound evidence of altered lumbar fascia in patients with low back pain. Clin Anat 2023; 36:36-41. [PMID: 36199243 DOI: 10.1002/ca.23964] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/14/2022] [Accepted: 10/01/2022] [Indexed: 12/14/2022]
Abstract
Different hypotheses have been proposed about the role of lumbar connective tissue in low back pain (LBP). However, none of the previous studies have examined the change in the elastic behavior of lumbar fascia in patients with LBP. The present study aimed to evaluate the changes in the elastic behavior of lumbar fascia in patients with chronic non-specific LBP based on ultrasound imaging. The sonographic strain imaging assessed the thoracolumbar fascia (TLF) of 131 human subjects (68 LBP and 63 non-LBP). Assessments were done at L2-L3 and L4-L5 levels bilaterally. The points were located 2 cm lateral to the midpoint of the interspinous ligament. There were no significant differences in age, sex, and BMI between LBP and healthy individuals. There is a strong inverse relationship between pain severity (r = -0.76, n = 68, p = 0.004) and the TLF elastic modulus coefficient. No significant relationship were observed between age (r = 0.053, n = 68, p = 0.600), BMI (r = -0.45, n = 68, p = 0.092), and gender (r = -0.09, n = 68, p = 0.231) with the TLF elasticity coefficient. The LBP group had a 25%-30% lower TLF elastic modulus coefficient than healthy individuals. The present study is the first to evaluate the elastic coefficient of TLF using the ultrasound imaging method. The study results showed that the TLF elastic coefficient in patients with LBP was reduced compared to healthy individuals and directly related to LBP severity.
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Affiliation(s)
- Hassan Tamartash
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farid Bahrpeyma
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Brandl A, Bartsch K, James H, Miller ME, Schleip R. Influence of Rolfing Structural Integration on Active Range of Motion: A Retrospective Cohort Study. J Clin Med 2022; 11:5878. [PMID: 36233746 PMCID: PMC9570915 DOI: 10.3390/jcm11195878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Recent work has investigated significant force transmission between the components of myofascial chains. Misalignments in the body due to fascial thickening and shortening can therefore lead to complex compensatory patterns. For the treatment of such nonlinear cause−effect pathology, comprehensive neuromusculoskeletal therapy such as the Rolf Method of Structural Integration (SI) could be targeted. Methods: A total of 727 subjects were retrospectively screened from the medical records of an SI practice over a 23-year period. A total of 383 subjects who had completed 10 basic SI sessions met eligibility criteria and were assessed for active range of motion (AROM) of the shoulder and hip before and after SI treatment. Results: Shoulder flexion, external and internal rotation, and hip flexion improved significantly (all p < 0.0001) after 10 SI sessions. Left shoulder flexion and external rotation of both shoulders increased more in men than in women (p < 0.0001) but were not affected by age. Conclusions: An SI intervention could produce multiple changes in the components of myofascial chains that could help maintain upright posture in humans and reduce inadequate compensatory patterns. SI may also affect differently the outcome of some AROM parameters in women and men.
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Affiliation(s)
- Andreas Brandl
- Department of Sports Medicine, Faculty for Psychology and Human Movement Science, Institute for Human Movement Science, University of Hamburg, 20148 Hamburg, Germany
- Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
- Osteopathic Research Institute, Osteopathie Schule Deutschland, 22297 Hamburg, Germany
| | - Katja Bartsch
- Department of Sport Science and Sports, Friedrich-Alexander University Erlangen-Nürnberg, 91058 Erlangen, Germany
| | - Helen James
- Department of Physical Therapy, California State University, Fresno, CA 93740, USA
| | - Marilyn E. Miller
- Department of Physical Therapy, University of St. Augustine for Health Sciences at San Diego, San Diego, CA 92069, USA
| | - Robert Schleip
- Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
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Hirata K, Akagi R. Contribution of muscle stiffness of the triceps surae to passive ankle joint stiffness in young and older adults. Front Physiol 2022; 13:972755. [PMID: 36726380 PMCID: PMC9885261 DOI: 10.3389/fphys.2022.972755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/09/2022] [Indexed: 01/18/2023] Open
Abstract
This study aimed to investigate whether triceps surae muscle stiffness is associated with passive ankle joint stiffness in 40 young (21-24 years) and older (62-83 years) males. Using ultrasound shear wave elastography, the shear modulus of each muscle of the triceps surae (the medial [MG], lateral gastrocnemius [LG], and soleus [Sol]) was assessed as muscle stiffness at the ankle neutral position (NP) and 15-degree dorsiflexed position (DF15) with the knee fully extended. Passive ankle joint stiffness at the NP and DF15 was calculated as the gradient of the angle-torque relationship at each joint angle during passive ankle dorsiflexion at 1°∙s-1 controlled by using an isokinetic dynamometer. Passive ankle joint stiffness was normalized by the body mass. There was no correlation between the absolute ankle joint stiffness and muscle shear modulus of triceps surae in the young and older groups at the NP (r ≤ 0.349, p ≥ 0.138). Significant positive correlations between absolute ankle joint stiffness and muscle shear modulus at DF15 were observed for MG and Sol in the young group (r ≥ 0.451, p ≤ 0.044) but not in the older group. The normalized ankle joint stiffness at the NP was significantly positively correlated with the LG shear modulus in young participants and with the MG and LG shear modulus in older participants (r ≥ 0.466 and p ≤ 0.039). There were significant positive correlations between the normalized ankle joint stiffness and the muscle shear modulus of the triceps surae at DF15 in young and older participants (r ≥ 0.464 and p ≤ 0.040), except for the MG shear modulus in older participants (r = 0.419 and p = 0.066). These results suggest that the material properties of the entire triceps surae, even Sol, which is the most compliant muscle among the triceps surae, affect passive ankle joint stiffness, especially when the triceps surae is lengthened and body size is considered.
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Affiliation(s)
- Kosuke Hirata
- Faculty of Sport Sciences, Waseda University, Saitama, Japan,*Correspondence: Kosuke Hirata, ; Ryota Akagi,
| | - Ryota Akagi
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan,College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan,*Correspondence: Kosuke Hirata, ; Ryota Akagi,
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Engerer N, Frank K, Moellhoff N, Alfertshofer M, Giunta RE, Green JB, Lorenc PZ, Chaney GK, Ehrl D, Cotofana S. Aging of the Neck Decoded: New Insights for Minimally Invasive Treatments. Aesthetic Plast Surg 2022; 46:1698-1705. [PMID: 35701594 DOI: 10.1007/s00266-022-02961-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Many signs of aging manifest in the neck region, including platysmal bands, excess skin, horizontal neck lines and decreasing contour of the neck. While the clinical signs of an aged neck are well-known, data determining the underlying aging process are limited. OBJECTIVE To decode aging of the neck. MATERIALS AND METHODS This prospective study investigated elasticity and firmness of skin, muscle activity and skin displacement upon muscular contraction in the neck in 77 young-, middle- and old-age individuals. Objective outcome measures, including 3-dimensional imaging, cutometry and surface electromyography, were utilized for all assessments. RESULTS Mean firmness of skin decreased significantly from young to old individuals (0.37 ± 0.13 mm, 0.30 ± 0.12 mm and 0.26 ± 0.12 mm in young, middle and old subjects, respectively; p < 0.001). Gross elasticity decreased significantly from 75.1 ± 13.0% in young subjects, to 64.53 ± 15.7% in middle-aged subjects and 55.79 ± 13.0% in old subjects (p < 0.001). The mean y-axis skin displacement increased from 2.48 ± 4.33 mm in young subjects, to 3.11 ± 4.49 mm in middle-aged subjects and 3.61 ± 5.38 mm in old subjects (p = 0.006). The mean signal-to-noise ratio decreased significantly from 16.74 ± 5.77 µV in young subjects, to 14.41 ± 4.86 µV in middle-aged subjects and to 12.23 ± 5.99 µV in old subjects (p < 0.001). CONCLUSION This study provides insights into the interplay between skin elasticity, muscular activity and the reflected movement of the skin of the neck. Appreciation of these age-related changes lays the fundament for aesthetic treatments in this delicate region. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Nina Engerer
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Konstantin Frank
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Nicholas Moellhoff
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Michael Alfertshofer
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Riccardo E Giunta
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Jeremy B Green
- Skin Associates of South Florida and Skin Research Institute, Coral Gables, Florida, USA
| | | | - Grace K Chaney
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Stabile Building 9-38, 200 First Street, Rochester, MN, 55905, USA
| | - Denis Ehrl
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Sebastian Cotofana
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Stabile Building 9-38, 200 First Street, Rochester, MN, 55905, USA.
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Yagi M, Taniguchi M, Tateuchi H, Hirono T, Fukumoto Y, Yamagata M, Nakai R, Yamada Y, Kimura M, Ichihashi N. Age- and sex-related differences of muscle cross-sectional area in iliocapsularis: a cross-sectional study. BMC Geriatr 2022; 22:435. [PMID: 35585587 PMCID: PMC9118574 DOI: 10.1186/s12877-022-03127-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/03/2022] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to determine in how many individuals the iliocapsularis muscle (IC) could be identified on magnetic resonance imaging (MRI) and whether age and sex are associated with the cross-sectional area (CSA) of the IC. Methods Thirty-seven healthy younger adults and 40 healthy older adults were assigned to four groups: 1) 20 younger men; 2) 17 younger women; 3) 20 older men; and 4) 20 older women. The CSAs of the IC, IP, the rectus femoris (RF) and the quadriceps (QUAD) were quantified on an axial MRI. Results The number of individuals with the identified IC was n = 17 (85.0%) of 20 younger men, n = 15 (88.2%) of 17 younger women, n = 18 (90.0%) of 20 older men, and 19 (95.0%) of 20 older women. Our results showed the main effect of sex, but not age, in the CSA of the IC. The men-groups had larger CSA of the IC than the women-groups; however, no difference in CSA of the IC was found between the younger and older groups. Meanwhile, the main effects of age and sex were found for the IP, RF, and QUAD; thus, younger or men groups have larger CSAs of the three muscles than the older or women groups. The IC muscle can be discriminated in 85% – 95% of healthy individuals. Conclusion Although sex and age are associated with the CSA of lower-limb muscles other than the IC, only sex is associated with the CSA of the IC.
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Affiliation(s)
- Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroshige Tateuchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Research Fellow of Japan Society for the Promotion of Science, Kojimachi Business Center Building, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan.,School of Health and Sport Science, Chukyo University, 101 Tokodachi, Kaizu-cho, Toyota, Aichi, 470-0393, Japan
| | - Yoshihiro Fukumoto
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyama Higashimachi, Hirakata, Osaka, 573-1136, Japan
| | - Momoko Yamagata
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyama Higashimachi, Hirakata, Osaka, 573-1136, Japan
| | - Ryusuke Nakai
- Institute for the Future of Human Society, Kyoto University, 46 Shimoadachi-cho, Yoshida Sakyo-ku, Kyoto, 606-8501, Japan
| | - Yosuke Yamada
- National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.,Institute for Active Health, Kyoto University of Advanced Science, Nanjo Otani, 1-1 Sogabecho, Kameoka, Kyoto, 621-8555, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, Nanjo Otani, 1-1 Sogabecho, Kameoka, Kyoto, 621-8555, Japan.,Faculty of Nursing, Doshisha Women's College of Liberal Arts, Koudo, Kyotanabe, Kyoto, 610-0395, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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36
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Besomi M, Salomoni SE, Cruz-Montecinos C, Stecco C, Vicenzino B, Hodges PW. Distinct displacement of the superficial and deep fascial layers of the iliotibial band during a weight shift task in runners: An exploratory study. J Anat 2022; 240:579-588. [PMID: 34697798 PMCID: PMC8819045 DOI: 10.1111/joa.13575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 01/19/2023] Open
Abstract
Motion of the fascial layers of the iliotibial band (ITB), as a reinforcement of the deep fascia lata, is likely to be relevant for its function and mechanical behaviour. This exploratory study aimed to evaluate the ITB fascial layers displacement during a weight shift task. Thirteen pain-free runners performed a 6-second standing weight shift task. B-mode ultrasound imaging using an automated fascicle tracking algorithm was used to measure proximal and distal displacement of superficial and deep ITB layers at the middle region. To study the potential contributors to individual variation of fascial motion, we recorded the activity of five hip/thigh muscles with electromyography (EMG), thigh/pelvis/trunk position with accelerometers, and centre of pressure with a force plate. Linear regressions estimated the relationship between displacement of fascial layers and hip/trunk angles. Independent t-tests or Fisher's exact tests compared EMG and movement-related parameters between participants who demonstrated motion of the fascia in the proximal and distal directions. Thickness of the ITB and the loose connective tissue between its layers were calculated. Proximal displacement was observed in six (-4.1 ± 1.9 mm [superficial]) and two (-6.2 ± 2.0 mm [deep]) participants. Distal displacement was observed for seven participants for each layer (3.1 ± 1.1 mm [superficial]; 3.6 ± 1.3 mm [deep]). Four participants did not show displacement of the deep layer. Trunk lateral flexion and gluteus medius muscle activity were determinants of proximal motion of the superficial layer. Loose connective tissue was thinner in participants without displacement of the deep layer. Displacement of the ITB fascial layers varies between individuals. Variation related to differences in joint movements and muscle activity. This study highlights the complex interaction between fascia and movement.
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Affiliation(s)
- Manuela Besomi
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sauro E Salomoni
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Carlos Cruz-Montecinos
- Clinical Biomechanics Laboratory, Department of Physical Therapy, University of Chile, Santiago, Chile
- Biomechanics and Kinesiology Laboratory, Hospital San José, Santiago, Chile
| | - Carla Stecco
- Human Anatomy and Movement Science, University of Padua, Padua, Italy
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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The Short-Term Effect of Myofascial Relaxation by Roller Massage on Ankle Joint Range of Motion in Older Adults. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Ultrasound Imaging of Brachial and Antebrachial Fasciae. Diagnostics (Basel) 2021; 11:diagnostics11122261. [PMID: 34943498 PMCID: PMC8700752 DOI: 10.3390/diagnostics11122261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 01/10/2023] Open
Abstract
Knowledge about fasciae has become increasingly relevant in connection to regional anesthesiology, given the growing interest in fascial plane, interfascial, and nerve blocks. Ultrasound (US) imaging, thanks to high definition, provides the possibility to visualize and measure their thickness. The purpose of this study was to measure and compare, by US imaging, the thickness of deep/muscular fasciae in different points of the arm and forearm. An observational study has been performed using US imaging to measure brachial and antebrachial fasciae thickness at anterior and posterior regions, respectively, of the arm and forearm at different levels with a new protocol in a sample of 25 healthy volunteers. Results of fascial thickness revealed statistically significant differences (p < 0.0001) in the brachial fascia between the anterior and the posterior regions; in terms of the antebrachial fascia, no statistically significant difference was present (p > 0.05) between the regions/levels. Moreover, regarding the posterior region/levels, the brachial fascia had a greater thickness (mean 0.81 ± 0.20 mm) than the antebrachial fascia (mean 0.71 ± 0.20 mm); regarding the anterior region/levels, the antebrachial fascia was thicker (mean 0.70 ± 0.2 mm) than the brachial fascia (mean 0.61 ± 0.11 mm). In addition, the intra-rater reliability reported good reliability (ICC2,k: 0.88). US imaging helps to improve grading of fascial dysfunction or disease by revealing subclinical lesions, clinically invisible fascial changes, and one of the US parameters to reliably evaluate is the thickness in the different regions and levels.
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Tomita K, Okada S, Sugihara S, Ikeuchi T, Touge H, Hasegawa J, Yamasaki A. Physical Characteristics of Injection Site Pain After COVID-19 mRNA BNT162b2 Vaccination. Yonago Acta Med 2021; 64:339-344. [PMID: 34840513 DOI: 10.33160/yam.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/08/2021] [Indexed: 11/05/2022]
Abstract
Background BNT162b2, an mRNA COVID-19 vaccine, was launched in many countries as an intramuscular vaccination for COVID-19 infection. Few studies have assessed the physical indications of pain at the immunization site. This study aimed to characterize pain at the injection site and investigate morphological attributes using ultrasound. Methods Forty-three of 211 healthcare workers who received a second dose of BNT162b2 between February 2021 and March 2021 were enrolled in the study. The mean age of the subjects was 40 years. We evaluated patients' pain at the injection site using the Numerical Rating Pain Scale (NRPS). We also assessed the thickness of the deltoid muscle fascia at the injection site by ultrasound. Bayesian robust correlation was employed to explore the relationship between the pain intensity scores and ultrasound measurements. Results All eligible subjects complained of pain at the injection site. A median pain onset of 8 hours post-vaccination and a median peak intensity score of 4 were reported. Onset of relief occurred after 2 days. Ultrasound images demonstrated a 2.5-fold increase in fascia thickness at the injection site without intramuscular echogenicity change in all subjects. A correlation was established between the NRPS score and the non-injection-to-injection-side ratio of fascia thickness at the injection site (rho = 0.66). Conclusion A sore arm was the most prevalent side effect of BNT162b2 vaccination and could be attributed to temporal fasciitis.
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Affiliation(s)
- Katsuyuki Tomita
- Department of Respiratory Medicine, National Hospital Organization Yonago Medical Center, Yonago 683-0006, Japan
| | - Shinichi Okada
- Department of Pediatrics, National Hospital Organization Yonago Medical Center, Yonago 683-0006, Japan
| | - Shuji Sugihara
- Department of Radiology, National Hospital Organization Yonago Medical Center, Yonago 683-0006, Japan
| | - Tomoyuki Ikeuchi
- Department of Respiratory Medicine, National Hospital Organization Yonago Medical Center, Yonago 683-0006, Japan
| | - Hirokazu Touge
- Department of Respiratory Medicine, National Hospital Organization Yonago Medical Center, Yonago 683-0006, Japan
| | - Junichi Hasegawa
- Department of Internal Medicine, National Hospital Organization Yonago Medical Center, Yonago 683-0006, Japan
| | - Akira Yamasaki
- Division of Medical Oncology and Molecular Respirology, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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40
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Okabe T, Suzuki M, Goto H, Iso N, Cho K, Hirata K, Shimizu J. Sex Differences in Age-Related Physical Changes among Community-Dwelling Adults. J Clin Med 2021; 10:jcm10204800. [PMID: 34682922 PMCID: PMC8538508 DOI: 10.3390/jcm10204800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/11/2021] [Accepted: 10/16/2021] [Indexed: 12/25/2022] Open
Abstract
The prevalence of physical functioning limitations is positively correlated with age in both men and women. However, whether the appearance of deterioration differs depending on physical function and sex remains unclear. This study aimed to clarify the modes of age-related changes in physical function and sex differences in middle-aged and older adults. This study comprised 124 (46 men and 78 women) healthy adults aged 30 years or older and examined gender differences in physical function. The results of this study showed that one-leg standing time had the highest rate of age-related decline in both men and women, followed by knee extension strength, skeletal muscle mass, the 5 m walking test, and the timed up and go test. The sex-specific points showed a high rate of decline in trunk forward bending in men and a high rate of decline in forced expiratory volume (1 s) and gradual rate of decline in the bone area ratio in women. After middle age, it is desirable to start monitoring and training balance, muscle function, and walking. Men require early intervention for flexibility, and women require early intervention for respiratory function and continued intervention for bone mineral density.
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McCartan AJS, Curran DW, Mrsny RJ. Evaluating parameters affecting drug fate at the intramuscular injection site. J Control Release 2021; 336:322-335. [PMID: 34153375 DOI: 10.1016/j.jconrel.2021.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/18/2022]
Abstract
Intramuscular (IM) injections are a well-established method of delivering a variety of therapeutics formulated for parenteral administration. While the wide range of commercial IM pharmaceuticals provide a wealth of pharmacokinetic (PK) information following injection, there remains an inadequate understanding of drug fate at the IM injection site that could dictate these PK outcomes. An improved understanding of injection site events could improve approaches taken by formulation scientists to identify therapeutically effective and consistent drug PK outcomes. Interplay between the typically non-physiological aspects of drug formulations and the homeostatic IM environment may provide insights into the fate of drugs at the IM injection site, leading to predictions of how a drug will behave post-injection in vivo. Immune responses occur by design after e.g. vaccine administration, however immune responses post-injection are not in the scope of this article. Taking cues from existing in vitro modelling technologies, the purpose of this article is to propose "critical parameters" of the IM environment that could be examined in hypothesis-driven studies. Outcomes of such studies might ultimately be useful in predicting and improving in vivo PK performance of IM injected drugs.
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Affiliation(s)
- Adam J S McCartan
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, Avon BA2 7AY, UK
| | - David W Curran
- CMC Analytical, GlaxoSmithKline, Collegeville, PA 19426, USA
| | - Randall J Mrsny
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath, Avon BA2 7AY, UK.
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Otsuka S, Shan X, Kurumisawa K, Omura S, Yamagishi T, Naito M, Kawakami Y. Investigation of the association between human fascia lata thickness and its neighboring tissues' morphology and function using B-mode ultrasonography. J Anat 2021; 239:1114-1122. [PMID: 34254666 PMCID: PMC8546528 DOI: 10.1111/joa.13505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/28/2021] [Accepted: 06/18/2021] [Indexed: 12/01/2022] Open
Abstract
The fascia lata is a membrane tissue which envelopes all thigh muscles and connects with the subcutaneous adipose tissues through loose connective tissues. It is presumable that the morphology of the fascia lata is strongly affected by the unique properties of underlying thigh muscles and subcutaneous adipose tissues. We aimed to investigate the relationships between characteristics of the fascia lata and adjoining adipose tissues and underlying muscles. Twenty healthy people were recruited (25 ± 3 years, 167.1 ± 8.5 cm, 62.5 ± 13.2 kg). The thickness of the skeletal muscles (rectus femoris, vastus lateralis, biceps femoris, and semitendinosus), and their overlying fascia lata and subcutaneous adipose tissues were measured by B‐mode ultrasonography. Isometric knee extension and flexion torque during maximal voluntary contraction were also tested. The fascia lata thickness demonstrated site‐dependent differences (vastus lateralis: 0.91 ± 0.20 mm > rectus femoris, biceps femoris, and semitendinosus: 0.56–0.69 mm, p < 0.01). Furthermore, there were large individual variations in the fascia lata thickness even in the same region of the thigh. The fascia lata showed positive simple correlations with height (rectus femoris: r = 0.39 p = 0.01, semitendinosus: r = 0.37 p < 0.05), body mass (rectus femoris: r = 0.59, p < 0.01, vastus lateralis: r = 0.47, p < 0.01, semitendinosus: r = 0.55, p < 0.01), corresponding muscle thickness (rectus femoris: r = 0.39, p < 0.05, semitendinosus: r = 0.74, p < 0.01) and knee extension (rectus femoris: r = 0.52, p < 0.01, vastus lateralis: r = 0.40, p < 0.01) and flexion (semitendinosus: r = 0.41, p < 0.01) torques. After adjusting for the influence of height and/or body mass, the fascia lata thickness showed a partial correlation only with the skeletal muscle thickness at the semitendinosus (r = 0.61, p < 0.01). The present study revealed that the fascia lata has site‐specific differences of the thickness, which positively correlates with the underlying muscle thickness and corresponding joint torque. Furthermore, the fascia lata over the semitendinosus is associated with the underlying muscle characteristics independent of the physical constitution. It is assumed that the fascia lata has the plasticity and changes its thickness, which likely corresponds to the morphology of the neighboring tissues and underlying muscle function. The fascia lata showed individual differences of its thickness which was positively correlated with its underlying muscle thickness and/or strength. Especially, the fascia lata over the ST reflects the underlying muscle characteristics regardless of the physical constitution.![]()
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Affiliation(s)
- Shun Otsuka
- Department of Anatomy, Aichi Medical University, Aichi, Japan.,Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Xiyao Shan
- Department of Anatomy, Aichi Medical University, Aichi, Japan
| | | | - Shiho Omura
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | | | - Munekazu Naito
- Department of Anatomy, Aichi Medical University, Aichi, Japan
| | - Yasuo Kawakami
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Chen Z, Wu J, Wang X, Wu J, Ren Z. The effects of myofascial release technique for patients with low back pain: A systematic review and meta-analysis. Complement Ther Med 2021; 59:102737. [PMID: 33984499 DOI: 10.1016/j.ctim.2021.102737] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/06/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The purpose of this meta-analytic review was to quantitatively examine the effects of myofascial release technique (MFR) on pain intensity, back disability, lumbar range of motion, and quality of life in patients with low back pain (LBP). METHODS Potential articles were retrieved using five electronic databases (Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, and Wanfang). The search period was from inception to January 27, 2021. Two researchers independently completed record retrieval and selection, data extraction, and methodological quality assessment. Randomized controlled trials (RCTs) assessing the effect of MFR on pain intensity, back disability, lumbar range of motion, and quality of life in LBP patients were included. Pooled effect sizes were calculated using random effects models and 95 % confidence interval (95 % CI). RESULTS Data from eight RCTs (386 patients with back pain) meeting the inclusion criteria were extracted for meta-analysis with methodological quality assessment scores ranging from 6 to 10. Compared to the control intervention, MFR induced significant decrease in back disability (SMD = -0.35, 95 % confidence interval [CI] = -0.68, -0.02, P = 0.04, I² = 46 %, n = 284). MFR induced non-significant decrease in the pain intensity (SMD = -0.12, 95 % confidence interval[CI] = -0.35, 0.11, P = 0.32, I² = 0%, n = 294), non-significant improvement in quality of life (SMD = -0.09, 95 % confidence interval [CI] = -0.46, 0.28, P = 0.62, I² = 0%, n = 114), and non-significant improvement in lumbar range of motion (Flexion SMD = 0.57,95 % confidence interval [CI] = -0.09, 1.24, P = 0.09, I² = 54 %, n = 80) (Extension SMD = 0.68, 95 % confidence interval[CI] = -0.72, 2.08, P = 0.34, I² = 89 %, n = 80) (Right flexion SMD = 0.05, 95 % confidence interval[CI] = -0.90, 0.99, P = 0.92, I² = 78 %, n = 80) (Left flexion SMD = 0.14, 95 % confidence interval[CI] = -0.59, 0.88, P = 0.70, I² = 64 %, n = 80). CONCLUSION The findings suggest that MFR can improve the effect of physical therapy alone and exercise therapy alone, and that MFR can be an effective adjuvant therapy. Meta-analysis showed that MFR has a significant effect on reducing back disability in patients with low back pain, but no significant effect on reducing pain intensity, improving quality of life, and improving lumbar range of motion.
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Affiliation(s)
- Ziyan Chen
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| | - Jinlong Wu
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| | - Xiaodong Wang
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| | - Jieqing Wu
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
| | - Zhanbing Ren
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
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Epimuscular myofascial force transmission from biarticular rectus femoris elongation increases shear modulus of monoarticular quadriceps muscles. J Biomech 2021; 122:110421. [PMID: 33915474 DOI: 10.1016/j.jbiomech.2021.110421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 03/13/2021] [Accepted: 03/25/2021] [Indexed: 11/22/2022]
Abstract
This study aimed to examine the effect of rectus femoris (RF) elongation with passive hip angle change on the shear moduli of the vastus lateralis (VL) and medialis (VM) to verify whether Epimuscular myofascial force transmission (EMFT) occurs in the human quadriceps. Fourteen healthy men participated in this study. The shear moduli of the RF, VL, and VM were measured in four hip positions: flexion (Flex), extension and abduction (Ext-Abd), extension (Ext), and extension and adduction (Ext-Add). As the behavior of shear moduli may differ depending on the parts of the vasti muscles, we measured the medial and lateral parts of the VL (Medial-VL and Lateral-VL) and VM (Medial-VM and Lateral-VM). The shear moduli at the Ext and Ext-Add positions were higher than at the Flex position in the RF, VL, and VM. The shear moduli during Ext and Ext-Add were higher than at the Ext-Abd in the RF, VL, and Lateral-VM. Moreover, the shear modulus of the Lateral-VM was higher than of the Medial-VM (Flex: 8.5% higher; Ext-Abd: 15.6%; Ext: 30.2%; Ext-Add: 32.6%). The shear moduli of the VL and VM, which are monoarticular muscles of the knee, increased with passive hip extension or adduction with extension, even when the knee angle was kept constant. The results suggest that EMFT occurs in the quadriceps, and EMFT had a great impact in the Lateral-VM, which is anatomically adjacent to the RF, but it had little effect in the Medial-VM, which is further away from the RF.
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45
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Ho CC, Lee PF, Chen HL, Tseng CY, Hsieh XY, Chiu CH. Poor health-related physical fitness performance increases the overweight and obesity risk in older adults from Taiwan. BMC Geriatr 2021; 21:170. [PMID: 33750323 PMCID: PMC7941954 DOI: 10.1186/s12877-021-02112-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 02/24/2021] [Indexed: 01/12/2023] Open
Abstract
Background The purpose of the present study was to investigate the associations between health-related physical fitness performance and overweight/obesity risk among Taiwanese healthy older adults. Methods A secondary dataset from the nationwide survey was applied in this study. Data from a total of 21,630 respondents aged 65–96 years were collected in this study. Demographic characteristics, life habits, perceived health status, anthropometric assessments, and health-related physical fitness measurements from this dataset were analyzed using the chi-square test, one-way analysis of variance, and logistic regression analysis. Results The results indicated that overweight and obesity significantly associated with health-related physical fitness performance in the Taiwanese older adult population. In particular, the upper extremity muscular endurance scores of older adults with poor activity and physical fitness scores revealed obesity as a critical indicator of health-related physical fitness performance. Conclusions Future studies can use muscle quality or body fat classification to predict obesity in older adults, which could more precisely portray the relationship between obesity and health-related physical fitness performance.
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Affiliation(s)
- Chien-Chang Ho
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, 242, Taiwan.,Research and Development Center for Physical Education, Health, and Information Technology, Fu Jen Catholic University, New Taipei City, 242, Taiwan
| | - Po-Fu Lee
- Research and Development Center for Physical Education, Health, and Information Technology, Fu Jen Catholic University, New Taipei City, 242, Taiwan.,Office of Physical Education Affairs, Taipei Medical University, Taipei City, 110, Taiwan
| | - Hui-Ling Chen
- Graduate Institute of Educational Leadership and Development, Fu Jen Catholic University, New Taipei City, 242, Taiwan
| | - Ching-Yu Tseng
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, 242, Taiwan.,Research and Development Center for Physical Education, Health, and Information Technology, Fu Jen Catholic University, New Taipei City, 242, Taiwan
| | - Xin-Yu Hsieh
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, 242, Taiwan.,Office of Physical Education Affairs, Taipei Medical University, Taipei City, 110, Taiwan
| | - Chih-Hui Chiu
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung City, Taiwan.
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46
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Hirata K, Yamadera R, Akagi R. Associations between Range of Motion and Tissue Stiffness in Young and Older People. Med Sci Sports Exerc 2021; 52:2179-2188. [PMID: 32348099 PMCID: PMC7497479 DOI: 10.1249/mss.0000000000002360] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Supplemental digital content is available in the text. Purpose The purpose of this study was to investigate differences in the associations between passive ankle dorsiflexion range of motion (ROM) and stiffness of the triceps surae, sciatic nerve, and deep fascia located in the posterior leg between young and older people. Methods Twenty young and twenty older males were recruited and were placed in a prone position with their hip and knee fully extended. Passive ankle dorsiflexion ROM was determined based on the onset of pain during passive dorsiflexion at 1°·s−1 using an isokinetic dynamometer. Shear wave speeds (as a stiffness index) of the triceps surae, the sciatic nerve, and the deep fascia in the posterior leg were evaluated by ultrasound shear wave elastography. Results The shear wave speeds of the medial and lateral gastrocnemius measured at 15° dorsiflexion correlated negatively with passive ROM in young but not in older participants. The shear wave speed of the sciatic nerve measured at 15° dorsiflexion correlated negatively with passive ROM only in older participants. No association was observed between passive ROM and shear wave speed of the deep fascia in the posterior leg. For data measured at maximal dorsiflexion angle (as an index of stretch tolerance), shear wave speeds of the triceps surae and passive joint torque correlated positively with passive ROM in both groups. Conclusion These results suggest that the tissues limiting passive ankle dorsiflexion ROM are muscle and nerve for young and older people, respectively, whereas stretch tolerance influences passive ROM for both groups. This implies that the relative contribution of nonmuscular tissues to joint flexibility become stronger than that of muscles with age.
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Affiliation(s)
| | - Ryosuke Yamadera
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama-shi, Saitama, JAPAN
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A Closer Look at the Cellular and Molecular Components of the Deep/Muscular Fasciae. Int J Mol Sci 2021; 22:ijms22031411. [PMID: 33573365 PMCID: PMC7866861 DOI: 10.3390/ijms22031411] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
The fascia can be defined as a dynamic highly complex connective tissue network composed of different types of cells embedded in the extracellular matrix and nervous fibers: each component plays a specific role in the fascial system changing and responding to stimuli in different ways. This review intends to discuss the various components of the fascia and their specific roles; this will be carried out in the effort to shed light on the mechanisms by which they affect the entire network and all body systems. A clear understanding of fascial anatomy from a microscopic viewpoint can further elucidate its physiological and pathological characteristics and facilitate the identification of appropriate treatment strategies.
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Ultrasound Imaging of Crural Fascia and Epimysial Fascia Thicknesses in Basketball Players with Previous Ankle Sprains Versus Healthy Subjects. Diagnostics (Basel) 2021; 11:diagnostics11020177. [PMID: 33530583 PMCID: PMC7911860 DOI: 10.3390/diagnostics11020177] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Fascial layers may play an important role in locomotor mechanics. Recent researches have revealed an association between increases of fascia thickness and reduced joint flexibility in patients with chronic pain. The purpose of this study was to measure and compare, through the use of ultrasound imaging, the thickness of the deep/crural fascia in different points of the leg as well as the epimysial fascia thickness at level 2 of anterior compartment of leg, in male basketball players with history of recurrent ankle sprain and in healthy participants. Methods: A cross-sectional study has been performed using ultrasound imaging to measure deep/crural fascia thickness of anterior, lateral and posterior compartment of the leg at different levels with a new protocol in a sample of 30 subjects, 15 basketball players and 15 healthy participants. Results: Findings of fascial thickness revealed statistically significant differences (p < 0.01) in epimysial fascia thickness and in deep/crural fascia thickness between levels/compartments of the same group and between two groups. Moreover, Post 3 deep/crural fascia thicknesses (p < 0.001) were decreased showing statistically significant difference for the basketball players group respect the healthy participants group. Conclusions: These findings suggested that the posterior compartment was thicker than anterior compartment, probably due to a postural reason in both groups. Moreover, they showed an increase of thickness of the epimysial fascia in basketball players with previous ankle sprains. This variability underlines the importance to assess the fasciae and to make results comparable.
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Pirri C, Fede C, Petrelli L, Guidolin D, Fan C, De Caro R, Stecco C. An anatomical comparison of the fasciae of the thigh: A macroscopic, microscopic and ultrasound imaging study. J Anat 2020; 238:999-1009. [PMID: 33219512 DOI: 10.1111/joa.13360] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 12/21/2022] Open
Abstract
Although the number of Ultrasound (US) imaging studies investigating the fascial layers are becoming more numerous, the majority tend to use different reference points and terminology to describe their findings. The current work set out to compare macroscopic and microscopic data of specimens of the fascial layers of the thigh with US imaging findings. Specimens of the different fascial layers of various regions of the thigh were collected for macroscopic and histological analyses from three fresh cadavers and compared with in vivo US images of the thighs of 20 healthy volunteers. The specimens showed that the subcutaneous tissue of the thigh is made up of three layers: a superficial adipose layer, a membranous layer/superficial fascia, and a deep adipose layer. The deep fascia is composed of an aponeurotic fascia, which envelops all the thigh muscles and is laterally reinforced by the iliotibial tract and an epimysial fascia, which is specific for each muscle. The morphometric measurements of the thickness of the superficial fascia were different (anterior: 153.2 ± 39.3 µm; medial: 128.4 ± 24.7 µm; lateral: 154 ± 28.9 µm; and posterior: 148.8 ± 33.2 µm) as were those of the deep fascia (anterior: 556.8 ± 176.2 µm; medial: 820.4 ± 201 µm; lateral: 1112 ± 237.9 µm; and posterior: 730.4 ± 186.5 µm). The US scans showed a clear picture of the superficial adipose tissue, the superficial fascia, and the deep adipose tissue, as well as the deep fasciae. The epimysial and aponeurotic fasciae of only some topographic areas could be independently identified. The US imaging findings confirmed that the superficial and deep fascia have different thicknesses, and they showed that the US measurements were always larger with respect to those produced by histological analysis (p < 0.001) probably due to shrinkage during the processing. The posterior region (level 1) of the superficial fascia had, for example, a mean thickness of 0.56 ± 0.12 mm at US, while the histological analysis showed that it was 148.8 ± 33.2 µm. Showing a similar pattern, the thickness of the deep fascia was as follows: 1.64 ± 0.85 mm versus 730.4 ± 186.5 µm. Study results have confirmed that US can be considered a valid, non-invasive instrument to evaluate the fascial layers. In any event, there is a clear need for a set of standardised protocols since the thickness of the fascial layers of different parts of the human body varies and the data obtained using inaccurate reference points are not reproducible or comparable. Given the inconsistent terminology used to describe the fascial system, it would also be important to standardise the terminology used to define its parts. The difficulty in distinguishing between the epimysial and aponeurotic/deep fascia can also impede data interpretation.
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Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Caterina Fede
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Lucia Petrelli
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Diego Guidolin
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Chenglei Fan
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
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Sednieva Y, Bruyère-Garnier K, Naaim A, Viste A, Gras LL. Strain release assessment of the iliotibial band (ITB) when using a pie-crusting technique: a preliminary ex vivo study. Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1816291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Y. Sednieva
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T 9406, Lyon, France
| | - K. Bruyère-Garnier
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T 9406, Lyon, France
| | - A. Naaim
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T 9406, Lyon, France
| | - A. Viste
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T 9406, Lyon, France
- Service de Chirurgie Orthopédique et Traumatologique, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite cedex, France
| | - L. L. Gras
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T 9406, Lyon, France
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