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Clark NC. Sensorimotor control of functional joint stability: Scientific concepts, clinical considerations, and the articuloneuromuscular cascade paradigm in peripheral joint injury. Musculoskelet Sci Pract 2024; 74:103198. [PMID: 39362022 DOI: 10.1016/j.msksp.2024.103198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 09/22/2024] [Accepted: 09/28/2024] [Indexed: 10/05/2024]
Abstract
Human movement depends on sensorimotor control. Sensorimotor control refers to central nervous system (CNS) control of joint stability, posture, and movement, all of which are effected via the sensorimotor system. Given the nervous, muscular, and skeletal systems function as an integrated "neuromusculoskeletal system" for the purpose of executing movement, musculoskeletal conditions can result in a cascade of impairments that affect negatively all three systems. The purpose of this article is to revisit concepts in joint stability, sensorimotor control of functional joint stability (FJS), joint instability, and sensorimotor impairments contributing to functional joint instability. This article differs from historical work because it updates previous models of joint injury and joint instability by incorporating more recent research on CNS factors, skeletal muscle factors, and tendon factors. The new 'articuloneuromuscular cascade paradigm' presented here offers a framework for facilitating further investigation into physiological and biomechanical consequences of joint injury and, in turn, how these follow on to affect physical activity (functional) capability. Here, the term 'injury' represents traumatic joint injury with a focus is on peripheral joint injury. Understanding the configuration of the sensorimotor system and the cascade of post-injury sensorimotor impairments is particularly important for clinicians reasoning rational interventions for patients with mechanical instability and functional instability. Concurrently, neurocognitive processing and neurocognitive performance are also addressed relative to feedforward neuromuscular control of FJS. This article offers itself as an educational resource and scientific asset to contribute to the ongoing research and applied practice journey for developing optimal peripheral joint injury rehabilitation strategies.
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Affiliation(s)
- Nicholas C Clark
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK, United Kingdom.
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2
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Suito H, Minamizono W, Yashima N, Matsunaga H, Fujikawa K, Ohsako M. Effect of load reduction on the calcification of rat tibial tuberosity: Focus on calcification factors and chondrocyte mechanosensors. J Anat 2024. [PMID: 39234669 DOI: 10.1111/joa.14128] [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: 09/06/2023] [Revised: 07/30/2024] [Accepted: 08/05/2024] [Indexed: 09/06/2024] Open
Abstract
The tibial tuberosity has a superficial patellar tendon-embedded portion and a deep uncalcified cartilage portion. Suppressed calcification of the tibial tuberosity leads to Osgood-Schlatter disease. The tibial tuberosity calcifies with age; load reduction degrades the cartilage matrix and promotes calcification, suggesting that reduced mechanical stimulation of the tibial tuberosity promotes calcification. However, this is yet to be clarified. Therefore, in this study, we aimed to investigate the effects of mechanical stimulation reduction on the tibial tuberosity tissue structure and calcification mechanism. Specifically, we examined the effect of load reduction on tibial tuberosity calcification in 20 male 7-week-old Wistar rats classified into two groups: hind-limb suspension (HS, n = 10) and control (CO, n = 10). We observed superficial and deep tibial tuberosities in both groups. The tibial tuberosity in the HS group had narrower areas of deep portions than did those in the CO group (p = 0.000539), and immature bone tissue and cartilage tissue were observed in the HS group. Enpp1 expression did not significantly differ between the groups (p = 0.804). In contrast, Alpl (p = 0.001) and Mmp3 (p = 0.006) expression increased whereas Timp3 expression decreased (p = 0.002) in the HS group. Thus, these results showed a maturing of bone ossification, and this gene expression trend was similar to that observed in a murine join instability model of osteoarthritis with articular cartilage calcification and ossification. The HS tibial tuberosity also showed immature bone tissue. In conclusion, reduced mechanical stimulation caused tibial tuberosity calcification and pathological changes. These findings highlight the importance of optimal exercise to avoid premature pathological structural changes in bones and joints.
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Affiliation(s)
- Hirai Suito
- Life Innovation Institute, Toyo University, Tokyo, Japan
- Department of Anatomy, Teikyo University of School of Medicine, Tokyo, Japan
| | | | - Nao Yashima
- Graduate School of Health Sports Science, Toyo University, Tokyo, Japan
| | - Hiroya Matsunaga
- Graduate School of Health Sports Science, Toyo University, Tokyo, Japan
| | - Kaoru Fujikawa
- Department of Oral Anatomy and Developmental Biology, Showa University School of Dentistry, Tokyo, Japan
| | - Masafumi Ohsako
- Graduate School of Health Sports Science, Toyo University, Tokyo, Japan
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3
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Wulff MW, Mackey AL, Kjær M, Bayer ML. Return to Sport, Reinjury Rate, and Tissue Changes after Muscle Strain Injury: A Narrative Review. TRANSLATIONAL SPORTS MEDICINE 2024; 2024:2336376. [PMID: 39263259 PMCID: PMC11390226 DOI: 10.1155/2024/2336376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 06/14/2024] [Accepted: 07/29/2024] [Indexed: 09/13/2024]
Abstract
A major challenge in sports medicine is to facilitate the fastest possible recovery from injury without increasing the risk of subsequent reruptures, and thus effective rehabilitation programs should balance between these two factors. The present review focuses on examining the role of different resistance training interventions in rehabilitation of acute muscle strain in the time frame from injury until return to sport (RTS), the rate of reinjuries, and tissue changes after injury. Randomized, controlled trials dealing with a component of resistance training in their rehabilitation protocols, as well as observational studies on tissue morphology and tissue changes as a result to muscle strain injuries, were included. The mean time for RTS varied from 15 to 86 days between studies (n = 8), and the mean rate of reinjury spanned from 0 to 70%. Eccentric resistance training at long muscle length and rapid introduction to rehabilitation postinjury led to significant improvement regarding RTS, and core-stabilizing exercises as well as implementing an individualized algorithm for rehabilitation seem to reduce the risk of reinjury in studies with a high rerupture rate. Independent of the rehabilitation program, structural changes appear to persist for a long time, if not permanently, after a strain injury.
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Affiliation(s)
- Mette W Wulff
- Institute of Sports Medicine Copenhagen Department of Orthopedic Surgery M Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen Department of Orthopedic Surgery M Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - Michael Kjær
- Institute of Sports Medicine Copenhagen Department of Orthopedic Surgery M Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - Monika L Bayer
- Institute of Sports Medicine Copenhagen Department of Orthopedic Surgery M Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
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Seo F, Clouette J, Huang Y, Potvin‐Desrochers A, Lajeunesse H, Parent‐L'Ecuyer F, Traversa C, Paquette C, Churchward‐Venne TA. Changes in brain functional connectivity and muscle strength independent of elbow flexor atrophy following upper limb immobilization in young females. Exp Physiol 2024; 109:1557-1571. [PMID: 38935545 PMCID: PMC11363139 DOI: 10.1113/ep091782] [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: 01/26/2024] [Accepted: 06/11/2024] [Indexed: 06/29/2024]
Abstract
Muscle disuse induces a decline in muscle strength that exceeds the rate and magnitude of muscle atrophy, suggesting that factors beyond the muscle contribute to strength loss. The purpose of this study was to characterize changes in the brain and neuromuscular system in addition to muscle size following upper limb immobilization in young females. Using a within-participant, unilateral design, 12 females (age: 20.6 ± 2.1 years) underwent 14 days of upper arm immobilization using an elbow brace and sling. Bilateral measures of muscle strength (isometric and isokinetic dynamometry), muscle size (magnetic resonance imaging), voluntary muscle activation capacity, corticospinal excitability, cortical thickness and resting-state functional connectivity were collected before and after immobilization. Immobilization induced a significant decline in isometric elbow flexion (-21.3 ± 19.2%, interaction: P = 0.0440) and extension (-19.9 ± 15.7%, interaction: P = 0.0317) strength in the immobilized arm only. There was no significant effect of immobilization on elbow flexor cross-sectional area (CSA) (-1.2 ± 2.4%, interaction: P = 0.466), whereas elbow extensor CSA decreased (-2.9 ± 2.9%, interaction: P = 0.0177) in the immobilized arm. Immobilization did not differentially alter voluntary activation capacity, corticospinal excitability, or cortical thickness (P > 0.05); however, there were significant changes in the functional connectivity of brain regions related to movement planning and error detection (P < 0.05). This study reveals that elbow flexor strength loss can occur in the absence of significant elbow flexor muscle atrophy, and that the brain represents a site of functional adaptation in response to upper limb immobilization in young females.
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Affiliation(s)
- Freddie Seo
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
| | - Julien Clouette
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
| | - Yijia Huang
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
| | - Alexandra Potvin‐Desrochers
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
- Centre for Interdisciplinary Research in Rehabilitation of Greater MontrealMontrealQCCanada
| | - Henri Lajeunesse
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
| | | | - Claire Traversa
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
| | - Caroline Paquette
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
- Centre for Interdisciplinary Research in Rehabilitation of Greater MontrealMontrealQCCanada
| | - Tyler A. Churchward‐Venne
- Department of Kinesiology and Physical EducationMcGill UniversityMontrealQCCanada
- Division of Geriatric MedicineMcGill UniversityMontrealQCCanada
- Research Institute of the McGill University Health CentreMontrealQCCanada
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Balshaw TG, McDermott EJ, Massey GJ, Hartley C, Kong PW, Maden-Wilkinson T, Folland J. Smaller Biceps Femoris Aponeurosis Size in Legs with a History of Hamstring Strain Injury. Int J Sports Med 2024. [PMID: 38897227 DOI: 10.1055/a-2348-2605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Biceps femoris long head (BFLH) aponeurosis size was compared between legs with and without prior hamstring strain injury (HSI) using two approaches: within-group (injured vs. uninjured legs of previous unilateral HSI athletes) and between-group (previously injured legs of HSI athletes vs. legs of No Prior HSI athletes). MRI scans were performed on currently healthy, competitive male athletes with Prior HSI history (n=23;≥1 verified BFLH injury; including a sub-group with unilateral HSI history; most recent HSI 1.6±1.2 years ago) and pair-matched athletes with No Prior HSI history (n=23). Anonymized axial images were manually segmented to quantify BFLH aponeurosis and muscle size. Prior unilateral HSI athletes' BFLH aponeurosis maximum width, aponeurosis area, and aponeurosis:muscle area ratio were 14.0-19.6% smaller in previously injured vs. contralateral uninjured legs (paired t-test, 0.008≤P≤0.044). BFLH aponeurosis maximum width and area were also 9.4-16.5% smaller in previously injured legs (n=28) from Prior HSI athletes vs. legs (n=46) of No Prior HSI athletes (unpaired t-test, 0.001≤P≤0.044). BFLH aponeurosis size was smaller in legs with prior HSI vs. those without prior HSI. These findings suggest BFLH aponeurosis size, especially maximum width, could be a potential cause or consequence of HSI, with prospective evidence needed to support or refute these possibilities.
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Affiliation(s)
- Thomas G Balshaw
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Emmet J McDermott
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Garry J Massey
- School of Sport & Health Sciences, University of Exeter, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Chris Hartley
- Department of Health Sciences, Birmingham City University, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Pui Wah Kong
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Tom Maden-Wilkinson
- Academy of Sport and Physical Activity, Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Jonathan Folland
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
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Boccia G, Brustio PR, Beratto L, Peluso I, Ferrara R, Munzi D, Toti E, Raguzzini A, Sciarra T, Rainoldi A. Upper-Limb Muscle Fatigability in Para-Athletes Quantified as the Rate of Force Development in Rapid Contractions of Submaximal Amplitude. J Funct Morphol Kinesiol 2024; 9:108. [PMID: 38921644 PMCID: PMC11204935 DOI: 10.3390/jfmk9020108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024] Open
Abstract
This study aimed to compare neuromuscular fatigability of the elbow flexors and extensors between athletes with amputation (AMP) and athletes with spinal cord injury (SCI) for maximum voluntary force (MVF) and rate of force development (RFD). We recruited 20 para-athletes among those participating at two training camps (2022) for Italian Paralympic veterans. Ten athletes with SCI (two with tetraplegia and eight with paraplegia) were compared to 10 athletes with amputation (above the knee, N = 3; below the knee, N = 6; forearm, N = 1). We quantified MVF, RFD at 50, 100, and 150 ms, and maximal RFD (RFDpeak) of elbow flexors and extensors before and after an incremental arm cranking to voluntary fatigue. We also measured the RFD scaling factor (RFD-SF), which is the linear relationship between peak force and peak RFD quantified in a series of ballistic contractions of submaximal amplitude. SCI showed lower levels of MVF and RFD in both muscle groups (all p values ≤ 0.045). Despite this, the decrease in MVF (Cohen's d = 0.425, p < 0.001) and RFDpeak (d = 0.424, p = 0.003) after the incremental test did not show any difference between pathological conditions. Overall, RFD at 50 ms showed the greatest decrease (d = 0.741, p < 0.001), RFD at 100 ms showed a small decrease (d = 0.382, p = 0.020), and RFD at 150 ms did not decrease (p = 0.272). The RFD-SF decreased more in SCI than AMP (p < 0.0001). Muscle fatigability impacted not only maximal force expressions but also the quickness of ballistic contractions of submaximal amplitude, particularly in SCI. This may affect various sports and daily living activities of wheelchair users. Early RFD (i.e., ≤50 ms) was notably affected by muscle fatigability.
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Affiliation(s)
- Gennaro Boccia
- Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy;
- Neuromuscular Function Research Group, School of Exercise and Sport Science, University of Turin, 10126 Turin, Italy;
| | - Paolo Riccardo Brustio
- Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy;
- Neuromuscular Function Research Group, School of Exercise and Sport Science, University of Turin, 10126 Turin, Italy;
| | - Luca Beratto
- Neuromuscular Function Research Group, School of Exercise and Sport Science, University of Turin, 10126 Turin, Italy;
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy;
| | - Ilaria Peluso
- Research Centre for Food and Nutrition (CREA-AN), 00178 Rome, Italy; (I.P.); (E.T.); (A.R.)
| | - Roberto Ferrara
- Rehabilitation Medicine Department, Italian Army Medical Hospital, 00143 Rome, Italy; (R.F.); (T.S.)
| | - Diego Munzi
- Joint Veteran Defence Center, 00184 Rome, Italy;
| | - Elisabetta Toti
- Research Centre for Food and Nutrition (CREA-AN), 00178 Rome, Italy; (I.P.); (E.T.); (A.R.)
| | - Anna Raguzzini
- Research Centre for Food and Nutrition (CREA-AN), 00178 Rome, Italy; (I.P.); (E.T.); (A.R.)
| | - Tommaso Sciarra
- Rehabilitation Medicine Department, Italian Army Medical Hospital, 00143 Rome, Italy; (R.F.); (T.S.)
- Joint Veteran Defence Center, 00184 Rome, Italy;
| | - Alberto Rainoldi
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy;
- Research Centre for Food and Nutrition (CREA-AN), 00178 Rome, Italy; (I.P.); (E.T.); (A.R.)
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Cavalcante JGT, Ribeiro VHDS, Marqueti RDC, Paz IDA, Bastos JAI, Vaz MA, Babault N, Durigan JLQ. Effect of muscle length on maximum evoked torque, discomfort, contraction fatigue, and strength adaptations during electrical stimulation in adult populations: A systematic review. PLoS One 2024; 19:e0304205. [PMID: 38857245 PMCID: PMC11164398 DOI: 10.1371/journal.pone.0304205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
Neuromuscular electrical stimulation (NMES) can improve physical function in different populations. NMES-related outcomes may be influenced by muscle length (i.e., joint angle), a modulator of the force generation capacity of muscle fibers. Nevertheless, to date, there is no comprehensive synthesis of the available scientific evidence regarding the optimal joint angle for maximizing the effectiveness of NMES. We performed a systematic review to investigate the effect of muscle length on NMES-induced torque, discomfort, contraction fatigue, and strength training adaptations in healthy and clinical adult populations (PROSPERO: CRD42022332965). We conducted searches across seven electronic databases: PUBMED, Web of Science, EMBASE, PEDro, BIREME, SCIELO, and Cochrane, over the period from June 2022 to October 2023, without restricting the publication year. We included cross-sectional and longitudinal studies that used NMES as an intervention or assessment tool for comparing muscle lengths in adult populations. We excluded studies on vocalization, respiratory, or pelvic floor muscles. Data extraction was performed via a standardized form to gather information on participants, interventions, and outcomes. Risk of bias was assessed using the Revised Cochrane risk-of-bias tool for cross-over trials and the Physiotherapy Evidence Database scale. Out of the 1185 articles retrieved through our search strategy, we included 36 studies in our analysis, that included 448 healthy young participants (age: 19-40 years) in order to investigate maximum evoked torque (n = 268), contraction fatigability (n = 87), discomfort (n = 82), and muscle strengthening (n = 22), as well as six participants with spinal cord injuries, and 15 healthy older participants. Meta-analyses were possible for comparing maximal evoked torque according to quadriceps muscle length through knee joint angle. At optimal muscle length 50° - 70° of knee flexion, where 0° is full extension), there was greater evoked torque during nerve stimulation compared to very short (0 - 30°) (p<0.001, CI 95%: -2.03, -1.15 for muscle belly stimulation, and -3.54, -1.16 for femoral nerve stimulation), short (31° - 49°) (p = 0.007, CI 95%: -1.58, -0.25), and long (71° - 90°) (p<0.001, CI 95%: 0.29, 1.02) muscle lengths. At long muscle lengths, NMES evoked greater torque than very short (p<0.001, CI 95%: -2.50, -0.67) and short (p = 0.04, CI 95%: -2.22, -0.06) lengths. The shortest quadriceps length generated the highest perceived discomfort for a given current amplitude. The amount of contraction fatigability was greater when muscle length allowed greater torque generation in the pre-fatigue condition. Strength gains were greater for a protocol at the optimal muscle length than for short muscle length. The quality of evidence was very high for most comparisons for evoked torque. However, further studies are necessary to achieve certainty for the other outcomes. Optimal muscle length should be considered the primary choice during NMES interventions, as it promotes higher levels of force production and may facilitate the preservation/gain in muscle force and mass, with reduced discomfort. However, a longer than optimal muscle length may also be used, due to possible muscle lengthening at high evoked tension. Thorough understanding of these physiological principles is imperative for the appropriate prescription of NMES for healthy and clinical populations.
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Affiliation(s)
- Jonathan Galvão Tenório Cavalcante
- Laboratory of Muscle and Tendon Plasticity, Graduate Program of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil
| | - Victor Hugo de Souza Ribeiro
- Laboratory of Muscle and Tendon Plasticity, Graduate Program of Rehabilitation Sciences, University of Brasília, Brasília, Distrito Federal, Brazil
| | - Rita de Cássia Marqueti
- Molecular Analysis Laboratory, Graduate Program of Rehabilitation Sciences, University of Brasília, Brasília, Distrito Federal, Brazil
| | - Isabel de Almeida Paz
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Júlia Aguillar Ivo Bastos
- Laboratory of Muscle and Tendon Plasticity, Graduate Program of Rehabilitation Sciences, University of Brasília, Brasília, Distrito Federal, Brazil
| | - Marco Aurélio Vaz
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nicolas Babault
- Centre d’Expertise de la Performance, INSERM UMR1093-CAPS, UFR des Sciences du Sport, University of Burgundy Franche-Comté, Besançon, Dijon, France
| | - João Luiz Quagliotti Durigan
- Laboratory of Muscle and Tendon Plasticity, Graduate Program of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil
- Laboratory of Muscle and Tendon Plasticity, Graduate Program of Rehabilitation Sciences, University of Brasília, Brasília, Distrito Federal, Brazil
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Murgia M, Rittweger J, Reggiani C, Bottinelli R, Mann M, Schiaffino S, Narici MV. Spaceflight on the ISS changed the skeletal muscle proteome of two astronauts. NPJ Microgravity 2024; 10:60. [PMID: 38839773 PMCID: PMC11153545 DOI: 10.1038/s41526-024-00406-3] [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: 02/05/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024] Open
Abstract
Skeletal muscle undergoes atrophy and loss of force during long space missions, when astronauts are persistently exposed to altered gravity and increased ionizing radiation. We previously carried out mass spectrometry-based proteomics from skeletal muscle biopsies of two astronauts, taken before and after a mission on the International Space Station. The experiments were part of an effort to find similarities between spaceflight and bed rest, a ground-based model of unloading, focused on proteins located at the costameres. We here extend the data analysis of the astronaut dataset and show compartment-resolved changes in the mitochondrial proteome, remodeling of the extracellular matrix and of the antioxidant response. The astronauts differed in their level of onboard physical exercise, which correlated with their respective preservation of muscle mass and force at landing in previous analyses. We show that the mitochondrial proteome downregulation during spaceflight, particularly the inner membrane and matrix, was dramatic for both astronauts. The expression of autophagy regulators and reactive oxygen species scavengers, however, showed partially opposite expression trends in the two subjects, possibly correlating with their level of onboard exercise. As mitochondria are primarily affected in many different tissues during spaceflight, we hypothesize that reactive oxygen species (ROS) rather than mechanical unloading per se could be the primary cause of skeletal muscle mitochondrial damage in space. Onboard physical exercise might have a strong direct effect on the prevention of muscle atrophy through mechanotransduction and a subsidiary effect on mitochondrial quality control, possibly through upregulation of autophagy and anti-oxidant responses.
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Affiliation(s)
- Marta Murgia
- Department of Biomedical Sciences, University of Padova, 35131, Padua, Italy.
- Max-Planck-Institute of Biochemistry, 82152, Martinsried, Germany.
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Department of Pediatrics and Adolescent Medicine, University Hospital Cologne, Cologne, Germany
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, 35131, Padua, Italy
- Science and Research Center Koper, Institute for Kinesiology Research, 6000, Koper, Slovenia
| | - Roberto Bottinelli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Matthias Mann
- Department of Biomedical Sciences, University of Padova, 35131, Padua, Italy
- NNF Center for Protein Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Marco V Narici
- Department of Biomedical Sciences, University of Padova, 35131, Padua, Italy
- Science and Research Center Koper, Institute for Kinesiology Research, 6000, Koper, Slovenia
- CIR-MYO Myology Center, 35121, Padua, Italy
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Casuso RA, Huertas JR, Aragón‐Vela J. The role of muscle disuse in muscular and cardiovascular fitness: A systematic review and meta-regression. Eur J Sport Sci 2024; 24:812-823. [PMID: 38874988 PMCID: PMC11235952 DOI: 10.1002/ejsc.12093] [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: 11/02/2023] [Revised: 01/06/2024] [Accepted: 02/12/2024] [Indexed: 06/15/2024]
Abstract
We aimed to assess the effects of muscle disuse on muscle strength (MS), muscle mass (MM) and cardiovascular fitness. Databases were scrutinized to identify human studies assessing the effects of muscle disuse on both (1) MM and (2) maximal oxygen uptake (VO2max) and/or MS. Random-effects meta-analysis and meta-regression with initial physical fitness and length of the protocol as a priori determined moderators were performed. We quantitatively analyzed 51 different studies, and the level of significance was set at p < 0.05. Data from the participants in 14 studies showed a decline in both VO2max (SMD: -0.93; 95% CI: -1.27 to -0.58) and MM (SMD: -0.34; 95% CI: -0.57 to -0.10). Data from 47 studies showed a decline in strength (-0.88; 95% CI: -1.04 to -0.73) and mass (SMD: -0.47; 95% CI: -0.58 to -0.36). MS loss was twice as high as MM loss, but differences existed between anatomical regions. Notably, meta-regression analysis revealed that initial MS was inversely associated with MS decline. VO2max and MS decline to a higher extent than MM during muscle disuse. We reported a more profound strength loss in subjects with high muscular strength. This is physiologically relevant for athletes because their required muscular strength can profoundly decline during a period of muscle disuse. It should however be noted that a period of muscle disuse can have devastating consequences in old subjects with low muscular strength.
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Affiliation(s)
- Rafael A. Casuso
- Department of Health SciencesUniversidad Loyola AndalucíaCórdobaSpain
| | - Jesús R. Huertas
- Department of PhysiologyInstitute of Nutrition and Food TechnologyUniversity of GranadaGranadaSpain
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Trappe TA, Minchev K, Perkins RK, Lavin KM, Jemiolo B, Ratchford SM, Claiborne A, Lee GA, Finch WH, Ryder JW, Ploutz-Snyder L, Trappe SW. NASA SPRINT exercise program efficacy for vastus lateralis and soleus skeletal muscle health during 70 days of simulated microgravity. J Appl Physiol (1985) 2024; 136:1015-1039. [PMID: 38328821 PMCID: PMC11365553 DOI: 10.1152/japplphysiol.00489.2023] [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: 07/18/2023] [Revised: 12/21/2023] [Accepted: 02/05/2024] [Indexed: 02/09/2024] Open
Abstract
The efficacy of the NASA SPRINT exercise countermeasures program for quadriceps (vastus lateralis) and triceps surae (soleus) skeletal muscle health was investigated during 70 days of simulated microgravity. Individuals completed 6° head-down-tilt bedrest (BR, n = 9), bedrest with resistance and aerobic exercise (BRE, n = 9), or bedrest with resistance and aerobic exercise and low-dose testosterone (BRE + T, n = 8). All groups were periodically tested for muscle (n = 9 times) and aerobic (n = 4 times) power during bedrest. In BR, surprisingly, the typical bedrest-induced decrements in vastus lateralis myofiber size and power were either blunted (myosin heavy chain, MHC I) or eliminated (MHC IIa), along with no change (P > 0.05) in %MHC distribution and blunted quadriceps atrophy. In BRE, MHC I (vastus lateralis and soleus) and IIa (vastus lateralis) contractile performance was maintained (P > 0.05) or increased (P < 0.05). Vastus lateralis hybrid fiber percentage was reduced (P < 0.05) and energy metabolism enzymes and capillarization were generally maintained (P > 0.05), while not all of these positive responses were observed in the soleus. Exercise offsets 100% of quadriceps and approximately two-thirds of soleus whole muscle mass loss. Testosterone (BRE + T) did not provide any benefit over exercise alone for either muscle and for some myocellular parameters appeared detrimental. In summary, the periodic testing likely provided a partial exercise countermeasure for the quadriceps in the bedrest group, which is a novel finding given the extremely low exercise dose. The SPRINT exercise program appears to be viable for the quadriceps; however, refinement is needed to completely protect triceps surae myocellular and whole muscle health for astronauts on long-duration spaceflights.NEW & NOTEWORTHY This study provides unique exercise countermeasures development information for astronauts on long-duration spaceflights. The NASA SPRINT program was protective for quadriceps myocellular and whole muscle health, whereas the triceps surae (soleus) was only partially protected as has been shown with other programs. The bedrest control group data may provide beneficial information for overall exercise dose and targeting fast-twitch muscle fibers. Other unique approaches for the triceps surae are needed to supplement existing exercise programs.
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Affiliation(s)
- Todd A Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Kiril Minchev
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Ryan K Perkins
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Kaleen M Lavin
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Bozena Jemiolo
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Stephen M Ratchford
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Alex Claiborne
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Gary A Lee
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - W Holmes Finch
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Jeffrey W Ryder
- Universities Space Research Association, NASA Johnson Space Center, Houston, Texas, United States
| | - Lori Ploutz-Snyder
- Universities Space Research Association, NASA Johnson Space Center, Houston, Texas, United States
| | - Scott W Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
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11
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Valli G, Sarto F, Casolo A, Del Vecchio A, Franchi MV, Narici MV, De Vito G. Lower limb suspension induces threshold-specific alterations of motor units properties that are reversed by active recovery. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:264-276. [PMID: 37331508 PMCID: PMC10980901 DOI: 10.1016/j.jshs.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/17/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE This study aimed to non-invasively test the hypothesis that (a) short-term lower limb unloading would induce changes in the neural control of force production (based on motor units (MUs) properties) in the vastus lateralis muscle and (b) possible changes are reversed by active recovery (AR). METHODS Ten young males underwent 10 days of unilateral lower limb suspension (ULLS) followed by 21 days of AR. During ULLS, participants walked exclusively on crutches with the dominant leg suspended in a slightly flexed position (15°-20°) and with the contralateral foot raised by an elevated shoe. The AR was based on resistance exercise (leg press and leg extension) and executed at 70% of each participant's 1 repetition maximum, 3 times/week. Maximal voluntary isometric contraction (MVC) of knee extensors and MUs properties of the vastus lateralis muscle were measured at baseline, after ULLS, and after AR. MUs were identified using high-density electromyography during trapezoidal isometric contractions at 10%, 25%, and 50% of the current MVC, and individual MUs were tracked across the 3 data collection points. RESULTS We identified 1428 unique MUs, and 270 of them (18.9%) were accurately tracked. After ULLS, MVC decreased by 29.77%, MUs absolute recruitment/derecruitment thresholds were reduced at all contraction intensities (with changes between the 2 variables strongly correlated), while discharge rate was reduced at 10% and 25% but not at 50% MVC. Impaired MVC and MUs properties fully recovered to baseline levels after AR. Similar changes were observed in the pool of total as well as tracked MUs. CONCLUSION Our novel results demonstrate, non-invasively, that 10 days of ULLS affected neural control predominantly by altering the discharge rate of lower-threshold but not of higher-threshold MUs, suggesting a preferential impact of disuse on motoneurons with a lower depolarization threshold. However, after 21 days of AR, the impaired MUs properties were fully restored to baseline levels, highlighting the plasticity of the components involved in neural control.
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Affiliation(s)
- Giacomo Valli
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy.
| | - Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
| | - Andrea Casolo
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
| | - Alessandro Del Vecchio
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander University, Erlangen-Nürnberg 91052, Germany
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
| | - Marco V Narici
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
| | - Giuseppe De Vito
- Department of Biomedical Sciences, University of Padova, Padova 35131, Italy
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12
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Ritsche P, Franchi MV, Faude O, Finni T, Seynnes O, Cronin NJ. Fully Automated Analysis of Muscle Architecture from B-Mode Ultrasound Images with DL_Track_US. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:258-267. [PMID: 38007322 DOI: 10.1016/j.ultrasmedbio.2023.10.011] [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: 06/13/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE B-mode ultrasound can be used to image musculoskeletal tissues, but one major bottleneck is analyses of muscle architectural parameters (i.e., muscle thickness, pennation angle and fascicle length), which are most often performed manually. METHODS In this study we trained two different neural networks (classic U-Net and U-Net with VGG16 pre-trained encoder) to detect muscle fascicles and aponeuroses using a set of labeled musculoskeletal ultrasound images. We determined the best-performing model based on intersection over union and loss metrics. We then compared neural network predictions on an unseen test set with those obtained via manual analysis and two existing semi/automated analysis approaches (simple muscle architecture analysis [SMA] and UltraTrack). DL_Track_US detects the locations of the superficial and deep aponeuroses, as well as multiple fascicle fragments per image. RESULTS For single images, DL_Track_US yielded results similar to those produced by a non-trainable automated method (SMA; mean difference in fascicle length: 5.1 mm) and human manual analysis (mean difference: -2.4 mm). Between-method differences in pennation angle were within 1.5°, and mean differences in muscle thickness were less than 1 mm. Similarly, for videos, there was overlap between the results produced with UltraTrack and DL_Track_US, with intraclass correlations ranging between 0.19 and 0.88. CONCLUSION DL_Track_US is fully automated and open source and can estimate fascicle length, pennation angle and muscle thickness from single images or videos, as well as from multiple superficial muscles. We also provide a user interface and all necessary code and training data for custom model development.
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Affiliation(s)
- Paul Ritsche
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Olivier Seynnes
- Department for Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Neil J Cronin
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland; School of Sport & Exercise, University of Gloucestershire, Gloucester, UK
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13
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Barker K, Rydberg L, Lanphere J, Malmut L, Neal J, Eickmeyer S. The utility of inpatient rehabilitation in heart transplantation: A review. Clin Transplant 2024; 38:e15182. [PMID: 37922201 DOI: 10.1111/ctr.15182] [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: 08/22/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 11/05/2023]
Abstract
Heart transplantation is considered definitive treatment for patients with end-stage heart failure. Unfortunately, medical and functional complications are common after heart transplantation for a variety of reasons, and these may impact the patients' functional recovery. Rehabilitation is often needed post-operatively to improve functional outcomes. This review article aims to discuss the transplanted heart exercise physiology that may affect the rehabilitation process and provide an overview of the functional benefits of inpatient rehabilitation for cardiac and surgical specialties who may be less familiar with post-acute care rehabilitation options for their patients.
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Affiliation(s)
- Kim Barker
- UT Southwestern Medical Center, Dallas, Texas, USA
| | - Leslie Rydberg
- Northwestern University Feinberg School of Medicine, Shirley Ryan AbilityLab, Chicago, Illinois, USA
| | | | - Laura Malmut
- MedStar National Rehabilitation Network, Washington, USA
- Department of Physical Medicine and Rehabilitation, Georgetown University School of Medicine, Washington, USA
| | - Jacqueline Neal
- Jesse Brown VA Medical Center, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sarah Eickmeyer
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, USA
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Sayed RKA, Hibbert JE, Jorgenson KW, Hornberger TA. The Structural Adaptations That Mediate Disuse-Induced Atrophy of Skeletal Muscle. Cells 2023; 12:2811. [PMID: 38132132 PMCID: PMC10741885 DOI: 10.3390/cells12242811] [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: 11/11/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
The maintenance of skeletal muscle mass plays a fundamental role in health and issues associated with quality of life. Mechanical signals are one of the most potent regulators of muscle mass, with a decrease in mechanical loading leading to a decrease in muscle mass. This concept has been supported by a plethora of human- and animal-based studies over the past 100 years and has resulted in the commonly used term of 'disuse atrophy'. These same studies have also provided a great deal of insight into the structural adaptations that mediate disuse-induced atrophy. For instance, disuse results in radial atrophy of fascicles, and this is driven, at least in part, by radial atrophy of the muscle fibers. However, the ultrastructural adaptations that mediate these changes remain far from defined. Indeed, even the most basic questions, such as whether the radial atrophy of muscle fibers is driven by the radial atrophy of myofibrils and/or myofibril hypoplasia, have yet to be answered. In this review, we thoroughly summarize what is known about the macroscopic, microscopic, and ultrastructural adaptations that mediated disuse-induced atrophy and highlight some of the major gaps in knowledge that need to be filled.
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Affiliation(s)
- Ramy K. A. Sayed
- Department of Comparative Biosciences, University of Wisconsin—Madison, Madison, WI 53706, USA; (R.K.A.S.); (J.E.H.); (K.W.J.)
- School of Veterinary Medicine, University of Wisconsin—Madison, Madison, WI 53706, USA
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Sohag University, Sohag 82524, Egypt
| | - Jamie E. Hibbert
- Department of Comparative Biosciences, University of Wisconsin—Madison, Madison, WI 53706, USA; (R.K.A.S.); (J.E.H.); (K.W.J.)
- School of Veterinary Medicine, University of Wisconsin—Madison, Madison, WI 53706, USA
| | - Kent W. Jorgenson
- Department of Comparative Biosciences, University of Wisconsin—Madison, Madison, WI 53706, USA; (R.K.A.S.); (J.E.H.); (K.W.J.)
- School of Veterinary Medicine, University of Wisconsin—Madison, Madison, WI 53706, USA
| | - Troy A. Hornberger
- Department of Comparative Biosciences, University of Wisconsin—Madison, Madison, WI 53706, USA; (R.K.A.S.); (J.E.H.); (K.W.J.)
- School of Veterinary Medicine, University of Wisconsin—Madison, Madison, WI 53706, USA
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15
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Wezenbeek E, Denolf S, Bourgois JG, Philippaerts RM, De Winne B, Willems TM, Witvrouw E, Verstockt S, Schuermans J. Impact of (long) COVID on athletes' performance: a prospective study in elite football players. Ann Med 2023; 55:2198776. [PMID: 37126052 PMCID: PMC10134946 DOI: 10.1080/07853890.2023.2198776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES To investigate possible persistent performance deficits after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in elite athletes. METHODS A prospective cohort study in three Belgian professional male football teams was performed during the 2020 - 2021 season. Participants were submitted to strength, jump, and sprint tests and an aerobic performance test (the Yo-Yo Intermittent Recovery test (YYIR)). These tests were repeated at fixed time intervals throughout the season. Assessment of SARS-CoV-2 infection was performed by a polymerase chain reaction (PCR) test before each official game. RESULTS Of the 84 included participants, 22 were infected with SARS-CoV-2 during follow-up. At the first testing after infection (52.0 ± 11.2 days after positive PCR testing) significantly higher percentages of maximal heart rate (%HRmax) were seen - within the isolated group of infected players- during (p = .006) and after the YYIR (2 min after, p = .013), compared to pre-infection data. This increase in %HRmax was resolved at the second YYIR testing after infection (127.6 ± 33.1 days after positive PCR testing). Additionally, when comparing the first test after infection in formerly infected to non-infected athletes, significantly higher %HRmax were found during (p < .001) and after the YYIR test (p < .001),No significant deficits were found for the jump, muscular strength or sprint tests. Aerobic performance seems compromised even weeks after infection. Simultaneously, anaerobic performance seemed to be spared. Because of the potential detrimental effects on the immune system, caution might be advised with high-intensity exposure until aerobic performance is restored.KEY MESSAGESElite football players' aerobic performance seems to be affected for weeks after they return to sports after a SARS-CoV-2 infection.Similarly, anaerobic performance tests showed no discernible changes between both before and after SARS-CoV-2 infections.Regular YYIR testing is recommended to monitor aerobic performance after SARS-CoV-2 infection.
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Affiliation(s)
- E Wezenbeek
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - J G Bourgois
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Performance and Sports Sciences, KAA Ghent - UGent, Ghent, Belgium
| | | | | | | | | | - S Verstockt
- Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
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16
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Pereira CS, Klauznicer J, Maree D, McAuliffe S, Farooq A, Whiteley R, Finni T. Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1283635. [PMID: 37928751 PMCID: PMC10624220 DOI: 10.3389/fresc.2023.1283635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023]
Abstract
Introduction Anterior cruciate ligament (ACL) injuries cause knee instability, knee pain, weight-bearing adjustments, and functional deficits but their association to patellar tendon quality is unknown. Our purpose was to investigate quadriceps strength, patellar tendon quality, relative load exposure, perceived knee stability, knee pain, extension angle, and time from ACL injury; in addition to examining their relative associations. Methods Injured and uninjured legs of 81 male athletes of different sports with a unilateral ACL injury (18-45 years) were examined. Participants reported location and intensity of knee pain and their perceived stability using a numerical rating scale (NRS 0-10). Strength was tested with an isokinetic device. Tendon quality was measured using ultrasound tissue characterization. Means ± standard deviation (SD) of perceived knee stability, knee extension angle, knee pain, isokinetic quadriceps strength in relation to body mass, proportion of echo-types (I-IV), tendon volume, and number of days from ACL injury to assessment are reported. Values of effect sizes (ES) and correlations (rs) were calculated. Results ACL injured leg demonstrated reduced reported knee stability (6.3 ± 2.5), decreased knee extension angle (-0.7 ± 3.1° vs. -2.7 ± 2.2°; ES = 0.7; P < 0.001), greater knee pain (NRS 3.1 ± 2.2 vs. 0.0 ± 0.1; ES = 2.0; P < 0.001), and 22% lower quadriceps strength (228.0 ± 65.0 vs. 291.2 ± 52.9 Nm/kg: ES = 1.2; P < 0.001) as compared to the uninjured leg. However, patellar tendons in both legs displayed similar quality. Quadriceps strength was associated with stability (rs = -0.54; P < 0.001), pain (rs = -0.47; P < 0.001), extension angle (rs = -0.39; P < 0.001), and relative load exposure (rs = -0.34; P < 0.004). Echo-types distribution was beneficially associated with time from ACL injury (rs range: -0.20/ -0.32; P < 0.05). Discussion ACL injured athletes displayed knee pain, extension deficit, and weaker quadriceps in the injured leg. While there were no differences in patellar tendon quality between legs, longer time from ACL injury showed better tendon quality.
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Affiliation(s)
- Carla S. Pereira
- Rehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- Neuromuscular Research Center, Biology of PhysicalActivity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jasenko Klauznicer
- Rehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Dustin Maree
- Rehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Sean McAuliffe
- Department of Physical Therapy & Rehabilitation Science, College of Health Sciences, Qatar University, Doha, Qatar
| | - Abdulaziz Farooq
- Rehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Rod Whiteley
- Rehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Taija Finni
- Neuromuscular Research Center, Biology of PhysicalActivity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Miccinilli S, Bravi M, Conti G, Bressi F, Sterzi S, Santacaterina F, Ciccozzi M. SARS-CoV-2 Infection Increases the Risk of Muscle Injury in Professional Male Soccer Players-A Retrospective Analysis of the Italian and Spanish Major Leagues. Infect Dis Rep 2023; 15:425-435. [PMID: 37623047 PMCID: PMC10454539 DOI: 10.3390/idr15040043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/06/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
A retrospective cohort study on professional soccer players from the Serie A and LaLiga was conducted to investigate the correlation between SARS-CoV-2 infection and muscle injuries. Players were divided into two groups based on whether they contracted the SARS-CoV-2 infection (C+) or not (C-) during the 2020/2021 season. In the 2019-2020 season, both championships showed a similar number of muscular injuries (MI) between C+ and C- (Serie A: p = 0.194; 95% CI: -0.044 to 0.215, LaLiga p = 0.915; 95% CI: -0.123 to 0.137). In the 2020-2021 season, C+ had a significantly higher number of MI compared to C- in both championships (Serie A: p < 0.05; 95% CI 0.731 to 1.038; LaLiga: p < 0.05; 95% CI: 0.773 to 1.054). Multiple linear regression analysis confirmed that belonging to C+ in the season 2020/2021 was the variable that most strongly influenced the probability of having a muscle injury. Survival analysis revealed a hazard ratio of 3.73 (95% CI 3.018 to 4.628) and of 5.14 (95% CI 3.200 to 8.254) for Serie A and LaLiga respectively. We found an association between SARS-CoV-2 infection and increased risk of muscle injury, emphasizing the importance of carefully considering the infection in the decision-making process for returning to sport. Therefore, SARS-CoV-2 infection should be judged as a real injury requiring specific assessment and training programs.
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Affiliation(s)
- Sandra Miccinilli
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
- Research Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Marco Bravi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Giorgio Conti
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
| | - Federica Bressi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
- Research Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Silvia Sterzi
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
- Research Unit of Physical and Rehabilitation Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Fabio Santacaterina
- Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy; (S.M.); (M.B.); (G.C.); (F.B.); (S.S.)
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy;
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Corsini A, Bisciotti A, Canonico R, Causarano A, Del Vescovo R, Gatto P, Gola P, Iera M, Mazzoni S, Minafra P, Nanni G, Pasta G, Pulcini I, Salvatori S, Scorcu M, Stefanini L, Tenore F, Palermi S, Casasco M, Calza S. Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The "Italian Injury Study" during the Serie a Championship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5182. [PMID: 36982090 PMCID: PMC10048896 DOI: 10.3390/ijerph20065182] [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: 01/30/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Football was the first sport to resume competitions after the coronavirus disease 2019 (COVID-19) lockdown and promptly the hypothesis was raised of a potential relationship between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and musculoskeletal injuries in athletes. This study aimed to confirm the association between SARS-CoV-2 infection and muscle strain injury in a large population of elite football players and to investigate if the COVID-19 severity level could affect the risk of injury. METHODS A retrospective cohort study involving 15 Italian professional male football teams was performed during the Italian Serie A 2020-2021 season. Injuries and SARS-CoV-2 positivity data were collected by team doctors through an online database. RESULTS Of the 433 included players, we observed 173 SARS-CoV-2 infections and 332 indirect muscle strains. COVID-19 episodes mostly belonged to severity level I and II. The injury risk significantly increased after a COVID-19 event, by 36% (HR = 1.36, CI95% 1.05; 1.77, p-value = 0.02). The injury burden demonstrated an 86% increase (ratio = 1.86, CI95% 1.21; 2.86, p-value = 0.005) in the COVID-19 severity level II/III versus players without a previous SARS-CoV-2 infection, while level I (asymptomatic) patients showed a similar average burden (ratio = 0.92, CI95% 0.54; 1.58, p-value = 0.77). A significantly higher proportion of muscle-tendon junction injuries (40.6% vs. 27.1%, difference = 13.5%, CI95% 0.002%; 26.9%, p-value = 0.047) was found when comparing level II/III versus Non-COVID-19. CONCLUSIONS This study confirms the correlation between SARS-CoV-2 infection and indirect muscle injuries and highlights how the severity of the infection would represent an additional risk factor.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Stefano Mazzoni
- Sport Medicine Department—Milan Lab, Associazione Calcistica Milan, 20149 Milano, Italy
| | | | - Gianni Nanni
- Bologna Football Club 1909, 40132 Bologna, Italy
| | | | | | | | | | | | | | - Stefano Palermi
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy;
| | | | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy
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19
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Capri M, Conte M, Ciurca E, Pirazzini C, Garagnani P, Santoro A, Longo F, Salvioli S, Lau P, Moeller R, Jordan J, Illig T, Villanueva MM, Gruber M, Bürkle A, Franceschi C, Rittweger J. Long-term human spaceflight and inflammaging: Does it promote aging? Ageing Res Rev 2023; 87:101909. [PMID: 36918115 DOI: 10.1016/j.arr.2023.101909] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Spaceflight and its associated stressors, such as microgravity, radiation exposure, confinement, circadian derailment and disruptive workloads represent an unprecedented type of exposome that is entirely novel from an evolutionary stand point. Within this perspective, we aimed to review the effects of prolonged spaceflight on immune-neuroendocrine systems, brain and brain-gut axis, cardiovascular system and musculoskeletal apparatus, highlighting in particular the similarities with an accelerated aging process. In particular, spaceflight-induced muscle atrophy/sarcopenia and bone loss, vascular and metabolic changes, hyper and hypo reaction of innate and adaptive immune system appear to be modifications shared with the aging process. Most of these modifications are mediated by molecular events that include oxidative and mitochondrial stress, autophagy, DNA damage repair and telomere length alteration, among others, which directly or indirectly converge on the activation of an inflammatory response. According to the inflammaging theory of aging, such an inflammatory response could be a driver of an acceleration of the normal, physiological rate of aging and it is likely that all the systemic modifications in turn lead to an increase of inflammaging in a sort of vicious cycle. The most updated countermeasures to fight these modifications will be also discussed in the light of their possible application not only for astronauts' benefit, but also for older adults on the ground.
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Affiliation(s)
- Miriam Capri
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy; Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate), University of Bologna, Bologna, Italy
| | - Maria Conte
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy; Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate), University of Bologna, Bologna, Italy.
| | - Erika Ciurca
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Chiara Pirazzini
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Paolo Garagnani
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy; Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate), University of Bologna, Bologna, Italy; Clinical Chemistry Department of Laboratory Medicine, Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden; CNR Institute of Molecular Genetics, Unit of Bologna, Bologna, Italy; Center for Applied Biomedical Research (CRBA), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Aurelia Santoro
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy; Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate), University of Bologna, Bologna, Italy
| | - Federica Longo
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Stefano Salvioli
- Department of Medical and Surgical Science, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Patrick Lau
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Ralf Moeller
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Jens Jordan
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Medical Faculty, University of Cologne, Cologne, Germany
| | - Thomas Illig
- Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Maria-Moreno Villanueva
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Markus Gruber
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Alexander Bürkle
- Department of Biology, University of Konstanz, Konstanz, Germany
| | - Claudio Franceschi
- Department of Applied Mathematics of the Institute of ITMM, National Research Lobachevsky State University of Nizhny Novgorod, the Russian Federation
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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20
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Preobrazenski N, Seigel J, Halliday S, Janssen I, McGlory C. Single-leg disuse decreases skeletal muscle strength, size, and power in uninjured adults: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023; 14:684-696. [PMID: 36883219 PMCID: PMC10067508 DOI: 10.1002/jcsm.13201] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/01/2022] [Accepted: 02/02/2023] [Indexed: 03/09/2023] Open
Abstract
We aimed to quantify declines from baseline in lower limb skeletal muscle size and strength of uninjured adults following single-leg disuse. We searched EMBASE, Medline, CINAHL, and CCRCT up to 30 January 2022. Studies were included in the systematic review if they (1) recruited uninjured participants; (2) were an original experimental study; (3) employed a single-leg disuse model; and (4) reported muscle strength, size, or power data following a period of single-leg disuse for at least one group without a countermeasure. Studies were excluded if they (1) did not meet all inclusion criteria; (2) were not in English; (3) reported previously published muscle strength, size, or power data; or (4) could not be sourced from two different libraries, repeated online searches, and the authors. We used the Cochrane Risk of Bias Assessment Tool to assess risk of bias. We then performed random-effects meta-analyses on studies reporting measures of leg extension strength and extensor size. Our search revealed 6548 studies, and 86 were included in our systematic review. Data from 35 and 20 studies were then included in the meta-analyses for measures of leg extensor strength and size, respectively (40 different studies). No meta-analysis for muscle power was performed due to insufficient homogenous data. Effect sizes (Hedges' gav ) with 95% confidence intervals for leg extensor strength were all durations = -0.80 [-0.92, -0.68] (n = 429 participants; n = 68 aged 40 years or older; n ≥ 78 females); ≤7 days of disuse = -0.57 [-0.75, -0.40] (n = 151); >7 days and ≤14 days = -0.93 [-1.12, -0.74] (n = 206); and >14 days = -0.95 [-1.20, -0.70] (n = 72). Effect sizes for measures of leg extensor size were all durations = -0.41 [-0.51, -0.31] (n = 233; n = 32 aged 40 years or older; n ≥ 42 females); ≤7 days = -0.26 [-0.36, -0.16] (n = 84); >7 days and ≤14 days = -0.49 [-0.67, -0.30] (n = 102); and >14 days = -0.52 [-0.74, -0.30] (n = 47). Decreases in leg extensor strength (cast: -0.94 [-1.30, -0.59] (n = 73); brace: -0.90 [-1.18, -0.63] (n = 106)) and size (cast: -0.61[-0.87, -0.35] (n = 41); brace: (-0.48 [-1.04, 0.07] (n = 41)) following 14 days of disuse did not differ for cast and brace disuse models. Single-leg disuse in adults resulted in a decline in leg extensor strength and size that reached a nadir beyond 14 days. Bracing and casting led to similar declines in leg extensor strength and size following 14 days of disuse. Studies including females and males and adults over 40 years of age are lacking.
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Affiliation(s)
| | - Joel Seigel
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Sandra Halliday
- Queen's University Library, Queen's University, Kingston, Ontario, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Chris McGlory
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.,Department of Medicine, Queen's University, Kingston, Ontario, Canada
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21
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Saveko A, Bekreneva M, Ponomarev I, Zelenskaya I, Riabova A, Shigueva T, Kitov V, Abu Sheli N, Nosikova I, Rukavishnikov I, Sayenko D, Tomilovskaya E. Impact of different ground-based microgravity models on human sensorimotor system. Front Physiol 2023; 14:1085545. [PMID: 36875039 PMCID: PMC9974674 DOI: 10.3389/fphys.2023.1085545] [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: 10/31/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
This review includes current and updated information about various ground-based microgravity models and their impact on the human sensorimotor system. All known models of microgravity are imperfect in a simulation of the physiological effects of microgravity but have their advantages and disadvantages. This review points out that understanding the role of gravity in motion control requires consideration of data from different environments and in various contexts. The compiled information can be helpful to researchers to effectively plan experiments using ground-based models of the effects of space flight, depending on the problem posed.
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Affiliation(s)
- Alina Saveko
- Russian Federation State Scientific Center—Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
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22
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Cicek F, Tastekin B, Baldan I, Tokus M, Pelit A, Ocal I, Gunay I, Ogur HU, Cicek H. Effect of 40 Hz Magnetic Field Application in Posttraumatic Muscular Atrophy Development on Muscle Mass and Contractions in Rats. Bioelectromagnetics 2022; 43:453-461. [PMID: 36477897 DOI: 10.1002/bem.22429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022]
Abstract
Muscle atrophy refers to the deterioration of muscle tissue due to a long-term decrease in muscle function. In the present study, we simulated rectus femoris muscle atrophy experimentally and investigated the effect of pulsed electromagnetic field (PEMF) application on the atrophy development through muscle mass, maximal contraction force, and contraction-relaxation time. A quadriceps tendon rupture with a total tenotomy was created on the rats' hind limbs, inhibiting knee extension for 6 weeks, and this restriction of the movement led to the development of disuse atrophy, while the control group underwent no surgery. The operated and control groups were divided into subgroups according to PEMF application (1.5 mT for 45 days) or no PEMF. All groups were sacrificed after 6 weeks and had their entire rectus femoris removed. To measure the contraction force, the muscles were placed in an organ bath connected to a transducer. As a result of the atrophy, muscle mass and strength were reduced in the operated group, while no muscle mass loss was observed in the operated PEMF group. Furthermore, measurements of single, incomplete and full tetanic contraction force and contraction time (CT) did not change significantly in the operated group that received the PEMF application. The PEMF application prevented atrophy resulting from 6 weeks of immobility, according to the contraction parameters. The effects of PEMF on contraction force and CT provide a basis for further studies in which PEMF is investigated as a noninvasive therapy for disuse atrophy development. © 2022 Bioelectromagnetics Society.
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Affiliation(s)
- Figen Cicek
- Department of Biophysics, Cukurova University, Adana, Turkey
| | - Bora Tastekin
- Department of Biophysics, Cukurova University, Adana, Turkey
| | - Ilknur Baldan
- Department of Biophysics, Cukurova University, Adana, Turkey
| | - Murat Tokus
- Department of Biophysics, Cukurova University, Adana, Turkey
| | - Aykut Pelit
- Department of Biophysics, Cukurova University, Adana, Turkey
| | - Isil Ocal
- Department of Biophysics, Cukurova University, Adana, Turkey
| | - Ismail Gunay
- Department of Biophysics, Cukurova University, Adana, Turkey
| | - Hasan U Ogur
- Adana City Hospital, Orthopedics and Traumatology Clinics, Adana, Turkey
| | - Hakan Cicek
- Adana City Hospital, Orthopedics and Traumatology Clinics, Adana, Turkey
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23
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Hardy EJO, Inns TB, Hatt J, Doleman B, Bass JJ, Atherton PJ, Lund JN, Phillips BE. The time course of disuse muscle atrophy of the lower limb in health and disease. J Cachexia Sarcopenia Muscle 2022; 13:2616-2629. [PMID: 36104842 PMCID: PMC9745468 DOI: 10.1002/jcsm.13067] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 07/01/2022] [Accepted: 07/20/2022] [Indexed: 12/15/2022] Open
Abstract
Short, intermittent episodes of disuse muscle atrophy (DMA) may have negative impact on age related muscle loss. There is evidence of variability in rate of DMA between muscles and over the duration of immobilization. As yet, this is poorly characterized. This review aims to establish and compare the time-course of DMA in immobilized human lower limb muscles in both healthy and critically ill individuals, exploring evidence for an acute phase of DMA and differential rates of atrophy between and muscle groups. MEDLINE, Embase, CINHAL and CENTRAL databases were searched from inception to April 2021 for any study of human lower limb immobilization reporting muscle volume, cross-sectional area (CSA), architecture or lean leg mass over multiple post-immobilization timepoints. Risk of bias was assessed using ROBINS-I. Where possible meta-analysis was performed using a DerSimonian and Laird random effects model with effect sizes reported as mean differences (MD) with 95% confidence intervals (95% CI) at various time-points and a narrative review when meta-analysis was not possible. Twenty-nine studies were included, 12 in healthy volunteers (total n = 140), 18 in patients on an Intensive Therapy Unit (ITU) (total n = 516) and 3 in patients with ankle fracture (total n = 39). The majority of included studies are at moderate risk of bias. Rate of quadriceps atrophy over the first 14 days was significantly greater in the ITU patients (MD -1.01 95% CI -1.32, -0.69), than healthy cohorts (MD -0.12 95% CI -0.49, 0.24) (P < 0.001). Rates of atrophy appeared to vary between muscle groups (greatest in triceps surae (-11.2% day 28), followed by quadriceps (-9.2% day 28), then hamstrings (-6.5% day 28), then foot dorsiflexors (-3.2% day 28)). Rates of atrophy appear to decrease over time in healthy quadriceps (-6.5% day 14 vs. -9.1% day 28) and triceps surae (-7.8% day 14 vs. -11.2% day 28), and ITU quadriceps (-13.2% day 7 vs. -28.2% day 14). There appears to be variability in the rate of DMA between muscle groups, and more rapid atrophy during the earliest period of immobilization, indicating different mechanisms being dominant at different timepoints. Rates of atrophy are greater amongst critically unwell patients. Overall evidence is limited, and existing data has wide variability in the measures reported. Further work is required to fully characterize the time course of DMA in both health and disease.
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Affiliation(s)
- Edward J O Hardy
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Thomas B Inns
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jacob Hatt
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Brett Doleman
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,Department of Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Joseph J Bass
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Philip J Atherton
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jonathan N Lund
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Bethan E Phillips
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
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24
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Sarto F, Stashuk DW, Franchi MV, Monti E, Zampieri S, Valli G, Sirago G, Candia J, Hartnell LM, Paganini M, McPhee JS, De Vito G, Ferrucci L, Reggiani C, Narici MV. Effects of short-term unloading and active recovery on human motor unit properties, neuromuscular junction transmission and transcriptomic profile. J Physiol 2022; 600:4731-4751. [PMID: 36071599 PMCID: PMC9828768 DOI: 10.1113/jp283381] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/26/2022] [Indexed: 01/12/2023] Open
Abstract
Electrophysiological alterations of the neuromuscular junction (NMJ) and motor unit potential (MUP) with unloading are poorly studied. We aimed to investigate these aspects and the underlying molecular mechanisms with short-term unloading and active recovery (AR). Eleven healthy males underwent a 10-day unilateral lower limb suspension (ULLS) period, followed by 21-day AR based on resistance exercise. Quadriceps femoris (QF) cross-sectional area (CSA) and isometric maximum voluntary contraction (MVC) were evaluated. Intramuscular electromyographic recordings were obtained during 10% and 25% MVC isometric contractions from the vastus lateralis (VL). Biomarkers of NMJ molecular instability (serum c-terminal agrin fragment, CAF), axonal damage (neurofilament light chain) and denervation status were assessed from blood samples and VL biopsies. NMJ and ion channel transcriptomic profiles were investigated by RNA-sequencing. QF CSA and MVC decreased with ULLS. Increased CAF and altered NMJ transcriptome with unloading suggested the emergence of NMJ molecular instability, which was not associated with impaired NMJ transmission stability. Instead, increased MUP complexity and decreased motor unit firing rates were found after ULLS. Downregulation of ion channel gene expression was found together with increased neurofilament light chain concentration and partial denervation. The AR period restored most of these neuromuscular alterations. In conclusion, the human NMJ is destabilized at the molecular level but shows functional resilience to a 10-day unloading period at least at relatively low contraction intensities. However, MUP properties are altered by ULLS, possibly due to alterations in ion channel dynamics and initial axonal damage and denervation. These changes are fully reversed by 21 days of AR. KEY POINTS: We used integrative electrophysiological and molecular approaches to comprehensively investigate changes in neuromuscular integrity and function after a 10-day unilateral lower limb suspension (ULLS), followed by 21 days of active recovery in young healthy men, with a particular focus on neuromuscular junction (NMJ) and motor unit potential (MUP) properties alterations. After 10-day ULLS, we found significant NMJ molecular alterations in the absence of NMJ transmission stability impairment. These findings suggest that the human NMJ is functionally resilient against insults and stresses induced by short-term disuse at least at relatively low contraction intensities, at which low-threshold, slow-type motor units are recruited. Intramuscular electromyography analysis revealed that unloading caused increased MUP complexity and decreased motor unit firing rates, and these alterations could be related to the observed changes in skeletal muscle ion channel pool and initial and partial signs of fibre denervation and axonal damage. The active recovery period restored these neuromuscular changes.
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Affiliation(s)
- Fabio Sarto
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
| | - Daniel W. Stashuk
- Department of Systems Design EngineeringUniversity of WaterlooOntarioCanada
| | - Martino V. Franchi
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly,CIR‐MYO Myology CenterUniversity of PadovaPadovaItaly
| | - Elena Monti
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
| | - Sandra Zampieri
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly,CIR‐MYO Myology CenterUniversity of PadovaPadovaItaly,Department of SurgeryOncology, and GastroenterologyUniversity of PadovaPadovaItaly
| | - Giacomo Valli
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
| | - Giuseppe Sirago
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
| | - Julián Candia
- Longitudinal Studies SectionTranslational Gerontology BranchNational Institute of AgingNational Institutes of HealthBaltimoreMDUSA
| | - Lisa M. Hartnell
- Longitudinal Studies SectionTranslational Gerontology BranchNational Institute of AgingNational Institutes of HealthBaltimoreMDUSA
| | - Matteo Paganini
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
| | - Jamie S. McPhee
- Department of Sport and Exercise SciencesManchester Metropolitan University Institute of SportManchesterUK
| | - Giuseppe De Vito
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly,CIR‐MYO Myology CenterUniversity of PadovaPadovaItaly
| | - Luigi Ferrucci
- Longitudinal Studies SectionTranslational Gerontology BranchNational Institute of AgingNational Institutes of HealthBaltimoreMDUSA
| | - Carlo Reggiani
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly,Science and Research Center KoperInstitute for Kinesiology ResearchKoperSlovenia
| | - Marco V. Narici
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly,CIR‐MYO Myology CenterUniversity of PadovaPadovaItaly,Science and Research Center KoperInstitute for Kinesiology ResearchKoperSlovenia
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25
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Bradley AP, Roehl AS, McGrath R, Smith J, Hackney KJ. Popliteal Blood Flow With Lower-Extremity Injury Mobility Devices. FOOT & ANKLE ORTHOPAEDICS 2022; 7:24730114221142784. [PMID: 36533090 PMCID: PMC9749042 DOI: 10.1177/24730114221142784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Ambulation devices may differ in their utility, muscle activation patterns, and how they affect regional blood flow. This study aimed to evaluate popliteal blood flow and vessel dimensions in response to ambulation with a hands-free crutch (HFC), axillary crutches (AC), a medical kneeling scooter (MKS), and regular walking in healthy adults. METHODS HFC, AC, MKS, and regular walking were completed in a random order by 40 adults aged 18-45 years. Participants ambulated at a comfortable pace for 10 minutes with each device. At baseline and immediately following each trial, a trained operator used diagnostic ultrasonography to capture popliteal vein and artery dimensional and flow characteristics. RESULTS Significant increases were observed from baseline (0.65 ± 0.23 cm) in venous diameter following walking (0.71 ± 0.21 cm, P = .012) and MKS (0.73 ± 0.21 cm, P = .003). Venous blood flow was also significantly different between conditions (P = .009) but was only greater following walking (124 ± 79 mL/min) compared to MKS (90 ± 64 mL/min, P = .021). No differences were observed in arterial dimensions between ambulation conditions. Significant increases were found in arterial blood flow from baseline (107 ± 69 mL/min) following walking (184 ± 97 mL/min, P < .001) and HFC (163 ± 86 mL/min, P < .001). Arterial blood flow following walking was greater than AC (132 ± 72 mL/min, P = .016) and MKS (128 ± 74 mL/min, P = .003). CONCLUSION We found an average decrease in venous time-averaged mean velocity between walking and use of the MKS, but no such decrease with either HFCs or use of ACs in this healthy experimental cohort. LEVEL OF EVIDENCE Level III, diagnostic comparative study.
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Affiliation(s)
- Adam P. Bradley
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Alexis S. Roehl
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Joseph Smith
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Kyle J. Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
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26
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Franchi MV, Sarto F, Simunič B, Pišot R, Narici MV. Early Changes of Hamstrings Morphology and Contractile Properties during 10 d of Complete Inactivity. Med Sci Sports Exerc 2022; 54:1346-1354. [PMID: 35324511 DOI: 10.1249/mss.0000000000002922] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The hamstrings (HS) muscle group plays a fundamental role in maintaining knee stability, thus contributing to the prevention and rehabilitation of lower limb musculoskeletal injuries. However, little is known about HS structural and functional adaptations after periods of prolonged inactivity. Our purpose was to investigate the HS morphological and contractile properties changes during 10 d of bed rest (BR). METHODS Ten young healthy males underwent a 10-d BR. HS cross-sectional area (CSA) (at 30%, 50%, and 70% of femur length) and biceps femoris long head (BFlh) architecture were assessed by ultrasound imaging after 0 d (BR0), 2 d (BR2), 4 d (BR4), 6 d (BR6), and 10 d (BR10) of BR, whereas BFlh contractile properties (radial twitch displacement [Dm] and contraction time [Tc]) were evaluated at the same time points by tensiomyography. HS muscle volume was assessed by magnetic resonance imaging at BR0 and BR10. RESULTS A reduction in muscle volume was observed in BFlh ( P = 0.002; Δ = -3.53%), biceps femoris short head ( P = 0.002; Δ = -3.54%), semitendinosus ( P = 0.002; Δ = -2.63%), semimembranosus ( P = 0.002; Δ = -2.01%), and HS pooled together ( P < 0.001; Δ = -2.78%). Early changes in CSA were detected at 30% femur length already at BR6 for BFlh ( P = 0.009; Δ = -2.66%) and biceps femoris short head ( P = 0.049; Δ = -1.96%). We also found a reduction in fascicle length at BR6 ( P = 0.035; Δ = -2.44%) and BR10 ( P < 0.001; Δ = -2.84%). Dm and Tc increased at BR2 ( P = 0.010; Δ = 30.0%) and B10 ( P = 0.019; Δ = 19.7%), respectively. CONCLUSIONS Despite being a nonpostural muscle group, HS exhibited a moderate reduction in muscle dimensions in response to a short unloading period. Small changes in BFlh fascicle length were also observed, accompanied by alterations in BFLh contractile properties. These HS modifications should not be ignored from a clinical perspective.
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Affiliation(s)
| | - Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova, ITALY
| | - Boštian Simunič
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, SLOVENIA
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, SLOVENIA
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27
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Murgia M, Ciciliot S, Nagaraj N, Reggiani C, Schiaffino S, Franchi MV, Pišot R, Šimunič B, Toniolo L, Blaauw B, Sandri M, Biolo G, Flück M, Narici MV, Mann M. Signatures of muscle disuse in spaceflight and bed rest revealed by single muscle fiber proteomics. PNAS NEXUS 2022; 1:pgac086. [PMID: 36741463 PMCID: PMC9896895 DOI: 10.1093/pnasnexus/pgac086] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/07/2022] [Indexed: 02/07/2023]
Abstract
Astronauts experience dramatic loss of muscle mass, decreased strength, and insulin resistance, despite performing daily intense physical exercise that would lead to muscle growth on Earth. Partially mimicking spaceflight, prolonged bed rest causes muscle atrophy, loss of force, and glucose intolerance. To unravel the underlying mechanisms, we employed highly sensitive single fiber proteomics to detail the molecular remodeling caused by unloading and inactivity during bed rest and changes of the muscle proteome of astronauts before and after a mission on the International Space Station. Muscle focal adhesions, involved in fiber-matrix interaction and insulin receptor stabilization, are prominently downregulated in both bed rest and spaceflight and restored upon reloading. Pathways of antioxidant response increased strongly in slow but not in fast muscle fibers. Unloading alone upregulated markers of neuromuscular damage and the pathway controlling EIF5A hypusination. These proteomic signatures of mechanical unloading in muscle fiber subtypes contribute to disentangle the effect of microgravity from the pleiotropic challenges of spaceflight.
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Affiliation(s)
| | - Stefano Ciciliot
- Veneto Institute of Molecular Medicine, Via Orus 2, 35129 Padua, Italy,Department of Molecular Medicine, University of Pavia, Via Forlanini 6, 27100 Pavia, Italy
| | | | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Via Ugo Bassi, 58/B, 35131 Padua, Italy,Science and Research Center Koper, Institute for Kinesiology Research, Garibaldijeva Street 1, 6000 Koper, Slovenia
| | | | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Via Ugo Bassi, 58/B, 35131 Padua, Italy
| | - Rado Pišot
- Science and Research Center Koper, Institute for Kinesiology Research, Garibaldijeva Street 1, 6000 Koper, Slovenia
| | - Boštjan Šimunič
- Science and Research Center Koper, Institute for Kinesiology Research, Garibaldijeva Street 1, 6000 Koper, Slovenia
| | - Luana Toniolo
- Department of Biomedical Sciences, University of Padova, Via Ugo Bassi, 58/B, 35131 Padua, Italy
| | - Bert Blaauw
- Department of Biomedical Sciences, University of Padova, Via Ugo Bassi, 58/B, 35131 Padua, Italy,Veneto Institute of Molecular Medicine, Via Orus 2, 35129 Padua, Italy
| | - Marco Sandri
- Department of Biomedical Sciences, University of Padova, Via Ugo Bassi, 58/B, 35131 Padua, Italy,Veneto Institute of Molecular Medicine, Via Orus 2, 35129 Padua, Italy
| | - Gianni Biolo
- Clinical Department of Medical, Surgical and Health Sciences, Strada di Fiume 447, 34149 Trieste, Italy
| | - Martin Flück
- Department of Medicine, University of Fribourg, Chemin du Musee 5, 1700 Fribourg, Switzerland
| | - Marco V Narici
- Department of Biomedical Sciences, University of Padova, Via Ugo Bassi, 58/B, 35131 Padua, Italy,Science and Research Center Koper, Institute for Kinesiology Research, Garibaldijeva Street 1, 6000 Koper, Slovenia,CIR-MYO Myology Center, Viale G Colombo 3, 35121 Padua, Italy
| | - Matthias Mann
- Max-Planck-Institute of Biochemistry, Am Klopferspitz 18, 82152 Martinsried, Germany,NNF Center for Protein Research, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Building 6.1, 2200 Copenhagen, Denmark
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28
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Brand A, Kröger I, Klöpfer-Krämer I, Wackerle H, Müßig JA, Dietrich A, Böttger M, Gaul L, Gabel J, Augat P. Recovery of the medial gastrocnemius muscle after calcaneus fracture differs between contractile and elastic components. Clin Biomech (Bristol, Avon) 2022; 96:105664. [PMID: 35569257 DOI: 10.1016/j.clinbiomech.2022.105664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 03/22/2022] [Accepted: 05/04/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Calcaneal fractures result in severe functional impairments and walking restrictions. Postoperative evaluation mainly focusses on the restoration of calcaneal anatomy while ankle plantar flexor insufficiency remains largely neglected. This study aims to investigate biomechanical and morphologic adaptions of elastic and contractile components of the gastrocnemius medialis after unilateral calcaneal fracture. METHODS 20 Patients (BMI: 27.6 ± 3.1 kgm-2, Age: 50 ± 12 years) were measured using gait analysis and portable ultrasound over a follow-up of three, six and twelve months after surgery. Data comparison was performed using 20 matched healthy controls (BMI: 26.2 ± 2.9 kgm-2, Age: 48 ± 11 years). Static and dynamic behavior of the gastrocnemius muscle tendon unit, muscle fascicle and the serial-elastic element as well ankle joint kinematics and kinetics were analyzed. FINDINGS Within patients, a significant (p < 0.05) increase in fascicle length (by 67%) during single support and a decrease of serial elastic element shortening (by 20%) during push off was found between three and twelve months follow-up comparisons. Patients showed differences for fascicle lengthening and pennation angle increase during single support after three and six months compared to healthy controls. A smaller shortening of the serial-elastic element (by 29%) and muscle-tendon unit (by 16%) persisted even for the twelve month comparisons. INTERPRETATION Patients with calcaneal fracture showed an incomplete restoration of the medial gastrocnemius dynamic morphological behavior. While muscle fascicle contraction almost recovered, the serial elastic component still showed restrictions regarding its shortening behavior. Limited foot mobility and plantarflexor strength as well as lowered responsiveness of elastic tissues to mechanical loading are regarded as key mechanisms.
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Affiliation(s)
- Andreas Brand
- Institute for Biomechanics, BG Klinikum Murnau, Murnau, Germany; Institute for Biomechanics, Paracelsus Medical Private University, Salzburg, Austria.
| | - Inga Kröger
- Institute for Biomechanics, BG Klinikum Murnau, Murnau, Germany; Institute for Biomechanics, Paracelsus Medical Private University, Salzburg, Austria
| | - Isabella Klöpfer-Krämer
- Institute for Biomechanics, BG Klinikum Murnau, Murnau, Germany; Institute for Biomechanics, Paracelsus Medical Private University, Salzburg, Austria
| | - Hannes Wackerle
- Institute for Biomechanics, BG Klinikum Murnau, Murnau, Germany; Institute for Biomechanics, Paracelsus Medical Private University, Salzburg, Austria
| | - Janina Anna Müßig
- Institute for Biomechanics, BG Klinikum Murnau, Murnau, Germany; Institute for Biomechanics, Paracelsus Medical Private University, Salzburg, Austria
| | - Andrea Dietrich
- Department of Foot and Ankle Surgery, BG Klinikum Murnau, Murnau, Germany
| | - Moritz Böttger
- Department of Foot and Ankle Surgery, BG Klinikum Murnau, Murnau, Germany
| | - Leander Gaul
- Department of Foot and Ankle Surgery, BG Klinikum Murnau, Murnau, Germany
| | - Johannes Gabel
- Department of Foot and Ankle Surgery, BG Klinikum Murnau, Murnau, Germany
| | - Peter Augat
- Institute for Biomechanics, BG Klinikum Murnau, Murnau, Germany; Institute for Biomechanics, Paracelsus Medical Private University, Salzburg, Austria
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29
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Wezenbeek E, Denolf S, Willems TM, Pieters D, Bourgois JG, Philippaerts RM, De Winne B, Wieme M, Van Hecke R, Markey L, Schuermans J, Witvrouw E, Verstockt S. Association between SARS-COV-2 infection and muscle strain injury occurrence in elite male football players: a prospective study of 29 weeks including three teams from the Belgian professional football league. Br J Sports Med 2022; 56:bjsports-2021-104595. [PMID: 35487684 PMCID: PMC9062454 DOI: 10.1136/bjsports-2021-104595] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the association between SARS-CoV-2 infection and muscle strain injury in elite athletes. METHODS A prospective cohort study in three Belgian professional male football teams was performed during the first half of the 2020-2021 season (June 2020-January 2021). Injury data were collected using established surveillance methods. Assessment of SARS-CoV-2 infection was performed by a PCR test before each official game. RESULTS Of the 84 included participants, 22 were infected with SARS-CoV-2 and 14 players developed a muscle strain during the follow-up period. Cox's proportional hazards regression analyses demonstrated a significant association between SARS-CoV-2 infection and the development of muscle strain (HR 5.1; 95% CI 1.1 to 23.1; p=0.037), indicating an increased risk of developing muscle strains following SARS-CoV-2 infection. All athletes who sustained a muscle strain after infection were injured within the first month (15.71±11.74 days) after sports resumption and completed a longer time in quarantine (14.57±6.50 days) compared with the infected players who did not develop a muscle strain (11.18±5.25 days). CONCLUSION This study reported a five times higher risk of developing a muscle strain after a SARS-CoV-2 infection in elite male football players. Although this association should be examined further, it is possible that short-term detraining effects due to quarantine, and potentially pathological effects of the SARS-CoV-2 infection are associated with a higher risk of muscle strain injury.
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Affiliation(s)
- Evi Wezenbeek
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Sander Denolf
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | | | - Dries Pieters
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Jan G Bourgois
- Department of Performance and Sports Sciences, KAA Ghent, Ghent, Belgium
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | | | - Matthias Wieme
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Robbe Van Hecke
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Laurence Markey
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Joke Schuermans
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Erik Witvrouw
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Steven Verstockt
- Department of Electronics and Information Systems, Ghent University, Gent, Belgium
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30
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Galli F, Giancamilli F, Palombi T, Vitale JA, Borghi S, De Maria A, Cavicchiolo E, Diotaiuti P, La Torre A, Zelli A, Lucidi F, Codella R, Chirico A. Anxiety, Motives, and Intention for Physical Activity during the Italian COVID-19 Lockdown: An Observational Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084689. [PMID: 35457555 PMCID: PMC9025152 DOI: 10.3390/ijerph19084689] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND The coronavirus (COVID-19) pandemic led governments to adopt strict containment measures to avoid spreading the virus. These essential measures led to home confinement that influenced both the physical and mental health of populations. Physical activity plays a key role in preventing chronic diseases and promoting protective psychological factors. In the context of a lockdown, understanding the motives that guide people to enact physical activity is an important issue for public health. The present study aimed to evaluate the relation between autonomous motivation and physical activity, considering the role of behavioral intention and anxiety in a longitudinal moderated mediation model. METHODS Italian participants (N = 86; meanage = 29.74, standard deviation = 9.74; female = 53.5%) completed a booklet composed of different questionnaires (motivation, intention, anxiety, and physical activity) 3 weeks apart. RESULTS The hypothesized model is supported by the evidence; both autonomous motivation and intention are direct predictors of physical activity. The results also show that the direct effect of autonomous motivation on physical activity is stronger in participants with low anxiety, while high levels of anxiety are a significant moderator of the intention-behavior relation. CONCLUSIONS In conclusion, a multidisciplinary approach should be promoting methods and infrastructures to permit people to adhere to physical activity, as a front line against any health emergency.
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Affiliation(s)
- Federica Galli
- Department of Movement, Human and Health Sciences, University of Rome, “Foro Italico”, 00135 Rome, Italy; (F.G.); (A.D.M.); (A.Z.)
| | - Francesco Giancamilli
- Department of Psychology of Development and Socialization Processes, “Sapienza”, University of Rome, 00185 Rome, Italy; (F.G.); (T.P.); (F.L.)
| | - Tommaso Palombi
- Department of Psychology of Development and Socialization Processes, “Sapienza”, University of Rome, 00185 Rome, Italy; (F.G.); (T.P.); (F.L.)
| | | | - Stefano Borghi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy; (S.B.); (R.C.)
| | - Alessandra De Maria
- Department of Movement, Human and Health Sciences, University of Rome, “Foro Italico”, 00135 Rome, Italy; (F.G.); (A.D.M.); (A.Z.)
| | - Elisa Cavicchiolo
- Department of Human, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano, Italy;
| | - Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy;
| | - Antonio La Torre
- IRCSS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (J.A.V.); (A.L.T.)
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy; (S.B.); (R.C.)
| | - Arnaldo Zelli
- Department of Movement, Human and Health Sciences, University of Rome, “Foro Italico”, 00135 Rome, Italy; (F.G.); (A.D.M.); (A.Z.)
| | - Fabio Lucidi
- Department of Psychology of Development and Socialization Processes, “Sapienza”, University of Rome, 00185 Rome, Italy; (F.G.); (T.P.); (F.L.)
| | - Roberto Codella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy; (S.B.); (R.C.)
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization Processes, “Sapienza”, University of Rome, 00185 Rome, Italy; (F.G.); (T.P.); (F.L.)
- Correspondence:
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31
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Abraham AC, Fang F, Golman M, Oikonomou P, Thomopoulos S. The role of loading in murine models of rotator cuff disease. J Orthop Res 2022; 40:977-986. [PMID: 34081350 PMCID: PMC8639823 DOI: 10.1002/jor.25113] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/07/2021] [Accepted: 05/31/2021] [Indexed: 02/04/2023]
Abstract
Rotator cuff disease pathogenesis is associated with intrinsic (e.g., age, joint laxity, muscle weakness) and extrinsic (e.g., mechanical load, fatigue) factors that lead to chronic degeneration of the cuff tissues. However, etiological studies are difficult to perform in patients due to the long duration of disease onset and progression. Therefore, the purpose of this study was to determine the effects of altered joint loading on the rotator cuff. Mice were subjected to one of three load-dependent rotator cuff tendinopathy models: underuse loading, achieved by injecting botulinum toxin-A into the supraspinatus muscle; overuse loading, achieved using downhill treadmill running; destabilization loading, achieved by surgical excision of the infraspinatus tendon. All models were compared to cage activity animals. Whole joint function was assessed longitudinally using gait analysis. Tissue-scale structure and function were determined using microCT, tensile testing, and histology. The molecular response of the supraspinatus tendon and enthesis was determined by measuring the expression of 84 wound healing-associated genes. Underuse and destabilization altered forepaw weight-bearing, decreased tendon-to-bone attachment strength, decreased mineral density of the humeral epiphysis, and reduced tendon strength. Transcriptional activity of the underuse group returned to baseline levels by 4 weeks, while destabilization had significant upregulation of inflammation, growth factors, and extracellular matrix remodeling genes. Surprisingly, overuse activity caused changes in walking patterns, increased tendon stiffness, and primarily suppressed expression of wound healing-related genes. In summary, the tendinopathy models demonstrated how divergent muscle loading can result in clinically relevant alterations in rotator cuff structure, function, and gene expression.
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Affiliation(s)
- Adam C. Abraham
- University of Michigan, Department of Orthopaedic Surgery, Biomedical Science Research Building, 109 Zina Pitcher Pl, Ann Arbor, MI 48109, USA,Corresponding author Adam C. Abraham, Ph.D., Research Investigator, University of Michigan, Department of Orthopaedic Surgery, Ann Arbor, MI 48109, USA,
| | - Fei Fang
- Columbia University Irving Medical Center, Department of Orthopaedic Surgery, New York, NY 10032, USA
| | - Mikhail Golman
- Columbia University, Department of Biomedical Engineering, New York, NY 10027
| | | | - Stavros Thomopoulos
- Columbia University Irving Medical Center, Department of Orthopaedic Surgery, New York, NY 10032, USA,Columbia University, Department of Biomedical Engineering, New York, NY 10027
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32
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Friebe D, Fischer M, Giesche F, Füzéki E, Banzer W. Auswirkungen des COVID-19-Lockdowns auf physische Leistungsparameter im professionellen Fußball. ZENTRALBLATT FÜR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2022; 72:89-97. [PMID: 35095213 PMCID: PMC8785923 DOI: 10.1007/s40664-022-00455-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 11/27/2022]
Abstract
Zusammenfassung
Hintergrund
Die staatlichen Maßnahmen zur Eindämmung des Coronavirus SARS-CoV‑2 im Jahr 2020 brachten den Trainings- und Wettkampfbetrieb im professionellen Fußball in vielen Ländern zum zeitweiligen Erliegen. In Folge des Lockdowns waren die Trainingsmöglichkeiten zumeist auf unspezifische heimbasierte Trainingsmethoden begrenzt. Es ist unklar, ob sich die fehlenden sportspezifischen Belastungsreize negativ auf die physische Leistungsfähigkeit der Fußballspielenden auswirkten.
Methodik
Im Rahmen eines narrativen Reviews wurde mittels einer selektiven Literaturrecherche in den Datenbanken PubMed, Google Scholar und BISp-Surf nach Studien gesucht, welche die Auswirkungen des Lockdowns auf physische Leistungsparameter bei erwachsenen professionellen Fußballspielenden untersuchten.
Ergebnisse
In die Übersichtsarbeit wurden sechs prospektive Längsschnittstudien eingeschlossen. In allen Studien kam während der Quarantäne ein heimbasiertes Ersatztraining zum Einsatz. Vier Studien verglichen die Leistungsfähigkeit der Fußballer/-innen mit Leistungsdaten aus vorherigen Spielzeiten. Zwei Studien ermittelten die Leistungsfähigkeit der Sportler/-innen unmittelbar vor und nach der Lockdownperiode.
Diskussion
Während die allgemeine Kraft- und Ausdauerleistung durch heimbasierte Ersatztrainingsprogramme erhalten werden kann, weisen die Studien darauf hin, dass sich die fehlenden spezifischen Belastungsreize vor allem negativ auf die Schnelligkeits- und Schnellkraftleistung der Fußballspielenden auswirken könnten. Bei Rückkehr in den regulären Trainingsbetrieb sollte daher auf eine progressive Belastungssteuerung insbesondere im Schnelligkeitstraining geachtet werden, um das Risiko für Verletzungen zu senken.
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Affiliation(s)
- D. Friebe
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
| | - M. Fischer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
| | - F. Giesche
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
| | - E. Füzéki
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
| | - W. Banzer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Arbeitsbereich Präventiv- und Sportmedizin, Goethe-Universität Frankfurt/Main, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt/Main, Deutschland
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Kruse A, Rivares C, Weide G, Tilp M, Jaspers RT. Stimuli for Adaptations in Muscle Length and the Length Range of Active Force Exertion-A Narrative Review. Front Physiol 2021; 12:742034. [PMID: 34690815 PMCID: PMC8531727 DOI: 10.3389/fphys.2021.742034] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/08/2021] [Indexed: 12/03/2022] Open
Abstract
Treatment strategies and training regimens, which induce longitudinal muscle growth and increase the muscles’ length range of active force exertion, are important to improve muscle function and to reduce muscle strain injuries in clinical populations and in athletes with limited muscle extensibility. Animal studies have shown several specific loading strategies resulting in longitudinal muscle fiber growth by addition of sarcomeres in series. Currently, such strategies are also applied to humans in order to induce similar adaptations. However, there is no clear scientific evidence that specific strategies result in longitudinal growth of human muscles. Therefore, the question remains what triggers longitudinal muscle growth in humans. The aim of this review was to identify strategies that induce longitudinal human muscle growth. For this purpose, literature was reviewed and summarized with regard to the following topics: (1) Key determinants of typical muscle length and the length range of active force exertion; (2) Information on typical muscle growth and the effects of mechanical loading on growth and adaptation of muscle and tendinous tissues in healthy animals and humans; (3) The current knowledge and research gaps on the regulation of longitudinal muscle growth; and (4) Potential strategies to induce longitudinal muscle growth. The following potential strategies and important aspects that may positively affect longitudinal muscle growth were deduced: (1) Muscle length at which the loading is performed seems to be decisive, i.e., greater elongations after active or passive mechanical loading at long muscle length are expected; (2) Concentric, isometric and eccentric exercises may induce longitudinal muscle growth by stimulating different muscular adaptations (i.e., increases in fiber cross-sectional area and/or fiber length). Mechanical loading intensity also plays an important role. All three training strategies may increase tendon stiffness, but whether and how these changes may influence muscle growth remains to be elucidated. (3) The approach to combine stretching with activation seems promising (e.g., static stretching and electrical stimulation, loaded inter-set stretching) and warrants further research. Finally, our work shows the need for detailed investigation of the mechanisms of growth of pennate muscles, as those may longitudinally grow by both trophy and addition of sarcomeres in series.
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Affiliation(s)
- Annika Kruse
- Department of Biomechanics, Training, and Movement Science, Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Cintia Rivares
- Laboratory for Myology, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Guido Weide
- Laboratory for Myology, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University Hospital Leuven, Leuven, Belgium
| | - Markus Tilp
- Department of Biomechanics, Training, and Movement Science, Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Richard T Jaspers
- Laboratory for Myology, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
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34
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Logerstedt DS, Ebert JR, MacLeod TD, Heiderscheit BC, Gabbett TJ, Eckenrode BJ. Effects of and Response to Mechanical Loading on the Knee. Sports Med 2021; 52:201-235. [PMID: 34669175 DOI: 10.1007/s40279-021-01579-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 11/30/2022]
Abstract
Mechanical loading to the knee joint results in a differential response based on the local capacity of the tissues (ligament, tendon, meniscus, cartilage, and bone) and how those tissues subsequently adapt to that load at the molecular and cellular level. Participation in cutting, pivoting, and jumping sports predisposes the knee to the risk of injury. In this narrative review, we describe different mechanisms of loading that can result in excessive loads to the knee, leading to ligamentous, musculotendinous, meniscal, and chondral injuries or maladaptations. Following injury (or surgery) to structures around the knee, the primary goal of rehabilitation is to maximize the patient's response to exercise at the current level of function, while minimizing the risk of re-injury to the healing tissue. Clinicians should have a clear understanding of the specific injured tissue(s), and rehabilitation should be driven by knowledge of tissue-healing constraints, knee complex and lower extremity biomechanics, neuromuscular physiology, task-specific activities involving weight-bearing and non-weight-bearing conditions, and training principles. We provide a practical application for prescribing loading progressions of exercises, functional activities, and mobility tasks based on their mechanical load profile to knee-specific structures during the rehabilitation process. Various loading interventions can be used by clinicians to produce physical stress to address body function, physical impairments, activity limitations, and participation restrictions. By modifying the mechanical load elements, clinicians can alter the tissue adaptations, facilitate motor learning, and resolve corresponding physical impairments. Providing different loads that create variable tensile, compressive, and shear deformation on the tissue through mechanotransduction and specificity can promote the appropriate stress adaptations to increase tissue capacity and injury tolerance. Tools for monitoring rehabilitation training loads to the knee are proposed to assess the reactivity of the knee joint to mechanical loading to monitor excessive mechanical loads and facilitate optimal rehabilitation.
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Affiliation(s)
- David S Logerstedt
- Department of Physical Therapy, University of the Sciences in Philadelphia, Philadelphia, PA, USA.
| | - Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia.,Orthopaedic Research Foundation of Western Australia, Perth, WA, Australia.,Perth Orthopaedic and Sports Medicine Research Institute, Perth, WA, Australia
| | - Toran D MacLeod
- Department of Physical Therapy, Sacramento State University, Sacramento, CA, USA
| | - Bryan C Heiderscheit
- Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Tim J Gabbett
- Gabbett Performance Solutions, Brisbane, QLD, Australia.,Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia
| | - Brian J Eckenrode
- Department of Physical Therapy, Arcadia University, Glenside, PA, USA
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35
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Di Girolamo FG, Fiotti N, Milanović Z, Situlin R, Mearelli F, Vinci P, Šimunič B, Pišot R, Narici M, Biolo G. The Aging Muscle in Experimental Bed Rest: A Systematic Review and Meta-Analysis. Front Nutr 2021; 8:633987. [PMID: 34422875 PMCID: PMC8371327 DOI: 10.3389/fnut.2021.633987] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/07/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Maintaining skeletal muscle mass and function in aging is crucial for preserving the quality of life and health. An experimental bed rest (BR) protocol is a suitable model to explore muscle decline on aging during inactivity. Objective: The purpose of this systematic review and meta-analysis was, therefore, to carry out an up-to-date evaluation of bed rest, with a specific focus on the magnitude of effects on muscle mass, strength, power, and functional capacity changes as well as the mechanisms, molecules, and pathways involved in muscle decay. Design: This was a systematic review and meta-analysis study. Data sources: We used PubMed, Medline; Web of Science, Google Scholar, and the Cochrane library, all of which were searched prior to April 23, 2020. A manual search was performed to cover bed rest experimental protocols using the following key terms, either singly or in combination: "Elderly Bed rest," "Older Bed rest," "Old Bed rest," "Aging Bed rest," "Aging Bed rest," "Bed-rest," and "Bedrest". Eligibility criteria for selecting studies: The inclusion criteria were divided into four sections: type of study, participants, interventions, and outcome measures. The primary outcome measures were: body mass index, fat mass, fat-free mass, leg lean mass, cross-sectional area, knee extension power, cytokine pattern, IGF signaling biomarkers, FOXO signaling biomarkers, mitochondrial modulation biomarkers, and muscle protein kinetics biomarkers. Results: A total of 25 studies were included in the qualitative synthesis, while 17 of them were included in the meta-analysis. In total, 118 healthy elderly volunteers underwent 5-, 7-, 10-, or 14-days of BR and provided a brief sketch on the possible mechanisms involved. In the very early phase of BR, important changes occurred in the skeletal muscle, with significant loss of performance associated with a lesser grade reduction of the total body and muscle mass. Meta-analysis of the effect of bed rest on total body mass was determined to be small but statistically significant (ES = -0.45, 95% CI: -0.72 to -0.19, P < 0.001). Moderate, statistically significant effects were observed for total lean body mass (ES = -0.67, 95% CI: -0.95 to -0.40, P < 0.001) after bed rest intervention. Overall, total lean body mass was decreased by 1.5 kg, while there was no relationship between bed rest duration and outcomes (Z = 0.423, p = 672). The meta-analyzed effect showed that bed rest produced large, statistically significant, effects (ES = -1.06, 95% CI: -1.37 to -0.75, P < 0.001) in terms of the knee extension power. Knee extension power was decreased by 14.65 N/s. In contrast, to other measures, meta-regression showed a significant relationship between bed rest duration and knee extension power (Z = 4.219, p < 0.001). Moderate, statistically significant, effects were observed after bed rest intervention for leg muscle mass in both old (ES = -0.68, 95% CI: -0.96 to -0.40, P < 0.001) and young (ES = -0.51, 95% CI: -0.80 to -0.22, P < 0.001) adults. However, the magnitude of change was higher in older (MD = -0.86 kg) compared to younger (MD = -0.24 kg) adults. Conclusion: Experimental BR is a suitable model to explore the detrimental effects of inactivity in young adults, old adults, and hospitalized people. Changes in muscle mass and function are the two most investigated variables, and they allow for a consistent trend in the BR-induced changes. Mechanisms underlying the greater loss of muscle mass and function in aging, following inactivity, need to be thoroughly investigated.
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Affiliation(s)
- Filippo Giorgio Di Girolamo
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,SC Assistenza Farmaceutica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Nicola Fiotti
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Zoran Milanović
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia.,Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia.,Faculty of Sports Studies, Incubator of Kinanthropological Research, Masaryk University, Brno, Czechia
| | - Roberta Situlin
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Filippo Mearelli
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Pierandrea Vinci
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Boštjan Šimunič
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Marco Narici
- Department of Biomedical Sciences, Neuromuscular Physiology Laboratory, University of Padova, Padova, Italy
| | - Gianni Biolo
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Gao Y, Lyu X, Liu Q, Meng Y, Wang J, Pan S. Quantitative Evaluation of Hip Muscle Atrophy in Patients with Unilateral Slipped Capital Femoral Epiphysis Based on Magnetic Resonance Imaging. Acad Radiol 2021; 28:1125-1132. [PMID: 32540199 DOI: 10.1016/j.acra.2020.05.007] [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: 03/12/2020] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 12/12/2022]
Abstract
RATIONALE AND OBJECTIVES Hip muscle atrophy commonly occurs in patients with unilateral slipped capital femoral epiphysis (SCFE), its effect in patients with unilateral SCFE is worthy of further investigation. This study aimed to investigate the relationship between hip muscle cross-sectional area (M-CSA) and unilateral SCFE using magnetic resonance imaging. MATERIALS AND METHODS Overall, 32 unilateral SCFE patients (SCFE group) and 15 asymptomatic subjects (control group) were evaluated. All patients underwent magnetic resonance imaging and frog-leg lateral radiograph examinations. M-CSA and Southwick angle were evaluated to calculate the M-CSA ratio of the affected side over the healthy side (A/H) ratio in the SCFE group and the control group. Associations between the A/H ratio, Southwick angle, and the disease time course were investigated with Spearman correlation test. An independent sample t-test, one-way analysis of variance tests, and intraclass correlation coefficients were also applied. RESULTS A/H ratios of the control group were significantly higher than those of the SCFE group (anterior muscles group: 1.09 ± 0.14 vs 0.86 ± 0.12, medial muscles group: 1.02 ± 0.15 vs 0.82 ± 0.18, posterior muscles group: 1.03 ± 0.07 vs 0.84 ± 0.11, all p < 0.01). A/H ratios of the medial and posterior muscle groups were significantly correlated with severity of SCFE (r = -0.504, p = 0.003, and r = -0.438, p = 0.012, respectively). CONCLUSION Hip muscle atrophy is associated with SCFE severity in patients with unilateral SCFE. The A/H ratio can reflect the patients' prognosis and rehabilitation status. Maintenance of hip muscle morphology and function may be beneficial to clinical performance and prognosis of patients with unilateral SCFE.
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Narici M, McPhee J, Conte M, Franchi MV, Mitchell K, Tagliaferri S, Monti E, Marcolin G, Atherton PJ, Smith K, Phillips B, Lund J, Franceschi C, Maggio M, Butler‐Browne GS. Age-related alterations in muscle architecture are a signature of sarcopenia: the ultrasound sarcopenia index. J Cachexia Sarcopenia Muscle 2021; 12:973-982. [PMID: 34060717 PMCID: PMC8350200 DOI: 10.1002/jcsm.12720] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/23/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The assessment of muscle mass is a key determinant of the diagnosis of sarcopenia. We introduce for the first time an ultrasound imaging method for diagnosing sarcopenia based on changes in muscle geometric proportions. METHODS Vastus lateralis muscle fascicle length (Lf) and thickness (Tm) were measured at 35% distal femur length by ultrasonography in a population of 279 individuals classified as moderately active elderly (MAE), sedentary elderly (SE) (n = 109), mobility impaired elderly (MIE) (n = 43), and in adult young controls (YC) (n = 60). The ratio of Lf/Tm was calculated to obtain an ultrasound index of the loss of muscle mass associated with sarcopenia (USI). In a subsample of elderly male individuals (n = 76) in which corresponding DXA measurements were available (MAE, n = 52 and SE, n = 24), DXA-derived skeletal muscle index (SMI, appendicular limb mass/height2 ) was compared with corresponding USI values. RESULTS For both young and older participants, USI values were found to be independent of sex, height and body mass. USI values were 3.70 ± 0.52 for YC, 4.50 ± 0.72 for the MAE, 5.05 ± 1.11 for the SE and 6.31 ± 1.38 for the MIE, all significantly different between each other (P < 0.0001). Based on the USI Z-scores, with reference to the YC population, the 219 elderly participants were stratified according to their muscle sarcopenic status. Individuals with USI values within a range of 3.70 < USI ≥ 4.23 were classified as non-sarcopenic (prevalence 23.7%), those with USI values within 4.23 < USI ≥ 4.76 were classified as pre-sarcopenic (prevalence 23.7%), those with USI values within 4.76 < USI ≥ 5.29 were classified as moderately sarcopenic (prevalence 15.1%), those with USI values within range 5.29 < USI ≥ 5.82 were classified as sarcopenic (prevalence 27.9%), and those with USI values >5.82 were classified as severely sarcopenic (prevalence 9.6%). The DXA-derived SMI was found to be significantly correlated with USI (r = 0.61, P < 0.0001). Notably, the USI cut-off value for moderate sarcopenia (4.76 a.u.) was found to coincide with the DXA cut-off value of sarcopenia (7.26 kg/m2 ). CONCLUSIONS We propose a novel, practical, and inexpensive imaging marker of the loss of muscle mass associated with sarcopenia, called the ultrasound sarcopenic index (USI), based on changes in muscle geometric proportions. These changes provide a useful 'signature of sarcopenia' and allow the stratification of individuals according to the presence and severity of muscle sarcopenia. We are convinced that the USI will be a useful clinical tool for confirming the diagnosis of sarcopenia, of which the assessment of muscle mass is a key-component.
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Affiliation(s)
- Marco Narici
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
- CIR‐MYO Myology CenterUniversity of PaduaPaduaItaly
| | - Jamie McPhee
- Department of Sport and Exercise SciencesManchester Metropolitan UniversityManchesterUK
| | - Maria Conte
- Department of Experimental, Diagnostic and Specialty MedicineUniversity of BolognaBolognaItaly
| | | | - Kyle Mitchell
- Dorsey County Hospital NHS Foundation TrustDorchesterUK
| | | | - Elena Monti
- Department of Biomedical SciencesUniversity of PadovaPadovaItaly
| | | | - Philip J. Atherton
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research Nottingham Biomedical Research CentreUniversity of NottinghamDerbyUK
| | - Kenneth Smith
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research Nottingham Biomedical Research CentreUniversity of NottinghamDerbyUK
| | - Bethan Phillips
- MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research Nottingham Biomedical Research CentreUniversity of NottinghamDerbyUK
| | - Jonathan Lund
- Department of Surgery and University of Nottingham School of MedicineRoyal Derby HospitalDerbyUK
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty MedicineUniversity of BolognaBolognaItaly
| | - Marcello Maggio
- Department of Internal Medicine and Biomedical Sciences, Section of GeriatricsUniversity of ParmaParmaItaly
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38
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D'Emanuele S, Maffiuletti NA, Tarperi C, Rainoldi A, Schena F, Boccia G. Rate of Force Development as an Indicator of Neuromuscular Fatigue: A Scoping Review. Front Hum Neurosci 2021; 15:701916. [PMID: 34305557 PMCID: PMC8301373 DOI: 10.3389/fnhum.2021.701916] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022] Open
Abstract
Because rate of force development (RFD) is an emerging outcome measure for the assessment of neuromuscular function in unfatigued conditions, and it represents a valid alternative/complement to the classical evaluation of pure maximal strength, this scoping review aimed to map the available evidence regarding RFD as an indicator of neuromuscular fatigue. Thus, following a general overview of the main studies published on this topic, we arbitrarily compared the amount of neuromuscular fatigue between the “gold standard” measure (maximal voluntary force, MVF) and peak, early (≤100 ms) and late (>100 ms) RFD. Seventy full-text articles were included in the review. The most-common fatiguing exercises were resistance exercises (37% of the studies), endurance exercises/locomotor activities (23%), isokinetic contractions (17%), and simulated/real sport situations (13%). The most widely tested tasks were knee extension (60%) and plantar flexion (10%). The reason (i.e., rationale) for evaluating RFD was lacking in 36% of the studies. On average, the amount of fatigue for MVF (−19%) was comparable to late RFD (−19%) but lower compared to both peak RFD (−25%) and early RFD (−23%). Even if the rationale for evaluating RFD in the fatigued state was often lacking and the specificity between test task and fatiguing exercise characteristics was not always respected in the included studies, RFD seems to be a valid indicator of neuromuscular fatigue. Based on our arbitrary analyses, peak RFD and early phase RFD appear even to be more sensitive to quantify neuromuscular fatigue than MVF and late phase RFD.
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Affiliation(s)
- Samuel D'Emanuele
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Cantor Tarperi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Alberto Rainoldi
- Department of Medical Sciences, University of Turin, Turin, Italy.,NeuroMuscularFunction
- Research Group, School of Exercise and Sport Sciences (SUISM), University of Turin, Turin, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Verona, Italy
| | - Gennaro Boccia
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,NeuroMuscularFunction
- Research Group, School of Exercise and Sport Sciences (SUISM), University of Turin, Turin, Italy
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39
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Cavalcante JGT, Marqueti RDC, Corrigan P, Sousa AMM, Bottaro M, Babault N, Geremia JM, Silbernagel KG, Durigan JLQ. The effects of knee and hip joint angles on patellar tendon loading during quadriceps neuromuscular electrical stimulation. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jonathan Galvão Tenório Cavalcante
- Graduate Program of Rehabilitation Sciences University of Brasília Brasília Brazil
- College of Physical Education University of Brasília Brasília Brazil
| | - Rita de Cássia Marqueti
- Graduate Program of Rehabilitation Sciences University of Brasília Brasília Brazil
- Graduate Program of Sciences and Technology of Health University of Brasília Brasília Brazil
| | - Patrick Corrigan
- Department of Physical Therapy, Movement & Rehabilitation Sciences Northeastern University Boston MA USA
| | | | - Martim Bottaro
- College of Physical Education University of Brasília Brasília Brazil
| | - Nicolas Babault
- Centre d’Expertise de la Performance INSERM UMR1093‐CAPS UFR des Sciences du Sport University of Burgundy Franche‐Comté Dijon France
| | - Jeam Marcel Geremia
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance Federal University of Rio Grande do Sul Porto Alegre Brazil
| | | | - João Luiz Quaglioti Durigan
- Graduate Program of Rehabilitation Sciences University of Brasília Brasília Brazil
- College of Physical Education University of Brasília Brasília Brazil
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40
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Sarto F, Spörri J, Fitze DP, Quinlan JI, Narici MV, Franchi MV. Implementing Ultrasound Imaging for the Assessment of Muscle and Tendon Properties in Elite Sports: Practical Aspects, Methodological Considerations and Future Directions. Sports Med 2021; 51:1151-1170. [PMID: 33683628 PMCID: PMC8124062 DOI: 10.1007/s40279-021-01436-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2021] [Indexed: 12/16/2022]
Abstract
Ultrasound (US) imaging has been widely used in both research and clinical settings to evaluate the morphological and mechanical properties of muscle and tendon. In elite sports scenarios, a regular assessment of such properties has great potential, namely for testing the response to training, detecting athletes at higher risks of injury, screening athletes for structural abnormalities related to current or future musculoskeletal complaints, and monitoring their return to sport after a musculoskeletal injury. However, several practical and methodological aspects of US techniques should be considered when applying this technology in the elite sports context. Therefore, this narrative review aims to (1) present the principal US measures and field of applications in the context of elite sports; (2) to discuss, from a methodological perspective, the strengths and shortcomings of US imaging for the assessment of muscle and tendon properties; and (3) to provide future directions for research and application.
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Affiliation(s)
- Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Daniel P Fitze
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jonathan I Quinlan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health Research, Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Marco V Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- CIR-MYO Myology Centre, University of Padova, Padova, Italy
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova, Italy.
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41
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Monti E, Reggiani C, Franchi MV, Toniolo L, Sandri M, Armani A, Zampieri S, Giacomello E, Sarto F, Sirago G, Murgia M, Nogara L, Marcucci L, Ciciliot S, Šimunic B, Pišot R, Narici MV. Neuromuscular junction instability and altered intracellular calcium handling as early determinants of force loss during unloading in humans. J Physiol 2021; 599:3037-3061. [PMID: 33881176 PMCID: PMC8359852 DOI: 10.1113/jp281365] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/30/2021] [Indexed: 01/18/2023] Open
Abstract
Key points Few days of unloading are sufficient to induce a decline of skeletal muscle mass and function; notably, contractile force is lost at a faster rate than muscle mass. The reasons behind this disproportionate loss of muscle force are still poorly understood. We provide strong evidence of two mechanisms only hypothesized until now for the rapid muscle force loss in only 10 days of bed rest. Our results show that an initial neuromuscular junction instability, accompanied by alterations in the innervation status and impairment of single fibre sarcoplasmic reticulum function contribute to the loss of contractile force in front of a preserved myofibrillar function and central activation capacity. Early onset of neuromuscular junction instability and impairment in calcium dynamics involved in excitation–contraction coupling are proposed as eligible determinants to the greater decline in muscle force than in muscle size during unloading.
Abstract Unloading induces rapid skeletal muscle atrophy and functional decline. Importantly, force is lost at a much higher rate than muscle mass. We aimed to investigate the early determinants of the disproportionate loss of force compared to that of muscle mass in response to unloading. Ten young participants underwent 10 days of bed rest (BR). At baseline (BR0) and at 10 days (BR10), quadriceps femoris (QF) volume (VOL) and isometric maximum voluntary contraction (MVC) were assessed. At BR0 and BR10 blood samples and biopsies of vastus lateralis (VL) muscle were collected. Neuromuscular junction (NMJ) stability and myofibre innervation status were assessed, together with single fibre mechanical properties and sarcoplasmic reticulum (SR) calcium handling. From BR0 to BR10, QFVOL and MVC decreased by 5.2% (P = 0.003) and 14.3% (P < 0.001), respectively. Initial and partial denervation was detected from increased neural cell adhesion molecule (NCAM)‐positive myofibres at BR10 compared with BR0 (+3.4%, P = 0.016). NMJ instability was further inferred from increased C‐terminal agrin fragment concentration in serum (+19.2% at BR10, P = 0.031). Fast fibre cross‐sectional area (CSA) showed a trend to decrease by 15% (P = 0.055) at BR10, while single fibre maximal tension (force/CSA) was unchanged. However, at BR10 SR Ca2+ release in response to caffeine decreased by 35.1% (P < 0.002) and 30.2% (P < 0.001) in fast and slow fibres, respectively, pointing to an impaired excitation–contraction coupling. These findings support the view that the early onset of NMJ instability and impairment in SR function are eligible mechanisms contributing to the greater decline in muscle force than in muscle size during unloading. Few days of unloading are sufficient to induce a decline of skeletal muscle mass and function; notably, contractile force is lost at a faster rate than muscle mass. The reasons behind this disproportionate loss of muscle force are still poorly understood. We provide strong evidence of two mechanisms only hypothesized until now for the rapid muscle force loss in only 10 days of bed rest. Our results show that an initial neuromuscular junction instability, accompanied by alterations in the innervation status and impairment of single fibre sarcoplasmic reticulum function contribute to the loss of contractile force in front of a preserved myofibrillar function and central activation capacity. Early onset of neuromuscular junction instability and impairment in calcium dynamics involved in excitation–contraction coupling are proposed as eligible determinants to the greater decline in muscle force than in muscle size during unloading.
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Affiliation(s)
- Elena Monti
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Science and Research Center Koper, Institute for Kinesiology Research, Koper, 6000, Slovenia
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Luana Toniolo
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Marco Sandri
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Biomedical Sciences, Venetian Institute of Molecular Medicine, University of Padova, Via Orus 2, Padova, 35129, Italy
| | - Andrea Armani
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Biomedical Sciences, Venetian Institute of Molecular Medicine, University of Padova, Via Orus 2, Padova, 35129, Italy
| | - Sandra Zampieri
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, 35124, Italy
| | - Emiliana Giacomello
- Clinical Department of Medical, Surgical and Health Sciences, Strada di Fiume, 447, Trieste, 34149, Italy
| | - Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Giuseppe Sirago
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Marta Murgia
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Proteomics and Signal Transduction, Max-Planck-Institute of Biochemistry Am Klopferspitz 18, Martinsried, 82152, Germany
| | - Leonardo Nogara
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Lorenzo Marcucci
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Stefano Ciciliot
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Biomedical Sciences, Venetian Institute of Molecular Medicine, University of Padova, Via Orus 2, Padova, 35129, Italy
| | - Boštjan Šimunic
- Science and Research Center Koper, Institute for Kinesiology Research, Koper, 6000, Slovenia
| | - Rado Pišot
- Science and Research Center Koper, Institute for Kinesiology Research, Koper, 6000, Slovenia
| | - Marco V Narici
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Science and Research Center Koper, Institute for Kinesiology Research, Koper, 6000, Slovenia.,CIR-MYO Myology Center, University of Padova, Padova, 35131, Italy
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Roffino S, Camy C, Foucault-Bertaud A, Lamy E, Pithioux M, Chopard A. Negative impact of disuse and unloading on tendon enthesis structure and function. LIFE SCIENCES IN SPACE RESEARCH 2021; 29:46-52. [PMID: 33888287 DOI: 10.1016/j.lssr.2021.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/19/2021] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
Exposure to chronic skeletal muscle disuse and unloading that astronauts experience results in muscle deconditioning and bone remodeling. Tendons involved in the transmission of force from muscles to skeleton are also affected. Understanding the changes that occur in muscle, tendon, and bone is an essential step toward limiting or preventing the deleterious effects of chronic reduction in mechanical load. Numerous reviews have reported the effects of this reduction on both muscle and bone, and to a lesser extent on the tendon. However, none focused on the tendon enthesis, the tendon-to-bone attachment site. While the enthesis structure appears to be determined by mechanical stress, little is known about enthesis plasticity. Our review first looks at the relationship between entheses and mechanical stress, exploring how tensile and compressive loads determine and influence enthesis structure and composition. The second part of this review addresses the deleterious effects of skeletal muscle disuse and unloading on enthesis structure, composition, and function. We discuss the possibility that spaceflight-induced enthesis remodeling could impact both the capacity of the enthesis to withstand compressive stress and its potential weakness. Finally, we point out how altered compressive strength at entheses could expose astronauts to the risk of developing enthesopathies.
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Affiliation(s)
- S Roffino
- ISM Inst Movement Sci, Aix-Marseille University, CNRS, Marseille, France.
| | - C Camy
- ISM Inst Movement Sci, Aix-Marseille University, CNRS, Marseille, France
| | - A Foucault-Bertaud
- INSERM 1263, INRA 1260, C2VN, Aix-Marseille University, Marseille, France
| | - E Lamy
- ISM Inst Movement Sci, Aix-Marseille University, CNRS, Marseille, France
| | - M Pithioux
- ISM Inst Movement Sci, Aix-Marseille University, CNRS, Marseille, France
| | - A Chopard
- DMEM, Montpellier University, INRAE, Montpellier, France
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Bagley L, Al-Shanti N, Bradburn S, Baig O, Slevin M, McPhee JS. Sex Comparison of Knee Extensor Size, Strength, and Fatigue Adaptation to Sprint Interval Training. J Strength Cond Res 2021. [PMID: 29533360 DOI: 10.1519/jsc.0000000000002496] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
ABSTRACT Bagley, L, Al-Shanti, N, Bradburn, S, Baig, O, Slevin, M, and McPhee, JS. Sex comparison of knee extensor size, strength, and fatigue adaptation to sprint interval training. J Strength Cond Res 35(1): 64-71, 2021-Regular sprint interval training (SIT) improves whole-body aerobic capacity and muscle oxidative potential, but very little is known about knee extensor anabolic or fatigue resistance adaptations, or whether effects are similar for men and women. The purpose of this study was to compare sex-related differences in knee extensor size, torque-velocity relationship, and fatigability adaptations to 12-week SIT. Sixteen men and 15 women (mean [SEM] age: 41 [±2.5] years) completed measurements of total body composition assessed by dual energy X-ray absorptiometry, quadriceps muscle cross-sectional area (CSAQ) assessed by magnetic resonance imaging, the knee extensor torque-velocity relationship (covering 0-240°·s-1) and fatigue resistance, which was measured as the decline in torque from the first to the last of 60 repeated concentric knee extensions performed at 180°·s-1. Sprint interval training consisted of 4 × 20-second sprints on a cycle ergometer set at an initial power output of 175% of power at V̇o2max, 3 times per week for 12 weeks. Quadriceps muscle cross-sectional area increased by 5% (p = 0.023) and fatigue resistance improved 4.8% (p = 0.048), with no sex differences in these adaptations (sex comparisons: p = 0.140 and p = 0.282, respectively). Knee extensor isometric and concentric torque was unaffected by SIT in both men and women (p > 0.05 for all velocities). Twelve-week SIT, totaling 4 minutes of very intense cycling per week, significantly increased fatigue resistance and CSAQ similarly in men and women, but did not significantly increase torque in men or women. These results suggest that SIT is a time-effective training modality for men and women to increase leg muscle size and fatigue resistance.
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Affiliation(s)
- Liam Bagley
- School of Healthcare Science, John Dalton Building, Manchester Metropolitan University, Manchester, United Kingdom
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Chapple LAS, Dirks ML, Kouw IW. Stable isotope approaches to study muscle mass outcomes in clinical populations. CLINICAL NUTRITION OPEN SCIENCE 2021. [DOI: 10.1016/j.nutos.2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Izzicupo P, Di Baldassarre A, Abelkalns I, Bisenieks U, Sánchez-Pato A, Cánovas-Alvarez FJ, Doupona M, Figueiredo AJ, García-Roca JA, Ghinassi B, Leiva-Arcas A, Meroño L, Paegle A, Radu LE, Rus CM, Rusu OM, Sarmento H, Stonis J, Vaquero-Cristóbal R, Vaz V, Capranica L. Dual Careers of Athletes During COVID-19 Lockdown. Front Psychol 2021; 12:657671. [PMID: 33868131 PMCID: PMC8047065 DOI: 10.3389/fpsyg.2021.657671] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 02/22/2021] [Indexed: 12/25/2022] Open
Abstract
This study aimed to investigate the student-athletes' capability to face the academic, sport, and social challenges during the coronavirus disease 2019 (COVID-19) lockdown and to disclose novel aspects of dual careers. A 32-item online survey encompassing demographic characteristics, sport and university engagement, support and dual-career benefits, physical activity, sitting time, and the time deemed necessary to recover the previous level of performance was developed. Four hundred sixty-seven student-athletes (males: 57%, females: 43%) from 11 countries, competing in 49 different sports (individual: 63.4%, team: 36.6%) at regional (17.5%), national (43.3%), and international (39.2%) levels, and enrolled at high school (21.9%) and university (78.1%) levels completed the survey. During the lockdown, the respondents decreased the time dedicated to sport and academics, although they maintained an active lifestyle. Student-athletes from countries under severe contagion were more likely to train at home, dedicate to academics, and receive support from the coach but less likely receive support from their teachers. With respect to their team sport counterparts, athletes competing in individual sports trained more and were more likely to receive support from their coaches. International athletes showed the highest training time and support from their coaches and as student-athletes. High school students received more support from their coaches and teachers, whereas university students were more likely considering dual careers useful to cope with the COVID-19 pandemic. This study substantiates the relevant role of competitive sports participation in the maintenance of active lifestyles, with student-athletes considering home training and e-learning valuable resources during the lockdown. Furthermore, their sport and academic commitments helped student-athletes cope with the emergency of the COVID-19 pandemic.
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Affiliation(s)
- Pascal Izzicupo
- Department of Medicine and Aging Sciences, University “G. D'Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, University “G. D'Annunzio” of Chieti-Pescara, Chieti, Italy
| | | | | | - Antonio Sánchez-Pato
- Areté Research Group, Faculty of Sport, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | | | - Mojca Doupona
- Department of Sport Sociology and History, Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
- European Athlete as Student Network, Ghaxaq, Malta
| | - António J. Figueiredo
- Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Juan Alfonso García-Roca
- Areté Research Group, Faculty of Sport, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Barbara Ghinassi
- Department of Medicine and Aging Sciences, University “G. D'Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Alejandro Leiva-Arcas
- Areté Research Group, Faculty of Sport, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Lourdes Meroño
- Areté Research Group, Faculty of Sport, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | | | - Liliana-Elisabeta Radu
- Faculty of Physical Education and Sport, University “Alexandru Ioan Cuza”, Iaşi, Romania
| | - Cristian-Mihail Rus
- Faculty of Physical Education and Sport, University “Alexandru Ioan Cuza”, Iaşi, Romania
| | - Oana-Mihaela Rusu
- Faculty of Physical Education and Sport, University “Alexandru Ioan Cuza”, Iaşi, Romania
| | - Hugo Sarmento
- Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | | | - Raquel Vaquero-Cristóbal
- Injury Prevention in Sport Research Group, Faculty of Sport, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Vasco Vaz
- Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Laura Capranica
- European Athlete as Student Network, Ghaxaq, Malta
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
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Martignon C, Ruzzante F, Giuriato G, Laginestra FG, Pedrinolla A, Di Vico IA, Saggin P, Stefanelli D, Tinazzi M, Schena F, Venturelli M. The key role of physical activity against the neuromuscular deterioration in patients with Parkinson's disease. Acta Physiol (Oxf) 2021; 231:e13630. [PMID: 33595917 DOI: 10.1111/apha.13630] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/11/2022]
Abstract
AIM Decreased muscle strength has been frequently observed in individuals with Parkinson's disease (PD). However, this condition is still poorly examined in physically active patients. This study compared quadriceps (Q) maximal force and the contribution of central and peripheral components of force production during a maximal isometric task between physically active PD and healthy individuals. In addition, the correlation between force determinants and energy expenditure indices were investigated. METHODS Maximal voluntary contraction (MVC), resting twitch (RT) force, pennation angle (θp), physiological cross-sectional area (PCSA) and Q volume were assessed in 10 physically active PD and 10 healthy control (CTRL) individuals matched for age, sex and daily energy expenditure (DEE) profile. RESULTS No significant differences were observed between PD and CTRL in MVC (142 ± 85; 142 ± 47 N m), Q volume (1469 ± 379; 1466 ± 522 cm3 ), PCSA (206 ± 54; 205 ± 71 cm2 ), θp (14 ± 7; 13 ± 3 rad) and voluntary muscle-specific torque (MVC/PCSA [67 ± 35; 66 ± 19 N m cm-2 ]). Daily calories and MVC correlated (r = 0.56, P = .0099). However, PD displayed lower maximal voluntary activation (MVA) (85 ± 7; 95 ± 5%), rate of torque development (RTD) in the 0-0.05 (110 ± 70; 447 ± 461 N m s-1 ) and the 0.05-0.1 s (156 ± 135; 437 ± 371 N m s-1 ) epochs of MVCs, whereas RT normalized for PCSA was higher (35 ± 14; 20 ± 6 N m cm-2 ). CONCLUSION Physically active PDs show a preserved strength of the lower limb. This resulted by increasing skeletal muscle contractility, which counterbalances neuromuscular deterioration, likely due to their moderate level of physical activity.
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Affiliation(s)
- Camilla Martignon
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
| | - Federico Ruzzante
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
| | - Gaia Giuriato
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
| | - Fabio G. Laginestra
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
| | - Anna Pedrinolla
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
| | - Ilaria A. Di Vico
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
| | - Paolo Saggin
- Division of Radiology and Imaging San Francesco Clinical Diagnostic Center Verona Italy
| | - Donato Stefanelli
- Division of Radiology and Imaging San Francesco Clinical Diagnostic Center Verona Italy
| | - Michele Tinazzi
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
| | - Massimo Venturelli
- Department of Neurosciences, Biomedicine, and Movement University of Verona Verona Italy
- Department of Internal Medicine University of Utah Salt Lake City UT USA
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Hirunsai M, Srikuea R. Autophagy-lysosomal signaling responses to heat stress in tenotomy-induced rat skeletal muscle atrophy. Life Sci 2021; 275:119352. [PMID: 33771521 DOI: 10.1016/j.lfs.2021.119352] [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: 10/18/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
AIMS The autophagy-lysosomal system plays a crucial role in maintaining muscle proteostasis. Excessive stimulation of the autophagic machinery is a major contributor to muscle atrophy induced by tendon transection. Hyperthermia is known to attenuate muscle protein loss during disuse conditions; however, little is known regarding the response of the autophagy pathway to heat stress following tenotomy-induced muscle atrophy. The purpose of this study was to evaluate whether heat stress would have a beneficial impact on the activation of autophagy in tenotomized soleus and plantaris muscles. MAIN METHODS Male Wistar rats were divided into control, control plus heat stress, tenotomy, and tenotomy plus heat stress groups. The effects of tenotomy were evaluated at 8 and 14 days with heat treatment applied using thermal blankets (30 min. day-1, at 40.5-41.5 °C, for 7 days). KEY FINDINGS Heat stress could normalize tenotomy-induced muscle loss and over-activation of autophagy-lysosomal signaling; this effect was evidently observed in soleus muscle tenotomized for 14 days. The autophagy-related proteins LC3B-II and LC3B-II/I tended to decrease, and lysosomal cathepsin L protein expression was significantly suppressed. While p62/SQSTM1 was not altered in response to intermittent heat exposure in tenotomized soleus muscle at day 14. Phosphorylation of the 4E-BP1 protein was significantly increased in tenotomized plantaris muscle; whereas heat stress had no impact on phosphorylation of Akt and FoxO3a proteins in both tenotomized muscles examined. SIGNIFICANCE Our results provide evidence that heat stress associated attenuation of tenotomy-induced muscle atrophy is mediated through limiting over-activation of the autophagy-lysosomal pathway in oxidative and glycolytic muscles.
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Affiliation(s)
- Muthita Hirunsai
- Department of Biopharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok 26120, Thailand.
| | - Ratchakrit Srikuea
- Department of Physiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
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Marusic U, Narici M, Simunic B, Pisot R, Ritzmann R. Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review. J Appl Physiol (1985) 2021; 131:194-206. [PMID: 33703945 DOI: 10.1152/japplphysiol.00363.2020] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Muscle atrophy and decline in muscle strength appear very rapidly with prolonged disuse or mechanical unloading after acute hospitalization or experimental bed rest. The current study analyzed data from short-, medium-, and long-term bed rest (5-120 days) in a pooled sample of 318 healthy adults and modeled the mathematical relationship between muscle strength decline and atrophy. The results show a logarithmic disuse-induced loss of strength and muscle atrophy of the weight-bearing knee extensor muscles. The greatest rate of muscle strength decline and atrophy occurred in the earliest stages of bed rest, plateauing later, and likely contributed to the rapid neuromuscular loss of function in the early period. In addition, during the first 2 wk of bed rest, muscle strength decline is much faster than muscle atrophy: on day 5, the ratio of muscle atrophy to strength decline as a function of bed rest duration is 4.2, falls to 2.4 on day 14, and stabilizes to a value of 1.9 after ∼35 days of bed rest. Positive regression revealed that ∼79% of the muscle strength loss may be explained by muscle atrophy, while the remaining is most likely due to alterations in single fiber mechanical properties, excitation-contraction coupling, fiber architecture, tendon stiffness, muscle denervation, neuromuscular junction damage, and supraspinal changes. Future studies should focus on neural factors as well as muscular factors independent of atrophy (single fiber excitability and mechanical properties, architectural factors) and on the role of extracellular matrix changes. Bed rest results in nonuniform loss of isometric muscle strength and atrophy over time, where the magnitude of change was greater for muscle strength than for atrophy. Future research should focus on the loss of muscle function and the underlying mechanisms, which will aid in the development of countermeasures to mitigate or prevent the decline in neuromuscular efficiency.NEW & NOTEWORTHY Our study contributes to the characterization of muscle loss and weakness processes reflected by a logarithmic decline in muscle strength induced by chronic bed rest. Acute short-term hospitalization (≤5 days) associated with periods of disuse/immobilization/prolonged time in the supine position in the hospital bed is sufficient to significantly decrease muscle mass and size and induce functional changes related to weakness in maximal muscle strength. By bringing together integrated evaluation of muscle structure and function, this work identifies that 79% of the loss in muscle strength can be explained by muscle atrophy, leaving 21% of the functional loss unexplained. The outcomes of this study should be considered in the development of daily countermeasures for preserving neuromuscular integrity as well as preconditioning interventions to be implemented before clinical bed rest or chronic gravitational unloading (e.g., spaceflights).
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Affiliation(s)
- Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea-European Center of Maribor, Maribor, Slovenia
| | - Marco Narici
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Bostjan Simunic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Rado Pisot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
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Solbiati S, Martin-Yebra A, Vaïda P, Caiani EG. Evaluation of Cardiac Circadian Rhythm Deconditioning Induced by 5-to-60 Days of Head-Down Bed Rest. Front Physiol 2021; 11:612188. [PMID: 33519517 PMCID: PMC7838678 DOI: 10.3389/fphys.2020.612188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/16/2020] [Indexed: 12/14/2022] Open
Abstract
Head-down tilt (HDT) bed rest elicits changes in cardiac circadian rhythms, generating possible adverse health outcomes such as increased arrhythmic risk. Our aim was to study the impact of HDT duration on the circadian rhythms of heart beat (RR) and ventricular repolarization (QTend) duration intervals from 24-h Holter ECG recordings acquired in 63 subjects during six different HDT bed rest campaigns of different duration (two 5-day, two 21-day, and two 60-day). Circadian rhythms of RR and QTend intervals series were evaluated by Cosinor analysis, resulting in a value of midline (MESOR), oscillation amplitude (OA) and acrophase (φ). In addition, the QTc (with Bazett correction) was computed, and day-time, night-time, maximum and minimum RR, QTend and QTc intervals were calculated. Statistical analysis was conducted, comparing: (1) the effects at 5 (HDT5), 21 (HDT21) and 58 (HDT58) days of HDT with baseline (PRE); (2) trends in recovery period at post-HDT epochs (R) in 5-day, 21-day, and 60-day HDT separately vs. PRE; (3) differences at R + 0 due to bed rest duration; (4) changes between the last HDT acquisition and the respective R + 0 in 5-day, 21-day, and 60-day HDT. During HDT, major changes were observed at HDT5, with increased RR and QTend intervals' MESOR, mostly related to day-time lengthening and increased minima, while the QTc shortened. Afterward, a progressive trend toward baseline values was observed with HDT progression. Additionally, the φ anticipated, and the OA was reduced during HDT, decreasing system's ability to react to incoming stimuli. Consequently, the restoration of the orthostatic position elicited the shortening of RR and QTend intervals together with QTc prolongation, notwithstanding the period spent in HDT. However, the magnitude of post-HDT changes, as well as the difference between the last HDT day and R + 0, showed a trend to increase with increasing HDT duration, and 5/7 days were not sufficient for recovering after 60-day HDT. Additionally, the φ postponed and the OA significantly increased at R + 0 compared to PRE after 5-day and 60-day HDT, possibly increasing the arrhythmic risk. These results provide evidence that continuous monitoring of astronauts' circadian rhythms, and further investigations on possible measures for counteracting the observed modifications, will be key for future missions including long periods of weightlessness and gravity transitions, for preserving astronauts' health and mission success.
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Affiliation(s)
- Sarah Solbiati
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.,Institute of Electronics, Computer and Telecommunication Engineering, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Alba Martin-Yebra
- Centro de Investigación Biomédica en Red - Bioingeniería, Biomateriales y Nanomedicina, BSICoS Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Pierre Vaïda
- College of Health Sciences, University of Bordeaux, Bordeaux, France
| | - Enrico G Caiani
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.,Institute of Electronics, Computer and Telecommunication Engineering, Consiglio Nazionale delle Ricerche, Milan, Italy
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Bass JJ, Hardy EJO, Inns TB, Wilkinson DJ, Piasecki M, Morris RH, Spicer A, Sale C, Smith K, Atherton PJ, Phillips BE. Atrophy Resistant vs. Atrophy Susceptible Skeletal Muscles: "aRaS" as a Novel Experimental Paradigm to Study the Mechanisms of Human Disuse Atrophy. Front Physiol 2021; 12:653060. [PMID: 34017264 PMCID: PMC8129522 DOI: 10.3389/fphys.2021.653060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Disuse atrophy (DA) describes inactivity-induced skeletal muscle loss, through incompletely defined mechanisms. An intriguing observation is that individual muscles exhibit differing degrees of atrophy, despite exhibiting similar anatomical function/locations. We aimed to develop an innovative experimental paradigm to investigate Atrophy Resistant tibialis anterior (TA) and Atrophy Susceptible medial gastrocnemius (MG) muscles (aRaS) with a future view of uncovering central mechanisms. METHOD Seven healthy young men (22 ± 1 year) underwent 15 days unilateral leg immobilisation (ULI). Participants had a single leg immobilised using a knee brace and air-boot to fix the leg (75° knee flexion) and ankle in place. Dual-energy X-ray absorptiometry (DXA), MRI and ultrasound scans of the lower leg were taken before and after the immobilisation period to determine changes in muscle mass. Techniques were developed for conchotome and microneedle TA/MG muscle biopsies following immobilisation (both limbs), and preliminary fibre typing analyses was conducted. RESULTS TA/MG muscles displayed comparable fibre type distribution of predominantly type I fibres (TA 67 ± 7%, MG 63 ± 5%). Following 15 days immobilisation, MG muscle volume (-2.8 ± 1.4%, p < 0.05) and muscle thickness decreased (-12.9 ± 1.6%, p < 0.01), with a positive correlation between changes in muscle volume and thickness (R2 = 0.31, p = 0.038). Importantly, both TA muscle volume and thickness remained unchanged. CONCLUSION The use of this unique "aRaS" paradigm provides an effective and convenient means by which to study the mechanistic basis of divergent DA susceptibility in humans, which may facilitate new mechanistic insights, and by extension, mitigation of skeletal muscle atrophy during human DA.
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Affiliation(s)
- Joseph J. Bass
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Edward J. O. Hardy
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
- Department of Surgery and Anaesthetics, Royal Derby Hospital, Derby, United Kingdom
| | - Thomas B. Inns
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Daniel J. Wilkinson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Mathew Piasecki
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Robert H. Morris
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Abi Spicer
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Ken Smith
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
| | - Philip J. Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
- Philip J. Atherton,
| | - Bethan E. Phillips
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham, United Kingdom
- *Correspondence: Bethan E. Phillips,
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