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Pirri C, Petrelli L, Guidolin D, Porzionato A, Fede C, Macchi V, De Caro R, Stecco C. Myofascial junction: Emerging insights into the connection between deep/muscular fascia and muscle. Clin Anat 2024; 37:534-545. [PMID: 38476005 DOI: 10.1002/ca.24148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
Muscles and fasciae are mutually connected and are influenced by force transmission. However, the anatomical connectivity and histological features of these structures remain unclear. The aim of this study was to assess the evidence for connection between muscles and deep/muscular fasciae. We assessed this relationship in different topographical regions of human cadavers and in mice. The results showed that myofascial junctions (MFJ) were made up of collagen I immune-positive structures occupying an average area of 5.11 ± 0.81 μm2, distributed in discrete regions at the interface between muscle and fascia with an average density of 9.7 ± 2.51 MFJ/mm and an average inclination angle of 35.25 ± 1.52°. These specialized structures also showed collagen III and HA immunopositivity and the presence of elastic fibers. The human myofascial junction can be visualized, opening emerging insights into the connection between deep/muscular fascia and muscle.
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Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy
| | - Lucia Petrelli
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy
| | - Diego Guidolin
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy
| | - Caterina Fede
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy
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Ryskalin L, Morucci G, Soldani P, Gesi M. Do the fasciae of the soleus have a role in plantar fasciitis? Clin Anat 2024; 37:413-424. [PMID: 37539773 DOI: 10.1002/ca.24102] [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: 04/12/2023] [Revised: 06/21/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023]
Abstract
Plantar fasciitis is a chronic, self-limiting, and painful disabling condition affecting the inferomedial aspect of the heel, usually extending toward the metatarsophalangeal joints. There is compelling evidence for a strong correlation between Achilles tendon (AT) loading and plantar aponeurosis (PA) tension. In line with this, tightness of the AT is found in almost 80% of patients affected by plantar fasciitis. A positive correlation has also been reported between gastrocnemius-soleus tightness and heel pain severity in this condition. Despite its high prevalence, the exact etiology and pathological mechanisms underlying plantar heel pain remain unclear. Therefore, the aim of the present paper is to discuss the anatomical and biomechanical substrates of plantar fasciitis with special emphasis on the emerging, though largely neglected, fascial system. In particular, the relationship between the fascia, triceps surae muscle, AT, and PA will be analyzed. We then proceed to discuss how structural and biomechanical alterations of the muscle-tendon-fascia complex due to muscle overuse or injury can create the conditions for the onset of PA pathology. A deeper knowledge of the possible molecular mechanisms underpinning changes in the mechanical properties of the fascial system in response to altered loading and/or muscle contraction could help healthcare professionals and clinicians refine nonoperative treatment strategies and rehabilitation protocols for plantar fasciitis.
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Affiliation(s)
- Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
| | - Gabriele Morucci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
| | - Paola Soldani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
| | - Marco Gesi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
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Palermo M, Reich S, Rives M. The Effect of Active Release Technique on Hamstring Extensibility: A Critically Appraised Topic. J Sport Rehabil 2024; 33:202-207. [PMID: 38290513 DOI: 10.1123/jsr.2023-0229] [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: 07/24/2023] [Revised: 10/30/2023] [Accepted: 12/12/2023] [Indexed: 02/01/2024]
Abstract
CLINICAL SCENARIO Hamstring extensibility plays a significant role in maintaining postural alignment essential for a functional musculoskeletal system. When hamstring extensibility is lacking, individuals are placed at a higher risk for developing various lumbar spine, pelvis, knee, and foot dysfunctions. Limited hamstring extensibility is common, occurring in as much as 40% of college students and 86% of the adult population. Therefore, it is essential to maintain hamstring extensibility, which can be aided by understanding intervention effectiveness for improving flexibility. PURPOSE To critically appraise the literature on the effectiveness of Active Release Technique (ART) for the treatment of hamstring extensibility deficits. CLINICAL QUESTION What is the effect of ART in a healthy population with or without hamstring extensibility deficits? SUMMARY OF KEY FINDINGS Three studies were included for critical appraisal. Two studies concluded a single treatment session of ART that individuals possessing limited straight leg raise range of motion experienced improved active knee extension, popliteal angle, and sit-and-reach test measures. In the third study, a single session of ART was effective at improving hamstring extensibility in males without hamstring extensibility dysfunction. CLINICAL BOTTOM LINE Based on the current level 1 and level 3 evidence, ART may be an effective treatment to produce acute increases in hamstring extensibility. Future research is still needed. STRENGTH OF RECOMMENDATION Level B evidence exists to support the use of ART to improve hamstring extensibility in the healthy population.
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Germain F, Perrin R. Stretch tolerance and elastic passive reaction of the quadriceps femoris seem to depend more on the fascia profundis taut surfaces than on the underlying stretched muscle. J Anat 2023; 243:1059-1065. [PMID: 37485997 PMCID: PMC10641038 DOI: 10.1111/joa.13931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023] Open
Abstract
The rectus femoris and its covering, the fascia lata (i.e., fascia profundis), are two anatomical structures involved in anterior thigh stretching. This study aimed to identify the role of strain changes in the fascia lata in limiting stretch tolerance. The reaction force intensity of 11 men and 5 women was assessed during passive stretching of the anterior thigh at 130, 110, 90, and 70° of knee flexion. Recent data suggest that the fascia lata strain field is modified with knee flexion. Therefore, the relationship between knee flexion angle and stretch tolerance was assessed. We found that the reaction force of the anterior thigh increased almost linearly with the degree of knee extension between 130° and 70°. The fascia lata stretched surface proprioceptive information seems responsible for stretch tolerance. Fascia profundis strain field must be considered during stretching experiments.
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Pirri C, Pirri N, Stecco C, Macchi V, Porzionato A, De Caro R, Özçakar L. Hearing and Seeing Nerve/Tendon Snapping: A Systematic Review on Dynamic Ultrasound Examination. SENSORS (BASEL, SWITZERLAND) 2023; 23:6732. [PMID: 37571516 PMCID: PMC10422582 DOI: 10.3390/s23156732] [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: 06/25/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
Nerve/tendon snapping can occur due to their sudden displacement during the movement of an adjacent joint, and the clinical condition can really be painful. It can actually be challenging to determine the specific anatomic structure causing the snapping in various body regions. In this sense, ultrasound examination, with all its advantages (especially providing dynamic imaging), appears to be quite promising. To date, there are no comprehensive reviews reporting on the use of dynamic ultrasound examination in the diagnosis of nerve/tendon snapping. Accordingly, this article aims to provide a substantial discussion as to how US examination would contribute to 'seeing' and 'hearing' these pathologies' different maneuvers/movements.
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Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (V.M.); (A.P.); (R.D.C.)
| | - Nina Pirri
- Department of Medicine—DIMED, School of Radiology, Radiology Institute, University of Padua, 35122 Padova, Italy;
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (V.M.); (A.P.); (R.D.C.)
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (V.M.); (A.P.); (R.D.C.)
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (V.M.); (A.P.); (R.D.C.)
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (C.S.); (V.M.); (A.P.); (R.D.C.)
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey;
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Pirri C, Biz C, Pirri N, Macchi V, Porzionato A, De Caro R, Ruggieri P, Stecco C. Crural and Plantar Fasciae Changes in Chronic Charcot Diabetic Foot: A Cross-Sectional Ultrasound Imaging Study-An Evidence of Fascial Continuity. J Clin Med 2023; 12:4664. [PMID: 37510779 PMCID: PMC10380358 DOI: 10.3390/jcm12144664] [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: 06/13/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Crural fascia (CF) and plantar fascia (PF) are biomechanically crucial in the gait and in the proprioception, particularly in the propulsion phase of the foot during the gait cycle and in the dissipation of forces during weight-bearing activities. Recent studies have revealed an association between increases in PF thickness and diabetes. The purpose of this study was to measure and compare by ultrasound (US) imaging the thickness of the CF and PF at different regions/levels in chronic Charcot diabetic foot patients (group 1) and in healthy volunteers (group 2). A cross-sectional study was performed using US imaging to measure the CF with Pirri et al.'s protocol and PF with a new protocol in a sample of 31 subjects (15 patients and 16 healthy participants). The findings for CF and PF revealed statistically significant differences in the poster region of CF (Post 1: group 1 vs. group 2: p = 0.03; Post 2: group 1 vs. group 2: p = 0.03) and in PF at two different levels (PF level 1: group 1 vs. group 2: p < 0.0001; PF level 2: group 1 vs. group 2: p < 0.0001). These findings suggest that chronic Charcot diabetic foot patients have CF and PF thicker compared to healthy volunteers. The US examination suggests that fascial thicknesses behavior in these patients points out altered fascial remodeling due to diabetes pathology and biomechanical changes.
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Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy
| | - Carlo Biz
- Department of Orthopedics and Orthopedic Oncology, University of Padova, 35128 Padova, Italy
| | - Nina Pirri
- Department of Medicine-DIMED, School of Radiology, Radiology Institute, University of Padova, 35121 Padova, Italy
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy
| | - Pietro Ruggieri
- Department of Orthopedics and Orthopedic Oncology, University of Padova, 35128 Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy
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Medeiros F, Martins W, Behm D, Ribeiro D, Marinho E, Santos W, Viana RB. Acute effects of foam roller or stick massage on indirect markers from exercise-induced muscle damage in healthy individuals: A systematic review and meta-analysis. J Bodyw Mov Ther 2023; 35:273-283. [PMID: 37330781 DOI: 10.1016/j.jbmt.2023.04.016] [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: 06/27/2021] [Revised: 09/21/2022] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND This systematic review and meta-analysis examined the effects of foam roller or stick massage performed after exercise-induced muscle damage protocols on indirect markers of muscle damage compared to a non-intervention control group in healthy individuals. METHODS PubMed, Biblioteca Virtual em Saúde, Scopus, Google Scholar, and Cochrane Library database were searched in August 2, 2020, with last update on February 21, 2021. Were included clinical trials involving healthy adult individuals who received foam roller/stick massage versus a non-intervention group and evaluated indirect markers of muscle damage. Risk of bias was assessed by the Cochrane Risk of Bias tools. Standardized mean differences with 95% confidence intervals were used to measure the foam roller/stick massage effect on muscle soreness. RESULTS The five included studies investigated 151 participants (136 men). Overall, the studies presented a moderate/high risk of bias. A between-groups meta-analysis showed no significant difference between massage and non-intervention control groups on muscle soreness immediately after (0.26 [95%CI: 0.14; 0.65], p = 0.20), 24 h (-0.64 [95%CI: 1.34; 0.07], p = 0.08), 48 h (-0.35 [95%CI: 0.85; 0.15], p = 0.17), 72 h (-0.40 [95%CI: 0.92; 0.12], p = 0.13), and 96 h (0.05 [95%CI: 0.40; 0.50], p = 0.82) after an exercise-induced muscle damage protocol. Moreover, the qualitative synthesis showed that foam roller or stick massage had no significant effect on range of motion, muscle swelling, and maximal voluntary isometric contraction recovery. CONCLUSION In conclusion, the current literature appears to not support the advantage of foam roller or stick massage to improve recovery of muscle damage indirect markers (muscle soreness, range of motion, muscle swelling, and maximal voluntary isometric contraction) compared to a non-intervention control group in healthy individuals. Furthermore, due to the heterogeneity of the methodological designs among the included studies, making it difficult to compare the results. In addition, there are not enough high-quality and well-designed studies on foam roller or stick massage to draw any definite conclusions. REVIEW PROTOCOL NUMBER The study was pre-registered in the International Prospective Register of Systematic Review (PROSPERO) on August 2, 2020, with last update on February 21, 2021. Protocol number: CRD2017058559.
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Affiliation(s)
- Flávia Medeiros
- College of Physical Education, University of Brasilia, Brazil.
| | | | - David Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, Canada.
| | - Deise Ribeiro
- College of Physical Education, University of Brasilia, Brazil.
| | | | - Wanderson Santos
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil.
| | - Ricardo Borges Viana
- Institute of Physical Education and Sport, Federal University of Ceará, Fortaleza, Brazil.
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Wang T, Long Y, Ma L, Dong Q, Li Y, Guo J, Jin L, Di L, Zhang Y, Wang L, Hou Z. Single-cell RNA-seq reveals cellular heterogeneity from deep fascia in patients with acute compartment syndrome. Front Immunol 2023; 13:1062479. [PMID: 36741388 PMCID: PMC9889980 DOI: 10.3389/fimmu.2022.1062479] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction High stress in the compartment surrounded by the deep fascia can cause acute compartment syndrome (ACS) that may result in necrosis of the limbs. The study aims to investigate the cellular heterogeneity of the deep fascia in ACS patients by single-cell RNA sequencing (scRNA-seq). Methods We collected deep fascia samples from patients with ACS (high-stress group, HG, n=3) and patients receiving thigh amputation due to osteosarcoma (normal-stress group, NG, n=3). We utilized ultrasound and scanning electron microscopy to observe the morphologic change of the deep fascia, used multiplex staining and multispectral imaging to explore immune cell infiltration, and applied scRNA-seq to investigate the cellular heterogeneity of the deep fascia and to identify differentially expressed genes. Results Notably, we identified GZMK+interferon-act CD4 central memory T cells as a specific high-stress compartment subcluster expressing interferon-related genes. Additionally, the changes in the proportions of inflammation-related subclusters, such as the increased proportion of M2 macrophages and decreased proportion of M1 macrophages, may play crucial roles in the balance of pro-inflammatory and anti-inflammatory in the development of ACS. Furthermore, we found that heat shock protein genes were highly expressed but metal ion-related genes (S100 family and metallothionein family) were down-regulated in various subpopulations under high stress. Conclusions We identified a high stress-specific subcluster and variations in immune cells and fibroblast subclusters, as well as their differentially expressed genes, in ACS patients. Our findings reveal the functions of the deep fascia in the pathophysiology of ACS, providing new approaches for its treatment and prevention.
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Affiliation(s)
- Tao Wang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China
| | - Yubin Long
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China
| | - Lijie Ma
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China
| | - Qi Dong
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China
| | - Yiran Li
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China
| | - Junfei Guo
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China
| | - Lin Jin
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China
| | - Luqin Di
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China,National Health Commission (NHC) Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ling Wang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China,Department of Orthopedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,*Correspondence: Zhiyong Hou, ; Ling Wang,
| | - Zhiyong Hou
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, China,National Health Commission (NHC) Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China,*Correspondence: Zhiyong Hou, ; Ling Wang,
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Fede C, Fan C, Pirri C, Petrelli L, Biz C, Porzionato A, Macchi V, De Caro R, Stecco C. The Effects of Aging on the Intramuscular Connective Tissue. Int J Mol Sci 2022; 23:ijms231911061. [PMID: 36232366 PMCID: PMC9569538 DOI: 10.3390/ijms231911061] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/01/2022] [Accepted: 09/18/2022] [Indexed: 11/24/2022] Open
Abstract
The intramuscular connective tissue plays a critical role in maintaining the structural integrity of the muscle and in providing mechanical support. The current study investigates age-related changes that may contribute to passive stiffness and functional impairment of skeletal muscles. Variations in the extracellular matrix in human quadriceps femoris muscles in 10 young men, 12 elderly males and 16 elderly females, and in the hindlimb muscles of 6 week old, 8 month old and 2 year old C57BL/6J male mice, were evaluated. Picrosirius red, Alcian blue and Weigert Van Gieson stainings were performed to evaluate collagen, glycosamynoglycans and elastic fibers. Immunohistochemistry analyses were carried out to assess collagen I, collagen III and hyaluronan. The percentage area of collagen was significantly higher with aging (p < 0.01 in humans, p < 0.001 in mice), mainly due to an increase in collagen I, with no differences in collagen III (p > 0.05). The percentage area of elastic fibers in the perimysium was significantly lower (p < 0.01) in elderly men, together with a significant decrease in hyaluronan content both in humans and in mice. No significant differences were detected according to gender. The accumulation of collagen I and the lower levels of hyaluronan and elastic fibers with aging could cause a stiffening of the muscles and a reduction of their adaptability.
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Affiliation(s)
- Caterina Fede
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padua, Italy
- Correspondence:
| | - Chenglei Fan
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padua, Italy
| | - Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padua, Italy
| | - Lucia Petrelli
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padua, Italy
| | - Carlo Biz
- Department of Surgery, Oncology and Gastroenterology, Orthopedic Clinic, University of Padua, 35128 Padua, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padua, Italy
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padua, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padua, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padua, 35121 Padua, Italy
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Ali H, Umander J, Rohlén R, Röhrle O, Grönlund C. Modelling intra-muscular contraction dynamics using in silico to in vivo domain translation. Biomed Eng Online 2022; 21:46. [PMID: 35804415 PMCID: PMC9270806 DOI: 10.1186/s12938-022-01016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advances in sports medicine, rehabilitation applications and diagnostics of neuromuscular disorders are based on the analysis of skeletal muscle contractions. Recently, medical imaging techniques have transformed the study of muscle contractions, by allowing identification of individual motor units' activity, within the whole studied muscle. However, appropriate image-based simulation models, which would assist the continued development of these new imaging methods are missing. This is mainly due to a lack of models that describe the complex interaction between tissues within a muscle and its surroundings, e.g., muscle fibres, fascia, vasculature, bone, skin, and subcutaneous fat. Herein, we propose a new approach to overcome this limitation. METHODS In this work, we propose to use deep learning to model the authentic intra-muscular skeletal muscle contraction pattern using domain-to-domain translation between in silico (simulated) and in vivo (experimental) image sequences of skeletal muscle contraction dynamics. For this purpose, the 3D cycle generative adversarial network (cycleGAN) models were evaluated on several hyperparameter settings and modifications. The results show that there were large differences between the spatial features of in silico and in vivo data, and that a model could be trained to generate authentic spatio-temporal features similar to those obtained from in vivo experimental data. In addition, we used difference maps between input and output of the trained model generator to study the translated characteristics of in vivo data. RESULTS This work provides a model to generate authentic intra-muscular skeletal muscle contraction dynamics that could be used to gain further and much needed physiological and pathological insights and assess and overcome limitations within the newly developed research field of neuromuscular imaging.
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Affiliation(s)
- Hazrat Ali
- Department of Electrical and Computer Engineering, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan.,Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | | | - Robin Rohlén
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Oliver Röhrle
- Stuttgart Center for Simulation Technology (SC SimTech), University of Stuttgart, Stuttgart, Germany.,Institute for Modelling and Simulation of Biomechanical Systems, Chair for Computational Biophysics and Biorobotics, University of Stuttgart, Stuttgart, Germany
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Vibrating Exercise Equipment in Middle-Age and Older Women with Chronic Low Back Pain and Effects on Bioelectrical Activity, Range of Motion and Pain Intensity: A Randomized, Single-Blinded Sham Intervention Study. BIOLOGY 2022; 11:biology11020268. [PMID: 35205134 PMCID: PMC8869153 DOI: 10.3390/biology11020268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022]
Abstract
Simple Summary Physical activity is often recommended as part of the management of chronic low back pain, which is one of the most common musculoskeletal disorders. Vibrating exercise equipment is used despite little scientific evidence to support its effectiveness in the prevention and treatment of musculoskeletal problems. The aim of this study was to evaluate the efficiency of using vibrating exercise equipment in women with chronic low back pain. Here, 92 women aged 49–80 years were assigned to one of two groups: the experimental and the control group. The intervention consisted of aerobic exercises with specific handheld equipment. Both groups performed physical activity twice weekly for 10 weeks. The erector spinae muscles’ bioelectrical activity, the lumbar range of motion and pain intensity were measured in all participants at baseline and after 10 weeks. Compared with baseline measures, there was a significant decrease in the bioelectrical activity of the erector spinae muscles during flexion movement, rest at maximum flexion, extension movement and rest in a prone position; an increase in the lumbar range of motion and a decrease in pain intensity following a program of physical activity with vibrating exercise equipment. No significant changes were found in intergroup comparisons; however, physical activity with vibrating exercise equipment could be a prospective strategy for increasing lumbar range of motion and decreasing pain and erector spinae muscle activity in people with chronic low back pain. Abstract Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders. Physical activity (PA) is often recommended as part of the management of CLBP, but to date, no one particular exercise has been shown to be superior. Vibrating exercise equipment (VEE) is widely available and used despite little scientific evidence to support its effectiveness in the prevention and treatment of musculoskeletal problems. The aim of this study was to evaluate the efficiency of using VEE compared with sham-VEE in women with CLBP. Methods: A randomized (1:1 randomization scheme) single-blinded sham-controlled intervention study was conducted. Through simple randomization, 92 women aged 49–80 years were assigned to one of two groups: VEE (the experimental group) and sham-VEE (the control group). The VEE and sham-VEE intervention consisted of aerobic exercises with specific handheld equipment. Both groups performed physical activity twice weekly for 10 weeks. The erector spinae muscles’ bioelectrical activity (using an eight-channel electromyograph MyoSystem 1400L), lumbar range of motion (Schober’s test) and pain intensity (visual analog scale) were measured in all participants at baseline and after 10 weeks. Results: There was a significant decrease in the bioelectrical activity of the erector spinae muscles during flexion movement (left: Me = 18.2 before; Me = 14.1 after; p = 0.045; right: Me = 15.4 before; Me = 12.6 after; p = 0.010), rest at maximum flexion (left: Me = 18.1 before; Me = 12.5 after; p = 0.038), extension movement (right: Me = 21.8 before; Me = 20.2 after; p = 0.031) and rest in a prone position (right: Me = 3.5 before; Me = 3.2 after; 0.049); an increase in lumbar range of motion (Me = 17.0 before; Me = 18.0 after; p = 0.0017) and a decrease in pain intensity (Me = 4.0 before; Me = 1.0 after; p = 0.001) following a program of PA in the VEE group. Conclusions: No significant changes were found in intergroup comparisons. The beneficial changes regarding decreased subjective pain sensation in the VEE and sham-VEE groups may be due to participation in systematic physical activity. However, PA with vibrating exercise equipment could be a prospective strategy for increasing lumbar range of motion and for decreasing pain and erector spinae muscle activity in people with CLBP.
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Langevin HM. Fascia Mobility, Proprioception, and Myofascial Pain. Life (Basel) 2021; 11:life11070668. [PMID: 34357040 PMCID: PMC8304470 DOI: 10.3390/life11070668] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/29/2021] [Accepted: 07/03/2021] [Indexed: 12/19/2022] Open
Abstract
The network of fasciae is an important part of the musculoskeletal system that is often overlooked. Fascia mobility, especially along shear planes separating muscles, is critical for musculoskeletal function and may play an important, but little studied, role in proprioception. Fasciae, especially the deep epimysium and aponeuroses, have recently been recognized as highly innervated with small diameter fibers that can transmit nociceptive signals, especially in the presence of inflammation. Patients with connective tissue hyper- and hypo-mobility disorders suffer in large number from musculoskeletal pain, and many have abnormal proprioception. The relationships among fascia mobility, proprioception, and myofascial pain are largely unstudied, but a better understanding of these areas could result in improved care for many patients with musculoskeletal pain.
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Affiliation(s)
- Helene M Langevin
- National Center for Complementary and Integrative Health, National Institutes of Health, 31 Center Drive, Suite 2B11, Bethesda, MD 20892, USA
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Zarco EPT, Aquino M, Petrizzo J, Wygand J, McGorry A. Perceived Benefits of a Guided Exercise Program Among Older Adults. Gerontol Geriatr Med 2021; 7:23337214211060147. [PMID: 35071693 PMCID: PMC8766912 DOI: 10.1177/23337214211060147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Michele Aquino
- Health and Sport Sciences, Adelphi University, Garden City, NY, USA
| | - John Petrizzo
- Health and Sport Sciences, Adelphi University, Garden City, NY, USA
| | - John Wygand
- Health and Sport Sciences, Adelphi University, Garden City, NY, USA
| | - Amy McGorry
- Health Sciences, Long Island University, Brookville, NY, USA
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