Functional outcomes of accelerated rehabilitation protocol for anterior cruciate ligament reconstruction in amateur athletes: a randomized clinical trial

BACKGROUND

Anterior cruciate ligament (ACL) rupture is the most common knee injury among athletes, and can result in long-term complications and career-ending conditions for sportspeople. There is no consensus in the literature on the effectiveness of rehabilitation after ACL reconstruction, or the best protocol to follow for functional outcome improvement.

OBJECTIVE

To determine the impact of an accelerated rehabilitation protocol on knee functional outcomes in amateur athletes with anterior cruciate ligament reconstruction (ACLR).

DESIGN

Two-arm, parallel-group randomized comparative design.

PATIENTS

A total of 100 amateur male athletes (mean age 22.01 ± 1.79 years) with ACLR were randomly divided into experimental and control groups (n = 50/group).

METHODS

An accelerated rehabilitation protocol and a conventional rehabilitation protocol were used for the experimental group. In contrast, only the conventional rehabilitation protocol was used for the control group. The rehabilitation was delivered in 5 weekly sessions for 22 weeks. The primary outcome measure, knee pain, was measured using a visual analogue scale (VAS). Extensive test batteries, for hop tests, Knee Injury and Osteoarthritis Outcome Score (KOOS), and knee effusion, were measured, aiming to add more objective criteria to determine functional performance.

RESULTS

Both groups (n = 50/group) were well-matched (p = 0.816), with insignificant differences in their demographic characteristics (p > 0.05). A multivariate analysis of variance (MANOVA) test showed no significant difference between the 2 groups (p = 0.781) at baseline. A 2-way MANOVA (2 × 2 MANOVA) of within- and between-group variations indicated overall significant treatment, time, and treatment × time interaction effects (p < 0.001) in favour of the accelerated rehabilitation group.

CONCLUSION

The accelerated rehabilitation protocol was more effective in improving functional outcomes than a conventional rehabilitation protocol in amateur athletes with ACLR.

Effects of hip abductor with external rotator strengthening versus proprioceptive training on pain and functions in patients with patellofemoral pain syndrome: A randomized controlled trial

BACKGROUND

Strengthening the hip muscles, particularly the abductors and rotators, has been reported beneficial for treating Patellofemoral pain syndrome (PFPS). Proprioceptive training (PT) is also shown to improve musculoskeletal pain and function in PFPS. The most appropriate treatment from these 2 is unclear. This study aimed to compare the effects of hip abductors and external rotator strengthening exercises along with conventional physical therapy (CPT) vs the proprioceptive training of the knee along with CPT in patients with PFPS.

METHODS

Forty-five participants were divided into 3 groups, experimental group 1 (EG 1), experimental group 2 (EG 2), and control group (CG), with fifteen participants in each group. EG 1 received hip abductor and external rotator strengthening exercises in addition to CPT. EG 2 received proprioceptive training and CPT. CG received CPT alone. Intervention programs lasted for 4 weeks. The pain was measured by Kujala Anterior Knee Pain Scale (AKPS). The study was registered retrospectively in the protocol registration and results system (clinicaltrials.gov, ID: NCT05698797 on 26/01/2023).

RESULTS

AKPS scores significantly (P < .001) improved in all 3 groups. A significant (P < .05) difference was also observed between all 3 groups. The greatest improvement was observed in EG 1, followed by EG 2 and CG.

CONCLUSION

The addition of hip abductor and external rotator strengthening exercises to a 4-week CPT program showed a more significant improvement in AKPS scores than the addition of proprioceptive training in patients with PFPS.

Association between back-leg-chest muscle strength and kicking speed in soccer players: an observational study

BACKGROUND

Several studies have been performed on soccer kicks and stressed the significance of strength/power and coordination between the agonist and antagonist muscles of the lower limb. Along with accuracy, speed is also an important factor in a successful kick. It is reported that trunk musculature, hip and knee extensors of the non-kicking extremity, and hip adductors of the kicking side have a role in increasing the foot velocity while kicking. Since muscles do not work in isolation while kicking and several muscle groups of the leg and trunk have been reported to have a role in high-speed kicks, therefore measuring the combined strength of the leg, trunk, and arm muscles will be an appropriate method to examine their association with the kicking speed. The aim of this study was to examine the association of the combined strength of the lower extremities, back, chest, and arm muscles with the kicking speed of soccer players.

METHODS

Forty male soccer players (mean age 15.7 years) participated in the study. The back-leg-chest (BLC) dynamometer (Baseline, New York, NY, USA) and the mobile camera measured isometric muscle strength and kicking speed, respectively. The BLC dynamometer measured the isometric strength of the knee, hip, back extensors, and arm muscles. The kicking speed was measured by asking participants to kick a football in three directions - right, middle, and left - from 11 meters.

RESULTS

Significant (P<0.001) negative correlations of isometric strength of the back, leg, chest, and arm muscles and kicking speeds were found in all three directions. In all three correlations, Pearson's correlation coefficient was -0.989. Simple linear regression results showed that 97.8% (adjusted R2) of the variance observed in kicking speed (KS; RT), KS (MD), and KS (LT), was explained by the movement in BLC muscle strength values.

CONCLUSIONS

Kicking speeds in the right, middle, and left directions were negatively associated with the isometric strengths of the back, leg, chest, and arms muscles, measured using the BLC dynamometer, in participating soccer players.

Circulating microRNAs and hepcidin as predictors of iron homeostasis and anemia among school children: a biochemical and cross-sectional survey analysis

BACKGROUND

MicroRNAs (miRNAs) can control several biological processes. Thus, the existence of these molecules plays a significant role in regulating human iron metabolism or homeostasis.

PURPOSE

The study aimed to determine the role of circulating microRNAs and hepcidin in controlling iron homeostasis and evaluating possible anemia among school children.

METHODS

The study was based on a biochemical and cross-sectional survey study that included three hundred fifty school children aged 12-18 years old. RT-PCR and immunoassay analysis were accomplished to estimate iron concentration, Hgb, serum ferritin (SF), soluble transferrin receptor (sTfR), total body iron stores (TIBs), total oxidative stress (TOS), total antioxidant capacity (TAC), α-1-acid glycoprotein (AGP), high sensitive C-reactive protein (hs-CRP), and miRNAs; miR-146a, miR-129b, and miR-122 in 350 school adolescents.

RESULTS

Iron disorders were cross-sectionally predicted in 28.54% of the study population; they were classified into 14.26% with ID, 5.7% with IDA, and 8.6% with iron overload. The overall proportion of iron depletion was significantly higher in girls (20.0%) than in boys (8.6%). MicroRNAs; miR-146a, miR-125b, and miR-122 were significantly upregulated with lower hepcidin expression in adolescence with ID and IDA compared to iron-overloaded subjects, whereas downregulation of these miRNAs was linked with higher hepcidin. Also, a significant correlation was recorded between miRNAs, hepcidin levels, AGP, hs-CRP, TAC, and other iron-related indicators.

CONCLUSION

Molecular microRNAs such as miR-146a, miR-125b, and miR-122 were shown to provide an additional means of controlling or regulating cellular iron uptake or metabolism either via the oxidative stress pathway or regulation of hepcidin expression via activating genes encoding Hfe and Hjv activators, which promote iron regulation. Thus, circulating miRNAs as molecular markers and serum hepcidin could provide an additional means of controlling or regulating cellular iron and be associated as valuable markers in diagnosing and treating cases with different iron deficiencies.

Effect of plyometric versus complex training on core strength, lower limb, and upper limb power in male cricketers: a randomized controlled trial

BACKGROUND

Complex training is found effective in improving physical performance in various sports. There is a paucity of research evidence comparing the efficacy of complex vs. plyometric training in cricket players. The study aimed to compare the efficacy of complex and plyometric training on physical performance parameters in cricket players.

METHODS

Participants (n = 42 Male; age group = 18-26 years) were randomly allocated into three groups, complex training group (CTG) (n = 14; BMI = 20.51 ± 2.23), plyometric training group (PTG) (n = 14; BMI = 20.57 ± 2.82), and control group (CG) (n = 14; BMI = 20.51 ± 2.23). CTG and PTG received their respective training twice weekly, and CG received routine training for four weeks. Pre and post-intervention assessments of core muscle strength (CM), multistage fitness (MF), push-up (PU), lateral cone jump (LCJ), and stationary vertical jump (SVJ) were performed. This study has been registered in clinicaltrials.gov (ID: NCT05646914, on 05/12/2022).

RESULTS

A significant difference was observed between CTG vs. CG for CM (p ≤ 0.01), LCJ (p < 0.05), and SVJ (p ≤ 0.01), similarly in PTG vs. CG for CM (p-value), LCJ (p ≤ 0.05) and SVJ (p ≤ 0.01). However, No significant difference was found between PTG vs. CTG for any variables (p ≥ 0.05). Also, No significant difference in MF and PU was found between the groups (p ≥ 0.05).

CONCLUSIONS

Complex training has been found to have effects similar to plyometric training alone. Therefore, either of the two strategies can be used to improve the performance of male cricket players.

Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: A randomized controlled trial

PURPOSE

The present study aims to investigate the combined effect of slow breathing exercise (SBE) and progressive muscle relaxation (PMR) technique on blood pressure (BP), heart rate (HR), respiratory rate (RR), and anxiety in patients diagnosed with essential hypertension.

TRIAL DESIGN

This study was based on a 4-arm parallel-group, randomized control design.

METHODS

Sixty-four participants diagnosed with essential hypertension were randomly allocated into SBE, PMR, SBE-PMR, and Control groups, with 16 subjects each. All 3 groups received different treatments according to their name; however, the Control group received no treatment. Systolic and diastolic BP (SBP and DBP), HR, RR, and anxiety were all evaluated as the study outcomes using a digital sphygmomanometer and perceived stress scale (PSS) at baseline (pretest), 2nd week and 4th weeks post-intervention. A repeated measure analysis of variance test assessed intra-group comparison (overall) analyses across multiple time points. Bonferroni multiple comparison tests were used to analyze the mean differences between the groups. The confidence interval was kept at 95% for all the statistical analyses, that is, P < .05 is considered significant.

RESULTS

There was a significant change in the HR (F = 239.04, P = .0001), RR (F = 167.74, P = .0001), SBP (F = 266.64, P = .0001), DSP (F = 279.80, P = .0001), and PSS (F = 473.42, P = .0001) as an outcome of baseline measurements versus (vs) the following weeks. There were significant (F = 48.57, P = .001) differences among different training on HR. The SBE vs SBE-PMR showed an insignificant difference (F = 48.54, P = 1.000). The RR showed significant differences (F = 32.05, 0.0001) between the SBE vs PMR, SBE vs Control, PMR vs Control, and SBE-PMR vs Control groups and insignificant differences for the SBE vs SBE-PMR and PMR vs SBE-PMR groups. The SBE vs SBE-PMR groups showed insignificant differences for DPP and SBP. However, PSS showed significant differences (F = 67.12, P = .0001) among the intervention groups except for the PMR and SBE-PMR groups.

CONCLUSIONS

The combined interventions of SBEs and progressive muscle relaxation techniques can effectively reduce the heart rate, respiratory rate, BP, and anxiety in essential hypertensive patients compared to both techniques when given alone.

Exploring the impact of integrated polyvagal exercises and knee reinforcement in females with grade II knee osteoarthritis: a randomized controlled trial

This study aimed to compare the effects of knee strengthening exercises to those of polyvagal theory-based exercises combined with knee strengthening exercises on selected outcomes in women with grade II knee osteoarthritis (OA). A randomized controlled trial was conducted, in which 60 female participants diagnosed with grade II knee OA, with a mean age of 57.27 ± 7.81 years and knee pain rated between 4 and 7 on the visual analog scale (VAS), were assigned to either the knee strengthening exercise group (Group 1, n = 30) or the polyvagal theory-based exercise plus knee strengthening exercise group (Group 2, n = 30). Pre- and posttreatment assessment of outcome variables, including WOMAC scores (joint pain, joint stiffness, functional limitations, and the overall index), WHOQOL scores (overall quality of life, general health, physical, psychological, social, and environmental domains), and heart rate variability (HRV, time and frequency domains), were analyzed. Group 2 demonstrated significantly greater reductions in joint pain, stiffness, and functional limitations than Group 1 after the intervention. Group 2 presented with significantly improved WOMAC scores, indicating better overall outcomes. Group 2 showed significant improvements in the psychological and social domains regarding quality of life. There were no significant differences in the physical domain or the environmental domain. Group 2 showed a significant increase in high-frequency power (HF) and a significant decrease in the LF/HF ratio, suggesting improved autonomic regulation. A combination of polyvagal exercise and knee strengthening training resulted in superior outcomes compared to knee strengthening exercises alone in women with grade II knee OA. These findings support the potential effectiveness of incorporating polyvagal exercises as an adjunctive intervention for osteoarthritis management.

Potential roles of circulating microRNAs in the healing of type 1 diabetic wounds treated with green tea extract: molecular and biochemical study

Background

Circulating miRNAs have been implicated in various aspects of diabetic wound healing, including inflammation, angiogenesis, and extracellular matrix remodeling. Thus, in alternative herbal medicine strategies, miRNAs will be potential therapeutic molecular targets in nonhealing wounds. These could be valuable elements for understanding the molecular basis of diabetic wound healing and could be used as good elements in bioinformatics.

Objectives

To elucidate the molecular mechanisms of microRNAs in association with apoptosis-inducing genes in controlling skin wound healing in diabetic wounds treated with green tea polyphenols (GTPs).

Methods

Green tea hydro extract (GTE) at doses of100-200 mg/ml was topically applied to the skin tissues of rats with T1DM induced by a single dose of streptozotocin (STZ; 100 mg/kg, in 0.01 M sodium citrate, pH 4.3-4.5) injected intraperitoneally for seven consecutive days to induce T1DM. The rats were treated with green tea for three weeks. A sterile surgical blade was used to inflict a circular wound approximately 2 cm in diameter on the anterior-dorsal side of previously anesthetized rats by a combination of ketamine hydrochloride (50 mg/kg, i.e., body weight) and xylazine hydrochloride. Afterward, the molecular roles of the circulating miRNAs miR-21, miR-23a, miR-146a, and miR-29b and apoptotic genes were determined by quantitative real-time PCR to evaluate Bax, Caspase-3, and Bcl-2 in wound healing. In addition, HPLC analysis was also performed to estimate the active polyphenols (GTPs) present in the hydro extract of green tea leaves.

Results

Wound healing was improved in diabetic skin wounds following treatment with GTE at doses of 100-200 mg/dl for three weeks. The wound parameters contraction, epithelialization, and scar formation significantly improved in a short time (14 days) compared to the longer periods identified in diabetic non-treated rats (20 days) and the standard control (15.5 days). Molecular analyses reported a significant increase in the levels of miR-21, miR-23a, and miR-146a and a decrease in the levels of miR-29b in green tea-treated diabetic rats compared to those in the standard control and STZ-diabetic non-treated rats. In addition, the molecular apoptotic genes Bax and caspase-3 significantly increased, and the BcL-2 gene significantly decreased following treatment with green tea polyphenols.

Conclusions

The data showed that active green tea polyphenols (GTPs) present in GTE significantly improved diabetic wound healing by controlling apoptotic genes and the circulating microRNAs miR-21, miR-23a, miR-146a, and miR-29b, which might be involved in cellular apoptosis and angiogenesis processes. Thus, to establish a future model for the treatment of diabetic wounds, further studies are needed to understand the potential association of these biological parameters with the wound-healing process in diabetic wounds.

Hand grip strength, vitamin D status, and diets as predictors of bone health in 6-12 years old school children

BACKGROUND

Vitamin D and calcium-rich foods, exposure to sunlight, and physical activities (PA) play a pivotal role in promoting the production of sufficient vitamin D and improving grip strength needed for better bone health among school children.

PURPOSE

This study aimed to determine the effects of hand grip muscle strength (HGS), vitamin D in addition to diets, and PA on bone health status among 6-12 years old schoolchildren.

METHODS

This study was based on a cross-sectional observational design, which was descriptive in nature. A diverse sample of 560 elementary school children aged 6-12 years old were invited to participate in this descriptive cross-sectional study. The Dual-Energy X-Ray Absorptiometry (DXA), QUS technique, and ACTi graph GT1M accelerometer were used respectively as a valid tools to identify BMD, BMC, and other parameters of bone health like c-BUA values and bone stiffness (SI), and physical activity (PA) of all individuals participated in this study. In addition, a hydraulic dynamometer was used to measure hand grip strength among the participants. Moreover, an immunoassay technique was used to measure the serum levels of vitamin 25(OH)D level, and bone metabolism markers; NTX, DPD, Ca, and sBAP in all participants. Bone loss (osteoporosis) was cross-sectionally predicted in 19.64% of the total population, most of whom were girls (14.3% vs. 5.4% for boys; P = 0.01). Compared to boys, the incidence of osteoporosis was higher and significantly correlated in girls with lower HGS, deficient vitamin D, inadequate vitamin D and Ca intake, greater adiposity, poor PA, and lower sun exposure. Also, in girls, lower vitamin 25(OH)D levels, and poor HGS were shown to be significantly associated with lower values of BMD, BMC, SI, and higher values of bone resorption markers; NTX, DPD, and sBAP and lower serum Ca than do in boys. The findings suggested that deficient vitamin D, lower HGS, adiposity, PA, and sun exposure as related risk factors to the pravelence of bone loss among school children, particularly in girls. In addition, these parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts; however, more studies are required.

Unleashing potential and optimizing adolescent roller skating performance through a structured exercise program - a randomized controlled trial

BACKGROUND

The intricate nature of an athlete's abilities evolves dynamically with the enhancement of motor skills. Hence the study sought to investigate the impact of a tailored four-week exercise program`encompassing exercises focused on balance, agility, and speed. The primary objective was to determine how this exercise program influences both the roller skating talent and overall physical fitness proficiency in young male roller skaters.

METHODS

Thirty male participants (age 11-14 years) enrolled in the school skating team were recruited. The participants were randomized into either an experimental group [n = 15], performing a short-term exercise program, or a control group [n = 15], involved in the physical education classes for eight sessions over four weeks. The primary outcome measure, the skating performance, was measured by the linear speed test (LST). The secondary outcomes, i.e., balance, agility, and speed, were evaluated using the star excursion balance test (SEBT), agility t-test (ATT), and arrowhead change of direction speed test (ACDT). SEBT was assessed in 8 directions. The study was registered with the Clinical Trials Registry India (TRN: CTRI/2018/09/015713) before the recruitment of the participants on 14/09/2018.

RESULTS

The results showed that LST, ATT, and ACDT improved significantly (p < 0.05) in both groups, however, greater (p < 0.05) improvement was observed in the experimental group (Cohen's d 0.8 to 1.3). Regarding SEBT, improvement was observed in a few directions only in both groups. However, no significant difference was observed between both groups in SEBT measurements.

CONCLUSIONS

A short-term structured exercise program consisting of balance, agility, and speed exercises significantly improved the talent of skating, agility, and speed compared to physical education classes activities in young male roller skaters. The study highlights the potential of targeted training interventions to enhance athletic performance in this population.

Mineral elements and adiposity-related consequences in adolescents with intellectual disabilities

BACKGROUND

Patients with intellectual disabilities are shown to have a limited capacity for cooperation, communication,and other biological consequences, which significantly require a specialized interest in healthcare professionals worldwide.

AIM

In this respect, the present study was designed to evaluate the levels mineral elements, and their correlation with oxidative stress markers and adiposity markers; leptin (L), adiponectin (A), and L/A ratio in adolescents with intellectual disabilities.

METHODS

A total of 350 schoolchildren aged (12-18 years) were randomly invited to participate in this prospective, observational study. Only 300 participants agreed to participate in this study. According to Intelligence quotients scores (IQ) measured by WISC-III, the participants were classified into two groups; the healthy control group (no = 180; IQ = 90-114); and the moderate intellectual disability (MID) group (no = 120; IQ = 35-49). Adiposity markers; body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), physical activity scores, adipokines biomarkers; leptin, adiponectin, L/A ratio, oxidative stress, and plasma mineral elements were evaluated by prevalidated questionnaires, inductively coupled plasma-mass spectrometry (ICP-MS), colorimetric, and immunoassay techniques.

RESULTS

Intellectual disability of moderate type was reported in 40% of the studied populations most of them are men aged 12-18 years (66.6% for men vs. 33.3 for females). Obesity was shown to be associated with the degree of intellectual disability of the students. There was a significant (P = 0.001) increase in the BMI, WHR, and WHtR scores as obesity markers with poor physical activity (P = 0.01) in students with poor disability compared to healthy controls (HC). The levels of leptin (P = 0.001), adiponectin (P = 0.01), and L/A ratio (P = 0.01) as adiposity biomarkers were significantly increased in students with MID compared to healthy controls. Also, oxidative stress measured by malondialdehyde (MDA) (P = 0.01) and total antioxidant capacity (TAC) (P = 0.01) were significantly increased in students with MID compared to healthy control subjects. In addition, mineral elements were shown to be linked with intellectual disability. The data showed that the levels of Fe, Mn, Zn, Hg, Pb, Ca, Cr, Mg, and Ni significantly (P = 0.001) increased, and the levels of Al, Na, K, Cu, and Zn/Cu ratio significantly (P = 0.001) decreased in subjects with MID compared to healthy controls. Correlation analysis concluded that changes in mineral elements significantly correlated with adiposity markers, oxidative stress, and the scores of intellectual disability (WISC III-IQ score).

CONCLUSION

The intellectual disability of moderate type (MID) was associated with abnormal changes in the levels of essential mineral elements and adipokines and increased levels of cellular oxidative stress. Thus, evaluating plasma mineral elements and adipokines levels could be a potential diagnostic parameter for diagnosing MID.

MicroRNAs as potential biopredictors for premenopausal osteoporosis: a biochemical and molecular study

BACKGROUND

Circulating micro-RNAs have been proposed as a new type of biomarker in several diseases, particularly those related to bone health. They have shown great potential due to their feasibility and simplicity of measurement in all body fluids, especially urine, plasma, and serum.

AIM

This study aimed to evaluate the expression of a set of mRNAs, namely miR-21, miR-24, mir-100, miR-24a, miR-103-3p, and miR-142-3p. Their proposed roles in the progression of osteoporosis were identified using a real-time polymerase chain reaction (RT-PCR) analysis in premenopausal women. In addition, their correlations with osteocalcin (OC), bone-specific alkaline phosphatase (BAP), and deoxypyridinoline (DPD) bone markers were explored.

METHODS

A total of 85 healthy premenopausal women aged 25-50 years old were included in this study. Based on a DXA scan (Z-score) analysis and calcaneus broadband ultrasound attenuation scores (c-BUAs), measured via quantitative ultrasound (QUS), the subjects were classified into three groups: normal group (n = 25), osteopenia (n = 30), and osteoporosis (n = 30). Real-time-PCR and immunoassay analyses were performed to determine miRNA expression levels and serum OC, s-BAP, and DPD, respectively, as biomarkers of bone health.

RESULTS

Among the identified miRNAs, only miR-21, miR-24, and mir-100 were significantly upregulated and increased in the serum of patients with osteopenia and osteoporosis, and miR-24a, miR-103-3p, and miR-142-3p were downregulated and significantly decreased in osteoporosis. Both upregulated and downregulated miRNAs were significantly correlated with BMD, c-BUA, OC, s-BAP, and DPD.

CONCLUSION

A group of circulating miRNAs was shown to be closely correlated with the parameters BMD, c-BUA, OC, s-BAP, and DPD, which are traditionally used for bone-health measurements. They could be identified as non-invasive biomarkers in premenopausal patients with osteoporosis. More studies with large sample sizes are recommended to estimate the mechanistic role of miRNAs in osteoporosis pathogenesis and to provide evidence for the use of these miRNAs as a non-invasive method of diagnosing clinical osteoporosis, especially in premenopausal patients.

Acute effects of muscle vibration on elbow joint position sense in healthy young men: A randomized trial

BACKGROUND

The study aimed to investigate and compare the acute effects of 2 local vibration frequencies (63 Hz vs 42 Hz frequencies) applied to the biceps brachii muscles on the elbow joint position sense (JPS) in healthy young men.

METHODS

A 3-arm parallel-group design with randomization of participants was used. Forty-five healthy young men aged 19 to 30 years were randomly assigned to 3 groups: to receive 63 Hz (n = 15) in experimental group 1 (EG1) or 42 Hz (n = 15) in experimental group 2 (EG2) or sham vibration in the control group (n = 15). Participants in the EG1 and EG2 received 5 bouts of 1-minute vibration exposure to the biceps brachii muscle, with a 1-minute rest between the bouts. In control group, sham vibration was applied with the same duration and interval as in EG1 and EG2. The active elbow joint position error was selected as an outcome measure to assess elbow JPS. The target angle and the angle reproduced were measured using a Universal Goniometer. The difference between the target and the reproduced angles was calculated to determine active elbow joint position error. Measurements were made before the vibration application and right after it.

RESULTS

No statistically significant difference was observed in the JPS of the elbow joint over time in any group (P = .625). No statistically significant differences were observed between the 33 groups in the JPS of the elbow (P = .075).

CONCLUSION

There was no acute effect of vibration of the biceps brachii muscle at 63 and 42 Hz on active elbow JPS in healthy adults.

The Efficacy of Manual Therapy and Pressure Biofeedback-Guided Deep Cervical Flexor Muscle Strength Training on Pain and Functional Limitations in Individuals with Cervicogenic Headaches: A Randomized Comparative Study

Objective

This study aimed to compare the efficacy of manual therapy and pressure biofeedback-guided DCFM strength training on pain intensity and functional limitations in individuals with CGH. Trial Design. A double-blinded, two-arm parallel group randomized comparative design.

Methods

After applying the eligibility criteria, sixty out of eighty-nine CGH patients were recruited from King Saud University Medical Center in Riyadh and randomly allocated to intervention groups using simple random sampling. Group 1 underwent pressure biofeedback-guided DCFM strength training and conventional treatment, while Group 2 received manual therapy and conventional treatment for three consecutive weeks. The main outcome measures were scores on the visual analog scale (VAS) and the headache disability index (HDI). One assessor and two physical therapists were blinded to group allocation.

Results

Sixty out of eighty participants aged 29-40 years were randomized into intervention groups (n = 30/group; age (mean ± standard deviation): group 1 = 35.0 ± 2.82; group 2 = 34.87 ± 2.60), and their data were analyzed. A significant improvement (95% CI, p < 0.05) was observed within each group when comparing the VAS and HDI scores between baseline and postintervention. In contrast, between-group comparisons for the outcome score of VAS and HDI revealed nonsignificant differences in the first, second, and third weeks after intervention, except for the VAS score, which showed a significant difference in weeks 2 and 3 after intervention. Cohen's d-value indicated that the intervention effect size for reducing pain was larger in group 1 than in group 2 at weeks 2 and 3.

Conclusion

Compared with manual therapy, pressure biofeedback-guided DCFM strength training showed a greater reduction in pain intensity (assessed using the VAS) at weeks two and three. However, both treatments were equally effective in lowering headache-related functional limitations in patients with CGH. This trial is registered with ClinicalTrial.gov PRS (Identifier ID: NCT05692232).

Effects of a program consisting of strain/counterstrain technique, phonophoresis, heat therapy, and stretching in patients with temporomandibular joint dysfunction: A pilot study

BACKGROUND

The present study was conceptualized as a pilot study to examine the effects of a 3-week program consisting of strain/counterstrain technique (SCST), phonophoresis, heat therapy, and stretching exercises on pain and functions in patients with temporomandibular dysfunction (TMD).

METHODS

Seven participants (mean age 25.85 years) diagnosed with TMD having pain in the temporomandibular joint (TMJ) area with decreased jaw opening were recruited for the study. Treatment interventions consisting of SCST, phonophoresis (ultrasound gel mixed with diclofenac gel), heat therapy, and stretching (mouth-opening) exercises were performed 3 days a week for 3 weeks. SCST was performed on the masseter, medial, and lateral pterygoid muscles. No control group was present in the study.

RESULTS

Paired samples t test revealed a significant difference in numerical pain rating scale (NPRS) (decreased by 50%, P < .001) and jaw functional limitation scale (JFLS) (reduced by 59.58%, P < .001) scores after 3 weeks of intervention. A large effect size (Cohen d = -3.00 for NPRS and -3.16 for JFLS) was observed for both variables. No correlation (R = 0) was found between the baseline values of NPRS and JFLS.

CONCLUSION

A 3-week program consisting of SCST, phonophoresis, heat therapy, and stretching exercises was effective in reducing the pain and improving the functions related to TMJ in patients suffering from TMD. However, a randomized controlled trial is needed to reach a definite conclusion.

Analysis of the kinematic variables that predict jump serve efficacy among volleyball players

In volleyball, a strong correlation exists between the proper application of kinematics factors and the serve results. Therefore, this study compared the kinematics parameters of the volleyball jump serve among different functional classes and established an appropriate multilinear regression model of performance. This correlational observational study involved thirty male collegiate volleyball players categorized into under twenty-three (U-23) men, under twenty-one (U-21) junior men, and under nineteen (U-19) youth boys. Data acquisition entailed the utilization of synchronized cameras to capture the volleyball serves meticulously, while subsequent data analysis was conducted through the implementation of silicon coach-pro 8 motion analysis software. Analysis of variance and multiple linear regressions were performed to analyze data, with a predetermined significance level of P < .05. Jump serve analysis showed significant mean differences in selected major kinematic variables among all 3 classes (U-23 men, U-21 junior men, and U-19 youth boys). U-23 men Model-3, which includes 3 independent variables (approach velocity [AV], shoulder extension angles during the cocking phase, and center of gravity [CG] height), predicted velocity with an R-square of 1.00, indicating that the selected independent variable caused 100% variation in ball velocity (BV), whereas models 1 and 2 showed 99% variation in BV, respectively. The U-21 Junior men Model-2, which includes 2 independent variables (height of CG and shoulder extension angles during the cocking phase), predicted velocity with an R-square of 9.80, indicating that the selected independent variable caused a 98% variation in BV. In contrast, model 1 showed a 94% variation in BV, respectively. U-19 youth boys Model-1, which includes one independent variable (AV), predicted velocity with an R-square of 0.89, indicating that the selected independent variable caused 89% variation in BV. The jump serve exhibits similar biomechanical characteristics across different classes. However, the major independent variables of the jump serve: U-23 men were AV, shoulder extension angles at cocking phase (SEACP), the height of CG, U-21 junior men were SEACP and height of CG, and U-19 youth boys were SEACP and height of CG AV showed significant with the dependent variable (BV).

High-Intensity Interval Training Improves Glycemic Control, Cellular Apoptosis, and Oxidative Stress of Type 2 Diabetic Patients

Background and Objectives: Physical exercise is an important therapeutic modality for treating and managing diabetes. High-intensity interval training (HIIT) is considered one of the best non-drug strategies for preventing and treating type 2 diabetes mellitus (T2DM) by improving mitochondrial biogenesis and function. This study aimed to determine the effects of 12 weeks of HIIT training on the expression of tumor suppressor protein-p53, mitochondrial cytochrome c oxidase (COX), and oxidative stress in patients with T2DM. Methods: A total of thirty male sedentary patients aged (45-60 years) were diagnosed with established T2DM for more than five years. Twenty healthy volunteers, age- and sex-matched, were included in this study. Both patients and control subjects participated in the HIIT program for 12 weeks. Glycemic control variables including p53 (U/mL), COX (ng/mL), total antioxidant capacity (TAC, nmole/µL), 8-hydroxy-2'-deoxyguanosine (8-OHdG, ng/mL), as well as genomic and mitochondrial DNA content were measured in both the serum and muscle tissues of control and patient groups following exercise training. Results: There were significant improvements in fasting glucose levels. HbA1c (%), HOMA-IR (mUmmol/L2), fasting insulin (µU/mL), and C-peptide (ng/mL) were reported in T2DM and healthy controls. A significant decrease was also observed in p53 protein levels. COX, 8-OhdG, and an increase in the level of TAC were reported in T2DM following 12 weeks of HIIT exercise. Before and after exercise, p53; COX, mt-DNA content, TAC, and 8-OhdG showed an association with diabetic control parameters such as fasting glucose (FG), glycated hemoglobin (HbA1C, %), C-peptide, fasting insulin (FI), and homeostatic model assessment for insulin resistance (HOMA-IR) in patients with T2DM. These findings support the positive impact of HIIT exercise in improving regulation of mitochondrial biogenesis and subsequent control of diabetes through anti-apoptotic and anti-oxidative pathways. Conclusions: A 12-week HIIT program significantly improves diabetes by reducing insulin resistance; regulating mitochondrial biogenesis; and decreasing oxidative stress capacity among patients and healthy controls. Also; p53 protein expression; COX; 8-OhdG; and TAC and mt-DNA content were shown to be associated with T2DM before and after exercise training.

Effects of High-Intensity Interval Training on Melatonin Function and Cellular Lymphocyte Apoptosis in Sedentary Middle-Aged Men

Background: Physical performance increased by controlled interventions of high-intensity intermittent training (HIIT); however, little is known about their influence as anti-aging and antioxidant effects, or their role in mitochondrial biogenesis. Purpose: This study aimed to determine the effects of HIIT for 12 weeks on melatonin function, lymphocyte cell apoptosis, oxidative stress on aging, and physical performance. Methods: Eighty healthy male subjects aged 18-65 years randomly participated in a HIIT-exercise training program for 12 weeks. Anthropometric analysis, cardiovascular fitness, total antioxidant capacity (TAC), lymphocyte count and apoptosis, and serum melatonin and cytochrome c oxidase (COX), were estimated for all subjects before and after HIIT-exercise training. HIIT training was performed in subjects for 12 weeks. Results: Data analysis showed a significant increase in the expression levels of the melatonin hormone (11.2 ± 2.3, p < 0.001), TAC (48.7 ± 7.1, p < 0.002), COX (3.7 ± 0.75, p < 0.001), and a higher percentage of lymphocyte apoptosis (5.2 ± 0.31, p < 0.003). In addition, there was an improvement in fitness scores (W; 196.5 ± 4.6, VO₂max; 58.9 ± 2.5, p < 0.001), adiposity markers (p < 0.001); BMI, WHtR, and glycemic control parameters (p < 0.01); FG, HbA1c (%), FI, and serum C-peptide were significantly improved following HIIT intervention. Both melatonin and lymphocyte apoptosis significantly correlated with the studied parameters, especially TAC and COX. Furthermore, the correlation of lymphocyte apoptosis with longer exercise duration was significantly associated with increased serum melatonin following exercise training. This association supports the mechanistic role of melatonin in promoting lymphocyte apoptosis either via the extrinsic mediator pathway or via inhibition of lymphocyte division in the thymus and lymph nodes. Additionally, the correlation between melatonin, lymphocyte apoptosis, TAC, and COX activities significantly supports their role in enhancing physical performance. Conclusions: The main findings of this study were that HIIT exercise training for 12 weeks significantly improved adiposity markers, glycemic control parameters, and physical performance of sedentary older adult men. In addition, melatonin secretion, % of lymphocyte apoptosis, COX activities, and TAC as biological aging markers were significantly increased following HIIT exercise training interventions for 12 weeks. The use of HIIT exercise was effective in improving biological aging, which is adequate for supporting chronological age, especially regarding aging problems. However, subsequent studies are required with long-term follow-up to consider HIIT as a modulator for several cardiometabolic health problems in older individuals with obesity.

Effects of an aerobic training program on liver functions in male athletes: a randomized controlled trial

The optimal functioning of the liver is essential for athletic performance. It is necessary to maintain the liver's enzymes at an optimal level so that liver cells can be protected from inflammation or damage. This study investigated the effects of a 12-week aerobic exercise program on the liver function of adult athletes. A pretest-posttest experimental design was used. A total of thirty healthy male athletes (football players) aged 21 to 24 years were recruited for this study and randomly and equally divided into the experimental group (EG) and control group (CG). The CG did not participate in any special activities. The EG performed an aerobic training program consisting of several exercises for 12 weeks. Evaluation of all participants in both groups was carried out before and after the intervention by measuring the blood levels of Alkaline phosphate, AST/SGOT, ALT/SGPT, Bilirubin Total/indirect/direct, Albumin, Globulin, and Total protein using the standard methods by collecting blood samples. There was a significant decrease (p < 0.05) in Bilirubin and globulin levels in the EG after 12 weeks of aerobic training sessions. However, there was no significant difference in alkaline phosphate, AST/SGOT, ALT/SGPT Total protein, and Albumin (p > 0.05) between both groups post-treatment. The 12 weeks of aerobic training used in the study can potentially improve the liver function of adult athletes.

Effects of modified sleeper stretch and modified cross-body stretch on upper limb functions and shoulder ROM in tennis players: a randomized trial

Tennis players often experience posterior shoulder pain due to restricted internal rotation (IR) range of motion (ROM) of the glenohumeral joint. No research has compared the effects of modified sleeper stretch (MSS) versus modified cross-body stretch (MCBS) on tennis players' upper limb functions and IR ROM. The study aimed to compare the efficacy of modified sleeper and cross-body adduction stretch in improving shoulder IR ROM and upper limb functions in tennis players. Thirty male lawn tennis players (aged 20 to 35 years) with more than 15° glenohumeral IR deficiency on the dominant side compared to the non-dominant side were recruited and divided into two groups: Modified sleeper stretch group (MSSG) and modified cross-body stretch group (MCBSG). MSSG received MSS, and MCBSG received MCBS, 3-5 repetitions once daily for 4 weeks. Upper limb functions were measured using the Disability of the Arm, Shoulder, and Hand (DASH) scale, and the IR ROM of the shoulder joint was measured using a universal goniometer. Both groups observed significant (p < 0.05) DASH scores and IR ROM improvements. DASH scores decreased by 85% in MSSG and 79.60% in MCBSG. IR ROM increased by 94.64% in MSSG and 89.52% in MCBSG. No significant differences (p > 0.05) were found in post-intervention DASH scores and IR ROM values between both groups. MSS and MCBS improved upper limb functions and IR ROM of the shoulder joint in the selected sample population of lawn tennis players. No difference was observed between both stretching techniques in improving upper limb functions and IR ROM of the shoulder joint.

Short-term effects of tactile stimulation of facial skin on hamstring muscle flexibility in healthy young males

BACKGROUND

Inhibition of the suboccipital muscle group is shown to increase the flexibility of hamstring muscles. Reversely, stretching of the hamstring muscles is shown to change the pressure pain thresholds over the masseter and upper trapezius muscles. There appears to be a functional link between the neuromuscular system of the head and neck, and lower extremities. The present study aimed to investigate the effect of tactile stimulation of facial skin on hamstring flexibility in healthy young males.

METHODS

A total of sixty-six participants participated in the study. Hamstring flexibility was measured by the sit and reach (SR) test in long sitting and the toe touch (TT) test in standing before and after two minutes of facial tactile stimulation in the experimental group (EG) and after rest in the control group (CG).

RESULTS

In both groups, significant (P<0.001) improvement was observed in both variables, i.e., SR (from 2.62 cm to -0.67 cm in EG and from 4.51 cm to 3.52 cm in CG) and TT (from 2.78 cm to -0.64 cm in EG and from 2.42 cm to 1.06 cm in CG). When both groups were compared, a significant (P=0.030) difference was observed between EG and CG in postintervention values of SR only. Greater improvement was observed in the SR test in EG.

CONCLUSIONS

Tactile stimulation of facial skin improved hamstring muscle flexibility. This indirect mode of increasing hamstring flexibility can be taken into consideration while managing individuals with hamstring muscle tightness.

Effects of an incentive spirometer versus a threshold inspiratory muscle trainer on lung functions in Parkinson's disease patients: a randomized trial

Upper airway obstruction, reduced maximal expiratory and inspiratory flows, reduced lung volumes, abnormal ventilatory control, and diaphragmatic dyskinesias are reported in patients with Parkinson's disease (PD). Inspiratory muscle training (IMT) has been reported to be effective in improving respiratory functions; however, no studies have compared the effects of the incentive spirometer (IS) with the threshold inspiratory muscle trainer (TIMT) in patients with PD. The study aimed to compare the effects of IS and TIMT on maximum inspiratory pressure (MIP), 6-min walk distance (6-MWD), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow rate (PEFR) in patients with stage 1-3 according to the Hoehn and Yahr scale. 18 patients were randomly assigned to two groups, i.e., incentive spirometer (IS) and threshold inspiratory muscle trainer (TIMT) group. The IS group received IMT with volume-based IS, and the TIMT group received IMT with TIMT. MIP, 6-MWD, FVC, FEV1, and PEFR were measured before and after six weeks of training. In IS group: A significant increase (p < 0.05) was observed in MIP and 6-MWD by 18.13 and 5%, respectively. In the TIMT group: A significant increase (p < 0.05) was observed in MIP and 6-MWD by 30.15 and 8.94%, respectively. Both groups observed no significant difference (p > 0.05) in FVC, FEV1, and PEFR. When the two groups were compared, a greater increase (p < 0.05) was observed in the MIP and 6-MWD in the TIMT group compared to IS group. IMT with IS or TIMT for six weeks effectively increased MIP and 6-MWD in patients with stage 1-3 (Hoehn and Yahr scale) of PD. No improvement was observed in FVC, FEV1, or PEFR with any of the techniques. TIMT is more effective than IS in improving MIP and 6-MWD.

The Combined Effect of the Trapezius Muscle Strengthening and Pectoralis Minor Muscle Stretching on Correcting the Rounded Shoulder Posture and Shoulder Flexion Range of Motion among Young Saudi Females: A Randomized Comparative Study

BACKGROUND

The shortening of the pectoralis minor muscle (PMi-M) and weakening of the lower trapezius muscle (LTr-M) affect scapular movement, resulting in the development of a rounded shoulder posture and reduction in the shoulder flexion range of motion (SFROM).

OBJECTIVE

This study evaluated the combined effect of LTr-M strengthening and PMi-M stretching on correcting the rounded shoulder postures and SFROM among young Saudi females.

METHODS

This study was based on a two-arm parallel-group repeated measures randomized comparative design. A total of sixty female participants with rounded shoulder postures were recruited and randomly allocated into groups 1 and 2 (n = 30/group). Each group performed supervised PMi-M stretching; however, group 2 performed a combination of LTr-M strengthening and PMi-M stretching. The outcomes, including rounded shoulder posture and SFROM, were assessed using the pectoralis minor length test (PMLT) and universal goniometer. A repeated measure ANOVA was used to compare the differences within-group and between-group for the outcomes measures at one-week (baseline) pre-intervention, two weeks, and three -weeks post-intervention. The significance level was set at q > 2.00 and p < 0.05 for all respective statistical analyses.

RESULTS

The within-group comparison revealed significant improvements (q > 2.00) in the outcomes of PMLT and SFROM when comparing their post-intervention scores to the baseline scores. The between-group comparison revealed a significant and an insignificant (q < 2.00) difference in the outcomes of PMLT and SFROM, respectively when comparing their scores at the second- and third-week post-intervention. Furthermore, the effect size of the intervention suggests an advantage of group 2 over group 1 in increasing the resting length of the PMi-M only among young Saudi females.

CONCLUSIONS

The combined effect of LTr-M strengthening and PMi-M stretching was more beneficial than PMi-M stretching alone in correcting the rounded shoulder posture among young Saudi females by increasing PMi-M resting length. However, it could not yield a differential improvement in the SFROM outcome among them.

Knowledge, attitude and dispensing practice of the pharmacists related to complementary alternative medicines in the Riyadh region of Saudi Arabia: a cross-sectional descriptive study

BACKGROUND

The use of complementary alternative medicines (CAMs) has risen globally in recent times. Such medications are exclusively and readily available in the Riyadh region of Saudi Arabia through community pharmacies and other retail outlets, exposing the consumers to various risks like harmful drug interactions. These situations take pharmacists to a responsible position where they should provide evidence-based information to help consumers make safe consumption. The consumption of CAMs can be ensured safe if pharmacists have appropriate knowledge and training about their use, dosing, side effects, etc. This study aimed to investigate and evaluate the pharmacist's factual knowledge, perception and dispensing practice related to various aspects of CAMs based on gender and experience.

METHODS

The study followed a structured self-administered questionnaire-based cross-sectional survey design. Out of 200, with a response rate of 89.5%, 179 pharmacists (115 males; 64 females) from the Riyadh region of Saudi Arabia participated in this study. The knowledge scores of male and female pharmacists were compared using an unpaired t-test. The correlation between pharmacists' knowledge and their work experience was determined using Pearson's correlation coefficient test, keeping the significance value at p < 0.05.

RESULTS

Almost all the respondents (99%) reported that they had never attended any lecture or course related to CAMs. Results show low knowledge scores, indicating poor respondents' knowledge concerning the use of CAMs. No significant difference was observed in knowledge scores based on gender, and no significant correlation between pharmacists' knowledge scores and their work experiences.

CONCLUSION

Therefore, the study concluded that both male and female pharmacists possess equal knowledge concerning the use of CAMs, and their work experience doesn't differentiate in their knowledge. Various factors like lack of time, etc., prevented respondents from interacting with patients. Regular organization of mandatory continuing education programs about the safe use of CAMs that can improve their knowledge is recommended. In addition, establishing a pharmacy connection network system can enhance patient monitoring and CAMs vigilance. This study lays a foundation for further work to assess pharmacists' knowledge and practice patterns in Saudi Arabia.

TRIAL REGISTRATION

Not applicable.

Correlation of Percentage Body Fat, Waist Circumference and Waist-to-Hip Ratio with Abdominal Muscle Strength

Sedentary lifestyle and consumption of high-fat foods have become widespread, especially in the urban population. This leads to a reduction in lean body mass and increased body fat. The correlation between body fat indices and low back pain has been less explored and documented. The aim of this study was to identify the correlation between the percentage of body fat, waist circumference and waist-to-hip ratio and abdominal muscle strength. Percentage of body fat was estimated by using the body composition analyzer method using Tanita BC-545 Innerscan Segmental Body Composition. Waist-to-hip ratio was calculated by dividing the waist circumference by hip circumference. Abdominal muscle (rectus abdominis and external oblique) strength was measured by maximum voluntary isometric contraction as measured by surface electromyography. A positive correlation was observed between waist circumference and the percentage of body fat, while a negative correlation was observed between the average maximum voluntary isometric contraction of rectus abdominis and external oblique muscles and the percentage of body fat. Individuals with a high percentage of body fat tend to have higher fat distribution over the abdominal region and decreased abdominal muscle strength. Therapists should emphasize the use of abdominal muscles in individuals with high body fat in order to reduce the associated risk of the development of poor posture and low back pain.

Work-related musculoskeletal disorders among information technology professionals in Riyadh, Saudi Arabia

BACKGROUND

This study was done to see the prevalence of work-related musculoskeletal disorders among information technology (IT) professionals in Saudi Arabia, the risk factors associated with them, their consequences, and to propose some preventive measures.

MATERIAL AND METHODS

A self-administered online questionnaire that included questions on the demographic data, job nature, medical history, work-related pain after joining information technology profession and distribution and severity of pain was sent to 250 information technology professionals working in Saudi Arabia.

RESULTS

Out of 250, 202 (81%) IT professionals participated in the study. At least 62 (32%) reported that they have developed some type of musculoskeletal pain after joining their profession and 38 (61%) respondents further reported that it was so severe that they had to seek some sort of treatment for their pain. On the Visual Analog Scale ranging 0-10, 14 (23%) respondents reported that their worst ever pain was >7. Despite lower representation 67% of the females reported to develop work-related pain.

CONCLUSIONS

Development of work-related musculoskeletal pain among information technology professionals has been shown to affect their activities of daily living. It may even force them to change their work setting or reduce working hours. Information technology sector has rapidly grown in Saudi Arabia in the recent times and there is no data on the incidence or prevalence of such disorders among them. Role of ergonomics and counseling should be emphasized during their training that help them work effectively and efficiently. A similar large-scale study should be conducted to see the effect of lifestyle related to COVID-19 on the lives of working population especially IT professionals. Med Pr. 2022;73(5):397-406.

Factors affecting pain and physical functions in patients with knee osteoarthritis: An observational study

Knee osteoarthritis (KOA) is more common as people age and have a higher body mass index (BMI). We must know the role of various factors in pain and physical functions in patients with KOA. Therefore, the present study sought to examine the factors associated with pain and physical functions in individuals with KOA. This cross-sectional observational study included patients with KOA (n = 125; 57 men, 68 women; mean age 52.9 years). Using the visual analogue scale and a reduced version of the Western Ontario McMaster Universities Osteoarthritis Index, pain severity and physical functions were assessed. Demographic factors such as age, BMI, sex, and Kellgren-Lawrence (K/L) radiographic grade of KOA were analyzed. Age (R = 0.263, P < .001), BMI (R = 0.379, P < .001), and K/L grade (R = 0.844, P < .001) were significantly associated with knee pain. Similarly, age (R = 0.310, P < .001), BMI (R = 0.374, P < .001), and K/L grade (R = 0.862, P < .001) were associated with physical functions. No significant association of sex with pain (R = 0.071, P = .440) and physical functions (R = 0.055, P = .545) was observed. Age, BMI, and K/L grade explained 71% and 74% of knee pain and physical functions, respectively. Age, BMI, and radiographic (K/L) grades were associated with pain and physical functions in patients with KOA. K/L grade was the most significant predictor of pain and physical functions in KOA.

Effects of different stretch durations on the strength of the proximal and distal group of muscles - a randomized trial

BACKGROUND

Different researchers have studied the effects of different types of stretching on different muscle groups. Since distal muscles are fully activated and proximal muscles are sub-optimally activated; thus, we might see different responses to stretching in the proximal and distal groups of muscles depending on their muscle activation. Therefore, this study aimed to compare the acute effects of 2, 4, and 8 minutes of intermittent static stretching (SS) on the isometric maximum voluntary contraction force (MVCF) of proximal (Hamstring) and distal (Calf) groups of muscles.

METHODS

Two groups pretest-posttest experimental design was used. A total of thirty participants were randomly assigned into two groups, and twenty-eight completed the intervention. In both groups, participants participated in three experimental trials (SS2, SS4, and SS8) on 3 days. 2-minute intermittent stretching (SS2) was performed on day-I, 4-minute (SS4) on day II, and 8-minute (SS8) on day III. Isometric MVCF was measured at pre-intervention, 0-, 10-, and 20-minute post-intervention periods in both groups.

RESULTS

In the proximal group: SS2, SS4, and SS8 did not affect isometric MVCF at the 0-, 10-, and 20-minute post-intervention periods (P > .05). In distal group: SS2 did not affect isometric MVCF at 0- and 10-minute post-intervention periods (P > .05), however at 20-minute, MVCF increased by 11.06% (P < .05). SS4 and SS8 also did not alter isometric MVCF in the Calf at 0-, 10-, and 20-minute post-intervention periods (P > .05). No significant differences were observed between the proximal and distal groups (P > .05).

CONCLUSION

2-, 4-, and 8-minute intermittent SS did not affect the isometric strength in both muscle groups. In addition, proximal and distal groups of muscles responded similarly to three different duration intermittent SS.

Effects of Kinesio taping on calf muscle fatigue in college female athletes: A randomized controlled trial

BACKGROUND

Fatigue is a common phenomenon encountered by athletes in ordinary life and sports. Fatigue results in decreased muscle strength, balance, agility, and an increased risk of injury, which together results in hampered sports performance. Several studies have examined the effects of Kinesio Tape (KT) application on muscle fatigue however, contradictory findings are reported. This study aimed to examine the effects of the application of KT on calf muscle fatigability.

METHODS

A three-arm parallel pretest-post-test experimental design was used. Forty-five collegiate female athletes (mean age of 20.57 years) were randomly assigned to three groups. For the experimental group, KT with 50% tension; for the sham group, KT without any tension; and for the placebo group, rigid tape without any tension was applied. The number of heel rises (HRn) was measured before and after taping in the three groups, using Haberometer and Metronome. The tapes were applied in the Y shape to the calf muscle region.

RESULTS

In the experimental group: The HRn significantly increased by 18.76 % (P = .000) after applying KT. In the sham and placebo groups: There was no change in HRn before and after Taping (P > .05).

CONCLUSION

Y-shaped application of KT with 50% tension over the calf muscle region is effective in reducing its fatigability.

Impacts of Adiposity on the Attentional Cost of Sensory-Motor Performance Associated with Mobility in a Dual-Task Paradigm

(1) Background: Obesity is one of the most prevalent health problems worldwide. Studies have evidenced that the increase in body weight affects the normal neuromusculoskeletal function, which leads to abnormal gait patterns and impaired balance. (2) Objective: The aim of this study was to examine the influence of dual-task activity (cognitive-motor task) on gait parameters and balance among obese students. (3) Material and methods: A cross-sectional study was conducted among students (18-28 years old), including 120 obese and 120 age-matched normal-weight control subjects, selected at random using simple random sampling, from the Majmaah, Riyadh, Dammam, and Jizan regions of Saudi Arabia. The gait speed was measured in seconds while the controls and the obese subjects performed a dual-task activity of walking down a level, well-lit, narrow lane at their own speed, counting backwards from 100 by 4 s. (4) Results: The results of our study suggest a significant difference in the effect of the dual-task paradigm on the gait speed (t = 21.05, p = 000) of obese participants when compared to their age-matched counterparts. A significant correlation was found between BMI and gait speed and balance, irrespective of the gender of the obese student. A high degree of positive correlation (r = 0.705, p < 0.001) was found between BMI and gait speed, and a high degree of inverse correlation (r = -0.648, p < 0.001) was found between BMI and balance among obese students A multiple regression model explained 60% of the variance in gait speed and was statistically significant (R² = 0.60, F (4, 235) = 90.65, p = 0.000) with BMI (β = 0.018, p = 0.000) and balance (β = 0.015, p = 0.000) significantly predicting gait speed. (5) Conclusion: The results of the current study provide evidence that obesity significantly influences gait speed and balance due to the inclusion of a contemporaneous cognitive task. The results also suggest that the dual-task paradigm affects both genders equally.

The Time-Based Effects of Kinesio Taping on Acute-Onset Muscle Soreness and Calf Muscle Extensibility among Endurance Athletes: A Randomized Cross-Over Trial

BACKGROUND

This study aims to determine the effects of kinesio tape (KT) application on acute-onset muscle soreness and the extensibility of the calf muscles in endurance athletes.

METHODS

A one-arm repeated-measures randomized cross-over controlled study design investigated 55 endurance athletes, including 10 cyclists, 30 badminton players, and 15 long-distance runners (mean age 16.40 ± 2.69) from different stadia in Delhi NCR, India. KT and sham tapes (ST) were applied randomly to right and left legs (prone position) in a cross-over manner with a gap of 72 h. Ankle dorsiflexion range of motion (ADFROM) and pain due to acute-onset muscle soreness were assessed immediately and 10 min and 30 min after treadmill running, using a universal goniometer and numeric pain rating scale (NPRS), respectively, along with the time to fatigue.

RESULTS

A statistically significant difference was observed for the NPRS when the mean scores obtained for the KT and ST groups were compared immediately after cessation of running; however, the difference was not statistically significant in the NPRS score that was recorded ten or thirty minutes after. The range of motion increased significantly after the application of both the KT and the ST. After running on a treadmill, the range of motion decreased significantly with both the KT and ST, and the decrease was similar.

CONCLUSION

KT was more effective in reducing the pain intensity immediately after running and increased the time spent running on the treadmill before fatigue set in among endurance athletes. In addition, the two taping methods (KT or ST) were equally effective in enhancing calf muscle extensibility (for both right and left legs) immediately after application. However, both taping methods failed in limiting the decrease in ankle ADFROM after treadmill running.

Mode-specific effects of concentric and eccentric isokinetic training of the hamstring muscle at slow angular velocity on the functional hamstrings-to-quadriceps ratio-a randomized trial

Background

Previous studies have examined the mode specificity of eccentric and concentric isokinetic training, but have reported conflicting results. Few studies have reported that eccentric and concentric isokinetic training are mode-specific, i.e., they will increase only the eccentric or concentric strength, respectively. Other studies have reported that mode specificity does not exist. Therefore, this study aimed to assess the mode-specific effects of eccentric and concentric isokinetic training of the hamstring muscle at slow angular velocity on eccentric peak torque of the hamstring (PT_ecc), concentric peak torque of the quadriceps (PT_con), acceleration time of the hamstring (AT_hams) and quadriceps (AT_quad), deceleration time of the hamstring (DT_hams) and quadriceps (DT_quad), time to peak torque of the hamstring (TPT_hams) and quadriceps (TPT_quad), and functional Hamstring-to-Quadriceps ratio (PT_ecc/PT_con).

Subjects

A total of 30 participants were randomly divided into eccentric and concentric groups.

Methods

Two groups pre-test-post-test experimental design was used. In the eccentric and concentric groups, eccentric and concentric isokinetic training of hamstring muscle was performed respectively, at an angular velocity of 60°/s for 6 weeks duration. PT_ecc, PT_con, AT_hams, AT_quad, DT_hams, DT_quad, TPT_hams, TPT_quad, and PT_ecc/PT_con were measured before and after the completion of training.

Results

In the eccentric group, a significant difference (p < 0.05) was observed in PT_ecc (increased by 21.55%), AT_hams (decreased by 42.33%), AT_quad (decreased by 28.74%), and PT_ecc/PT_con (increased by 17.59%). No significant difference (p > 0.05) was observed in PT_con, TPT_hams, TPT_quad, DThams, and DT_quad. In the concentric group, a significant difference (p < 0.05) was observed in PT_ecc (increased by 12.95%), AT_hams (decreased by 27.38%) AT_quad (decreased by 22.08%), DT_quad (decreased by 26.86%), and PT_ecc/PT_con (increased by 8.35%). No significant difference (p > 0.05) was observed in PT_quad, TPT_hams, TPTquad, and DT_hams. Between-group analysis revealed a significant difference (p < 0.05) only in TPT_quad; otherwise, in the rest of the parameters, no significant difference (p > 0.05) was observed.

Conclusions

Both eccentric and concentric isokinetic training of the hamstring for 6 weeks increased PT_ecc, PT_ecc/PT_con, and decreased AT_hams and AT_quad. The effects of eccentric and concentric isokinetic training of the hamstring on PT_ecc, PT_ecc/PT_con, AT_hams, and AT_quad were not mode specific.

In hypertensive individuals, sleep time and sleep efficiency did not affect the number of angina episodes: a cross-sectional study

Previous studies have reported adverse effects of short and long sleep duration on cardiovascular health. However, how sleep time and sleep efficiency affect angina have not been studied in hypertensive individuals. This study aimed to assess the relationship of sleep with angina. Using a cross-sectional design, data from 1563 hypertensive individuals were collected from the parent Sleep Heart Health Study (SHHS). Age, alcohol use, average diastolic blood pressure (ADBP), average systolic blood pressure (ASBP), cigarette use, sleep time, sleep efficiency, percent time in stage N3 of sleep, and body mass index (BMI) were used as covariates. Multiple linear regression, the Chi-Square test, and Pearson’s correlation coefficient were used for data analysis. Unadjusted sleep efficiency, sleep time, ADBP, and age were significant (p < 0.05) predictors of the number of angina episodes (Angina_n). When the covariates were adjusted, only ADBP and ASBP were significant (p < 0.05) predictors of Angina_n. Sleep efficiency, BMI, ADBP, sleep time, and age had a significant (p < 0.05) correlation with Angina_n. In hypertensive individuals, sleep time and sleep efficiency did not affect Angina_n when adjusted for covariates. ADBP and ASBP were found to be significant predictors of Angina_n when the covariates were adjusted.

Effect of static and dynamic jaw positions on postural stability among people with blindness

BACKGROUND

In comparison with the people with normal sight, the mean center of gravity (COG) velocity is significantly higher among blind people. A strong relationship has been shown between jaw and neck sensorimotor and postural control. The purpose of this study was to determine the effect of different static and dynamic jaw positions on postural stability among subjects with blindness.

METHODS

Postural stability was measured as COG velocity in 39 blind subjects under the following five conditions: resting jaw (natural jaw position with no instructions, control), open jaw (teeth of both jaws slightly apart), clenched jaw (teeth tightly closed across each other), chewing (a standard bolus of gum at the natural palace), and tongue position (positioned behind the upper incisors) while standing on firm and foam surfaces.

RESULTS

The mean COG velocity while standing on the firm surface during resting, open jaw position, clenched jaw position, chewing, and tongue positions were 0.54, 0.50, 0.44, 0.59, and 0.46 deg/s, respectively. The mean COG velocity while standing on the foam surface during resting, open jaw position, clenched jaw position, chewing, and tongue positions were 1.42, 1.23, 1.10, 1.14, and 1.06 deg/s, respectively. Compared to the firm surface, the COG velocity was significantly higher on the foam surface in all five conditions (p < .001). In the comparison between the conditions, there were no significant differences in either the firm or foam surface in all five conditions (p > .05).

CONCLUSION

People with blindness behave in the same way as sighted subjects on firm and foam surfaces. However, changes in static and dynamic jaw positions do not affect postural stability among them.

Association of eccentric quadriceps torque with pain, physical function, and extension lag in women with grade ≤ II knee osteoarthritis: An observational study

Knee osteoarthritis (OA) is a prevalent disabling disease among women and quadriceps weakness is attributed to one of the causes of knee pain (KP) and disability. The study aimed to test the correlation of eccentric quadriceps torque (EQT) with 2 subscales of the reduced WOMAC questionnaire (KP and physical function) and extension lag range of motion (ROM) at the knee joint in osteoarthritic women. A cross-sectional design was used. A total of 70 patients (mean age 41.1 years) who had grade I or II knee OA participated in the study. The pearson correlation coefficient was used to test the correlation between the EQT and 2 subscales of the reduced WOMAC questionnaire and extension lag ROM. EQT presented a significant moderate negative correlation with pain (r = -0.489, P < .001) and physical function (r = -0.425, P < .001), and low positive correlation with available ROM (R = 0.349, P < .001). KP, physical function, and extension lag in the early stages of knee OA in women are associated with EQT. Therefore, designing a rehabilitation program that has eccentric quadriceps strengthening exercises may improve KP and physical activities, but more randomized controlled trials are needed to verify this.

Effects of myofascial release with tennis ball on spasticity and motor functions of upper limb in patients with chronic stroke: A randomized controlled trial

BACKGROUND

Impaired motor function and upper extremity spasticity are common concerns in patients after stroke. It is essential to plan therapeutic techniques to recover from the stroke. The objective of this study was to investigate the effects of myofascial release with the tennis ball on spasticity and motor functions of the upper extremity in patients with chronic stroke.

METHODS

Twenty-two chronic stroke patients (male-16, female-6) were selected to conduct this study. Two groups were formed: the control group (n=11) which included conventional physiotherapy only and the experimental group (n=11) which included conventional physiotherapy along with tennis ball myofascial release - in both groups interventions were performed for 6 sessions (35 minutes/session) per week for a total of 4 weeks. The conventional physiotherapy program consisted of active and passive ROM exercises, positional stretch exercises, resistance strength training, postural control exercises, and exercises to improve lower limb functions. All patients were evaluated with a modified Ashworth scale for spasticity of upper limb muscles (biceps brachii, pronator teres, and the long finger flexors) and a Fugl-Meyer assessment scale for upper limb motor functions before and after 4 weeks. Nonparametric (Mann-Whitney U test and Wilcoxon signed-rank test) tests were used to analyze data statistically. This study has been registered on clinicaltrial.gov (ID: NCT05242679).

RESULTS

A significant improvement (P < .05) was observed in the spasticity of all 3 muscles in both groups. For upper limb motor functions, significant improvement (P < .05) was observed in the experimental group only. When both groups were compared, greater improvement (P < .05) was observed in the experimental group in comparison to the control group for both spasticity of muscles and upper limb motor functions.

CONCLUSION

Myofascial release performed with a tennis ball in conjunction with conventional physiotherapy has more beneficial effects on spasticity and motor functions of the upper extremity in patients with chronic stroke compared to conventional therapy alone.

Time-based effects of different duration stretching on calf muscle strength

BACKGROUND: There are conflicting reports on the acute effects of stretching on muscle strength. Some studies report reduction in muscle strength however others report no change following stretching. OBJECTIVE: To assess the acute effects of static stretching (SS) of different durations on the isometric maximum voluntary contraction force (MVCF) of the calf muscle. METHODS: Pretest-posttest experimental design was used. Ten male participants (mean age 25.4 ± 2.11 years) participated in three experimental trials: SS for 2-minutes (SS2), 4-minutes (SS4), and 8-minutes (SS8). MVCF was measured before, immediately after, at 10- and 20-minutes post-stretch intervals. Each SS trial involved varied repetitions of 30-seconds stretches and 20-seconds relaxation periods. The isometric maximum voluntary contraction force (MVCF) was the outcome measure. RESULTS: SS2, SS4, and SS8 did not change the MVCF at 0-, 10- and 20-minutes post stretching intervals (p> 0.05). CONCLUSIONS: 2-, 4-, and 8-minutes intermittent SS did not change the isometric muscle strength in the Calf muscle up to 20 minutes after stretching and thus can safely be performed before those sporting events that require significant muscle strength.

Does an Adjustable-Loop Device Loosen following ACL Reconstruction with a Hamstring Graft? A Retrospective Study with a Follow-Up of Two Years

Arthroscopic anatomic anterior cruciate ligament reconstruction (ACLR) is the gold standard treatment for an ACL tear and requires the use of fixed or adjustable-loop devices to fix a femoral-side graft. Although the adjustable mechanism is designed to provide one-way tensioning, there is a concern that the adjustable loop will loosen and lengthen during cyclic loads, creating graft laxity. The present paper is a retrospective study of patients who underwent ACLR with the fixation of a hamstring graft with an adjustable loop on the femoral side from November 2016 to October 2018. The knee’s functional outcome was evaluated using an International Knee Documentation Committee (IKDC) score, Lysholm score, Lachman test, and pivot shift test. The patients were assessed preoperatively and finally postoperatively after two years of surgery. Thirty-two patients were analyzed. Significant improvement was obtained in the final clinical outcome of the patients. Twenty-seven patients (84.4%) were Lachman negative, and twenty-eight patients (87.5%) were pivot shift test negative, the mean Lysholm score was 96.91, and the IKDC score was 91.47 (p < 0.001). There was no infection, graft failure, or flexion restriction. Arthroscopic ACLR with an adjustable-loop suspensory device is a successful fixation method for femoral-side graft fixation and offers a similar functional outcome as with fixed-loop devices.

Attitude, Beliefs, and Use of Herbal Remedies by Patients in the Riyadh Region of Saudi Arabia

Background: The consumption of herbal medicines (HMs) is increasing worldwide, especially in developing countries. This study attempts to investigate and evaluate the patient’s perception with regard to the security of HMs, their attitudes towards the concomitant use of HMs with modern medicines, and counseling about their use. Design: Self-administered questionnaire-based cross-sectional survey study. Setting: A self-administered structured questionnaire was administered to 200 patients who received HMs from four different government and private hospitals in the Riyadh region of Saudi Arabia, over a period of three months. Results: The response rate was 74.5%. Out of these, 76.83% of respondents reported using HMs in some form for a variety of conditions. There was no statistically significant relationship between various demographic characteristics and the use of herbs. The majority of the respondents (76.72%) reported using HMs without any professional supervision. This exposes them to the risk of harmful side effects and drug interactions. Conclusions: Physicians and pharmacists should work to provide evidence-based information about HMs to patients about effectiveness and side effects and be vigilant while writing prescriptions and dispensing drugs to them. Patient counseling and education about medication use are required to augment their awareness about their use.

Poor Sleep in Community-Dwelling Polysubstance Users: Association With Khat Dependence, Metacognition, and Socio-Demographic Factors

Purpose

Poor sleep and cognitive deficits are often associated with increased drug use. However, no study has addressed the relationship between poor sleep, substance dependence, and metacognitive deficit in polysubstance users.

Methods

This was a cross-sectional study with a simple random sampling involving community-dwelling polysubstance users (n = 326, age = 18-43 years) in Mizan, Ethiopia. Participants completed a brief sleep questionnaire, severity of dependence on khat (SDS-Khat), a brief meta-cognition questionnaire, and a socio-demographic survey.

Results

Majority (56.4%) of the polysubstance users had sleep disturbance. Chronic health conditions [adjusted odds ratio (AOR) = 2.52, 95% confidence interval (CI) 1.31-4.85], chronic conditions in the family (AOR = 2.69, 95% CI 1.40-5.20), illiterate-primary level of educational status (AOR = 2.40, 95% CI 1.30-4.04), higher SDS-Khat score (AOR = 1.39, 95% CI 1.13-1.72), and lower meta-cognition score (AOR = 0.90, 95% CI 0.84-0.97) predicted poor sleep in the polysubstance users. Moreover, low metacognition score and high SDS score also predicted additional sleep disturbances like chronic sleep insufficiency, lethargy and restlessness after nighttime sleep, socio-occupational dysfunctions, and daytime disturbances in polysubstance users.

Conclusion

Poor sleep, severe khat dependence, and metacognitive deficits are common in community polysubstance users. Moreover, poor sleep is associated with higher khat dependence, lower metacognitive ability, lower educational status, and the presence of chronic conditions in polysubstance users or their families.

Effects of plyometric and whole-body vibration on physical performance in collegiate basketball players: a crossover randomized trial

While many studies suggested the isolated effects of plyometric and whole-body vibration exercises on physical performance variables, only few studies have compared the acute effects of plyometric and whole-body vibration on the occurrence of post-activation potentiation and the resultant improvements in performance. Therefore, we aimed to compare the acute effects of plyometric exercises and whole-body vibration training on physical performance in collegiate basketball players. Twenty-four collegiate male basketball players (age 20.8 ± 2.02 years, height 1.79 ± 0.7 m, and weight 71.2 ± 7.6 kg) participated in this randomized crossover study. Subjects were received both plyometric and whole-body vibration exercises after a 48-h washed-out period. Countermovement Jump height, sprint, and agility time were measured at baseline, 4- and 12-min post-plyometric, and whole-body vibration exercises. The result suggests a positive effect of both the plyometric and whole-body vibration exercises on countermovement jump and agility time (p = 0.001). While the countermovement jump height and agility were higher in the plyometric group (mean difference 1.60 cm and 0.16 s, respectively), the sprint performance was higher in the whole-body vibration group. However, these differences were statistically non-significant between the two groups (p > 0.05). This study suggests that both plyometric and whole-body vibration exercises may improve post-activation potentiation, which leads to better physical performance.

Trial registration CTRI/2019/05/019059. Registered with the Clinical trials registry, India on 10/05/2019. http://ctri.nic.in/Clinicaltrials/advsearch.php.

The Potential Role of Circulating MicroRNAs in Male Rat Infertility Treated with Kaempferia parviflora

BACKGROUND

Therapeutic strategies based on herbal plants and diets containing sufficient amounts of antioxidants and essential vitamins are very important factors in treating reproduction and male infertility worldwide. Thus, the aim of this study was to investigate the potential effects of Kaempferia parviflora (KP) on the role of some microRNAs in treated and nontreated infertile rats. In addition, the correlation of expressed microRNAs with sperm count, sperm motility, and sperm viability was identified. The probable use of these microRNAs as a diagnostic marker for predicting the clinical response of infertility to the treatment with KP was also achieved.

METHODS

In the present study, the potential effects of Kaempferia parviflora (KP) at different doses (140, 280, and 420 mg/kg) for six weeks on male rats with subinfertility were explored. In addition, the effect of KP on the expression of circulating microRNAs and its correlation with the parameters of sexual infertility was identified by performing both in vitro and in vivo assays. In vitro antioxidant activity, sperm functional analysis, serum testosterone, and expression of circulating microRNAs were conducted using colorimetric, ELISA, and real-time RT-PCR analysis, respectively.

RESULTS

Kaempferia parviflora (KP) at nontoxic doses of 140-420 mg/kg/day for six weeks significantly improved serum testosterone and epididymal sperm parameters (sperm count, motility, and sperm viability), increased testicular weight, and provided a reduction in the percentage of abnormal spermatozoon in infertile male rats. The expression of miR-328 and miR-19b significantly decreased, and miR-34 significantly increased in infertile rats treated with KP compared to infertile nontreated rats. After six weeks of KP therapy, the change in the expression levels of miRNAs was correlated positively with higher levels of serum testosterone and the measures of epididymal sperm parameters. The respective area under the receiver operating characteristic curve (AUC-ROC) was applied to predict the potential use of miR-328, miR-19b, and miR-34 in the diagnosis of male infertility in treated and nontreated infertile male rats. The data showed that AUC cutoff values of 0.91 for miR-328, 0.89 for miR-19b, and 0.86 for miR34 were the best estimated values for the clinical diagnosis of male rats with infertility. In rats treated with KP for six weeks, AUC cutoff values of 0.76 for miR-328, 0.79 for miR-19b, and 0.81 for miR-34 were the best cutoff values reported for the clinical response of infertility to KP therapy after six weeks.

CONCLUSIONS

In this study, the improvement of male infertility might proceed via antioxidant and antiapoptotic pathways, which significantly improve spermatogenesis and aphrodisiac properties of males. In addition, the expression of miRNAs, miR-328, miR-34, and miR-19b, in KP-treated and nontreated infertile rats significantly correlated with increased serum testosterone levels and epididymal sperm parameters as well. MicroRNAs, miR-328, miR-34, and miR-19b, might be related to oxidative and apoptotic pathways that proceeded in spermatogenesis. Thus, the use of miRNAs could have a role as diagnostic, therapeutic, and predictive markers for assessing the clinical response of Kaempferia parviflora treatment for six weeks. This may have potential applications in the therapeutic strategies based on herbal plants for male infertility. However, in subsequent studies, the genetic regulatory mechanisms of the expressed miRNAs should be fully characterized.

Circulating MicroRNA Expression, Vitamin D, and Hypercortisolism as Predictors of Osteoporosis in Elderly Postmenopausal Women

BACKGROUND

MicroRNAs (miRNA) identified as critical molecular regulators for bone development, function, and modeling/remodeling process and could be predictable for osteoporotic fractures in postmenopausal elderly women.

AIM

The potential diagnostic role of circulating miRNAs, miR-148a and miR-122-5p, in the pathogenesis of osteoporosis and its association with bone markers, hypercortisolism, and vitamin D deficiency were explored in postmenopausal elderly women with osteoporosis.

METHODS

A total of 120 elderly women aged 50-80 years old were recruited in this study, of which only 100 eligible women with amenorrhea of at least 12 consecutive months or surgical menopause participated in this study. Based upon bone mineral density (BMD) measurements, the participants were classified according into two groups: normal (n = 45; T score of ≥-1.0) and osteoporosis (n = 55; T score: ≤-2.5). Circulating miRNAs, miR-148a and miR-122-5p, were estimated by real-time RT-PCR analysis. In addition, bone markers, hypercortisolism, and vitamin D deficiency were colorimetrically and ELISA immune assay estimated. The potential role of miR-148a, miR-122-5p, cortisol, and vitamin D in the diagnosis of osteoporosis was predicted using the analysis of the respective area under the receiver operating characteristic curve (AUC-ROC).

RESULTS

The expressed level of miR-148a significantly increased and miR-122-5p significantly decreased in the serum of osteoporotic patients compared to healthy controls. In addition, a significant increase in the levels of cortisol, s-BAP, and CTx and significant decrease in the levels of T-BMD, the levels of OC, and s-Ca were also identified. All parameters significantly correlated with fracture risk parameters; BMD, and T score lumbar spine (L2-L4). Thus, the data showed AUC cut off values (miR-148a; 0.876, miR-122-5p; 0.761) were best evaluated for clinical diagnosis of patients with osteoporosis and that AUC cut off values of 0.748 for cortisol and 0.635 for vitamin D were the best cut off values, respectively, reported for the prediction of osteoporosis clinical diagnosis.

CONCLUSION

In this study, expressed miRNAs miR-148a and miR-122-5p and changes in the levels of both cortisol and vitamin D status are significantly associated with bone loss or osteoporosis. Thus, circulation miRNAs alone or in combination with cortisol and vitamin D status might be considered predictable biomarkers in the diagnosis or the pathogenesis of osteoporosis in elderly postmenopausal women; however, more studies are recommended.

Expression of Circulating MicroRNAs and Myokines and Interactions with Serum Osteopontin in Type 2 Diabetic Patients with Moderate and Poor Glycemic Control: A Biochemical and Molecular Study

BACKGROUND

Cellular miRNAs are expressed in tissue fluids with sufficient amounts and were identified as potential molecular targets for studying the physiological mechanisms and correlations with many human diseases particularly diabetes. However, molecular-based changes among older adults with diabetes mellitus (DM) are rarely fully elucidated.

AIM

This study is aimed at identifying circulating miRNAs, which hold the potential to serve as biomarkers for the immune-inflammatory changes in older T2D patients with moderate and poor glycemic control status. In addition, the association of both myokines and osteopontin (OPN) levels with circulating miRNAs was identified.

METHODS

A total of 80 subjects aged 20-80 years were invited during the period of October 2017-May 2018 to participate in this descriptive cross-sectional study. All subjects were diagnosed with T2D for more than 5 years. Subjects were grouped based on glycemic control (HbA1c values) into two groups: moderate glycemic control (>7-8% HbA1c, no = 30) and poor glycemic control (>8% HbA1c, no = 50), respectively. Diabetic control parameters, fasting blood sugar (FS), HbA1c, fasting insulin (IF), insulin resistance (IR), HOMA-IR, inflammatory cytokines (IL-6, IL-8, IL-18, IL-23, TNF-α, and CRP), osteopontin, and myokines (adropin and irisin) were estimated by colorimetric and immune ELISA assays, respectively. In addition, real-time RT-PCR analysis was performed to evaluate the expression of circulating miRNAs, miR-146a and miR-144, in the serum of all diabetic subjects.

RESULTS

In this study, T2D patients with poor glycemic control showed a significant increase in the serum levels of IL-6, IL-8, IL-18, IL-23, TNF-α, CRP, and OPN and a reduction in the levels of myokines, adropin and irisin, compared to patients with moderate glycemic control. The results obtained are significantly correlated with the severity of diabetes measured by HbA1c, FS, IF, and HOMA-IR. In addition, baseline expression of miR-146a is significantly reduced and miR-144 is significantly increased in T2D patients with poor glycemic control compared to those with moderate glycemic control. In all diabetic groups, the expression of miR-146a and miR-144 is significantly correlated with diabetic controls, inflammatory cytokines, myokines, and serum levels of OPN. Respective of gender, women with T2D showed more significant change in the expressed miRNAs, inflammatory cytokines, OPN, and serum myokine markers compared to men. ROC analysis identified AUC cutoff values of miR-146a, miR-144, adropin, irisin, and OPN expression levels with considerable specificity and sensitivity which recommends the potential use of adropin, irisin, and OPN as diagnostic biomarkers for diabetes with varying glycemic control status.

CONCLUSION

In this study, molecular expression of certain microRNA species, such as miR-146a and miR-144, was identified and significantly associated with parameters of disease severity, HbA1c, inflammatory cytokines, myokines, and serum osteopontin in T2D patients with moderate and poor glycemic control. The AUC cutoff values of circulating miRNAs, miR-146a and miR-144; myokines, adropin and irisin; and serum OPN were significantly identified by ROC analysis which additionally recommends the potential use of these biomarkers, miR-146a, miR-144, adropin, irisin, and OPN, as diagnostic biomarkers with considerable specificity and sensitivity for diabetes in patients with varying glycemic control status.

Circulating microRNAs and Molecular Oxidative Stress in Older Adults with Neuroprogression Disorders

BACKGROUND

circulating microRNAs are potential blood biomarkers differentially expressed in many diseases including neuro depression disorders. It controls the expression of human genes and associated cellular and physiological processes in normal and diseased cells. We aimed to evaluate the potential role of circulating miRNAs and their association with both stress hormones and cellular oxidative stress in neuro depression disorders occurred among older adults.

METHODS

a total of 70 healthy subjects were included in this study. Based upon the profile of mood states (POMS-32 score), the participants classified into two groups; healthy subjects (n =30) and depression (n =40). The expression of microRNAs; miR-124, miR-34a-5p, miR-135, and miR-451-a and their correlation with cellular oxidative stress parameters; cellular NO, genes of SOD2, CAT and iNOS, and hormones; cortisol and serotonin were estimated by a quantitative real-time RT-PCR, high-performance liquid chromatography, and ELISA Immunoassay techniques, respectively.

RESULTS

depression was reported in 57.14% of the participants. The results showed a significant increase (p =0.01) in the total mood scores, and relative depression domains in older adults with depression compared to healthy controls. The relative expression levels of miR-124, miR-34a-5p significantly increased and the expression levels of miR-135, and miR-451-a significantly decreased in older adults with depression compared to healthy controls. In addition, the levels of cortisol significantly increased and serotonin (5HT) significantly reduced in all participants with depression. Cellular oxidative stress analysis for depressed subjects showed that serum NO levels and the expression of iNO gene significantly increased conversely with a decline in the molecular expression antioxidative genes; SOD2, CAT, respectively. The results showed that cellular oxidative stress parameters correlated positively with depression scores, cortisol, and negatively with cellular serotonin levels. In depressed subjects, the relative expression of microRNAs correlated positively with depression score, NO, iNOS, cortisol, and negatively associated with SOD2, CAT, and serotonin.

CONCLUSION

The combination of cellular oxidative stress and hormonal levels strongly supports a role for circulating miRNAs; miR-124, miR-34a-5p, miR-135, and miR-451-a in the regulation of depression and mood disorders among older adults. The expressed microRNAs with their related association to cellular oxidative stress and adrenal hormones are a step towards understanding the role of these small RNA molecules in the progression of depression among older adults. Thus, cellular miRNAs might have a prognostic role in the diagnosis and as a target for treatment strategies in depressed subjects.

Association of psychological variants with functional outcomes among people with spinal cord injury

This study aimed to investigate the association of psychological variants, including fear, anxiety, and depression, with functional outcomes, including measures of functions and physical performance, among people with spinal cord injury (SCI). An observational study was conducted at the university hospital in Riyadh, Saudi Arabia. Thirty patients, including 19 males (63.33%) and 11 females (36.67%) with a history of traumatic SCI, aged 18–30 years, 1–3 years postinjury T2 and below, with motor complete paraplegia, permanent neurological loss, and the ability to rise from sitting and stand for at least one minute, were included in this study. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Fear Avoidance Belief Questionnaire-Physical Activity (FABQ-PA) were used to assess the psychological variants of participants. The Spinal Cord Independence Measure (SCIM) and Walking Index of Spinal Cord Injury (WISCI-II) were used to assess the functional outcomes. Psychological variants showed a strong negative correlation with functional outcomes (p < 0.05) among people with SCI. In addition, a significant difference was found between females and males with SCI for the scores of psychological variants and functional outcomes. Psychological variants, including fear, anxiety, and depression, were found to be strongly and negatively associated with functional outcomes, including measures of functions and physical performance, and were especially higher among females than males with SCI. Thus, a higher level of fear, anxiety, and depression results in a lower level of measures of functions and physical performance among people with SCI. Depression is the strongest factor that affects the functional outcomes most among people with SCI.

The Relationships of Watching Television, Computer Use, Physical Activity, and Food Preferences to Body Mass Index: Gender and Nativity Differences among Adolescents in Saudi Arabia

BACKGROUND

Adolescents and ethnic subgroups have been identified at high risks of overweight and its associated complications. Although some studies have investigated overweight, obesity, nutritional status, physical activity, and associated factors among Saudi students, no studies have examined these characteristics among non-Saudi students or compared non-Saudi to Saudi adolescent students. The objective of this study was to compare differences between Saudi and non-Saudi adolescent students regarding time spent watching television, using computers, engaging in physical activity, and their food preferences. The relationships between these lifestyle behaviors and body mass index by Saudi nativity and gender were tested.

METHODS

Students aged 12 to 18 years (n = 214) from various schools in Riyadh, Saudi Arabia, completed a self-administered questionnaire that included questions about demographic and anthropometric characteristics, daily after-school routine, physical activity, watching television, using computers, and food preferences. Non-parametric (Mann-Whitney U) tests assessed the statistical differences between Saudi and non-Saudi respondents, and males and females were separately tested.

RESULTS

Saudi boys who reported physical activity two to five times per week, the most television time, the most computer time, and the highest frequency of eating fast food and drinking soft drinks had a significantly higher mean body mass index than the non-Saudi boys in their categories. However, there were no significant differences found between the Saudi and non-Saudi girls.

CONCLUSIONS

High levels of sedentary and low levels of physical activities as well as high consumption of high-fat fast foods and high-sugar drinks threaten the health of Saudi adolescents. Cultural differences in lifestyle between Saudi and non-Saudi families should be considered when developing programs to improve knowledge, attitudes, and behaviors regarding diet quality and physical activity. The objective of this study is more important in the current situation where increased time spent on computers and mobile phones due to online teaching in schools or working from home, decreased physical activity due to precautionary lockdowns, and unchecked eating patterns while spending more time in sedentary activities in homes has become our COVID-19 pandemic lifestyle in all the age groups. A similar study should be replicated on a large scale to study the effect of this lifestyle on our lives in all the age groups.

Influence of Work-Related Safety and Health Guidelines on Knowledge and Prevalence of Occupational Back Pain among Rehabilitation Nurses in Saudi Arabia: A 6-Month Follow-Up Study

Background: Nurses are frequently involved in different types of patient handling activities in different departments of the hospitals. Mishandling the patients causes accumulative stress on their spine that results in occupational back pain (OBP), substantial morbidity, and incurred cost. Objectives: This study aimed to observe the influence of work-related safety and health guidelines on knowledge and prevalence of occupational back pain among rehabilitation nurses in Saudi Arabia. Methodology: This cohort study was conducted with the inclusion of a total of 116-registered rehabilitation nurses (97-female, 19-male, mean age = 39.6-years) from different regions of Saudi Arabia. After the invitation, these nurses attended an ergonomic workshop focusing on work-related safety and patient handling guidelines, risk assessment, and control of OBP. A self-administered questionnaire was used to assess the knowledge, risk, and prevalence of OBP at baseline and 6-months follow-up. Results: The perceived knowledge score significantly improved (95% CI; t = 4.691; p < 0.001; Cohen’s d = 0.72) at 6-month follow-up (mean ± SD = 81.6 ± 18.2) from its baseline score (mean ± SD = 68.2 ± 19.2). Likewise, the prevalence score of OBP markedly reduced from 71.5% (baseline) to 65.0% (6-month follow-up). Conclusion: The level of knowledge highly improved and the prevalence of OBP markedly reduced within a span of 6-month among rehabilitation nurses in Saudi Arabia after attending an ergonomic workshop. Importantly, the nurses learned and geared up themselves for practicing the safe patient handling guidelines to avoid occupational back pain in the future. Therefore, rehabilitation nurses should update their knowledge and awareness about occupational safety and health guidelines, risk assessments, and control of OBP at a regular interval for increasing the knowledge and reducing the prevalence of OBP among them.

Time-based effects of different duration stretching on hamstring muscle strength

BACKGROUND

Stretching is believed to decrease muscle strength. The aim of this paper was to examine the time course (immediate, and 10- and 20-minutes post-stretching) for the effects of 2, 4, and 8 minutes of static-stretching (SS) on the isometric maximum voluntary contraction force (MVCF) of hamstring muscles with a pretest-post-test experiment design.

METHODS

A total of 14 subjects with a mean age of 25 years participated in three experimental trials on three different days. Day I for static stretching for 2 minutes (SS<inf>2</inf>), day II for 4 minutes (SS<inf>4</inf>), and day III for 8 minutes (SS<inf>8</inf>). Testing was conducted before (pre), immediately after (post), and at 10- and 20-minutes post-stretching. MVCF was measured using the strain gauze as the main outcome measure.

RESULTS

MVCF increased with SS<inf>2</inf> at 0 minutes (1.31%), 10 minutes (3.4%), and 20 minutes (4.1%) postintervention. MVCF increased with SS<inf>4</inf> at 0 minutes (1.13%), 10 minutes (9.6%) and 20 minutes (7.1%) postintervention. MVCF decreased with SS<inf>8</inf> at 0 minutes (2.9%), but increased at 10 minutes (1.86%) and 20 minutes (0.99%) postintervention. All these changes were not statistically significant (P>0.05).

CONCLUSIONS

In hamstring stretching, 2, 4 and 8 minutes increased MVCF, but results were not statistically significant. Thus, 2 to 8 minutes long-duration stretching exercises could safely be performed before a strength-training session.

Oxidative Stress and Musculoskeletal Pain in University Students with Generalized Joint Hypermobility: A Case-Control Study

Objective

The current case–control study aimed to evaluate generalized joint hypermobility (GJH) and its association with pain intensity, cellular oxidative stress, and collagen-associated disorders in university students aged 18–25 years old.

Background

Joint hypermobility has been recognized in healthy subjects and people who are carriers of cellular disorders in connective tissues. Cellular tissue oxidative stress and collagen-associated disorders were shown to be associated with joint hypermobility (JH).

Materials and Methods

A total of 300 university students aged 18–25 years were randomly invited from different medical and science faculties in Mansoura university, Mansoura, Egypt to participate in this case–control study. Only 280 university students who had no exclusion criteria like chronic health problems, physical disability, musculoskeletal disorders, and body mass index (BMI) of ≥25 underwent an initial clinical interview and Beighton scoring as measures of GJH. Pain intensity, physical activity, oxidative stress parameters; TAC, TOC, OSI, and collagen-associated parameters; cellular prolidase activity and hydroxyproline were evaluated by using a prevalidated questionnaire, colorimetric, and immunoassay techniques.

Results

GJH was significantly reported in 57.1% of the study population, and most of them are females. Compared to men, females with GJH showed poor physical activity, lower TAC, and significantly higher levels of TOC, OSI, cellular prolidase activity, and hydroxyproline. Based on our findings, a high Beighton score is closely related to the tissue levels of prolidase, hydroxyproline, antioxidant activity, pain intensity, and poor physical activity in the female with GJH compared to men.

Conclusion

GJH was significantly reported in 57.1% of the study population, and most of them are females. The incidence of GJH showed to be associated with poor physical activity, abnormal cellular oxidative stress, and collagen abnormalities measured by significant increase in change in cellular prolidase activity and hydroxyproline.