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Disruptions in gait function are common after concussion in adolescents; however, the neuromotor control deficits driving these gait disruptions are not well known. Fifteen concussed (age mean [SD]): 17.4 [0.6], 13 females, days since injury: 26.3 [9.9]) and 17 uninjured (age: 18.0 [0.7], 10 females) adolescents completed 3 trials each of single-task gait and dual-task gait (DT). During DT, participants simultaneously walked while completing a serial subtraction task. Gait metrics and variability in instantaneous mean frequency in lower extremity muscles were captured by inertial sensors and surface electromyography, respectively. A 2-way analysis of covariance was used to compare gait metrics across groups and conditions. Functional principal components analysis was used to identify regions of variability in instantaneous mean frequency curves. Functional principal component scores were compared across groups using a Welch statistic. Both groups displayed worse performance on gait metrics during DT condition compared to single-task, with no differences between groups (P <.001). Concussed adolescents displayed significantly greater instantaneous mean frequency, indicated by functional principal component 1, in the tibialis anterior, biceps femoris, and semitendinosus (P <.05) during single-task and DT compared with uninjured adolescents. Our observations suggest that concussed adolescents display inefficient motor unit recruitment lasting longer than 2 weeks following injury, regardless of the addition of a secondary task. [ABSTRACT FROM AUTHOR]

Context: Decreased muscle strength and balance in patients with functional ankle instability (FAI) can be effectively improved by ankle strength training. Low-load blood flow restriction (LL-BFR) training increases muscle size and strength, but there is limited evidence from studies on muscle strength and balance in FAI patients. Objective: To study the effects of LL-BFR training versus high-load training (HLT) on muscle strength and balance in FAI patients. Design: Randomized controlled trial. Participants: Forty-six young adults with a history of FAI. Interventions: Participants in the LL-BFR and HLT groups performed 4 sets (30 x 15 x 15 x 15) of ankle training at 20% to 40% of the one-repetition maximum and 70% to 85% one-repetition maximum, respectively, twice a week for 6 weeks. Main Outcome Measure(s): Plantar flexion, dorsiflexion, inversion, and eversion muscle strength, and the Y-balance test scores were assessed at baseline and after 3 and 6 weeks; the thickness of the tibialis anterior, triceps surae, and peroneus longus muscles were assessed at baseline and after 6 weeks. Results: Inversion, eversion, dorsiflexion, and plantar flexion muscle strength; tibialis anterior, triceps surae, and peroneus longus thickness; and Y-balance test scores were significantly increased in the LL-BFR group after 3 and 6 weeks compared with baseline (P < .05), with no significant difference between the LL-BFR and HLT groups after 6 weeks (P > .05). However, at the end of 3 weeks, eversion muscle strength and Y-balance test scores were significantly higher in the LL-BFR group than in the HLT group (P < .05). Conclusions: Over 6 weeks, LL-BFR training was as effective as HLT in improving ankle muscle strength, muscle thickness, and balance in FAI patients, but LL-BFR training improved the ankle eversion muscle strength and dynamic balance more than HLT did in the early stages of the intervention. This finding will provide a new intervention strategy for the clinical rehabilitation of FAI patients. [ABSTRACT FROM AUTHOR]

Humans experience unanticipated external postural perturbations and recover their posture faster via involuntary responses than voluntary responses. Previous cross-sectional comparisons between athletes and untrained populations have suggested that daily motor experiences can lead to adaptations in the reftex system, but the temporal aspect of this adaptation has been unclear. Here we show that judokas have an earlier muscle activation response to even non-judo-specific external perturbations compared with an untrained population. The response latency to a backward push-and-release type postural perturbation was compared between male judokas (n = 7. career >13 years. ranging from world champions to prefectural competitors) and untrained nonjudokas (n = 7). Latency was defined as the instant of tibialis anterior muscle activity onset. Judokas exhibited shorter latency (20.6 ± 7.1 ms) than nonjudokas (28.3 ± 8.9 ms). The rank order of latency in judokas did not correlate with their competition performance. We suggest that daily training in responding to perturbations might improve some parts of the sensorimotor pathway relating to postural response latency, and that this excellence in involuntary response is independent of athletic performance. The findings provide a novel perspective for understanding postural control ability in humans. [ABSTRACT FROM AUTHOR]

Wearing loose footwear, such as slippers, poses a risk factor for tripping. Previous studies liave examined obstacle crossing to find strategies to avoid tripping. However, the effect of wearing slippers on the likelihood of tripping remains unclear. Therefore, this study aimed to determine whether wearing slippers while level walking and obstacle crossing affects kinematic characteristics and muscle activity. Sixteen healthy, young adults performed two tasks (a) while wearing slippers and (b) while barefoot: (1) level walking and (2) crossing a 10-cm obstacle. Toe clearance, joint angles, muscle activity. and cocontraction were measured for both the leading and trailing lower limbs. In the slipper-wearing condition, knee flexion and hip flexion angles were significantly increased in the swing phase for the leading limb (p< .001 andp <.001, respectively) and trailing liinb (p <.001 and p =.004, respectively) compared with the barefoot condition. Tibialis anterior activity (p = .01) and muscle cocontraction of the tibialis anterior and the medial head of the gastrocnemius (p = .047) were significantly increased in the swing phase of the trailing limb for the slipper-wearing condition compared with the barefoot condition in the obstacle crossing task. Wearing slippers increased knee and hip flexion angles, and muscle cocontraction of the tibialis anterior and medial head of gastrocnemius increased during obstacle crossing. The results revealed that obstacle crossing while wearing slippers would require foot fixation adjustment in addition to increased knee and hip flexion to avoid toe collision. [ABSTRACT FROM AUTHOR]

Objectives: Some young individuals participating in sports activities may encounter lower leg muscle pain and tightness, potentially indicating chronic exertional compartment syndrome (CECS). While muscle pressure measurement is typically recommended for diagnosis, it is invasive and associated with low sensitivity and specificity. Thus, there is a need for novel diagnostic approaches. Methods: This feasibility study aims to assess whether an ultrasound-guided technique can effectively measure the compressibility of the anterior tibial muscle compartment, focusing on optimal leg positioning and identifying reliable external and internal anatomical landmarks. The compressibility of the anterior tibial muscle compartment was evaluated using ultrasound images obtained at 10 mmHg and 80 mmHg external pressure, with the drop in compartment thickness used to calculate the compressibility ratio. Measurements were conducted in various leg positions and utilizing different external and internal landmarks. Results: Studies in healthy volunteers showed that knee and heel support positioning, measuring at the leg's widest circumference, and using the interosseous membrane as an internal landmark yielded the lowest measurement variability with an intra class correlation of.977 (.764–1.000; 95%-confidence interval). Conclusion: These findings suggest that ultrasound-guided techniques can feasibly determine the compressibility ratio of the anterior tibial muscle compartment, providing valuable insights for standardized protocols in future studies on suspected cases of chronic exertional compartment syndrome. [ABSTRACT FROM AUTHOR]

Background: Previous studies have found that inhibitory priming with continuous theta burst stimulation (cTBS) can enhance the effect of subsequent excitatory conditioning stimuli with intermittent theta burst stimulation (iTBS) in the upper limbs. However, whether this combined stimulation approach elicits a comparable compensatory response in the lower extremities remains unclear. This study aimed to investigate how cTBS preconditioning modulated the effect of iTBS on motor cortex excitability related to the lower limb in healthy individuals. Methods: Using a randomised cross-over design, a total of 25 healthy participants (19 females, mean age = 24.80 yr) were recruited to undergo three different TBS protocols (cTBS + iTBS, sham cTBS + iTBS, sham cTBS + sham iTBS) in a random order. Each TBS intervention was administered with one-week intervals. cTBS and iTBS were administered at an intensity of 80% active motor threshold (AMT) delivering a total of 600 pulses. Before intervention (T0), immediately following intervention (T1), and 20 min after intervention (T2), the corticomotor excitability was measured for the tibialis anterior muscle of participants' non-dominant leg using a Magneuro100 stimulator and matched double-cone coil. The average amplitude of the motor-evoked potential (MEP) induced by applying 20 consecutive monopulse stimuli at an intensity of 130% resting motor threshold (RMT) was collected and analysed. Results: Compare with T0 time, the MEP amplitude (raw and normalised) at T1 and T2 showed a statistically significant increase following the cTBS + iTBS protocol (p < 0.01), but no significant differences were observed in amplitude changes following other protocols (sham cTBS + iTBS and sham cTBS + sham iTBS) (p > 0.05). Furthermore, no statistically significant difference was found among the three protocols at any given time point (p > 0.05). Conclusions: Preconditioning the lower extremity motor cortex with cTBS prior to iTBS intervention can promptly enhance its excitability in healthy participants. This effect persists for a minimum duration of 20 min. [ABSTRACT FROM AUTHOR]

Horizontal decelerations are frequently performed during team sports and are closely linked to sports performance and injury. This study aims to provide a comprehensive description of the kinetic demands of decelerations at the whole-body, structural, and tissue-specific levels of the musculoskeletal system. Team-sports athletes performed maximal-effort horizontal decelerations whilst full-body kinematics and ground reaction forces (GRFs) were recorded. A musculoskeletal model was used to determine whole-body (GRFs), structural (ankle, knee, and hip joint moments and contact forces), and tissue (twelve lower-limb muscle forces) loads. External GRFs in this study, especially in the horizontal direction, were up to six times those experienced during accelerated or constant-speed running reported in the literature. To cope with these high external forces, large joint moments (hip immediately after touchdown; ankle and knee during mid and late stance) and contact forces (ankle, knee, hip immediately after touchdown) were observed. Furthermore, eccentric force requirements of the tibialis anterior, soleus, quadriceps, and gluteal muscles were particularly high. The presented loading patterns provide the first empirical explanations for why decelerating movements are amongst the most challenging in team sports and can help inform deceleration-specific training prescription to target horizontal deceleration performance, or fatigue and injury resistance in team-sports athletes. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the contribution of the common synaptic drives to motor units during obstacle avoidance, using coherence analysis between a-pair electromyography (EMG) signals (EMG-EMG coherence). Materials and Methods: Fourteen healthy volunteers walked on a treadmill with and without obstacle avoidance. During obstacle gait, subjects were instructed to step over an obstacle with their right leg while walking that would randomly and unpredictably appear. Surface EMG signals were recorded from the following muscles of the right leg: the proximal and distal ends of tibialis anterior (TAp and TAd), biceps femoris (BF), semitendinosus (ST), lateral gastrocnemius (LG), and medial gastrocnemius (MG). Beta-band (13–30 Hz) EMG-EMG coherence was analysed. Results: Beta-band EMG-EMG coherence of TAp-TAd during swing phase and BF-ST during pre and initial swing phase when stepping over an obstacle were significantly higher compared to normal gait (both p < 0.05). Beta-band EMG-EMG coherence of TAp-TAd, BF-ST, and LG-MG during stance phase were not significantly different between the two gait conditions (all p > 0.05). Conclusions: The present findings suggest increased common synaptic drives to motor units in ankle dorsiflexor and knee flexor muscles during obstacle avoidance. It also may reflect an increased cortical contribution to modify the gait patterns to avoid an obstacle. [ABSTRACT FROM AUTHOR]

Background: Drop foot is common post-stroke, elevating fall risks and mobility limitations. It is caused by weakness and lack of control of the tibialis anterior muscle (TA), for which various rehabilitation treatments are used. A reliable objective estimate of changes in TA muscle morphology and composition can enhance treatment optimization. Objectives: We aimed to ascertain 3D freehand ultrasound (3DfUS) reliability in measuring TA muscle volume, length, and echo intensity in stroke patients and healthy controls and its validity by comparing these features across legs, between patients and controls, and between clinical subgroups (i.e. patients with and without ankle contracture, spastic muscle overactivity, and foot dorsiflexor paresis). Methods: We included 9 stroke patients and 9 healthy controls to define reliability and 26 stroke patients and 28 healthy controls to define validity. For reliability, data were collected and processed by 2 different operators and processors. For inter- and intra-rater reliability, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used. For validity, Wilcoxon-Signed-Ranked and Mann-Whitney U tests were used for comparisons between groups and subgroups. Results: All measurements showed good to excellent inter- and intra-rater reliability (ICC: 0.816 to 0.997, SEM: 0.5% to 7.8%). Comparison analyses revealed no differences in muscle features among legs, groups, or subgroups. Conclusion: While the 3DfUS is a reliable method to define TA morphology and composition, its clinical validity needs further investigation into factors influencing muscle property changes across various age groups and post-stroke time points. MeSH terms: Stroke; Skeletal muscle morphology; muscle composition; 3D freehand ultrasonography, Anterior Tibial Muscle [ABSTRACT FROM AUTHOR]

Background: Hallux valgus is a deformity characterized by lateral deviation of the big toe and medial deviation of the first metatarsal, causing difficulty in walking and requiring various treatments. Despite its multifactorial etiology, the role of the tibialis anterior tendon in hallux valgus and its variations in the morphology of tibialis anterior tendon distal insertion sites have not been fully explored. This study aimed to evaluate the effect of such variations on hallux valgus using magnetic resonance imaging. Methods: This was a retrospective study and included 115 individuals aged 18 years and older who underwent foot radiographs and MRI. The participants were divided into a hallux valgus group of 53 patients and a control group of 62 people based on radiographic measurements. Tibialis anterior tendon distal attachment was classified into five types according to the attachment morphology. Statistical analyses were performed to evaluate the relationship between the tibialis anterior tendon types and hallux valgus severity. Results: Among the participants, patients who underwent foot radiography and MRI due to any medical indication 70.4% were female, with a mean age of 43.83 ± 15.25 years. In terms of tibialis anterior tendon distal attachment, the most common type was Type 5 (40.9%), followed by Type 2 (34.8%). Type 4 was not observed in any case. In all participants, the mean hallux valgus angle was 20.63 ± 8.42o, and the mean intermetatarsal angle was 9.69 ± 2.68o. Tibialis anterior tendon distal attachment Type 5 was significantly associated with an increased hallux valgus angle but not with the intermetatarsal angle. We found a significant relationship between the diameter of the tibialis anterior tendon and hallux valgus angle. Conclusions: This study revealed a significant association between hallux valgus and Type 5 tibialis anterior tendon distal attachment, suggesting that tibialis anterior tendon morphology influences hallux valgus severity. The findings underscore the importance of considering variations in tibialis anterior tendon distal attachment sites in the etiopathogenesis and treatment planning of hallux valgus. [ABSTRACT FROM AUTHOR]

Background/Objective: Spasticity following stroke causes structural changes in the muscles and fascia, affecting the mobility and functional recovery of patients. Understanding these structural changes is critical to optimizing the rehabilitation strategies for patients. Therefore, in this study, we aimed to investigate the differences in crural and epimysial fascia thickness and muscle stiffness in the affected and unaffected lower limbs of chronic stroke patients with spasticity. Methods: A total of 88 patients with chronic stroke (mean age: 62.7 ± 10.2 years) were included in this study. Ankle range of motion, crural fascial thickness, and muscle stiffness in affected and unaffected lower limbs were assessed using ultrasound. Results: For the affected lower limbs, 59 patients (67.1%) exhibited a modified Ashworth scale score of 2, whereas 29 patients (32.9%) exhibited a score of 3. Ankle range of motion, fascia thickness, and muscle stiffness were also measured. The range of motion in ankle dorsiflexion and plantar flexion was significantly reduced on the affected side (p < 0.05). Crural fascia thickness was significantly greater in all regions of the affected side (anterior: 0.96 ± 0.14 vs. 0.72 ± 0.08 mm [p < 0.001]; lateral: 1.01 ± 0.14 vs. 0.75 ± 0.14 mm [p < 0.001]), and the epimysial fascia of the tibialis anterior muscle was similarly greater in the affected side (0.46 ± 0.07 vs. 0.34 ± 0.03 mm [p < 0.001]). However, no significant differences in muscle stiffness were observed between the affected and unaffected sides (p > 0.05). Conclusions: Overall, these findings revealed significant fascial thickening with only minimal changes in muscle stiffness on the affected side, highlighting the importance of controlling fascial changes for post-stroke spasticity management. [ABSTRACT FROM AUTHOR]

In severe skeletal muscle damage, muscle tissue regeneration process has to face the loss of resident muscle stem cells (MuSCs) and the lack of connective tissue necessary to guide the regeneration process. Biocompatible and standardized 3D structures that can be injected to the muscle injury site, conforming to the defect shape while actively guiding the repair process, holds great promise for skeletal muscle tissue regeneration. In this study, we explore the use of an injectable and porous lysine dendrimer/polyethylene glycol (DGL/PEG) hydrogel as an acellular support for skeletal muscle regeneration. We adjusted the DGL/PEG composition to achieve a stiffness conducive to the attachment and proliferation of murine immortalized myoblasts and human primary muscle stems cells, sustaining the formation and maturation of muscle fibers in vitro. We then evaluated the potential of one selected "myogenic-porous hydrogel" as a supportive structure for muscle repair in a large tibialis anterior muscle defect in rats. This injectable and porous formulation filled the defect, promoting rapid cellularization with the presence of endothelial cells, macrophages, and myoblasts, thereby supporting neo-myogenesis more specifically at the interface between the wound edges and the hydrogel. The selected porous DGL/PEG hydrogel acted as a guiding scaffold at the periphery of the defect, facilitating the formation and anchorage of aligned muscle fibers 21 days after injury. Overall, our results indicate DGL/PEG porous injectable hydrogel potential to create a pro-regenerative environment for muscle cells after large skeletal muscle injuries, paving the way for acellular treatment in regenerative muscle medicine. [ABSTRACT FROM AUTHOR]

Reciprocal inhibition and coactivation are strategies of the central nervous system used to perform various daily tasks. In automatic postural responses (APR), coactivation is widely investigated in the ankle joint muscles, however reciprocal inhibition, although clear in manipulative motor actions, has not been investigated in the context of APRs. The aim was to identify whether reciprocal inhibition can be observed as a strategy in the recruitment of gastrocnemius Medialis (GM), Soleus (So) and Tibialis Anterior (TA) muscles in low- and high-velocity forward and backward perturbations. We applied two balance perturbations with a low and a high velocity of displacement of the movable platform in forward and backward conditions and we evaluated the magnitude and latency time of TA, GM and So activation latency, measured by electromyography (EMG). In forward perturbations, coactivation of the three muscles was observed, with greater activation amplitude of the GM and lesser amplitude of the So and TA muscles. For backward, the pattern of response observed was activation of the TA muscle, a decrease in the EMG signal, which characterizes reciprocal inhibition of the GM muscle and maintenance of the basal state of the So muscle. This result indicates that backward perturbations are more challenging. [ABSTRACT FROM AUTHOR]

Purpose: We tested the hypothesis that heat stress influences the closed-loop cardio-postural control by an increased blood pressure (BP) drop and postural sway. Methods: Fourteen healthy individuals (eight women) performed two orthostatic tests under thermal reference (TC; ~ 24 ºC) and HOT (~ 38 ºC) conditions. The center-of-pressure (COP) displacements and the electromyography (EMG) activity of the calf muscles (medial gastrocnemius and tibialis anterior) were recorded during the initial orthostasis (ORT onset) after the supine-to-stand challenge. At the same period, BP (beat-to-beat) was continuously monitored, and supine-to-stand variations (∆%) were calculated. Sublingual temperature (Tsl) was measured as a surrogate of internal temperature. Results: Tsl increased in HOT compared to TC (TC 36.5 ± 0.3 vs. HOT 36.7 ± 0.3 ºC; p < 0.01). COP distance was greater in HOT compared to TC condition (TC 596.6 ± 242.4 vs. HOT 680.2 ± 249.1 mm; p < 0.01). EMG activity of the gastrocnemius decreased in HOT compared to TC condition (TC 95.5 ± 19.8 vs. HOT 78.4 ± 22.8%mV; p = 0.02). EMG of tibialis did not change between TC and HOT (TC 83.5 ± 42.9 vs. HOT 66.1 ± 31.9% mV; p = 0.29). BP showed a greater fall in HOT compared to TC condition (∆%TC − 24.5 ± 13.2 vs. ∆%HOT − 33.2 ± 20.2%; p = 0.01). Conclusion: Heat stress causes a greater fall in blood pressure and a reduction in musculoskeletal pump activity during orthostatic onset. These effects could be potential mechanisms that underlie augmented postural instability under a heated environment. [ABSTRACT FROM AUTHOR]

Background and Aims: Gait initiation (GI) in individuals with chronic ankle instability (CAI) has shown differences in the center of pressure (COP) and muscular measures compared to healthy controls. Some studies reported that these alterations appeared when GI was with the affected leg, while others indicated that they occurred when GI was with the non‐affected leg. This systematic review aimed to understand kinetic and muscular differences between individuals with CAI, healthy controls, and the affected and non‐affected legs of individuals with CAI. Methods: PubMed, Science Direct, Web of Science, Google Scholar, and Scopus databases (1990–2023) were searched using the Population, Exposure, Comparator, and Outcome measure. The PRISMA guidelines were followed. The outcome measures were the peak and rate of COP displacement in the medial‐lateral and anterior‐posterior directions, and resultant plane during phases 1, 2, and 3 of COP trace during GI and the duration of each phase. The other measures included the onset time of the tibialis anterior and soleus muscle activity between individuals with CAI, healthy controls, and the affected and non‐affected legs of the individuals with CAI. The studies' quality assessment was conducted based on the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Results: Five studies were included in the final evaluation. The results of included studies showed, individuals with CAI spent less time during phases 1 and 2, as well as a shorter peak of COP displacement in the lateral direction during phase 1 compared to healthy controls, regardless of whether the GI was with the affected or non‐affected leg. Conclusion: Individuals with CAI have probably adopted a strategy involving adjusting the peak of COP displacement to manage internal sway while in a single‐leg stance. Overall, there was no comprehensive conclusion about differences between the two legs in individuals with CAI. [ABSTRACT FROM AUTHOR]

BACKGROUND: Trolley bags have gained popularity among students, but there is limited research comparing them to backpack-style school bags. OBJECTIVE: This study aimed to compare how carrying a backpack versus a trolley bag affects the activity of trunk and lower limb muscles in secondary school students. METHODS: Electromyographic activity was measured in 25 students (13.4±1.1 years) as they walked on level ground and up/down stairs while carrying both types of bags. The activity of the gastrocnemius, tibialis anterior, semitendinosus, rectus femoris, lumbar erector spinae, and rectus abdominis muscles was assessed on both the dominant and non-dominant sides. RESULTS: The study found significantly reduced muscle activation in most of the targeted muscles when walking on level ground with the trolley bag and when going up/down stairs with the backpack. CONCLUSIONS: Lifting a trolley bag depends on the slope of the walking surface and is more efficient on level ground, while carrying a backpack is more efficient when going up and down stairs. Since it is not practical to switch bags when encountering stairs in schools, a bag with a mixed model design incorporating features of both trolley and backpack may be more beneficial and practical for students to use. Students, parents, and teachers should be aware of the injury risks associated with carrying different types of bags. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease, pathologically characterized by TDP‐43 aggregates. Recent evidence has been indicated that phosphorylated TDP‐43 (pTDP‐43) is present not only in motor neurons but also in muscle tissues. However, it is unclear whether testing pTDP‐43 aggregation in muscle tissue would assist in the diagnosis of ALS. We propose three key questions: (i) Is aggregation of pTDP‐43 detectable in routine biopsied muscles? (ii) Can detection of pTDP‐43 aggregation discriminate between ALS and non‐ALS patients? (iii) Can pTDP‐43 aggregation be observed in the early stages of ALS? We conducted a diagnostic study comprising 2 groups: an ALS group in which 18 cases underwent muscle biopsy screened from a registered ALS cohort consisting of 802 patients and a non‐ALS control group, in which we randomly selected 54 muscle samples from a biospecimen bank of 684 patients. Among the 18 ALS patients, 3 patients carried pathological GGGGCC repeats in the C9ORF72 gene, 2 patients carried SOD1 mutations, and 7 patients were at an early stage with only one body region clinically affected. The pTDP‐43 accumulation could be detected in routine biopsied muscles, including biceps brachii, deltoid, tibialis anterior, and quadriceps. Abnormal aggregation of pTDP‐43 was present in 94.4% of ALS patients (17/18) compared to 29.6% of non‐ALS controls (16/54; p < 0.001). The pTDP‐43 aggregates were mainly close to the sarcolemma. Using a semi‐quantified pTDP‐43 aggregates score, we applied a cut‐off value of 3 as a diagnostic biomarker, resulting in a sensitivity of 94.4% and a specificity of 83.3%. Moreover, we observed that accumulation of pTDP‐43 occurred in muscle tissues prior to clinical symptoms and electromyographic lesions. Our study provides proof‐of‐concept for the detection of pTDP‐43 accumulation via routine muscle biopsy which may serve as a novel biomarker for diagnosis of ALS. [ABSTRACT FROM AUTHOR]

Reciprocal inhibition (RI) between leg muscles is crucial for smooth movement. Pedaling is a rhythmic movement that can increase RI in healthy individuals. Transcutaneous spinal cord stimulation (tSCS) stimulates spinal neural circuits by targeting the afferent fibers. Pedaling with simultaneous tSCS may modulate the plasticity of the spinal neural circuit and alter neural activity based on movement and muscle engagement. This study investigated the RI changes after pedaling and tSCS and determined the phase of pedaling in which tSCS should be applied for optimal RI modulation in healthy individuals. Eleven subjects underwent three interventions: pedaling combined with tSCS during the early phase of lower extension (phase 1), pedaling combined with tSCS during the late phase of lower flexion (phase 4) of the pedaling cycle, and pedaling combined with sham tSCS. The RI from the tibialis anterior to the soleus muscle was assessed before, immediately after, 15 min, and 30 min after the intervention. RI increased immediately after phase 4 and pedaling combined with sham tSCS, whereas no changes were observed after phase 1. These results demonstrate that tSCS modulates RI changes induced by pedaling in a stimulus phase-dependent manner in healthy individuals. However, the mechanism involved in this intervention needs to be explored to achieve higher efficacy. [ABSTRACT FROM AUTHOR]

Background. This study aims to determine if Riluzole usage can change the function and excitability of motor neurons. Methods. The clinical data and indices of motor neuron excitability were assessed using high-density surface EMG parameters from 80 ALS participants. The persistent inward current was assessed using the discharge rate from paired motor units obtained from the tibialis anterior muscle. This enabled the discharge rate at recruitment, peak discharge rates and the hysteresis of the recruitment–derecruitment frequencies (also known as delta F) to be calculated. Limbs were classified according to their strength. Results. No differences in these motor neuron discharge properties were found according to whether Riluzole was used. Conclusions. The possible interpretations of this finding are discussed. [ABSTRACT FROM AUTHOR]

Ankle fractures can lead to issues such as limited dorsiflexion, strength deficits, swelling, stiffness, balance disorders, and functional limitations, which complicate daily activities. This study aimed to describe neuromuscular adaptations at 6 and 12 months post-surgery during static and dynamic balance tasks, specifically using the Y-Balance Test (YBT). Additionally, the relationship between neuromuscular patterns, balance, and musculoskeletal deficits was evaluated. In 21 participants (14 at 6 months and 21 at 12 months) with bimalleolar fractures, hip strength, ankle dorsiflexion, ankle functionality, and static and dynamic balance were assessed using electromyography of five lower limb muscles (tibialis anterior, peroneus longus, lateral gastrocnemius, biceps femoris, and gluteus medius). A significant interaction effect (limb × proximal [hip]—distal [ankle] muscle) (F = 30.806, p < 0.001) was observed in the anterior direction of the Y-Balance Test (YBTA) at 6 months post-surgery. During the YBTA and YBT posteromedial (YBTPM), it was found that a lower dorsiflexion range of movement was associated specifically at 6 months with greater activation of the lateral gastrocnemius. However, these differences tended to diminish by 12 months. These findings suggest that neuromuscular patterns differ between operated and non-operated limbs during the YBTA at 6 months post-surgery. The Y-Balance Test, particularly its anterior direction, effectively highlighted these neuromuscular changes. This is a preliminary study; further research is needed to explore these findings in depth. [ABSTRACT FROM AUTHOR]

DUX4 is the major gene responsible for facioscapulohumeral dystrophy (FSHD). Several mouse models expressing DUX4 have been developed, the most commonly used by academic laboratories being ACTA1-MCM/FLExDUX4. In this study, molecular and histological modifications in the tibialis anterior and quadriceps muscles were investigated in this model at different time points. We investigated several changes that could be used as markers of therapeutic efficacy. Our results confirm the progressive muscular dystrophy previously described but also highlight biases associated with tamoxifen injections and the complexity of choosing the genes used to calculate a DUX4-pathway gene composite score. We also developed a comprehensive force test that better reflects the movements made in everyday life. This functional force–velocity–endurance model, which describes the force production capacities at all velocity and fatigue levels, was applied on 12–13-week-old animals without tamoxifen. Our data highlight that previously unsuspected muscle properties are also affected by the expression of DUX4, leading to a weaker muscle with a lower initial muscle force but with preserved power and endurance capacity. Importantly, this force–velocity–endurance approach can be used in humans for clinical evaluations. [ABSTRACT FROM AUTHOR]

Purpose: The few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running. Design/methodology/approach: Five healthy amateur runners(three female and two male)were recruited for a 30-min running trial. They wear a Calf CG on their right leg (CG group), but not on their left leg(CON group). After obtaining the clothing pressure of Calf CG on the gastrocnemius lateral head (GL), gastrocnemius medial head (GM) and tibialis anterior(TA) of the right leg, surface electromyography (sEMG)of four muscles of GL, GM, TA and rectus femoris (RF) of the left and right legs were measured during running, and heart rate, cardiopulmonary rate, and human RPE were also measured. Blood bleed oxygen before and after the running trial were measured. The root mean square (RMS) of the characteristic values was selected as an index for the analysis of sEMG signals, and the data were analyzed using statistical and computational methods. Findings: The results showed that the indexes of heart rate, blood oxygen, and RPE were significantly increased, indicating that the subjects had reached the fatigue level. The comparison of mean clothing pressure at GL, GM and TA locations reveals that the TA location consistently exhibits the highest pressure for both types of CG. When wearing CG1, the mean clothing pressure at the GL and GM test points is greater than that of CG2(CG1-GL = 0.2059 kPa > CG2-GL = 0.148 kPa; CG1-GM = 0.1633 kPa > CG2-GM = 0.127 kPa). This is attributed to the double-layered fabric on the sides of CG1, which precisely covers the GL and GM areas, thereby resulting in higher mean clothing pressure at these locations compared to CG2. Conversely, the mean clothing pressure at the TA location for CG1 is lower than that for CG2(CG1-TA = 0.3852 kPa < CG2-TA = 0.426 kPa). The pressure exerted by the CG1 on the lower limb test areas has both positive and negative effects, though neither are statistically significant. The pressure exerted by CG2 alleviates fatigue at the directly affected locations GL and GM, but exerts excessive pressure on TA, resulting in a negative effect. Additionally, CG2 pressure alleviates fatigue at the indirectly affected location RF on the same side. Based on the specific clothing pressure data, it is concluded that when the pressure at the GM location is 0.127 kPa, 30 min of running has a fatigue-relieving effect. However, the pressure should not be excessively high, at 0.1633 kPa it exhibits an insignificant adverse effect. At the TA location, a garment pressure mean between 0.3852 and 0.426 kPa does not alleviate fatigue after 30 min of running, and the negative effect becomes more pronounced as the pressure increases. The pressure exerted by the CG at GL, GM, TA and RF locations shows significant changes from the previous time period during the 15–18 min interval after running. Therefore, in the design of CG, attention should be paid to the changes in clothing pressure effects on muscles during this specific time period. Originality/value: The few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running. [ABSTRACT FROM AUTHOR]

Elevated glucocorticoids alter the skeletal muscle transcriptome to induce a myopathy characterized by muscle atrophy, muscle weakness, and decreased metabolic function. These effects are more likely to occur and be more severe in aged muscles. Resistance exercise can blunt the development of glucocorticoid myopathy in young muscle, but the potential to oppose the signals initiating myopathy in aged muscle is unknown. To answer this, young (4-mo-old) and aged (24-to 25-mo-old) male C57BL/6 mice were randomized to receive either an intraperitoneal (IP) injection of dexamethasone (DEX; 2 mg/kg) or saline as a control. Two hours postinjections, the tibialis anterior (TA) muscles of mice were subjected to unilateral high-force contractions. Muscles were harvested 4 h later. The glucocorticoid- and contraction-sensitive genes were determined by RNA sequencing. The number of glucocorticoid-sensitive genes was similar between young and aged muscle. Contractions opposed changes to more glucocorticoid-sensitive genes in aged muscle, with this outcome primarily occurring when hormone levels were elevated. Glucocorticoid-sensitive gene programs opposed by contractions were primarily related to metabolism in young mice and muscle size regulation and inflammation in aged mice. In silico analysis implied peroxisome proliferator-activated receptor gamma-1 (PPARG) contributed to the contraction-induced opposition of glucocorticoid-sensitive genes in aged muscle. Increasing PPARG expression in the TA of aged mice using adeno-associated virus serotype 9 partially counteracted the glucocorticoid-induced reduction in runt-related transcription factor 1 (Runx1) mRNA content, recapitulating the effects observed by contractions. Overall, these data contribute to our understanding of the contractile regulation of the glucocorticoid transcriptome in aged skeletal muscle. NEW & NOTEWORTHY: We establish the extent to which muscle contractions oppose changes to the glucocorticoid-sensitive transcriptome in both young and aged muscle. We also identify peroxisome proliferator-activated receptor gamma (PPARG) as a transcription factor likely contributing to contraction-induced opposition to the glucocorticoid transcriptome in aged muscle. Overall, these data contribute to our understanding of the contractile regulation of the glucocorticoid transcriptome. [ABSTRACT FROM AUTHOR]

The foot structure is associated with different running mechanics. The central nervous system is responsible for using the muscles through synergies during locomotion. The purpose of the present study was to examine the effect of foot structure on the electromyography factors and the synergy of the selected muscles of the lower extremity. Tibialis anterior, extensor digitorum longus, peroneus longus, soleus, biceps femoris, vastus lateralis, gastrocnemius lateralis and medialis muscles activity of 60 barefoot recreational runners with different foot structures was recorded while running at a speed of 3.3 m/s. Muscle activity was measured in the running cycle. Besides, muscle synergies were extracted using non-negative matrix factorization algorithm. The results showed that there were differences between groups with different foot type in muscle activity under different phases of running in some muscles. Furthermore, the findings indicated that the number of synergies was similar in different groups and the relative weight of muscles was not different across groups. In conclusion, despite the difference in muscle activity under different phases of the running cycle, muscle synergies are similar among the groups. This can indicate similar control by the central nervous system in runners with different arch structures while running and the observed changes in muscle activity can be attributed to the type of forces exerted on the body, the length-tension relationship, and changes in the direction of the lower limbs in people with different arch structures. [ABSTRACT FROM AUTHOR]

Exoskeleton robots have the potential to augment human motor capabilities. however, current control strategies often require task-specific control laws tailored for different scenarios, which limits the applicability of exoskeletons. In this study, we propose a control strategy for exoskeleton robots that is adaptable across various scenarios. We employ adaptive oscillators (AO) with feedback control to rapidly estimate the wearer'smotion phase and subsequently provide torque assistance to the wearer's hip joint based on a TCN-LSTM model. During experiments, we collected surface electromyographic (sEMG) signals from the tibialis anterior, gastrocnemius, and rectus muscles of seven groups of subjects performing treadmill walking and inclined treadmill exercises. We utilized the short-time Fourier transform to extract frequency characteristics of the signals and statistically analyzed the rate of frequency change in each muscle group under different strategies. The results indicate that when wearing the exoskeleton, the overall muscle frequency changes more slowly, suggesting that subjects can maintain activity for a longer duration before fatigue sets in. This control strategy effectively reduces the energetic cost of lower limb work for the wearer and enhances the exoskeleton's versatility in various applications. [ABSTRACT FROM AUTHOR]

Myofibers are large multinucleated cells that have long thought to have a rather simple organization. Single-nucleus transcriptomics, spatial transcriptomics and spatial metabolomics analysis have revealed distinct transcription profiles in myonuclei related to myofiber type. However, the use of local tissue collection or dissociation methods have obscured the spatial organization. To elucidate the full tissue architecture, we combine two spatial omics, RNA tomography and mass spectrometry imaging. This enables us to map the spatial transcriptomic, metabolomic and lipidomic organization of the whole murine tibialis anterior muscle. Our findings on heterogeneity in fiber type proportions are validated with multiplexed immunofluorescence staining in tibialis anterior, extensor digitorum longus and soleus. Our results demonstrate unexpectedly strong regionalization of gene expression, metabolic differences and variable myofiber type proportion along the proximal-distal axis. These new insights in whole-tissue level organization reconcile sometimes conflicting results coming from previous studies relying on local sampling methods. Multi-dimensional analysis of gene expression, myofiber types and metabolic activity in whole skeletal muscle reveals specific regionalization of gene expression and metabolites related to the glycolytic and oxidative potential of myofibers [ABSTRACT FROM AUTHOR]

Myofibers are large multinucleated cells that have long thought to have a rather simple organization. Single-nucleus transcriptomics, spatial transcriptomics and spatial metabolomics analysis have revealed distinct transcription profiles in myonuclei related to myofiber type. However, the use of local tissue collection or dissociation methods have obscured the spatial organization. To elucidate the full tissue architecture, we combine two spatial omics, RNA tomography and mass spectrometry imaging. This enables us to map the spatial transcriptomic, metabolomic and lipidomic organization of the whole murine tibialis anterior muscle. Our findings on heterogeneity in fiber type proportions are validated with multiplexed immunofluorescence staining in tibialis anterior, extensor digitorum longus and soleus. Our results demonstrate unexpectedly strong regionalization of gene expression, metabolic differences and variable myofiber type proportion along the proximal-distal axis. These new insights in whole-tissue level organization reconcile sometimes conflicting results coming from previous studies relying on local sampling methods. Multi-dimensional analysis of gene expression, myofiber types and metabolic activity in whole skeletal muscle reveals specific regionalization of gene expression and metabolites related to the glycolytic and oxidative potential of myofibers [ABSTRACT FROM AUTHOR]

Background and Objectives: Remodeling and healing of the graft are crucial processes for long-term graft survival after anterior cruciate ligament reconstruction (ACLR). However, few studies have objectively evaluated the differences in graft healing between autografts and allografts. This study aimed to compare the status of the anterior cruciate ligament (ACL) grafts between hamstring tendon (HT) autografts and tibialis anterior tendon (TAT) allografts using second-look arthroscopy. Materials and Methods: The outcomes of 193 consecutive patients (153 males and 40 females, with an average age of 30.38 and BMI of 25.43 kg/m2) who underwent second-look arthroscopy following primary ACLR were retrospectively reviewed. Prior to participating in this study, all patients provided written informed consent. The patients were divided into two groups: those with HT autografts and those with TAT allografts. Confounding factors were matched between the two groups using propensity score matching (PSM). ACL graft status was assessed during second-look arthroscopy using a numeric scale system based on the degree of four parameters: graft tension, continuity, synovium coverage, and vascular marking. Clinical outcomes were assessed using the Lysholm and International Knee Documentation Committee (IKDC) scores. Graft status and clinical outcomes were compared between the two groups. Additionally, a subgroup analysis based on the timing of the second-look arthroscopy (12–24 months vs. >24 months after the initial ACLR) was conducted. Results: After PSM, 62 patients were included in each group. The second-look arthroscopy was conducted at 23.6 ± 6.6 months for the HT group and at 24.0 ± 7.9 months for the TAT group (p = 0.749). The continuity and tension of the ACL graft were not significantly different between the two groups (p = 0.146 and 0.075, respectively). However, the TAT group exhibited significantly inferior synovial coverage and vascular marking of the ACL graft compared with the HT group (p = 0.021 and 0.007, respectively). These findings were consistent regardless of the timing of the second-look arthroscopy. Clinical outcomes, according to the Lysholm and IKDC scores, significantly improved in both groups with no significant differences (p = 0.386 and 0.733, respectively). Conclusions: Although there were no differences in graft tension and continuity between HT autografts and TAT allografts, the biological healing of ACL grafts, in terms of synovialization and vascularization, was superior in HT autografts compared to TAT allografts. [ABSTRACT FROM AUTHOR]

Falls and fall-induced injuries are common and consequential in older adults. Ballet emphasizes full-body coordination, leg strength, and postural control. However, it remains unknown whether ballet can indeed reduce falls in older adults. This study examined biomechanical and neuromuscular responses of older recreational ballet dancers to an unexpected standing-slip. Twenty older ballet dancers (17 females, 3 males) and 23 age- and sex-matched nondancers (19 females, 4 males) were exposed to an unexpected slip during treadmill standing. The slip-faller rate was the primary outcome. The secondary outcomes were kinematic measurements, including dynamic gait stability, slip distance, and recovery stepping performance (step latency, duration, length, and speed). The tertiary outcome was the electromyography latency of leg muscles (bilateral tibialis anterior, medial gastrocnemius, rectus femoris, and biceps femoris). Fewer dancers fell than nondancers after the standing-slip (45% vs. 83%, P = 0.005, d = 0.970). Dancers displayed better stability at recovery foot liftoff (P = 0.006) and touchdown (P = 0.012), a shorter step latency (P = 0.020), shorter step duration (P = 0.011), faster step speed (P = 0.032), and shorter slip distance (P = 0.015) than nondancers. They also exhibited shorter latencies than nondancers for the standing leg rectus femoris (P = 0.028) and tibialis anterior (P = 0.002), and the stepping leg biceps femoris (P = 0.031), tibialis anterior (P = 0.017), and medial gastrocnemius (P = 0.030). The results suggest that older ballet dancers experience a lower fall risk and are more stable than nondancers following an unexpected standing-slip. The greater stability among dancers could be attributed to more biomechanically effective recovery stepping, possibly associated with the ballet-induced neuromuscular benefit—an earlier leg muscle activation. NEW & NOTEWORTHY: This is the first study to examine how older ballet dancers respond to an unexpected external slip perturbation while standing. The results suggest that older ballet dancers experience a reduced fall risk after the slip than their nondancer counterparts. The lower fall risk can be accounted for by dancers' quicker neuromuscular reactions to the slip that result in a more effective recovery step and thus higher stability against backward falls due to the slip. [ABSTRACT FROM AUTHOR]

Objective: To clarify the effect of growth and advancing age on lymphatic capillarization in rat skeletal muscles, we examined the histological and biochemical changes of lymphatic capillaries in different fiber types of skeletal muscles across juvenile, young, and middle‐aged generations. Methods: We collected the tibialis anterior (TA), extensor digitorum longus (EDL), and soleus (SOL) muscles. Immunohistochemical staining using LYVE‐1 and CD31 markers was used for lymphatic and blood capillaries, respectively. Real‐time PCR was used to analyze mRNA expression of lymphangiogenic factors. Results: The density of LYVE‐1‐positive lymphatic capillaries in the muscles peaked during the juvenile period and subsequently decreased with increasing age. In contrast to blood capillaries, fast‐twitch dominant muscles (i.e., TA and EDL) exhibited an age‐related decrease in lymphatic capillaries. Similar to blood capillaries, lymphatic capillaries were abundant in SOL, a slow‐twitch dominant muscle, which showed less susceptibility to age‐related lymphatic decline. The mRNA expression of lymphangiogenic factors was significantly upregulated in SOL and decreased in all muscles of middle‐aged rats. Conclusions: The age‐related decrease of lymphatic capillaries in fast‐twitch muscles might be associated with age‐related muscle atrophy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Trolley bags have gained popularity among students, but there is limited research comparing them to backpack-style school bags. OBJECTIVE: This study aimed to compare how carrying a backpack versus a trolley bag affects the activity of trunk and lower limb muscles in secondary school students. METHODS: Electromyographic activity was measured in 25 students (13.4±1.1 years) as they walked on level ground and up/down stairs while carrying both types of bags. The activity of the gastrocnemius, tibialis anterior, semitendinosus, rectus femoris, lumbar erector spinae, and rectus abdominis muscles was assessed on both the dominant and non-dominant sides. RESULTS: The study found significantly reduced muscle activation in most of the targeted muscles when walking on level ground with the trolley bag and when going up/down stairs with the backpack. CONCLUSIONS: Lifting a trolley bag depends on the slope of the walking surface and is more efficient on level ground, while carrying a backpack is more efficient when going up and down stairs. Since it is not practical to switch bags when encountering stairs in schools, a bag with a mixed model design incorporating features of both trolley and backpack may be more beneficial and practical for students to use. Students, parents, and teachers should be aware of the injury risks associated with carrying different types of bags. [ABSTRACT FROM AUTHOR]

Background: To study the effects of different interventions on automatic gait processing in contrast with voluntary gait processing in healthy subjects. Methods: A double-blind randomised controlled trial was designed (120 able-body persons between 18 and 65 years old entered and completed the study), with pre-intervention and post-intervention assessments using the 6-Minute Walk Test (6MWT). The participants were randomly distributed into four groups. Prior to intervention, all participants performed voluntary gait on the ground (VoG) in a calibrated circuit following the 6MWT. The presence of automatic gait (AG) was explored post-intervention without a voluntary demand in the same circuit following the 6MWT. Each group received a different intervention for 30 min: Vojta stimulation, MOTOMED® at no less than 60 revolutions/minute, treadmill walking at 3 km/h, and resting in a chair (control). The main assessment, conducted by a blinded rater, was the difference in distance covered (in meters) during the 6MWT between pre- and post-intervention. Surface electromyography (sEMG) average root mean square (RMS) signals in the right tibialis anterior, right soleus, right rectus femoris, and right biceps femoris were also considered outcome measures. Results: The Vojta group was the only one that initiated AG after the intervention (476.4 m ± 57.1 in VoG versus 9.0 m ± 8.9 in AG, p < 0.001) with comparable kinematics and EMG parameters during voluntary gait, except for ankle dorsal flexion. Within the Vojta group, high variability in kinematics, sEMG activity, and distance covered was observed. Conclusions: AG isolation is approachable through Vojta at only one session measurable with the 6MWT without any voluntary gait demand. No automatic gait effects were observed post-intervention in the other groups. Trial registration: NCT04689841 (ClinicalTrials.gov). [ABSTRACT FROM AUTHOR]

The objective was to investigate the effects of running shoes with midsole hollow structure span and height on the biomechanics of the lower limbs during running. We collected 21 adults with running habits who wore two pairs of running shoes with different midsole hollow structures and ran at a speed of 3.3 m/s on a force-measuring treadmill. The lower limb kinematics, ground reaction force (GRF) and lower limb muscle activation characteristics were simultaneously captured by a motion capture system, a 3D force treadmill, and a surface electromyography (sEMG) system. Paired t-tests were performed on data for the two shoe conditions that fit the normal distribution assumptions; otherwise, Wilcoxon signed-rank tests were used. The statistical parameter mapping (SPM) technology was used for the analysis of 1D parameters of kinematic, dynamic, and sEMG activation characteristics. The result showed that the time to the peak impact force at touchdown of Hollow shoe2 was significantly increased (P < 0. 0 1), the maximum loading rate (P < 0. 0 1) and average loading rate (P < 0. 0 5) were significantly reduced, braking time (P < 0. 0 5), push time (P < 0. 0 5), contact time (P < 0. 0 1) of Hollow shoe2 were significantly increased compared with Hollow shoe1. Hollow shoe2 push phase of the tibialis anterior muscle activation characteristics was significantly lower (SPM, P < 0. 0 5) than Hollow shoe1. Our conclusion is that running shoes offer the solution as they have the advantage of the complex structure of the hollow midsole. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of magnifying the damage caused by obesity induced by monosodium glutamate, using a model of maternal periodontitis, on the structure of the anterior tibialis muscle of the offspring. Materials and Methods: Twenty‐four female Wistar rats were divided into four experimental groups: control (n = 6), obese (n = 6), control with periodontitis (n = 6) and obese with periodontitis (n = 6). At 78 days of life, the rats were mated with males without any experimental intervention. The offspring of these rats (n = 1/L), at 120 days of life, were weighed and measured, then euthanized. Plasma was collected for analysis of cytokines IL‐6, IL‐10, IL‐17 and TNF‐α. Adipose tissues were collected and weighed, and the anterior tibial muscle was designated for histomorphological analyses (n = 6/group). Results: Monosodium glutamate offspring showed significant muscle changes, such as a reduction in the size of fibres and neuromuscular junctions, and an increase in the nucleus and capillaries. However, all these changes were more expressed in monosodium glutamate‐obese with periodontitis offspring. Conclusion: This leads us to suggest a magnifying effect promoted by periodontitis to the damage already well described by monosodium glutamate‐obesity, determined by low‐intensity inflammation, causing greater muscle damage. [ABSTRACT FROM AUTHOR]

The near-infrared spectroscopy (NIRS) vascular occlusion test (VOT) assesses microvascular reperfusion. Two strategies have been used to quantify reperfusion following reactive hyperemia, but it is unclear whether both yield similar results when comparing biological sex. This study aimed to determine whether sex differences in NIRS-based microvascular reperfusion are similarly apparent using the 10-s reactive hyperemia slope of the tissue saturation index (StO2) signal (slope 2) and the halftime to maximal reperfusion (T ½). Healthy, recreationally active males (n = 31) and females (n = 31) between 18 and 82 years took part in this study. A NIRS VOT was performed on the tibialis anterior muscle, and reperfusion was quantified using slope 2 (% s−1) and T ½ (s). Adipose tissue thickness (ATT) was higher in females (P = 0.009), which was associated with a lower StO2 (P = 0.001) and oxygenated hemoglobin (O2Hb) (P = 0.05) signal range. The StO2 slope 2 was significantly steeper in males versus females (P = 0.001) but not after correcting for ATT (P = 0.295). There were no sex differences in StO2 T ½ (P = 0.067) or O2Hb T ½ (P = 0.197). In a subset of males (n = 26) and females (n = 21) with similar ATT, there were no sex differences in StO2 slope 2 (P = 0.068), StO2 T ½ (P = 0.491), or O2Hb T ½ (P = 0.899). An ATT-corrected StO2 slope 2 or the T ½ approach is recommended for analysis of NIRS-based microvascular reperfusion when differences in ATT are present between sexes. NEW & NOTEWORTHY: Sex differences in near-infrared spectroscopy (NIRS)-based microvascular reperfusion have been previously reported. We found that greater adipose tissue thickness in females reduces kinetic measures of NIRS-based microvascular reperfusion. Sex differences are eliminated when performing an adipose tissue thickness correction, when the NIRS signal range is accounted for, or when adipose tissue thickness is similar between sexes. This highlights the importance of considering factors that affect NIRS signals, such as adipose tissue thickness, when drawing comparisons between groups. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effect of maturation on vertical jumping performance, in adolescent boys and girls, concerning plantar flexor activity and Achilles tendon (AT) stiffness. Thirty-nine adolescents were tested in a counter-movement jump (CMJ) at three different time points: 18 and 9 months before peak height velocity (PHV) and at PHV. The EMG activity of the medialis gastrocnemius (MG) and tibialis anterior (TA) muscles was evaluated, in relation to jump height. Boys showed higher jumping ability and AT stiffness than girls. Additionally, boys revealed increased eccentric (ecc) and concentric (con) MG activity, along with decreased ecc and con TA activity, near PHV. On the other hand, girls showed increased ecc and con TA/MG co-contraction compared to boys, mainly near PHV. In conclusion, a different mechanism of vertical jumping performance is adopted between early adolescent boys and girls. Nevertheless, no notable alterations in jumping capability were detected over time, indicating that the maturation process does not influence stretch-shortening cycle (SSC) performance. [ABSTRACT FROM AUTHOR]

This paper presents Part 2 of a study that investigated the effects of an 8-week (3x/week) underwater treadmill (UT) walking intervention on knee osteoarthritis (KOA) outcomes in 6 adults with KOA (62.7 ± 14.2 years). The Knee Outcome Survey (KOS) for activities of daily living and muscle activity during a 10-m walk and a 20 cm step down were measured before and after the intervention. The following KOS measures improved after the UT walking program (p < 0.05; g > 0.8): stiffness, swelling, weakness, walking, going up stairs, going downstairs, kneeling on the front of the knee, squatting, and sitting with the knee bent. Knee flexion excursion during stance of walking increased after the UT walking intervention (p = .01). Co-activation between the tibialis anterior and medial gastrocnemius decreased during the 20 cm step down (p = .04). The findings of this study support using the WWE as a model for UT walking interventions in KOA. [ABSTRACT FROM AUTHOR]

Purpose: We previously reported that a Hammerobics exercise using weights can enhance trunk and lower extremity muscles, some studies suggested that training effects could also be expected without heavy weights. If the muscle activity induced by Hammerobics swinging with a 'light plastic ball' equals or surpasses that of the isometric static squat and synchronized squat with a heavy ball, this training approach could alleviate joint strain, fostering an exercise regimen universally accessible across generations, benefit for workouts sports and rehabilitation. Methods: Fifteen healthy men participated in this study. By using surface electromyography, muscle activities for the abductor hallucis, tibialis anterior, tibialis posterior, peroneus longus, rectus femoris, biceps femoris long head, semitendinosus, gluteus maximus, multifidus, and internal oblique muscles were measured during a light Hammerobics synchronized squat (HSS-light), Hammerobics synchronized squat, and conventional isometric squat, and statistically compared. Results: The front-to-back tibialis anterior activity of HSS-light was significantly higher than that of conventional isometric squat. The activities of all other muscles, except for the multifidus, were not significantly different between these exercises in the front-to-back and back-to-front phases. Compared to the Hammerobics synchronized squat, the light Hammerobics synchronized squat showed no differences in front-to-back tibialis anterior, rectus femoris, biceps femoris long head, and internal oblique activities and back-to-front abductor hallucis, tibialis anterior, rectus femoris, and internal oblique activities. Conclusion: The HSS-light could stimulate muscles to the same level as the conventional isometric squat without weight bearing. While the HSS-light was less effective than the Hammerobics synchronized squat, there was no significant difference in internal oblique, rectus femoris, and tibialis anterior activities between these exercises. Hence, the HSS-light is an exercise method that can be viable approach to promoting accessible workouts sports and rehabilitation. [ABSTRACT FROM AUTHOR]

Task-specific focal dystonia (TSFD), characterized by the loss of fine motor control and coordination, affects drummers' lower-limb movements. This study explores lower-limb dystonia's impact on drumming performance and underlying muscle activity in a professional rock drummer. The drummer executed an eight-beat pattern on a drum kit. The participant reported the occurrence of symptoms when he felt the abnormality such as the loss of control related to involuntary aspects of movement. We measured the peak amplitude of the bass drumhead vibration, synchronization errors as the time elapsed between the metronome onset and the bass drum onset, and amplitude of electromyographic (EMG) recordings centered on metronome beat. Dystonia symptoms primarily manifested in the initial beat, with fewer symptoms on syncopation of the third beat. Analysis revealed decreased bass-drum peak amplitude and earlier synchronization error during the initial beat. EMG measurements of 10 muscles in the affected right lower limb showed significant changes in the Biceps Femoris (BF), Tibialis Anterior (TA), Extensor Digitorum Longus (EDL), and Extensor Digitorum Brevis (EDB) muscles during symptom onset. We observed (1) earlier overactivation of the TA and EDL muscles during the leg lift-up motion or preparatory phase of pedaling, (2) reduced activation of the EDB muscle, and (3) increased activation of the BF muscle during the final pedaling movement when symptoms occurred. These findings suggest that lower-limb dystonia symptoms are characterized by a reduction in amplitude of the bass drumhead vibration and an increase in synchronization error, potentially due to premature overactivation of the ankle dorsiflexor muscles. [ABSTRACT FROM AUTHOR]

Purpose: Falls are common in liver cirrhosis. Our aim was to investigate fall risk, postural control, muscle strength and cognitive function in cirrhosis, compare the results to healthy controls and investigate the inter-relationships. Materials and Methods: Twenty-four patients (12 males, 12 females) and 24 healthy controls (11 males, 13 females) were enrolled. Fall risk was assessed with Falls Efficacy Scale (FES) and Timed Up and Go Test (TUGT). Postural control was assessed using posturography. Quadriceps Femoris and Tibialis Anterior strength were assessed with dynamometer. Cognitive function was evaluated with Stroop test. Disease severitywas assessed with Child-Pugh and Model for End-Stage Liver Disease scores. Results: Postural sway velocity (PSV) on foam surface eyes open (FSEO), FES score and TUGT duration were higher in patients (p<0.05). TUGT duration was correlated with disease severity. Lower extremity muscle strength was lower in patients (p<0.05). Dynamic postural control was deteriorated in patients (p<0.05). Lower extremity muscle strength was correlated with PSV-FSEO and FES score (p<0.05). Conclusion: Patients with liver cirrhosis present significant decrease in muscle strength independent from disease severity, associated with static postural control on an unstable surface and fear of falling. Dynamic postural control is significantly deteriorated in liver cirrhosis, not in relation to muscle strength. [ABSTRACT FROM AUTHOR]

Repetitive passive movement (RPM) enhances reciprocal inhibition. RPM is more effective when performed rapidly and at wide joint angles. However, patients with limited joint range of motion may not receive the most effective RPM. Therefore, having an alternative method for performing RPM in patients who cannot perform actual exercise due to limited joint motion is necessary. This study investigated the effects of RPM on spinal excitability using a visual kinesthetic illusion. Participants included 17 healthy adults (7 women). Measurements were taken before, during, and immediately after the intervention. We established two intervention conditions: the control condition, in which participants focused their attention forward, and the illusion condition, in which participants watched a video about RPM. F-waves from the tibialis anterior and soleus muscles were measured, and F-wave persistence and F/M amplitude ratios were analyzed. Under the illusion condition, compared with the preintervention condition, the F/M amplitude ratio of the tibialis anterior increased by approximately 44% during the intervention (p < 0.05), whereas the F-wave persistence of the soleus decreased by approximately 23% from the immediate start of the intervention (p < 0.05). This study suggests that a visual kinesthetic illusion can increase the spinal excitability of the tibialis anterior, whereas reciprocal inhibition can decrease the spinal excitability of the soleus. [ABSTRACT FROM AUTHOR]

We studied simultaneous EMG and midline EEG responses, including over the cerebellum, in 10 standing subjects (35 ± 15 yr; 5 females, 5 males). Recordings were made following repeated taps to the sternum, stimuli known to evoke short-latency EMG responses in leg muscles, consistent with postural reflexes. EEG power had relatively more high-frequency components (>30 Hz) when recorded from electrodes over the cerebellum (Iz and SIz) compared with other midline electrodes. We confirmed a previous report using a similar stimulus that evoked short-latency potentials over the cerebellum. We showed clear midline-evoked EEG potentials occurring at short latency over the cerebellum (P23, N31, N42, and P54) and frontally (N28 and N57) before the previously described perturbation-evoked potential (P1/N1/P2). The P23 response correlated with the subsequent EMG response in the tibialis anterior muscles (r = 0.72, P = 0.018), confirming and extending previous observations. We did not find a correlation with the N1 amplitude. We conclude that early activity occurs from electrodes over the inion in response to a brief tap to the sternum. This is likely to represent cerebellar activity and it appears to modulate short-latency postural EMG responses. NEW & NOTEWORTHY: We studied the effects of a brief tap to the sternum in human subjects, known to evoke short-latency postural responses. Using an extended EEG recording system, we showed early evoked responses over the midline cerebellum, including the P23 potential, which correlated with the EMG responses in tibialis anterior, consistent with a cerebellar role in postural reflexes. The stimulus also evoked later EEG responses, including the perturbation potential. [ABSTRACT FROM AUTHOR]

Motoneuronal persistent inward currents (PICs) are facilitated by neuromodulatory inputs but are highly sensitive to local inhibitory circuits. Estimates of PICs are reduced by group Ia reciprocal inhibition, and increased with the diffuse actions of neuromodulators released during remote muscle contraction. However, it remains unknown how motoneurons function in the presence of simultaneous excitatory and inhibitory commands. To probe this topic, we investigated motor unit discharge patterns and estimated PICs during voluntary co‐contraction of ankle muscles, which simultaneously demands the contraction of agonist–antagonist pairs. Twenty participants performed triangular ramps of both co‐contraction (simultaneous dorsiflexion and plantar flexion) and isometric dorsiflexion to a peak of 30% of their maximum muscle activity from a maximal voluntary contraction. Motor unit spike trains were decomposed from high‐density surface EMG activity recorded from tibialis anterior using blind source separation algorithms. Voluntary co‐contraction altered motor unit discharge rate characteristics. Discharge rate at recruitment and peak discharge rate were modestly reduced (∼6% change; P < 0.001; d = 0.22) and increased (∼2% change; P = 0.001, d = −0.19), respectively, in the entire dataset but no changes were observed when motor units were tracked across conditions. The largest effects during co‐contraction were that estimates of PICs (ΔF) were reduced by ∼20% (4.47 vs. 5.57 pulses per second during isometric dorsiflexion; P < 0.001, d = 0.641). These findings suggest that, during voluntary co‐contraction, the inhibitory input from the antagonist muscle overcomes the additional excitatory and neuromodulatory drive that may occur due to the co‐contraction of the antagonist muscle, which constrains PIC behaviour. Key points: Voluntary co‐contraction is a unique motor behaviour that concurrently provides excitatory and inhibitory synaptic input to motoneurons.Co‐contraction of agonist–antagonist pairs alters agonist motor unit discharge characteristics, consistent with reductions in persistent inward current magnitude. [ABSTRACT FROM AUTHOR]

This study aimed to identify changes in the architecture and performance of the peri‐ankle muscles in patients with chronic ankle instability (CAI) and investigate the relationship between them. In total, 17 subjects were evaluated retrospectively. Each subject underwent anthropometric and isokinetic test, and peroneus longus (PL) and brevis (PB), medial gastrocnemius (MGCM), and tibialis anterior (TA) ultrasound imaging were performed at rest and maximum voluntary contraction (MVC) conditions. Regarding muscle architectural variables, the pennation angle (PA) of the MGCM at rest and the PA of the TA, MGCM, and PL in MVC were significantly reduced on the injured side compared to the intact side. There were no significant differences in muscle thickness of PL, PB, MGCM, and TA observed between intact and injured side during both rest and MVC. Regarding muscle performance parameters, significant decreased were observed in the muscle strength for both limbs in all four directions under the two different conditions. A secondary finding was that the relative PA ratio of the TA showed moderate correlation with the relative dorsiflexion ratio at 30°/s. These findings can provide opportunities to better understand how injuries in patients with CAI may be related to changes in ankle and foot function. [ABSTRACT FROM AUTHOR]

Dynamic muscle fatigue during repetitive movements can lead to changes in communication between the central nervous system and peripheral muscles. This study investigated these changes by examining electromyogram (EMG) characteristics from agonist and antagonist muscles during a fatiguing task. Twenty-two healthy male university students (age: 22.92 ± 2.19 years) performed heel raises until fatigue. EMG signals from lateral gastrocnemius (GL) and tibialis anterior (TA) muscles were processed using synchrosqueezed wavelet transform (SST). Root mean square (RMS), mean frequency (MF), power across frequency ranges, wavelet coherence, and co-activation ratio were computed. During the initial 80% of the task, RMS and EMG power increased for both muscles, while MF declined. In the final 20%, GL parameters stabilized, but TA showed significant decreases. Beta and gamma intermuscular coherence increased upon reaching 60% of the task. Alpha coherence and co-activation ratio remained constant. Results suggest that the central nervous system adopts a differentiated control strategy for agonist and antagonist muscles during fatigue progression. Initially, a coordinated "common drive" mechanism enhances both muscle groups' activity. Later, despite continued increases in muscle activity, neural-muscular coupling remains stable. This asynchronous, differentiated control mechanism enhances our understanding of neuromuscular adaptations during fatigue, potentially contributing to the development of more targeted fatigue assessment and management strategies. [ABSTRACT FROM AUTHOR]

Background: Thoracolumbar transcutaneous spinal cord stimulation (tSCS) non-invasively evokes posterior root-muscle reflexes (PRMR) with the aim of neuromodulating sensorimotor function following spinal cord injury. Research is still in its infancy regarding the effect of body position on the nature of these spinally evoked responses. Therefore, the aim of this study was to investigate the influence of body position on the nature of PRMR responses during tSCS. Methods: A total of 11 (6M, 5F) participants completed a full PRMR recruitment curve from 10 ma up to 120 ma (10 ma increments) at the T11/12 intervertebral space using a singular 3.2 cm diameter cathode. At each intensity, three paired pulses (50 ms inter-pulse interval), followed by three singular pulses with a six-second delay were applied in each body position (supine, supine 90-90, sitting and standing) in a randomised order. The PRMR responses in lower limb muscles were recorded using wireless electromyographic sensors placed on the Soleus, Tibialis Anterior, Rectus Femoris and Bicep Femoris long head. A two-way (body position × muscle) repeated measures analysis of variance was used to investigate the effect of body position on PRMR-evoked responses. Results: There was a significant main effect of body position on PRMR resting motor threshold (RMT) (p < 0.001), first response peak-to-peak amplitude (p = 0.003) and percentage post-activation depression (%PAD) (p = 0.012). Sitting had significantly higher RMT and significantly lower first response peak-to-peak amplitudes compared to all other positions, but significant differences in %PAD were only detectible between supine and standing. Conclusions: Body position influences the nature of PRMR-evoked responses during tSCS. [ABSTRACT FROM AUTHOR]

This study investigated the coactivation of plantar flexor and dorsiflexor muscles and oxygen uptake during running with forefoot and rearfoot strikes at 15 and 19 km/h. We included 16 male runners in this study. The participants ran each foot strike pattern for 5 min at 15 and 19 km/h on a treadmill. During the running, respiratory gas exchange data and surface electromyographic (EMG) activity of the medial gastrocnemius (MG), lateral gastrocnemius (LG), soleus, and tibialis anterior muscles of the right lower limb were continuously recorded. The indices of oxygen uptake, energy expenditure (EE), and muscle activation were calculated during the last 2 min in each condition. During the stance phase of running at 15 and 19 km/h, activation of the tibialis anterior and MG muscles was lower and higher, respectively, with forefoot strike than with rearfoot strike. The foot strike pattern did not influence the oxygen uptake. These results suggest that the foot strike pattern has no clear effect on the oxygen uptake when running at 15 and 19 km/h. However, forefoot strike leads to plantar flexion dominance during co‐contraction of the tibialis anterior and MG muscles, which are an antagonist and agonist for plantar flexion, respectively, during the stance phase. [ABSTRACT FROM AUTHOR]

Hydrogen peroxide (H2O2) is one of the key signaling factors regulating skeletal muscle adaptation to muscle contractions. Eccentric (ECC) and concentric (CONC) contractions drive different muscle adaptations with ECC resulting in greater changes. The present investigation tested the hypothesis that ECC produces higher cytosolic and mitochondrial H2O2 concentrations [H2O2] and alters gene expression more than CONC. Cytosolic and mitochondrial H2O2-sensitive fluorescent proteins, HyPer7 and MLS-HyPer7, were expressed in the anterior tibialis muscle of C57BL6J male mice. Before and for 60 min after either CONC or ECC (100 Hz, 50 contractions), [H2O2]cyto and [H2O2]mito were measured by in vivo fluorescence microscopy. RNA sequencing was performed in control (noncontracted), CONC, and ECC muscles to identify genes impacted by the contractions. [H2O2]cyto immediately after ECC was greater than after CONC (CONC: +6%, ECC: +11% vs. rest, P < 0.05) and remained higher for at least 60 min into recovery. In contrast, the elevation of [H2O2]mito was independent of the contraction modes (time; P < 0.0042, contraction mode; P = 0.4965). The impact of ECC on [H2O2]cyto was abolished by NADPH oxidase 2 (Nox2) inhibition (GSK2795039). Differentially expressed genes were not present after CONC or ECC + GSK but were found after ECC and were enriched for vascular development and apoptosis-related genes, among others. In conclusion, in mouse anterior tibialis, ECC, but not CONC, evokes a pronounced cytosolic H2O2 response, caused by Nox2, that is mechanistically linked to gene expression modifications. NEW & NOTEWORTHY: This in vivo model successfully characterized the effects of eccentric (ECC) and concentric (CONC) contractions on cytosolic and mitochondrial [H2O2] in mouse skeletal muscle. Compared with CONC, ECC induced higher and more sustained [H2O2]cyto—an effect that was abolished by Nox2 inhibition. ECC-induced [H2O2]cyto elevations were requisite for altered gene expression. [ABSTRACT FROM AUTHOR]

Purpose: This study explored the association of the elasticity modulus and shear wave velocity (SWV) of the tibialis anterior muscle, as measured by two-dimensional shear wave elastography (2D-SWE), with the intracompartmental pressure (ICP) determined using the Whitesides method in a New Zealand rabbit model of acute compartment syndrome (ACS). Additionally, it evaluated the viability of 2D-SWE as a noninvasive, quantitative tool for the early detection of ACS. Methods: An ACS model was established through direct external compression by applying pressure bandaging to the lower legs of 15 New Zealand rabbits using neonatal blood pressure cuffs. Another five animals represented a non-modeled control group. To measure the elasticity modulus and SWV of the tibialis anterior muscles, 2D-SWE was employed. Blood oxygen saturation, serum creatine kinase (CK), and myoglobin levels were monitored. Subsequently, the anterior tibial compartment was dissected, and the tibialis anterior was removed for hematoxylin and eosin staining to assess muscle injury. Results: The elasticity modulus and SWV of the tibialis anterior muscle increased with compression duration, as did serum CK and myoglobin levels. ICP was strongly positively correlated with these parameters, particularly mean velocity (r=0.942, P<0.001) and CK (r=0.942, P<0.001). Blood oxygen saturation was negatively correlated with ICP (r=-0.887, P<0.001). Histological analysis indicated progressive muscle cell swelling over time, with damage transitioning from reversible to irreversible and culminating in necrosis. Conclusion: In a rabbit ACS model, ICP was strongly positively correlated with muscle elasticity modulus/SWV. Consequently, 2D-SWE may represent a novel tool for assessing early-phase ACS. [ABSTRACT FROM AUTHOR]

Background: Equinovarus deformity correction was performed by soft tissue release and bone deformity correction, and tendon transfer to maintain deformity correction. Because of the high complication rate of tendon fixation methods, partial or total anterior tibial tendon or posterior tibial tendon transfer to the peroneus tertius tendon was reported. The purpose of this study was (i) to review the results of this tendon transfer technique after release and correction of talipes equinovarus, and (ii) to analyze the complication of this technique. Methods: Between February 2017 and May 2022, 176 patients (210 feet) with equinus and/or varus foot and ankle deformities underwent anterior or posterior tibial tendon transfer to the peroneus tertius in our institute. Preoperative and postoperative foot and ankle range of motion (passive and active) were checked. The postoperative radiographic assessment included antero‐posterior (AP), lateral, and hindfoot alignment radiographs. Preoperative and postoperative lateral tibio‐talar, talo‐calcaneal, talo‐first metatarsal, tibial‐sole angles, hindfoot alignment, and anterior subluxation of the talus were checked. The American Orthopedic Foot and Ankle Society (AOFAS) ankle‐hindfoot scale, and visual analog scale (VAS) were used to assess pain. Paired Student's t‐test was used to compare the clinical scores and radiographic angles before the operation and at the last follow‐up. Results: The mean age of the patients was 23.27 ± 13.44 years (range, 3–69 years). The mean follow‐up time was 25.56 ± 16.37 months (range, 12–68 months). There were significant differences between the preoperative and postoperative measurements of the lateral tibio‐talar angle, lateral talo‐calcaneal angle, lateral talo‐first metatarsal angle, lateral tibial‐sole angle, and hindfoot alignment (p < 0.001). There was significant difference between the preoperative and postoperative AOFAS and VAS scores (p < 0.001). The early complications included infection in one patient, skin necrosis in two patients, and plantar numbness in three patients. The late complications included pin infection in three patients, tibio‐talar joint compression in four patients, forefoot pain in two patients, toe flexion in two patients, and plantar numbness in one patient. There were three cases of complications (1.43%) related to the transferred tendons. Conclusion: Tibialis anterior or posterior tendon transfer to the peroneus tertius is a safe and effective method for equinovarus deformity correction. It yielded excellent outcomes that produced high patient satisfaction and few complications. [ABSTRACT FROM AUTHOR]