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• Vitamin D supplementation has no beneficial effect on self-reported SAMS intensity. • Vitamin D supplementation has no beneficial effect on self-reported HRQoL. • Vitamin D supplementation has no beneficial effect on objective muscle performance. Statins are the leading lipid-lowering drugs, reducing blood cholesterol by controlling its synthesis. Side effects are linked to the use of statins, in particular statin-associated muscle symptoms (SAMS). Some data suggest that vitamin D supplementation could reduce SAMS. The purpose of this study was to evaluate the potential benefits of vitamin D supplementation in a randomized controlled trial. Men (n = 23) and women (n = 15) (50.5 ± 7.7 years [mean ± SD]) in primary cardiovascular prevention, self-reporting or not SAMS, were recruited. Following 2 months of statin withdrawal, patients were randomized to supplementation (vitamin D or placebo). After 1 month of supplementation, statins were reintroduced. Before and 2 months after drug reintroduction, muscle damage (creatine kinase and myoglobin) was measured. Force (F), endurance (E) and power (P) of the leg extensors (ext) and flexors (fle) and handgrip strength (FHG) were also measured with isokinetic and handheld dynamometers, respectively. The Short Form 36 Health Survey (SF-36) questionnaire and a visual analog scale (VAS) were administrated to assess participants' self-reported health-related quality of life and SAMS intensity, respectively. Repeated-measures analysis was used to investigate the effects of time, supplementation, and their interaction, according to the presence of SAMS. Despite no change for objective measures, subjective measures worsened after reintroduction of statins, independent of supplementation (VAS, SF-36 mental component score, all p < 0.05). However, no interaction between time and supplementation according to the presence of SAMS was observed for any variables. Vitamin D supplementation does not appear to mitigate SAMS. [ABSTRACT FROM AUTHOR]

How much do active pelvic movements on a Swiss ball during labour affect maternal and neonatal outcomes? A randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis. Two-hundred parturient women. The experimental group performed pelvic anteversion and retroversion, lateral pelvic tilts and circular hip movements according to individual obstetric evaluation (foetal station and position, cervical dilatation and the presence of early pushing urge) on a Swiss ball. The control group received usual care. Both groups were permitted to walk and shower. The primary outcome was the duration of the first stage of labour. The secondary outcomes were the duration of the second stage of labour, pain intensity, delivery mode, medication use, local swelling, fatigue, anxiety, satisfaction and neonatal outcomes. The experimental intervention reduced the duration of labour by 179 minutes (95% CI 146 to 213) in stage one and 19 minutes (95% CI 13 to 25) in stage two. It decreased pain by approximately 2 points (95% CI 2 to 2) on a 0-to-10 scale at 30, 60 and 90 minutes. It reduced the risk of a caesarean section (ARR 0.14, 95% CI 0.03 to 0.25; NNT 7, 95% CI 4 to 32) and vulvar swelling (ARR 0.11, 95% CI 0.03 to 0.19; NNT 9, 95% CI 5 to 31). It reduced fatigue by 18 points (95% CI 16 to 21) on a 15-to-75-point scale and anxiety by 9 points (95% CI 8 to 11) on an 18-to-72-point scale. Other effects were negligible or unclear. Active pelvic movements on a Swiss ball during labour reduced the duration of labour, pain intensity, and maternal fatigue and anxiety; they also lowered the risk of caesarean section and vulvar swelling. Several effects exceeded the smallest worthwhile effect. NCT04124835. [ABSTRACT FROM AUTHOR]

Couch's spadefoot toad (Scaphiopus couchii) spends most of the year underground in a hypometabolic state known as estivation. During this time, they overcome significant dehydration and lack of food through many mechanisms including employing metabolic rate depression (MRD), increasing urea concentration, switching to lipid oxidation as the primary energy source, and decreasing their breathing and heart rate. MicroRNA (miRNA) are known to regulate translation by targeting messenger RNA (mRNA) for degradation or temporary storage, with several studies having reported that miRNA is differentially expressed during MRD, including estivation. Thus, we hypothesized that miRNA would be involved in gene regulation during estivation in S. couchii heart. Next-generation sequencing and bioinformatic analyses were used to assess changes in miRNA expression in response to two-month estivation and to predict the downstream effects of this expression. KEGG and GO analyses indicated that ribosome and cardiac muscle contraction are among the pathways predicted to be upregulated, whereas cell signaling and fatty acid metabolism were predicted to be downregulated. Together these results suggest that miRNAs contribute to the regulation of gene expression related to cardiac muscle physiology and energy metabolism during estivation. [Display omitted] • Spadefoot toads undergo estivation for ∼10 months in response to drought conditions. • 4 miRNAs increase and 11 miRNAs decrease in S. couchii heart during estivation. • miRNAs predict upregulation of ribosome and cardiac muscle contraction. • miRNAs predict downregulation of cell signaling and fatty acid metabolism. [ABSTRACT FROM AUTHOR]

Assessing co-activation characteristics in knee osteoarthritis (knee OA) using method of quantification of the activity ratio (such as the co-contraction index (CCI) or the directed co-activation ratios (DCAR)) for surface electromyography (EMG) has been reported. However, no studies have discussed the differences in results between non-negative matrix factorization (NNMF) and the DCAR. Does DCAR or NNMF reflect the characteristic co-activation pattern of knee OA while using EMG normalized by the peak dynamic method? Ten elderly control participants (EC) and ten knee OA patients (KOA) volunteered to participate in this study. EMG data from 20 participants were obtained from our previous study. Patients with knee OA were recruited from a local orthopedic clinic. The DCAR of agonist and antagonist muscles and the number of modules using NNMF were calculated to evaluate multiple muscle co-activations. An independent t-test statistical parametric mapping approach was used to compare the DCAR between the two groups. The difference in the number of modules between EC and KOA was evaluated using the Wilcoxon rank-sum test. There was no significant difference in the DCAR between the two groups. However, NNMF had significantly fewer modules with KOA than with EC. The NNMF with the ratio of the amplitude of each muscle and duration of activity as variables reflected the co-activation of KOA, characterized by the high synchronous and prolonged activity of each muscle. Therefore, the NNMF is suitable for extracting characteristic muscle activity patterns of knee OA independent of the normalization method. • The non-negative matrix factorization showed knee osteoarthritis' characteristics. • No difference in the directed co-activation ratios between the two groups. • Non-negative matrix factorization extracts characteristic muscle activity patterns. [ABSTRACT FROM AUTHOR]

Mobilization of body reserves including fat, protein, and glycogen is necessary to overcome phases of negative nutrient balance typical for high-yielding dairy cows during the periparturient period. Skeletal muscle, the largest internal organ in mammals, plays a crucial role in maintaining metabolic homeostasis. However, unlike in liver and adipose tissue, the metabolic and regulatory role of skeletal muscle in the adaptation of dairy cows to the physiological needs of pregnancy and lactation has not been studied extensively. The functional integrity and quality of skeletal muscle are maintained through a constant turnover of protein, resulting from both protein breakdown and protein synthesis. Thus, muscle protein breakdown (MPB) and synthesis are intimately connected and tightly controlled to ensure proper protein homeostasis. Understanding the regulation of MPB, the catabolic component of muscle turnover, and its assessment are therefore important considerations to provide information about the timing and extent of tissue mobilization in periparturient dairy cows. Based on animal models and human studies, it is now evident that MPB occurs via the integration of 3 main systems: autophagy-lysosomal, calpain Ca2+-dependent cysteine proteases, and the ubiquitin-proteasome system. These 3 main systems are interconnected and do not work separately, and the regulation is complex. The ubiquitin-proteasomal system is the most well-known cellular proteolytic system and plays a fundamental role in muscle physiology. Complete degradation of a protein often requires a combination of the systems, depending on the physiological situation. Determination of MPB in dairy cows is technically challenging, resulting in a relative dearth of information. The methods for assessing MPB can be divided into either direct or indirect measurements, both having their strengths and limitations. Available information on the direct measures of MPB primarily comes from stable isotopic tracer methods and those of indirect measurements from assessing expression and activity measures of the components of the 3 MPB systems in muscle biopsy samples. Other indirect approaches (i.e., potential indicators of MPB), including ultrasound imaging and measuring metabolites from muscle degradation (i.e., 3-methylhistidine and creatinine), seem to be applicable methods and can provide useful information about the extent and timing of MPB. This review presents our current understanding, including methodological considerations, of the process of MPB in periparturient dairy cows. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the effect of adding core stability to usual care for pregnant women with lumbar and pelvic girdle (LPG) pain. This was a repeated-measures design randomized controlled trial with blinded outcome assessors. Thirty-five pregnant women with LPG pain were recruited from prenatal health care providers. They were allocated to 2 study groups to receive either usual prenatal care (control group, n = 17) or usual care with core stability exercises focusing on the pelvic floor muscles and deep abdominal muscles (exercise group, n = 18) for 10 weeks. The visual analog scale, score on the Oswestry Disability Index, and the World Health Organization's Quality of Life Brief Version (WHOQOL-BREF) were evaluated with analysis of variance at pre-intervention, post-intervention, at the end of pregnancy, and 6 weeks after childbirth. There was a statistically significant interaction of group and time for all outcome measures except for the Social category (P =.18) in the WHOQOL-BREF questionnaire. The analysis of the group within time showed that mean scores in the exercise group were substantially improved at the post-intervention, end of pregnancy, and 6-week follow-up evaluation, except in the Environment category (end of pregnancy: P =.36; 6-week follow-up: P =.75) in the WHOQOL-BREF questionnaire. The results of this study indicate that the addition of core stability exercises was more effective than the usual care alone in pain relief, improving disability, and quality of life of pregnant women with LPG pain. [ABSTRACT FROM AUTHOR]

Objective: The main objective was to assess the relationship between inter-recti distance (IRD) and abdominal muscle endurance, pelvic floor functions, respiratory muscle strength, and postural control in women with Diastasis Recti Abdominis (DRA). Additionally, the secondary purpose of the study is to investigate the independent predictors of IRD in women with DRA.Study Design: Fifty-one women who were diagnosed with DRA participated to the study. IRD assessment with a caliper, abdominal muscle endurance test, Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20), maximum inspiratory and expiratory pressure (MIP and MEP, respectively) tests, Clinical Test of Sensory Integration of Balance (m-CTSIB) under eyes open on a firm surface (EOFS), eyes closed on a firm surface (ECFS), eyes open on a foam surface (EOFoS), and eyes closed on a foam surface (ECFoS) conditions, and Limits of Stability (LOS) tests were performed for all subjects. Pearson or Spearman correlation analyses were used to determine the relationship between IRD and static abdominal flexion endurance test, PFDI-20, MIP and MEP, m-CTSIB, and LOS scores depending on the distribution properties of the data. Additionally, linear regression analysis was utilized for analyzing the independent predictors of IRD among the age, BMI, parity, time since last birth, birth weight, weight gains last pregnancy, and mode of delivery.Results: IRD had correlations with Colorectal-Anal Distress score of PFDI-20 (r = -0.317, p = 0.03) and EOFS, ECFS, EOFoS, ECFoS and composite score of m-CTSIB (r = 0.356, p = 0.01; r = 0.337, p = 0.02, r = 0.279, p = 0.04; r = 0.265, p = 0.04; r = 0.413, p = 0.004, respectively) and LOS scores (r = 0.422, p = 0.003). Increased IRD did not influence abdominal muscle endurance and respiratory muscle strength in women with DRA (p < 0.05). Age, BMI, time since last birth, weight gains last pregnancy, and mode of delivery were not determined as the factors that influence IRD in women with DRA (p < 0.05).Conclusion: We concluded that increased IRD is associated with worse postural control, but better colorectal functions in women with DRA. Additionally, IRD does not show a clear association with abdominal muscle endurance, pelvic floor functions, and respiratory muscle strength. According to our results, postural stability assessments may perform in the physiotherapeutic management of women with DRA. [ABSTRACT FROM AUTHOR]

Red drum, Sciaenops ocellatus , are a marine teleost native to the Gulf of Mexico that routinely experiences periods of low oxygen (hypoxia). Recent work has demonstrated this species has the capacity to improve aerobic performance in hypoxia through respiratory acclimation. However, it remains unknown how hypoxia acclimation impacts anaerobic metabolism in red drum, and the consequences of exhaustive exercise and recovery. Juvenile fish were acclimated to normoxia (n = 15, DO 90.4 ± 6.42 %) or hypoxia (n = 15, DO 33.6 ± 7.2 %) for 8 days then sampled at three time points: at rest, after exercise, and after a 3 h recovery period. The resting time point was used to characterize the acclimated phenotype, while the remaining time points demonstrate how this phenotype responds to exhaustive exercise. Whole blood, red muscle, white muscle, and heart tissues were sampled for metabolites and enzyme activity. The resting phenotype was characterized by lower pH e and changes to skeletal muscle ATP. Exhaustive exercise increased muscle lactate, and decreased phosphocreatine and ATP with no effect of acclimation. Interestingly, hypoxia-acclimated fish had higher pH e and pH i than control in all exercise time points. Red muscle ATP was lower in hypoxia-acclimated fish versus control at each sample period. Moreover, acclimated fish increased lactate dehydrogenase activity in the red muscle. Hypoxia acclimation increased white muscle ATP and hexokinase activity, a glycolytic enzyme. In a gait-transition swim test, hypoxia-acclimated fish recruited anaerobic-powered burst swimming at lower speeds in normoxia compared to control fish. These data suggest that acclimation increases reliance on anaerobic metabolism, and does not benefit recovery from exhaustive exercise. Keywords: acclimation, enzyme activity, exercise, fish, hypoxia, marine, metabolite, plasticity, respiration, swim performance. [Display omitted] • Hypoxia acclimation did not benefit exercise recovery. • Hypoxia-acclimated fish decreased ATP and increased LDH activity in the red muscle. • White muscle increased ATP and anaerobic enzyme activity. • Acclimated fish recruit anaerobic burst swimming at lower speeds compared to control. [ABSTRACT FROM AUTHOR]

• Muscle thickness detect by fabric strain sensors can facilitate recognition and prediction of muscle fatigue. • Features of muscle thickness related to muscle fatigue was proposed and verified. • Based on proposed features, fatigued cycles of curl were successfully recognized. • A model for fatigue prediction was designed and observed with favorable accuracy. Localized muscle fatigue is of major kinematic and medical significance in the field of sports and rehabilitations. However, only few works reported fatigue recognition for field training, and via analysis of only the noise-susceptible electromyography. In this study, along with portable EMG sensors, a wearable smart arm band powered by fabric strain sensors was implemented to detect the thickness variation of biceps. Dumbbell curl training protocol was designed, and 32 subjects were enrolled, contributing to a database of 580 curl samples. Fatigue-related characteristics of muscle thickness were proposed according to muscle physiology and combined with that of sEMG signals, forming feature vectors of the samples. Clustering results showed that the fatigued cycles can be successfully recognized and labeled. For potential applications, fatigue prediction models based on supervised learning methods were further proposed and compared, of which the SVM-based model was observed with satisfactory overall accuracy of 83.3%, yet the fatigue samples can be predicted at much higher rate, with effective recall 90%, F1-SCORE 95% and AUC 98.7%. This work not only exploits feasibility of using latent physiological indicators such as muscle thickness in muscle fatigue monitoring, the result and methodologies will also inspire wider horizon of human-centered applications using novel flexible sensors. [ABSTRACT FROM AUTHOR]

Recessive mutations in the Parkin gene (PRKN) are the most common cause of young-onset inherited parkinsonism. Parkin is a multifunctional E3 ubiquitin ligase that plays a variety of roles in the cell including the degradation of proteins and the maintenance of mitochondrial homeostasis, integrity, and biogenesis. In 2001, the R275W mutation in the PRKN gene was identified in two unrelated families with a multigenerational history of postural tremor, dystonia and parkinsonism. Drosophila models of Parkin R275W showed selective and progressive degeneration of dopaminergic neuronal clusters, mitochondrial abnormalities, and prominent climbing defects. In the Prkn mouse orthologue, the amino acid R274 corresponds to human R275. Here we described an age-related motor impairment and a muscle phenotype in R274W +/+ mice. In vitro, Parkin R274W mutation correlates with abnormal myoblast differentiation, mitochondrial defects, and alteration in mitochondrial mRNA and protein levels. Our data suggest that the Parkin R274W mutation may impact mitochondrial physiology and eventually myoblast proliferation and differentiation. [Display omitted] • Parkin R274W +/+ mice show age-related motor impairment. • Parkin R274W +/+ mice show age-related muscle defects. • Parkin R274W affects mitochondria in myoblasts. [ABSTRACT FROM AUTHOR]

• Pelvic floor muscle training is effective for improving women's sexual function after hysterectomy. • The effects of pelvic floor muscle training on urinary symptoms and pelvic floor muscle strength are imprecise. • Pelvic floor muscle training is unlikely to improve vaginal prolapse and quality of life. After hysterectomy, women could experience pelvic floor dysfunction and negative impact on quality of life, which could be improved by pelvic floor muscle training. To investigate effects of pelvic floor muscle training on urinary symptoms, vaginal prolapse, sexual function, pelvic floor muscle strength, and quality of life after hysterectomy. Systematic review with meta-analyses of randomized controlled trials. Trials with pelvic floor muscle training in women after hysterectomy were included. The outcomes measures were urinary symptoms, vaginal prolapse, sexual function, pelvic floor muscle strength, and quality of life. Quality of evidence was assessed by adopting the GRADE approach. Six trials, involving 776 participants, were included. The mean PEDro score of trials was 5.5. Moderate-quality evidence suggested that pelvic floor muscle training improves sexual function by 5 points (95% CI: 4, 6) on the Female Sexual Function Index, compared with no intervention. It might affect strength (SMD 0.5; 95% CI: −0.4, 1.3), quality of life (SMD 0.5 points out of 108, 95% CI: −0.1, 0.9), urinary symptoms (RD −0.02; 95% CI: −0.06, 0.1); however, the estimates were too imprecise. In addition, it produces no or negligible effects on vaginal prolapse (RD 0; 95% CI: −0.1, 0.1). Long-term effects remain uncertain. This systematic review provides moderate-quality evidence that pelvic floor muscle training is effective for improving women's sexual function after hysterectomy, in comparison with no intervention. Benefits on urinary symptoms, pelvic floor muscle strength, quality of life, and vaginal prolapse remains unclear. Also, the effects beyond the intervention period remains uncertain. [ABSTRACT FROM AUTHOR]

This paper proposes a new framework for investigating neural signals sufficient for a conscious sensation of movement and their role in motor control. We focus on signals sufficient for proprioceptive awareness, particularly from muscle spindle activation and from primary motor cortex (M1). Our review of muscle vibration studies reveals that afferent signals alone can induce conscious sensations of movement. Similarly, studies employing peripheral nerve blocks suggest that efferent signals from M1 are sufficient for sensations of movement. On this basis, we show that competing theories of motor control assign different roles to sensation of movement. According to motor command theories, sensation of movement corresponds to an estimation of the current state based on afferent signals, efferent signals, and predictions. In contrast, within active inference architectures, sensations correspond to proprioceptive predictions driven by efferent signals from M1. The focus on sensation of movement provides a way to critically compare and evaluate the two theories. Our analysis offers new insights into the functional roles of movement sensations in motor control and consciousness. [Display omitted] • New framework for studying the conscious sensation of movement. • Proprioceptive afferent signals are sufficient for conscious sensation of movement. • Efferent signals are sufficient for conscious sensation of movement. • Motor command theories explain results better than an active inference theory. [ABSTRACT FROM AUTHOR]

• The phenotypes associated with Sarcopenia share a common genetic architecture. • There exists a strong genetic correlation between muscle strength and gait speed. • Thirteen pleiotropic loci were identified for pairs of Sarcopenia subphenotypes. • Novel candidate genes and molecular markers were proposed for Sarcopenia risk. Sarcopenia is a progressive age-related muscle disease characterized by low muscle strength, quantity and quality, and low physical performance. The clinical overlap between these subphenotypes (reduction in muscle strength, quantity and quality, and physical performance) was evidenced, but the genetic overlap is still poorly investigated. Herein, we investigated whether there is a genetic overlap amongst sarcopenia subphenotypes in the search for more effective molecular markers for this disease. For that, a Bioinformatics approach was used to identify and characterize pleiotropic effects at the genome, loci and gene levels using Genome-wide association study results. As a result, a high genetic correlation was identified between gait speed and muscle strength (rG=0.5358, p=3.39 × 10-8). Using a Pleiotropy-informed conditional and conjunctional false discovery rate method we identified two pleiotropic loci for muscle strength and gait speed, one of them was nearby the gene PHACTR1. Moreover, 11 pleiotropic loci and 25 genes were identified for muscle mass and muscle strength. Lastly, using a gene-based GWAS approach three candidate genes were identified in the overlap of the three Sarcopenia subphenotypes: FTO, RPS10 and CALCR. The current study provides evidence of genetic overlap and pleiotropy among sarcopenia subphenotypes and highlights novel candidate genes and molecular markers associated with the risk of sarcopenia. [Display omitted] [ABSTRACT FROM AUTHOR]

Actin, one of the most abundant proteins in nature and a key component of the cytoskeleton, undergoes a unique multistep N-terminal (Nt) maturation. In a recent report, Haahr et al. identified actin maturation protease (ACTMAP) as the dedicated actin aminopeptidase and showed that its absence is associated with abnormal muscle physiology. [ABSTRACT FROM AUTHOR]

The oxidative phosphorylation (OXPHOS) system is intricately organized, with respiratory complexes forming super-assembled quaternary structures whose assembly mechanisms and physiological roles remain under investigation. Cox7a2l, also known as Scaf1, facilitates complex III and complex IV (CIII-CIV) super-assembly, enhancing energetic efficiency in various species. We examined the role of Cox7a1, another Cox7a family member, in supercomplex assembly and muscle physiology. Zebrafish lacking Cox7a1 exhibited reduced CIV 2 formation, metabolic alterations, and non-pathological muscle performance decline. Additionally, cox7a1 −/− hearts displayed a pro-regenerative metabolic profile, impacting cardiac regenerative response. The distinct phenotypic effects of cox7a1 −/− and cox7a2l −/− underscore the diverse metabolic and physiological consequences of impaired supercomplex formation, emphasizing the significance of Cox7a1 in muscle maturation within the OXPHOS system. [Display omitted] • Cox7a1 stabilizes CIV dimers • Impaired CIV dimer formation rewires skeletal and cardiac muscle metabolism • Loss of Cox7a1 impacts muscle physiology and heart regeneration • Cox7a1 and Cox7a2l loss of function lead to distinct alterations in striated muscle Complexes of the mitochondrial respiratory chain can assemble into supercomplexes (SCs). García-Poyatos et al. explore the role of Cox7a1 as a SC assembly factor and find that it controls mitochondrial respiration, influencing skeletal muscle physiology as well as cardiac injury response. [ABSTRACT FROM AUTHOR]

• Based on the data available, both bladder training and drug treatment isolated did not seem to promote helpful effects in patients with OAB. • Bladder training combined with intravaginal electrical stimulation seems to present positive results on overactive bladder symptoms; however the quality of evidence of the studies assessed was not satisfactory. • There are few randomized clinical trials on the effect of treatment on overactive bladder symptoms, which makes the efficacy of bladder training inconclusive. Bladder training (BT), the maintenance of a scheduled voiding regime at gradually adjusted intervals, is a common treatment for overactive bladder (OAB). To assess the effects of isolated BT and/or in combination with other therapies on OAB symptoms. A systematic review of eight databases was conducted. After screening titles and abstracts, full texts were retrieved. Cochrane RoB 2 and the GRADE approach were used. Fourteen RCTs were included: they studied isolated BT (n = 11), BT plus drug treatment (DT; n = 5), BT plus intravaginal electrical stimulation (IVES; n = 2), BT plus biofeedback and IVES (n = 1), BT plus pelvic floor muscle training and behavioral therapy (n = 2), BT plus percutaneous tibial nerve stimulation, and BT plus transcutaneous tibial nerve stimulation (n = 1). In a meta-analysis of short-term follow-up data, BT plus IVES resulted in greater improvement in nocturia (mean difference [MD]: 0.89, 95% CI: 0.5, 1.20), urinary incontinence (UI; MD: 1.93, 95% CI: 1.32, 2.55), and quality of life (QoL; MD: 4.87, 95% CI: 2.24, 7.50) than isolated BT, while DT and BT improved UI (MD: 0.58, 95% CI: 0.23, 0.92) more than isolated BT. In the short term, BT plus IVES improves the OAB symptoms of nocturia and UI while improving QoL. The limited number of RCTs and heterogeneity among them provide a low level of evidence, making the effect of BT on OAB inconclusive, which suggests that new RCTs should be performed. [ABSTRACT FROM AUTHOR]

Muscle degeneration is a common feature in cancer cachexia that cannot be reversed. Recent advances show that the endocannabinoid system, and more particularly cannabinoid receptor 1 (CB1), regulates muscle processes, including metabolism, anabolism and regenerative capacity. However, it is unclear whether muscle endocannabinoids, their receptors and enzymes are responsive to cachexia and exercise. Therefore, this study investigated whether cachexia and exercise affected muscle endocannabinoid signaling, and whether CB1 expression correlated with markers of muscle anabolism, catabolism and metabolism. Male BALB/c mice were injected with PBS (CON) or C26 colon carcinoma cells (C26) and had access to wheel running (VWR) or remained sedentary (n = 5–6/group). Mice were sacrificed 18 days upon PBS/tumor cell injection. Cachexic mice exhibited a lower muscle CB1 expression (−43 %; p < 0.001) and lower levels of the endocannabinoid anandamide (AEA; −22 %; p = 0.044), as well as a lower expression of the AEA-synthesizing enzyme NAPE-PLD (−37 %; p < 0.001), whereas the expression of the AEA degrading enzyme FAAH was higher (+160 %; p < 0.001). The 2-AG-degrading enzyme MAGL, was lower in cachexic muscle (−34 %; p = 0.007), but 2-AG and its synthetizing enzyme DAGLβ were not different between CON and C26. VWR increased muscle CB1 (+25 %; p = 0.005) and increased MAGL expression (+30 %; p = 0.035). CB1 expression correlated with muscle mass, markers of metabolism (e.g. p-AMPK, PGC1α) and of catabolism (e.g. p-FOXO, LC3b, Atg5). Our findings depict an emerging role of the endocannabinoid system in muscle physiology. Future studies should elaborate how this translates into potential therapies to combat cancer cachexia, and other degenerative conditions. [Display omitted] • The endocannabinoid (eCB) system consists of endocannabinoids, enzymes & receptors • The eCB system plays a key role in metabolic control • Muscle metabolism is severely affected in cancer cachexia • Cachexic muscle undergoes eCB remodeling: ↓ eCB receptor 1 and ↓ anandamide abundance • The eCB system might have a therapeutic potential to combat cancer cachexia [ABSTRACT FROM AUTHOR]

In women with stress urinary incontinence, how does pelvic floor muscle (PFM) function differ between supine and standing when assessed using manometry, vaginal palpation, dynamometry and electromyography? An experimental crossover study. A total of 101 women with stress urinary incontinence were included. The PFM evaluations were performed and compared in supine and standing positions. The participants were assigned to either Group 1 (assessments in supine followed by standing) or Group 2 (assessments in standing followed by supine). The primary outcome was the PFM pressure during the maximum voluntary contraction (MVC). Secondary outcomes were the measures of PFM pressure at rest; PFM function (PERFECT scheme); active and passive forces (dynamometry); and PFM electromyography (EMG) activity. The mean MVC pressure was significantly lower in standing (MD −7 cmH 2 O, 95% CI −10 to −4). The mean PFM resting pressure was higher in standing (7 cmH 2 O, 95% CI 5 to 10). Three measures of PFM function derived from vaginal palpation were better in supine than in standing. The PFM active and the passive forces measured using dynamometry were higher in standing (0.18 kgf, 95% CI 0.16 to 0.20). The resting EMG activity was higher in standing than in supine (MD 3.6 μV, 95% CI 2.6 to 4.5), whereas EMG activity during MVC was higher in supine than standing (MD −8.7 μV, 95% CI −12.5 to −4.8). The pressure and EMG activity during MVC, and PFM function were lower in standing. The resting pressure, the passive and active forces of the PFM and the resting EMG activity of the PFM were higher in standing. [ABSTRACT FROM AUTHOR]

Electric pulse-stimulated C2C12 myotubes are gaining interest in the field of muscle physiology and biotechnology because electric pulse stimulation (EPS) enhances sarcomere structure development and active tension generation capability. Recently, we found that termination of EPS results in the rapid loss of active tension generation accompanied by disassembly of the sarcomere structure, which may represent an in vitro muscle atrophy model. To elucidate the molecular mechanism underlying this rapid loss of active tension generation and sarcomere structure disassembly after termination of EPS, we performed transcriptomic analysis using microarray. After termination of EPS, 74 genes were upregulated and 120 genes were downregulated after 30 min; however, atrophy-related genes were not found among these genes. To further assess the effect of EPS on gene expression, we re-applied EPS after its termination for 8 h and searched for genes whose expression was reversed. Four genes were upregulated by termination of EPS and downregulated by the re-application of EPS, whereas two genes were downregulated by termination of EPS and upregulated by the re-application of EPS. Although none of these genes were atrophy- or hypertrophy-related, the results presented in this study will contribute to the understanding of gene expression changes that mediate rapid loss of active tension generation and sarcomere structure disassembly following termination of EPS in C2C12 myotubes. [ABSTRACT FROM AUTHOR]

• The EFSMAP was developed by a panel of nine experts. • The EFSMAP is a valid and reliable exam of the women's PFM using visual observation and digital palpation. • EFSMAP can be used in clinical and research settings. • The EFSMAP set valid diagnostic labels for PFM impairments based on movement systems and ICF/WHO terminology. • The EFSMAP can facilitate standard communication and data gathering. The accurate diagnosis of pelvic floor muscle impairments is essential. The plethora of terms and the lack of evidence to support widely used pelvic floor muscle function (PFMF) measurements hinder diagnostic labels. To structure an examination of PFMF using visual observation and digital palpation and terms consistent with the ICF terminology, and to test its intra and interrater reliability/agreement. A panel of 9 physical therapists applied Delphi method to structure the PFMF exam under ICF terminology and to verify its measurements reproducibility. For reliability and agreement, a convenience sample of women aged 51.2 ± 14.7 years had the sensitivity to pressure, pain, muscle tone, involuntary movement reaction, control of voluntary movement (contraction/relaxation), coordination, strength, and endurance examined by two raters, in the same day for interrater (n = 40), and one week apart, for intrarater reliability (n = 25). Percent agreement, linear weighted kappa, intraclass correlation coefficient, and Bland-Altman's limits of agreement were calculated (alpha = 0.05). Four round Delphi discussion structured the PFMF exam, named EFSMAP (Exame das Funções Sensoriais e Motoras do Assoalho Pélvico/Examination of Pelvic Floor Sensory and Motor Functions), set a list of concepts and instructions targeted at reproducibility and established PFMF diagnostic labels. Reliability, except for pain and tone, were moderate to excellent (Kw= 0.67–1.0 and ICC=0.48–0.82). Agreement was substantial for most PFMF features (0.64–1.00), except pain. The EFSMAP was successfully developed as a valid and reliable exam to be used in research and clinical practice; it provides labels for the diagnosis of pelvic floor muscle impairments. It might be easily adopted worldwide as it uses ICF terminology. [ABSTRACT FROM AUTHOR]

The number of motor units included in calculations of mean firing rates varies widely in the literature. It is unknown how the number of decomposed motor units included in the calculation of firing rate per participant compares to the total number of active motor units in the muscle, and if this is different for males and females. Bootstrapped distributions and confidence intervals (CI) of mean motor unit firing rates decomposed from the tibialis anterior were used to represent the total number of active motor units for individual participants in trials from 20 to 100 % of maximal voluntary contraction. Bootstrapped distributions of mean firing rates were constructed using different numbers of motor units, from one to the maximum number for each participant, and compared to the CIs. A probability measure for each number of motor units involved in firing rate was calculated and then averaged across all individuals. Motor unit numbers required for similar levels of probability increased as contraction intensity increased (p < 0.001). Increased levels of probability also required higher numbers of motor units (p < 0.001). There was no effect of sex (p ≥ 0.97) for any comparison. This methodology should be repeated in other muscles, and aged populations. [ABSTRACT FROM AUTHOR]

Treadmill belt-accelerations are a commonly utilised surrogate for tripping, but their physiological validity is unknown. This study examined if a treadmill belt-acceleration induces lower limb muscle activation responses similar to a trip on a walkway. 38 older people (65+ years) experienced one treadmill belt-acceleration and one walkway obstacle trip in random order. Muscle responses were assessed bilaterally using surface electromyography on the rectus femoris (RF), tibialis anterior (TA), semitendinosus (ST) and gastrocnemius medial head (GM). Unperturbed muscle activity, post-perturbation onset latency, peak magnitude, time to peak and co-contraction index (CCI) were examined. Muscle activity in the right ST was greater during unperturbed walking on the treadmill compared to walkway (P =0.011). Compared to a treadmill belt-acceleration, a walkway trip elicited faster onset latencies in all muscles; greater peak magnitudes in the left RF, TA, GM and right GM; faster time to peaks in the left TA and right GM; and lower knee and ankle muscle CCI (P <0.05). Walkway trips and treadmill belt-accelerations elicit distinct muscle activation patterns. While walkway trips induced faster and larger muscle responses, treadmill belt-accelerations involved greater co-contraction. Therefore, treadmill belt-accelerations may not accurately simulate the muscle responses to trips. [ABSTRACT FROM AUTHOR]

The functionality of the pelvic floor musculature (PFM) assists in the support of pelvic organs as well as provides urinary, fecal continence and sexual functions within normal limits. For the PFM to be considered functional, it is necessary that strength, resistance, relaxation capacity, superficial sensitivity, tonus, and proprioception are present in a harmonious way. Changes in one or more of these components can trigger, for example, urinary incontinence (UI). To Identify the sensory and muscle functions of the pelvic floor and UI and their correlations in young nulliparous women. A descriptive, observational, and cross-sectional study was carried out. The sampling process was of the convenience type, with women aged between 18 and 30 years old, nulliparous, who had never been pregnant and who were not menstruating on the day of the assessment selected. The evaluation was carried out through the application of questionnaires (socio-clinical questionnaire, International Consultation on Incontinence Questionnaire-Short Form) and, later, by physical examination evaluating the superficial sensitivity, the tonus of the perineal body, tonus of the external anal sphincter and strength of MAP through the Perfect scheme. Data were analyzed using the Statistical Program for Social Sciences (version 23) considering a significance level of 5%. The sample consisted of 45 women with a mean age of 22.18 ± 3.15 years. The prevalence of UI was 31.11%, with the majority referring a feeling of incomplete emptying and 17.77% referring a situation of urinary urgency. The entire sample showed normal sensitivity. Changes in perineal body and external anal sphincter tone were observed in 26.6% and 15.5%, respectively. The group with UI showed more muscle weakness (p=0.04) and less ability to repeat PFM contractions (p=0.02). There was a correlation between PFM functions and the presence of UI in the components of muscle strength (R=-0.78), maintenance of muscle contraction capacity (R=-0.60), repetition potential (R=-0.65) and presence of contraction of the lower abdominal muscles (R=0.55). UI is directly related to muscle weakness, difficulty maintaining the contraction, lack of ability to repeat PFM contractions and the presence of co-contraction of lower abdominal muscles. In scientific terms, it was shown that, in terms of MAP, for the development of UI, muscle strength is not a single factor to be considered, considering the importance of other parameters. In clinical terms, this study underscores the importance of considering motor, but also sensory, aspects when evaluating PFM functionality. [ABSTRACT FROM AUTHOR]

• Vehicle-assisted ligature strangulation is an extremely rare suicide method. • Incomplete decapitation due to this suicide method is a rare occurrence. • Rope features are related to the occurrence of decapitation. • Common autopsy findings include thyroid cartilage rupture and spine injuries. • On-site inspection is pivotal to differentiate between homicide and suicide. Vehicle-assisted ligature strangulation is an extremely rare suicide method. We report a case of a 43-year-old man who secured one end of a nylon rope to a tree and the other end around his neck, then got inside his vehicle and stepped on the gas, leading to an incomplete decapitation. A sharply demarcated encircling ligature mark was found upon external examination, along with a deep laceration in the anterior region of the neck. The severance plane passed between the third and fourth cervical vertebrae, with diffuse haemorrhagic infiltration of the cervical muscles, in accordance with autopsy findings reported in the literature. The lung histological examination described a large amount of red blood cells and pulmonary oedema. A review of the literature concerning suicidal vehicle-assisted ligature strangulation cases allowed us to investigate some common autopsy findings, as well as the rope features relevant to the beheading. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine myoelectric activity, fatigue index and volume load adopting different intersession recovery periods between repeated resistance training (RT) bouts. Fifteen recreationally-trained men participated in this study. Eight-repetition maximum (8RM) loads were determined for the bench press (BP) and 30° incline bench press (BP30) over two non-consecutive days. Three experimental protocols were performed in randomized order to examine the effect of different intersession recovery periods between repeated RT sessions for upper body muscles (pectoral major activity, anterior deltoid, triceps brachii, and biceps brachii) on volume load and myoelectric activity (SEMG), including: 24 hours (P24); 48 hours (P48); and 72 hours (P72). Each RT session consisted of performing four sets to failure for the BP and BP30 with 8-RM loads and 2-minute rest intervals between sets. The results showed that for SEMG activity, during the BP and BP30 exercises, there were no significant main effects for session, protocol, or interaction between protocols and sessions in the percentage difference between sets in activity of all muscles analyzed. Considering the overall session volume load, a significant main effect for session was noted. Volume load was significantly lower in Session 2 versus Session 1 under the P24 h protocol, without significant differences between the P48 and P72. Therefore, coaches and practitioners who need to accomplish a higher volume load without negatively impacting fatigue index and myoelectric activity for upper body muscles, should adopt recovery periods longer than 24 hours between similar RT bouts. [ABSTRACT FROM AUTHOR]

The purpose of the present study is to explore the characteristics of the postural control in Kung-Fu trained young boys, in comparison with non-trained age-matched ones. Two groups of 11–13-year old boys (10 practicing Kung-Fu and 10 controls) were asked to maintain upright bipedal and unipedal stances on a force platform with eyes open and closed in a static and two dynamic postures. Postural control was assessed with centre of pressure excursions. Muscle response characteristics were recorded during maintaining a bipedal stance on an unstable platform with eyes open and closed. Kung-Fu practitioners had significantly (P <.05) better balance than controls in dynamic postures. Removal of vision significantly (P <.001) decreased the balance of both groups similarly. In dynamic conditions, controls were affected by removal of vision in both postures, but Kung-Fu practitioners depended on vision in unipedal posture only. Kung-Fu group showed significantly (P <.01) better neuromuscular responses than controls. Removal of vision significantly (P <.05) increased muscle-response amplitude for the two groups. Kung-Fu trained young boys seems to have better postural control in dynamic (unipedal-eyes open and bipedal-eyes closed) postures and better neuromuscular responses compared to non-trained ones. [ABSTRACT FROM AUTHOR]

The female pelvic floor (PF) muscles provide support to the pelvic organs. During delivery, some of these muscles have to stretch up to three times their original length to allow passage of the baby, leading frequently to damage and consequently later-life PF dysfunction (PFD). Three-dimensional (3D) ultrasound (US) imaging can be used to image these muscles and to diagnose the damage by assessing quantitative, geometric and functional information of the muscles through strain imaging. In this study we developed 3D US strain imaging of the PF muscles and explored its application to the puborectalis muscle (PRM), which is one of the major PF muscles. [ABSTRACT FROM AUTHOR]

• Nepali women appear to have variations in pelvic floor muscle function. • Weaker and thinner pelvic floor muscles are not always associated with a greater stage of prolapse. • A larger hiatal area is associated with a greater stage of prolapse. Pelvic floor muscle function has been shown to be inversely associated with pelvic organ prolapse in Western women, however differences have been documented between ethnic groups. To determine if pelvic floor muscle strength and thickness and hiatal area are associated with pelvic organ prolapse in Nepali women. This cross-sectional study included non-pregnant Nepali women ≥18 years attending an outpatient gynecology clinic in Kathmandu, Nepal. A clinical examination included the pelvic organ prolapse quantification (POP-Q)- system examination and Modified Oxford Scale. Puborectalis muscle thickness and hiatal area were assessed using 3D/4D translabial ultrasound. Statistical analysis included Pearson's correlation and multiple regression (p < 0.05). Of the 123 women; 14 (11%) had POP-Q stage 0 prolapse, 29 (24%) stage I, 69 (56%) stage II, 8 (7%) stage III, and 3 (2%) stage IV. Mean ± SD Modified Oxford Scale was 3.37 ± 0.48 and muscle thickness was 1.14 ± 0.21 cm, hiatal area at rest was 14.67 ± 3.11 cm2 and on contraction was 11.29 ± 2.51 cm2. No associations were found between pelvic floor muscle strength or thickness and POP-Q stages 0–IV. There was a positive correlation found between hiatal area at rest and pelvic organ prolapse stage (r = 0.34, p < 0.001)and hiatal area on contraction and prolapse stage (r = 0.30, p < 0.001) and a negative correlation between pelvic floor muscle strength and hiatal area on contraction (r = −0.36, p < 0.001). In contrast to previous findings, pelvic floor muscle strength and thickness are not associated with pelvic organ prolapse in this sample of Nepali women. It is important to consider these findings when developing pelvic organ prolapse treatment and management strategies in this population. [ABSTRACT FROM AUTHOR]

This study aimed to clarify exercise-induced changes in intravoxel incoherent motion (IVIM) parameters obtained from diffusion-weighted imaging (DWI) of the calf muscle, as well as the relationships between IVIM parameters, perfusion, and water content in muscle tissue. Thirteen healthy volunteers underwent IVIM-DWI, arterial spin labeling (ASL), and multi-echo spin-echo T 2 mapping of the right calf on a 3.0-T magnetic resonance imaging scanner before and after performing dorsiflexion exercise. From the data, we derived the perfusion-related diffusion coefficient (D⁎), perfusion component fraction (F), blood flow parameter (FD⁎), and restricted diffusion coefficient (D) in the tibialis anterior muscle. The muscle blood flow (MBF) and transverse relaxation time (T 2) were also calculated from the ASL and multi-echo spin-echo data, respectively. We compared the parameters measured before and after exercise and assessed the relationship of each IVIM-derived perfusion parameter (D⁎, F, and FD⁎) with MBF and each diffusion parameter (D and ADC) or F with T 2. Notably, all these parameters were significantly increased after exercise. Before exercise, the FD⁎ exhibited a significant positive correlation with the MBF, whereas no significant correlation was observed between D⁎ or F and MBF. After exercise, both D⁎ and FD⁎ exhibited significant positive correlations with MBF, whereas F was not significantly correlated with MBF. Additionally, D was significantly correlated with T 2 after exercise, but not before exercise. No significant correlations were found between ADC and T 2 either before or after exercise. The IVIM analyses before and after exercise enable the simultaneous evaluation of exercise-induced changes in perfusion and water diffusion in the muscle and increases the body of information on muscle physiology. • The aim of the study was to clarify exercise-induced changes in intravoxel incoherent motion (IVIM) parameters of the calf muscle. • This study also aimed to determine the relationships between IVIM parameters, perfusion, and water content in the muscle tissue. • All IVIM parameters were significantly increased after exercise in the exercised muscle. • The IVIM perfusion and restricted diffusion parameters correlated with the muscle blood flow and T 2 , respectively, after exercise. • IVIM analysis enables the simultaneous evaluation of exercise-induced changes in perfusion and water diffusion in muscle. [ABSTRACT FROM AUTHOR]

• Multivariate analysis of surface and intramuscular EMG showed large differences between age groups. • Surface and intramuscular EMG show decreases in motor unit number estimation and stability in older adults. • Multivariate analysis of DQEMG may identify age-related hand neuromuscular changes. Decomposition-based quantitative electromyography (DQEMG) is one method of measuring neuromuscular physiology in human muscles. The objective of the current study is to compare the neuromuscular physiology of a typical aging population in the intrinsic hand muscles. Measurements of DQEMG were detected with a standard concentric needle and surface EMG from the intrinsic hand muscles. DQEMG was obtained from the first dorsal interosseous (FDI), the abductor digiti minimi (ADM) and fourth dorsal interosseous (4DI). Multivariate analysis of variance (MANOVA) were performed for the surface and intramuscular EMG measures to identify age differences in motor unit properties. Large differences were observed between the age groups for the canonical intramuscular and surface EMG variables. Older adults demonstrated a large decrease in motor unit number estimation in the ADM and FDI. Likewise, medium to large decreases in motor unit stability were observed in the FDI, ADM and 4DI. With aging, there are decreases in motor unit number estimation and stability in the intrinsic hand muscles. Using a multivariate approach allows for age-related differences and the relationship between the variables to be further elucidated. Multivariate analysis of DQEMG may be useful for identifying patterns of change in neuromuscular physiology with age-related changes to hand musculature. This may potentially lead to future prognostic biomarkers of age-related changes to hand muscles. [ABSTRACT FROM AUTHOR]

• The bridge test with knee extension is a valid test to measure core stability. • Trunk rotators strength predicts the performance during this test. • Hip extensors and internal rotators strength can also predict the performance during the test. • Addressing these muscles might be important in people with poor performance during the bridge test. A better understanding about the relationship between trunk and hip muscles strength and core stability may improve evaluation and interventions proposed to improve core stability. To investigate if trunk and hip muscles strength predict pelvic posterior rotation during the bridge test with unilateral knee extension. This is a cross-sectional study. Sixty-one healthy individuals of both sexes (age, 28 ± 6.4 years, weight, 66.5 ± 10.9 kg, height, 167 ± 9.5 cm) performed the bridge test with unilateral knee extension. The pelvic posterior rotation during the bridge test was obtained with two-dimensional video analysis. Isometric strength of the trunk extensors and rotators, and hip abductors, external and internal rotators and extensors were measured with a hand-held dynamometer. Multiple linear regression analysis was performed to identify if the strength variables could explain the pelvic posterior rotation during the test. Muscle strength predicted pelvic posterior rotation during the bridge test (r = 0.54; p = 0.003). Strength of the trunk rotators (p = 0.045) and hip internal rotators (p = 0.015) predicted reduced magnitude of pelvic posterior rotation during the bridge test, and strength of the hip extensors (p = 0.003) predicted increased magnitude of pelvic posterior rotation. Trunk rotators and hip internal rotators and extensors strength predict 29% of the performance during the bridge test with unilateral knee extension. The strength of these muscles should be evaluated in individuals with increased pelvic posterior rotation during the bridge test with unilateral knee extension. [ABSTRACT FROM AUTHOR]

The article discusses the physiotherapy management of urinary incontinence in females. Topics discussed include Urinary incontinence (UI) is a prevalent and bothersome condition affecting women of all ages; and UI can be treated with lifestyle interventions, bladder training, electrical stimulation, surgery and pelvic floor muscle training (PFMT) with or without biofeedback.

This study aimed to evaluate the effects of corrective exercises on posture, pain, and muscle activation of patients with chronic neck pain exposed to anterior-posterior perturbation. A total of 32 women (37.76 ± 3.83 years) with chronic, nonspecific neck pain were randomized into corrective exercise and control groups. The experimental group underwent a corrective exercise program for 8 weeks, 30 min/d, 3 days per week. The control group received active self-exercise instructions. Neck pain, forward head and protracted shoulder posture, and timing of superficial neck muscle activation were evaluated using the visual analog scale, photogrammetry, and electromyogram, respectively, before and then 48 hours after the 8-week program for both the experimental and control groups. All measurements at pretest and posttest were taken by a blinded assessor. Significant alterations were observed in cervical angle (P =.003, effect size = 0.329), shoulder angle (P =.008, effect size = 0.457), neck pain and disability (P =.009, effect size = 0.645), movement control (P =.038, effect size = 0.353), activation onset of the upper trapezius (P =.015, effect size = 0.746), the sternocleidomastoid (P =.018, effect size = 0.879) and cervical erector spinae (P =.031, effect size = 0.765), and the root mean square of the upper trapezius (P =.033, effect size = 0.742), the sternocleidomastoid (P =.041, effect size = 0.587), and the cervical erector spinae (P =.024, effect size = 0.832) in the intervention group from pre- to posttest (P <.05). Positive and significant alterations have been observed in the forward head and protracted shoulder posture, the timing of superficial neck muscle activation, neck pain, and disability in female patients with chronic neck pain exposed to anterior-posterior perturbation after performing an 8-week corrective exercise program. [ABSTRACT FROM AUTHOR]

Objective: To compare medium/long-term outcomes in terms of pelvic floor function, patient reported prolapse recurrence and repeat prolapse surgery after laparoscopic sacrohysteropexy (LSHP) and vaginal hysterectomy with McCall suspension (VH&McCall) which is the most commonly performed surgical option for severe uterine prolapse from past to present.Study Design: Files of patients who underwent LSHP and VH&McCall for advanced utero-vaginal prolapse (stage 3 & 4) at the Department of Gynecology in Ankara University School of Medicine between 2008 and 2018 were reviewed (n = 517). Data of women who were followed up for at least 1-year and containing both the full-filled Patient Global Impression of Improvement (PGI-I) survey and Turkish validated Pelvic Floor Distress Inventory-20 (PFDI-20), were included.Results: A total of 132 women were included in the study; 46 women who underwent LSHP and 86 women who underwent VH&McCall. Even though the median age of the LSHP group was significantly lower than the median age of VH&McCall group (42 vs. 67 years; P<;0.001), recurrence and repeat surgery rates were found to be similar after both surgical approaches as well as the scores of PGI-I and PFDI-20. However, in women who were operated before their sixties, symptomatic recurrence was found to be significantly lower after LSHP than VH&McCall (16.2 % vs. 47.4 %, respectively; P = 0.024) as well as repeat prolapse surgery (2.7 % vs. 26.3 %, respectively; P = 0.014). PGI-I and PFDI-20 scores also suggested better pelvic floor function after LSHP significantly (p = 0.004 & p = 0.003 respectively). When adjusted for age, VH&McCall significantly increased the risk of symptomatic prolapse recurrence compared to LSHP (OR: 4.65; 95 % CI: 1.326-16.312; P = 0.016).Conclusion: LSHP and VH&McCall might seem to be surgical options for individualized management with similar pelvic floor function & recurrence in the medium/long-term follow-up, but the age adjusted risk analysis showed higher rates of symptomatic recurrence after VH&McCall. Moreover, the better outcomes after LSHP in the younger subset, revealed the need of further clarification with well-designed prospective studies. [ABSTRACT FROM AUTHOR]

Background: Obesity is associated with an increased risk of falls in older women. However, it is not certain whether factors commonly associated with obesity and falls mediate this risk.Research Question: Do lower-limb muscle quality, foot loads and postural control mediate the relationship between obesity and falls in women aged 60 years and older?Methods: At baseline, 246 female participants underwent obesity screening (BMI≥30 kg/m²), and measurements of muscle quality (isokinetic dynamometer and dual-energy X-ray absorptiometry), foot loads (pressure platform) and postural balance (force platform). Incident falls were recorded at the end of the 18-month follow-up period via participant recall. To test whether, and to what extent, biomechanical factors mediated the relationship between obesity and falls, the Natural Indirect Effects (NIE), Natural Direct Effect (NDE) and proportion mediated were calculated using the counterfactual approach. Significance level was set at p < .05.Results: 204 participants (83 %) completed the follow-up. As expected, obesity was associated with a higher risk of being a faller (RR: 2.13, 95 % CI: 1.39-3.27). Using the counterfactual approach, only specific torque (NIE: 1.11, 95 % CI: 1.01-1.38) and flatfoot (NIE: 1.10, 95 % CI: 1.01-1.32) were significant mediators of the relationship between obesity and falls. Specific torque and flatfoot mediated 19 % and 21 % of the relationship, respectively.Significance: Lower-limb muscle quality (specific torque) and foot loads (flatfoot) mediate the relationship between obesity and falls in older women. The inclusion of muscle strengthening and podiatry interventions as part of a fall prevention program may benefit this population. [ABSTRACT FROM AUTHOR]

Background: Lower limb amputation is a major public health issue globally, and its prevalence is increasing significantly around the world. Previous studies on lower limb amputees showed analogous complexity implemented by the neurological system which does not depend on the level of amputation.Research Question: What are the differences in muscle synergies between healthy subjects (HS) and transfemoral amputees (TFA) during self-selected normal transient-state walking speed?Methods: thirteen male HS and eleven male TFA participated in this study. Surface electromyography (sEMG) data were collected from HS dominant leg and TFA intact limb. Concatenated non-negative matrix factorization (CNMF) was used to extract muscle synergy components synergy vectors (S) and activation coefficient profiles (C). Correlation between a pair of synergy vectors from HS and TFA was analyzed by means of the coefficient of determination (R2). Statistical parametric mapping (SPM) was used to compare the temporal components of the muscle synergies between groups.Results: the highest correlation was perceived in synergy 2 (S2) and 3 (S3) and the lowest in synergy 1 (S1) and 4 (S4) between HS and TFA. Statistically significant differences were observed in all of the activation coefficients, particularly during the stance phase. Significant lag in the activation coefficient of S2 (due mainly to activated plantarflexors) resulted in a statistically larger portion of the gait cycle (GC) in stance phase in TFA.Significance: Understanding the activation patterns of lower limb amputees' muscles that control their intact leg (IL) and prosthetic leg (PL) joints could lead to greater knowledge of neuromuscular compensation strategies in amputees. Studying the low-dimensional muscle synergy patterns in the lower limbs can further this understanding. The findings in this study could contribute to improving gait rehabilitation of lower limb amputees and development of the new generation of prostheses. [ABSTRACT FROM AUTHOR]

Many researchers emphasize adaptations following pregnancy. Our purpose was to get more insight into how morphology interacts with the pelvic walking pattern - the segment most prone to the adaptation following altered body demands. Thirty women were enrolled. Three experimental sessions were arranged according to the same protocol in the first, second and third trimesters of pregnancy. First, the anthropometric measures were taken, then walking trials at a self-selected speed were registered. At the end of the experimental session the subjects were asked to fill out a questionnaire on pain. The sagittal plane pelvic range of motion (RoM) significantly increased throughout pregnancy. There were significant positive correlations between pelvic anthropometric dimensions and pelvic tilt and rotation primarily in the third trimester of pregnancy. Significant positive correlations were found between pelvic RoM and thigh circumference. Indicators associated with body mass increase were positively correlated with pelvic obliquity in the second trimester and pelvic tilt and rotation in late pregnancy. It is also worth noting that the individual differences were not related to back pain and that the reported correlations were observed in some but not in all trimesters. Morphological changes following the fetus growth induced increased pelvic tilt and rotation, however, pelvis movements were not associated with back pain. Overall, the results highlight correlations between morphology and pelvis kinematic patterns in some but not in all trimesters. • The sagittal plane pelvis movements were significantly different between trimesters. • Dimensions of pelvis positively correlated with its rotation and tilt in late pregnancy. • Pelvic mobility did not correlate with pain in the gravid women. [ABSTRACT FROM AUTHOR]

• Moderate and high-intensity strength training in older adults can positively impact the immune system by reducing pro-inflammatory markers and promoting the production of anti-inflammatory markers. • The concurrent increase in muscle mass and release of inflammatory cytokines may enhance immune function in older adults with sarcopenia. • Engaging in moderate to high-intensity strength training helps in maintaining a favorable body composition, including the preservation of muscle mass, which plays a vital role in supporting a healthy immune system. This study investigated the intensity-effects of strength training on thigh muscle mass, cytokines, and immunocytes in the older adults. A total of 81 participated in this study. Participants were assigned randomly to four groups: control group (CON), low- (LSE), moderate- (MSE), and high-intensity strength exercise (HSE) groups. Three exercise groups worked out for 50 min/day, 3 days/week for 12 weeks. In the thigh volume analyzed by computed tomography, the exercise groups showed a significant increase in the muscle mass, with a clear pattern of change observed in the groups who exercised with moderate to high intensity. The lowest levels of interleukin (IL)-6 in the MSE group (-20.94%) and tumor necrosis factor-α in the HSE group (-28.75%) were observed. Notably, IL-10 showed a significant increase (35.72%) only in the MSE group. In the CON group, natural killer (NK) cells showed a decrease, while in the exercise groups, their levels increased. The highest levels of NK cells were observed in the HSE group. Similar patterns of change were observed in CD4 T cells and CD19 B cells. CD3 and CD8 T cells exhibited significant increases in the MSE and HSE groups. : This study presents evidence that engaging in moderate to high-intensity exercise may have a positive impact on cytokines and immunocytes by increasing muscle mass in older adults who may have sarcopenia. Engaging in strength training exercises is considered crucial for maintaining the health of older individuals who are susceptible to sarcopenia. When resistance exercises are performed at a moderate to strenuous intensity, it is anticipated that positive changes can occur in cytokines and immunocytes. These changes can be observed through improvements in thigh muscle volumes as measured by computed tomography. [ABSTRACT FROM AUTHOR]

Increased longevity is often associated with age-related conditions. The most common neurodegenerative disorders in the older population are Alzheimer's disease (AD) and Parkinson's disease (PD), associated with progressive neuronal loss leading to functional and cognitive impairments. Although symptomatic treatments are available, there is currently no cure for these conditions. Gut dysbiosis has been involved in the pathogenesis of AD and PD, thus interventions targeting the "gut-brain axis" could potentially prevent or delay these pathologies. Recent evidence suggests that the skeletal muscle and the gut microbiota can affect each other via the "gut-muscle axis". Importantly, cognitive functions in AD and PD patients significantly benefit from physical activity. In this review, we aim to provide a comprehensive picture of the crosstalk between the brain, the skeletal muscle and the gut microbiota, introducing the concept of "gut-muscle-brain axis". Moreover, we discuss human and animal studies exploring the modulatory role of exercise and probiotics on cognition in AD and PD. Collectively, the findings presented here support the potential benefits of physical activity and probiotic supplementation in AD and PD. Further studies will be needed to develop targeted and multimodal strategies, including lifestyle changes, to prevent or delay the course of these pathologies. • Dysbiosis has been implicated in neurodegenerative disorders. • Physical exercise can promote microbiota diversity and taxonomic shifts towards anti-inflammatory bacterial species. • Gut microbiota can affect the muscle physiology by increasing aminoacids availability and by releasing SCFAs. • Probiotic supplementation and physical exercise may ameliorate cognitive dysfunctions in AD and PD. • Both nutritional factors and exercise may have converging effects on brain functions via a "gut-muscle-brain axis". [ABSTRACT FROM AUTHOR]

The glycolytic capacity in the "white muscle fibers" found predominantly in broiler and turkey breast muscle have long been recognized as being key components contributing to optimal pH changes post-harvest and the quality of breast muscle products. The pectoralis major (PMAJ) is the predominant breast muscle and is almost exclusively comprised of fast-twitch glycolytic (anaerobic) type IIb muscle fibers (white). In nature, the pectoralis muscles are designed to meet the intense, periodic energy demands of flight in contrast to the continual, oxidative metabolism (aerobic) inherent to the type I slow twitch fibers (red) in the thigh and drum. Within the past decade, it has been recognized that increased breast muscle yield in modern broiler strains may have contributed to muscle myopathies characterized by visible white striations (white striping; WS) often accompanied by surface hemorrhages and areas of extreme firmness (woody breast; WB). The research to date has primarily addressed differences in muscle physiology and processing characteristics in "normal" and "abnormal" muscle samples from older broilers. One hypothesis is that the extensive accretion of protein in a poorly vascularized breast muscle overwhelms the capacity for coping with excessive production of reactive oxygen species and the term "oxidative stress" has been used to describe this condition. There are few recent reports in poultry, however, which have addressed the potential negative physiological effects imposed by multiple layers of fascia surrounding individual muscle fibers, fiber bundles, and intact muscles on circulation and oxidative stability. The objective of this review is to support our hypothesis that the extensive accretion of breast muscle in a poorly vascularized and tightly bound PMAJ could be creating a "compartment syndrome" like condition leading to the development of the WS and WB anomalies in heavy, high yielding birds. Recent gene expression data support this hypothesis. [ABSTRACT FROM AUTHOR]

Excess body mass is thought to be a major cause of altered biomechanics in obesity, but the effects of body mass distribution in biomechanics during daily living tasks are unknown. The purpose of this study was to determine how increasing body mass centrally and peripherally affects lower extremity kinematics, kinetics, and muscle activation when transitioning from stair descent to level gait. Fifteen normal weight volunteers descended a staircase at a self-selected pace under unloaded, centrally loaded, and peripherally loaded conditions. Spatial-temporal gait characteristics and lower extremity joint kinematics, kinetics, and mean electromyography amplitude were calculated using 3D motion analysis. Both central and peripheral loading reduced gait velocity. Peripheral loading increased time spent in stance phase, increased step width, and reduced step length. At the hip joint, peripheral loading reduced peak hip extension and adduction angle. Conversely, central loading reduced peak hip flexor moment. Both central and peripheral loading increased peak knee flexion angle, but only peripheral loading increased peak knee extensor moment. Central and peripheral loading increased mean electromyography amplitude of the medial gastrocnemius, but only peripheral loading increased mean electromyography amplitude of the semitendinosus and the vastus medialis. Increasing mass centrally and peripherally differently affects spatial-temporal gait characteristics and lower extremity joint kinematics, kinetics, and electromyography when transitioning from stair descent to level gait. Body mass distribution may be an important factor for obesity-induced biomechanical alterations and should be considered when developing biomechanical models of obesity. • Increasing body mass, regardless of distribution, reduces stair descent velocity • Adding mass to thighs, but not the trunk, negatively impacts spatial-temporal parameters during stair transition • Hip and knee kinematics and kinetics are differently affected by adding mass to the trunk and thighs • Adding mass to the thighs, but not the trunk, increases EMG activity of the knee flexors and extensors • Distribution of mass is an important determinant of kinematics, kinetics, and muscle recruitment during stair transitions [ABSTRACT FROM AUTHOR]

The mechanical characterization of skeletal muscle under high-rate loading regimes is important for predicting traumatic injuries due to traffic accidents and contact sports. However, it is difficult to perform dynamic mechanical tests at rates relevant to such rapid loading events. In the present study, a series of stress relaxation tests were conducted on rabbit hind-limb muscle fiber bundles using a custom tensile tester. Using relatively moderate loading conditions compared to those typically associated with traumatic injuries, the passive stress-decaying mechanical properties of muscle fiber bundles were characterized. In addition, stress relaxation responses to various ramp-hold stretches were theoretically predicted by a custom-built code. The results showed that the muscle fiber bundles exhibit greater stress relaxation at higher loading rates and greater stretch magnitudes. Based on these results, the data points representing the "elastic" stress–strain tensile behavior typical of traumatic injury were extrapolated using curve fitting. The theoretical model revealed rate-dependent characteristics of the muscle fiber bundles under traumatic loading conditions, which would result in tensile strengths of 300–500 kPa at the maximum engineering strain of 54%. This strength is on the order of magnitude as the maximum isometric stress of an active muscle contraction. The proposed numerical model is expected to serve as a powerful research tool to investigate injury mechanisms of the skeletal muscle. Moreover, the elastic response that was theoretically predicted here will be useful in the development of effective countermeasures to prevent traumatic injuries due to rapid loading events. • Rapidly stretched muscle fiber bundles showed 20% stress relaxation for 0.4 s after the ramp period. • Traumatic loading condition will theoretically lead to tensile strength of~400 kPa at 54% strain. • Predicted tensile strength was equivalent to the maximum isometric stress of muscle contraction. [ABSTRACT FROM AUTHOR]

Background The combined supplementation of medium-chain triglycerides (MCTs), l -leucine–rich amino acids, and cholecalciferol was previously shown to increase muscle strength and function in frail elderly individuals. Objective We examined whether treatment with MCTs alone is sufficient to increase muscle strength and function and activities of daily living (ADL) in such individuals. Methods We enrolled 64 elderly nursing home residents (85.5 ± 6.8 y) in a 3-mo randomized, controlled, single-blinded intervention trial. The participants were randomly assigned to 3 groups: the first group received supplemental l -leucine (1.2 g) and cholecalciferol (20 μg) enriched with 6 g/d of MCTs (LD + MCT group) as a positive control, the second group received 6 g/d of MCTs (MCT group) as a target, and the third group received 6 g/d of long-chain triglycerides (LCT group) as a negative control. Changes in muscle mass, strength, function, and ADL were monitored 4 times: at baseline, at 1.5 and 3 mo after initiation of the intervention (intervention), and 1.5 mo after termination of the intervention (washout). Results The 64 participants randomly assigned to the 3 groups were included in an intention-to-treat analysis. Forty-eight participants completed the study and were included in a per-protocol analysis. At 3 mo, participants in the MCT group had a 48.1% increase in 10-s leg open and close test performance [intention-to-treat adjusted means: MCT 2.28 n/10 s (1.37, 3.19) compared with LCT −0.59 n/10 s (−1.52, 0.35), P  < 0.05], a 27.8% increase in a 30-s repetitive saliva swallowing test [MCT 0.5 n/30 s (0.1, 1.0) compared with LCT −0.5 n/30 s (−0.9, 0.0), P  < 0.05], and a 7.5% increase in Functional Independence Measure score, a questionnaire for assessing ADL [MCT 5.6 points (1.3, 9.9) compared with LCT −6.6 points (−11.3, −2.0), P  < 0.05]. Conclusion MCTs (6 g/d) could increase the muscle strength and function of frail elderly individuals and also improve their ADL. This trial was registered at the University Hospital Medical Information Network Clinical Trial Registry as UMIN000023302. [ABSTRACT FROM AUTHOR]

• Report clinical and histological features of two families with recessive MYH7 -related myopathy. • Skinned myofiber studies on muscle from myosin storage myopathy patients. • Mutant MYH7 myosin expression in COS-7 cells shows altered self-assembly of myosin. Myopathies due to recessive MYH7 mutations are exceedingly rare, reported in only two families to date. We describe three patients from two families (from Australia and the UK) with a myopathy caused by recessive mutations in MYH7. The Australian family was homozygous for a c.5134C > T , p.Arg1712Trp mutation, whilst the UK patient was compound heterozygous for a truncating (c.4699C > T ; p.Gln1567*) and a missense variant (c.4664A > G ; p.Glu1555Gly). All three patients shared key clinical features, including infancy/childhood onset, pronounced axial/proximal weakness, spinal rigidity, severe scoliosis, and normal cardiac function. There was progressive respiratory impairment necessitating non-invasive ventilation despite preserved ambulation, a combination of features often seen in SEPN1 - or NEB -related myopathies. On biopsy, the Australian proband showed classical myosin storage myopathy features, while the UK patient showed multi-minicore like areas. To establish pathogenicity of the Arg1712Trp mutation, we expressed mutant MYH7 protein in COS-7 cells, observing abnormal mutant myosin aggregation compared to wild-type. We describe skinned myofiber studies of patient muscle and hypertrophy of type II myofibers, which may be a compensatory mechanism. In summary, we have expanded the phenotype of ultra-rare recessive MYH7 disease, and provide novel insights into associated changes in muscle physiology. [ABSTRACT FROM AUTHOR]