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The relaxation of trapezius muscles is widely believed to alleviate fatigue or injury of the trapezius muscles and reduce the risk of shoulder and neck pain. This study aims to examine the effects of different muscle relaxation techniques on the physical properties of the trapezius muscle and to explore how changes in the physical properties of the upper trapezius muscle affect those of the middle trapezius muscle. Twenty-four healthy males (mean age: 23.08 ± 0.97 years; height: 172.42 ± 4.61 cm; weight: 66.38 ± 6.68 kg; and body mass index: 22.30 ± 1.81 kg/m2), randomly divided into four groups: stretching relaxation group (ST, n = 6), mechanical vibration massage (MV, n = 6), pulse massage (PU, n = 6), and control (CO, n = 6). Measurements using the Myoton digital muscle assessment system were conducted daily over 2 weeks. The experimental groups demonstrated a notable decrease in tension and stiffness, accompanied by heightened elasticity in the upper trapezius muscles. Conversely, the control group exhibited contrasting trends. Although no significant variances were detected among the relaxation techniques, all proved efficacious compared to the control group (P < 0.05). Moreover, relaxation of the upper trapezius muscles significantly influenced the middle trapezius muscles (P < 0.05). Various relaxation methods positively influenced trapezius muscle attributes over 2 weeks, with inter-regional effects noted.

Objective: To explore the application effect of different administration methods of cisatracurium combined with propofol in laparoscopic surgery and its impact on muscle relaxation and recovery. Methods: 120 patients who underwent laparoscopic surgery in our hospital from January 2021 to November 2023 were selected. They were randomly divided into an intermittent medication group and a one-time medication group, with 60 patients in each group. All patients were treated with 2 mg/kg propofol, 0. 4μg/kg sufentanil, and 0. 5μg/kg after entering the operating room. The intermittent administration group received intravenous injection of cisatracurium once every 2 hours, with a dose of 0. 1 mg/kg. The one-time administration group received a single intravenous injection of 0. 1 mg/kg cisatracurium to induce muscle relaxation, and the muscle relaxation effect was determined based on the T1 seizure inhibition value, with T1=12%. When T1＞12%, intravenous injection of 0. 03 mg/kg cisatracurium was administered. Compare the dosage, effective time of muscle relaxation, maintenance time of muscle relaxation, maximum inhibition of T1, onset time of muscle relaxation, baseline value upon entry (T1), immediate start of surgery (T2), 20 minutes after surgery (T3), and immediate end of surgery (T4) in two groups of patients, as well as the changes in vital signs, recovery of postoperative muscle relaxation, and incidence of adverse reactions. Results: There was no significant difference in the maintenance time, T1maximum inhibition program, and onset time of muscle relaxation between the two groups of patients (P＞0. 05). The dosage of cisatracurium in the one-time treatment group was lower than that in the intermittent treatment group, and the effective time of muscle relaxation was higher than that in the intermittent treatment group (P＜0. 05); There were no significant changes in heart rate (HR), systolic blood pressure (SBP), blood oxygen saturation (SPO2), and diastolic blood pressure (DBP) levels at T1, T2, T3, and T4 in the two groups of patients, and there was no significant difference between the one-time administration group and the intermittent administration group (P＞0. 05); The TOFr 0. 90, TOFr 0. 80, TOFr 0. 75, TOFr 0. 25, and extubation time of patients in the one-time administration group were significantly lower than those in the intermittent administration group (P＜0. 05); The incidence of ad verse reactions such as bradycardia, rash, bronchospasm, and hypotension in the one-time administration group was significantly lower than that in the intermittent administration group (P＜0. 05). Conclusion: Intermittent administration and one-time administration of cisatracurium in laparoscopic surgery have no significant impact on the patient’s intraoperative vital signs, muscle relaxation maintenance time, and muscle relaxation effect. However, one-time administration and T1 seizure inhibition value can reduce the dosage of cisatracurium administration, promote postoperative muscle relaxation recovery, and have high safety. [ABSTRACT FROM AUTHOR]

The relaxation of trapezius muscles is widely believed to alleviate fatigue or injury of the trapezius muscles and reduce the risk of shoulder and neck pain. This study aims to examine the effects of different muscle relaxation techniques on the physical properties of the trapezius muscle and to explore how changes in the physical properties of the upper trapezius muscle affect those of the middle trapezius muscle. Twenty-four healthy males (mean age: 23.08 ± 0.97 years; height: 172.42 ± 4.61 cm; weight: 66.38 ± 6.68 kg; and body mass index: 22.30 ± 1.81 kg/m2), randomly divided into four groups: stretching relaxation group (ST, n = 6), mechanical vibration massage (MV, n = 6), pulse massage (PU, n = 6), and control (CO, n = 6). Measurements using the Myoton digital muscle assessment system were conducted daily over 2 weeks. The experimental groups demonstrated a notable decrease in tension and stiffness, accompanied by heightened elasticity in the upper trapezius muscles. Conversely, the control group exhibited contrasting trends. Although no significant variances were detected among the relaxation techniques, all proved efficacious compared to the control group (P < 0.05). Moreover, relaxation of the upper trapezius muscles significantly influenced the middle trapezius muscles (P < 0.05). Various relaxation methods positively influenced trapezius muscle attributes over 2 weeks, with inter-regional effects noted. [ABSTRACT FROM AUTHOR]

Pathological puncture biopsy is the key to early diagnosis and treatment of thoracic tumours, and percutaneous puncture biopsy (PTNB) technology has been widely used in clinical practice. Common complications of PTNB include pneumothorax, air embolism and pulmonary hemorrhage. In order to optimize traditional PTNB, our center has developed a new percutaneous puncture diagnosis and ablation technology for lung lesions, which greatly reduces the occurrence of complications, increases the accuracy of pathological biopsy. At the same time, it can bridge target lesion ablation. This article describes the standard operating procedure for diagnosis and ablation techniques of filling operation assisted percutaneous transthoracic needle biopsy under rigid endoscopy with regular frequency controlled ventilation during general anesthesia. [ABSTRACT FROM AUTHOR]

Intraoperative neurophysiological monitoring (IONM) is a valuable technique used during brain tumor resections to assess and preserve neurological function. This case report investigates the impact of intraoperative magnesium sulfate infusion on neuroprotection and muscle relaxation in the context of IONM during brain tumor resection. A 48-year-old male with altered awareness and occasional convulsive movements involving his right upper and lower limbs accompanied by progressive right-sided weakness and occasional sensory disturbances was diagnosed with a left temporal lobe tumor. He underwent craniotomy for tumor resection, with concurrent IONM and an intraoperative magnesium sulfate infusion. The patient’s neurophysiological parameters, surgical outcomes, and postoperative recovery were analyzed, suggesting a potential synergistic effect between magnesium sulfate and IONM in optimizing patient outcomes.

Introduction. Hemorrhagic stroke causes significant deviations in the psycho-emotional, moral-volitional and social spheres. Kinesiotherapy is a new effective method used in rehabilitation and physical therapy programs for post-stroke patients with myofascial pain syndrome. This publication presents the results of the study of the quality of life of post-stroke patients before and at different times after complex kinesiotherapy, as well as the characteristics of the answers related to the quality of life after the program of combined rehabilitation and physical therapy are given. The aim of the study is to substantiate the inclusion of kinesiotherapy in the basic rehabilitation and physical therapy programs for post-stroke patients with myofascial pain syndrome. Materials and methods. The study included 105 patients aged 57 to 64 with a verified diagnosis of hemorrhagic stroke complicated by myofascial pain syndrome." The SF-36 general questionnaire was used to assess the quality of life. Results. It was established that indicators of the quality of life of post-stroke patients before implementation programs of rehabilitation and physical therapy are significantly reduced on most scales of physical, mental and social functioning; the quality of life profile of patients is characterized by compression and deformation. Conducting kinesiotherapy with acupuncture is accompanied by a marked improvement in quality of life indicators of post-stroke patients with myofascial pain syndrome. Responses related to the quality of life, in the form of improvement or stabilization, were registered in the majority of post-stroke patients with myofascial pain syndrome after complex kinesiotherapy – in 96% of patients after a combined program of rehabilitation and physical therapy and in 87% of patients after kinesiotherapy. Conclusions. The profile of the quality of life of patients with hemiparesis indicates its compression and deformation, which is caused by a significant decrease in indicators that characterize the physical, mental and social scales of functioning. Long-term monitoring of such patients after the implementation of the author's physical rehabilitation program indicates a stabilization of the quality of life, which is manifested by a pronounced improvement in the profile of 96% of post-stroke patients with myofascial pain syndrome after complex and in 87% of patients in combination with acupuncture.

The force drop after transcranial magnetic stimulation (TMS) delivered to the motor cortex during voluntary muscle contractions could inform about muscle relaxation properties. Because of the physiological relation between skeletal muscle fibertype distribution and size and muscle relaxation, TMS could be a noninvasive index of muscle relaxation in humans. By combining a noninvasive technique to record muscle relaxation in vivo (TMS) with the gold standard technique for muscle tissue sampling (muscle biopsy), we investigated the relation between TMS-induced muscle relaxation in unfatigued and fatigued states, and muscle fiber-type distribution and size. Sixteen participants (7F/9M) volunteered to participate. Maximal knee-extensor voluntary isometric contractions were performed with TMS before and after a 2-min sustained maximal voluntary isometric contraction. Vastus lateralis muscle tissue was obtained separately from the participants’ dominant limb. Fiber type I distribution and relative cross-sectional area of fiber type I correlated with TMS-induced muscle relaxation at baseline (r = 0.67, adjusted P = 0.01; r = 0.74, adjusted P = 0.004, respectively) and normalized TMS-induced muscle relaxation as a percentage of baseline (r = 0.50, adjusted P = 0.049; r = 0.56, adjusted P = 0.031, respectively). The variance in the normalized peak relaxation rate at baseline (59.8%, P < 0.001) and in the fatigue resistance (23.0%, P = 0.035) were explained by the relative cross-sectional area of fiber type I to total fiber area. Fiber type I proportional area influences TMS-induced muscle relaxation, suggesting TMS as an alternative method to noninvasively inform about skeletal muscle relaxation properties. NEW & NOTEWORTHY Transcranial magnetic stimulation (TMS)-induced muscle relaxation reflects intrinsic muscle contractile properties by interrupting the drive from the central nervous system during voluntary muscle contractions. We showed that fiber type I proportional area influences the TMS-induced muscle relaxation, suggesting that TMS could be used for the noninvasive estimation of muscle relaxation in unfatigued and fatigued human muscles when the feasibility of more direct method to study relaxation properties (i.e., muscle biopsy) is restricted. [ABSTRACT FROM AUTHOR]

Movement and muscle control are crucial for the survival of all free-living organisms. This study aimed to explore differential patterns of cortical and subcortical activation across different stages of muscle control using functional magnetic resonance imaging (fMRI). An event-related design was employed. In each trial, participants (n = 10) were instructed to gently press a button with their right index finger, hold it naturally for several seconds, and then relax the finger. Neural activation in these temporally separated stages was analyzed using a General Linear Model. Our findings revealed that a widely distributed cortical network, including the supplementary motor area and insula, was implicated not only in the pressing stage, but also in the relaxation stage, while only parts of the network were involved in the steady holding stage. Moreover, supporting the direct/indirect pathway model of the subcortical basal ganglia, their substructures played distinct roles in different stages of muscle control. The caudate nucleus exhibited greater involvement in muscle contraction, whereas the putamen demonstrated a stronger association with muscle relaxation; both structures were implicated in the pressing stage. Furthermore, the subthalamic nucleus was exclusively engaged during the muscle relaxation stage. We conclude that even the control of simple muscle movements involves intricate automatic higher sensory–motor integration at a neural level, particularly when coordinating relative muscle movements, including both muscle contraction and muscle relaxation; the cortical and subcortical regions assume distinct yet coordinated roles across different stages of muscle control. [ABSTRACT FROM AUTHOR]

During the hibernation season, Arctic ground squirrels (AGS) experience extreme temperature fluctuations (body temperature, Tb, as low as − 3 °C), during which they are mostly physically inactive. Once Tb reaches ~ 15 °C during interbout arousals, hibernators recruit skeletal muscle (SkM) for shivering thermogenesis to reach Tb of ~ 35 °C. Polyunsaturated fatty acids (PUFA) in the diet are known to influence SkM function and metabolism. Recent studies in the cardiac muscle of hibernators have revealed that increased levels of ω-6 and the ω-6:ω-3 PUFA ratio correlate with sarco/endoplasmic reticulum calcium ATPase (SERCA) activity and hibernation status. We hypothesized that diet (increased ω-6:ω-3 PUFA ratio) and torpor status are important in the regulation of the SERCA pump and that this may improve SkM performance during hibernation. Ex vivo functional assays were used to characterize performance changes in SkM (diaphragm) from AGS fed the following diets. (1) Standard rodent chow with an ω-6:ω-3 ratio of 5:1, or (2) a balanced diet with an ω-6:ω-3 ratio of 1:1 that roughly mimics wild diet. We collected diaphragms at three different stages of hibernation (early torpor, late torpor, and arousal) and evaluated muscle function under hypothermic temperature stress at 4 °C, 15 °C, 25 °C, and 37 °C to determine functional resilience. Our data show that torpid animals fed standard rodent chow have faster SkM relaxation when compared to the balanced diet animals. Furthermore, we discovered that standard rodent chow AGS during torpor has higher SkM relaxation kinetics, but this effect of torpor is eliminated in balanced diet AGS. Interestingly, neither diet nor torpor influenced the rate of force development (rate of calcium release). This is the first study to show that increasing the dietary ω-6:ω-3 PUFA ratio improves skeletal muscle performance during decreased temperatures in a hibernating animal. This evidence supports the interpretation that diet can change some functional properties of the SkM, presumably through membrane lipid composition, ambient temperature, and torpor interaction, with an impact on SkM performance. [ABSTRACT FROM AUTHOR]

Jatropha podagrica Hook., a member of the Euphorbiaceae family and known as “Dầu lai có củ” in Vietnamese, has a rich traditional use in treating constipation, skin infections, jaundice, and fever. The plant's chemical profile includes flavonoids, coumarins, phenolic acids, diterpenoids, peptides, and steroids. Numerous studies have highlighted the diverse biological effects of Jatropha podagrica, encompassing antibacterial and anticancer properties, antioxidant activity, insecticidal effects, muscle relaxation, and hypotensive activity. Despite its promising medicinal attributes, Jatropha podagrica remains underutilized, largely due to a lack of awareness. This review aims to offer an up-to-date and comprehensive exploration of the botany, phytochemistry, and bioactivities of Jatropha podagrica. To compile this information, searches were conducted on scientific databases such as Google Scholar, Elsevier, Springer and PubMed. In conclusion, Jatropha podagrica, with its diverse bioactive compounds, emerges as a valuable resource for addressing various health conditions. [ABSTRACT FROM AUTHOR]

Abstract Objectives The quantitative assessment of muscle stiffness or weakness is essential for medical care. Shear wave elastography is non-invasive ultrasound method and provides quantitative information on the elasticity of soft tissue. However, the universal velocity scale for quantification has not been developed. The aim of the study is to determine the shear wave velocities of abdominal muscle during anesthetic induction and to identify methods to cancel the effects of confounders for future development in the quantitative assessment of muscle tone using the universal scale. Methods We enrolled 75 adult patients undergoing elective surgery with ASA-PS I – III in the period between December 2018 and March 2021. We measured and calculated the shear wave velocity (SWV) before and after opioid administration (i.e., the baseline at rest and opioid-induced rigidity condition), and after muscle relaxant administration (i.e., zero reference condition). The SWV value was adjusted for the subcutaneous fat thickness by our proposed corrections. The SWVs after the adjustment were compared among the values in baseline, rigidity, and relaxation using one-way repeated-measures ANOVA and post hoc Tukey–Kramer test. A p-value of

Objectives: The quantitative assessment of muscle stiffness or weakness is essential for medical care. Shear wave elastography is non-invasive ultrasound method and provides quantitative information on the elasticity of soft tissue. However, the universal velocity scale for quantification has not been developed. The aim of the study is to determine the shear wave velocities of abdominal muscle during anesthetic induction and to identify methods to cancel the effects of confounders for future development in the quantitative assessment of muscle tone using the universal scale. Methods: We enrolled 75 adult patients undergoing elective surgery with ASA-PS I – III in the period between December 2018 and March 2021. We measured and calculated the shear wave velocity (SWV) before and after opioid administration (i.e., the baseline at rest and opioid-induced rigidity condition), and after muscle relaxant administration (i.e., zero reference condition). The SWV value was adjusted for the subcutaneous fat thickness by our proposed corrections. The SWVs after the adjustment were compared among the values in baseline, rigidity, and relaxation using one-way repeated-measures ANOVA and post hoc Tukey–Kramer test. A p-value of < 0.05 was considered to be statistically significant. UMIN Clinical Trials Registry identifier UMIN000034692, registered on October 30, 2018. Results: The SWVs in the baseline, opioid-induced rigidity, and muscle relaxation conditions after the adjustment were 2.08 ± 0.48, 2.41 ± 0.60, and 1.79 ± 0.30 m/s, respectively (p < 0.001 at all comparisons). Conclusion: The present study suggested that the SWV as reference was 1.79 m/s and that the SWVs at rest and opioid-induced rigidity were ~ 10% and ~ 30% increase from the reference, respectively. The SWV adjusted for the subcutaneous fat thickness may be scale points for the assessment of muscle tone. [ABSTRACT FROM AUTHOR]

Prolonged operation times should be avoided due to the associated complications and negative effects on the efficiency of the use of operating room resources. Surgical treatment of mandibular condylar head fractures is a well-established routine procedure at our department, nevertheless, we recognized fluctuating operating times. This study aims to pinpoint the influencing factors, in particular the hypothesis whether the efficiency of intraoperative muscle relaxation may decisively affect the duration of surgery. It analyses 168 mandibular condylar head fractures that were surgically treated in the period from 2007 to 2022 regarding the duration of the surgery and potential factors affecting it. The potential predictors' influence on the dependent variable operation time was mainly calculated as a bivariate analysis or linear regression. Efficiency of relaxation (p ≤ 0.001), fragmentation type (p = 0.031), and fracture age (p = 0.003) could be identified as decisive factors affecting the duration of surgery, as the first surgeon was a constant. In conclusion, surgical intervention should start as soon as possible after a traumatic incident. In addition, a dosage regimen to optimize the efficiency of relaxation should be established in future studies. Fragmentation type and concomitant fractures should also be considered for a more accurate estimation of the operating time. [ABSTRACT FROM AUTHOR]

A child with Down syndrome (DS) is physically characterized by muscle hypotonia, joint instability, and poor motor coordination. Here, we tested whether Dohsa-hou training could improve motor coordination among children with DS, compared to a control condition. Forty children with DS were randomly assigned either to Dohsa-hou training or to a control condition. All participants completed a bimanual coordination test, at the following time points: baseline, seven weeks later at completion of the intervention, and again 4 weeks later at follow-up. Bimanual coordination accuracy and consistency improved from baseline to intervention completion and to follow-up, but only in the Dohsa-hou training, compared to the control group. The findings suggest that among children with DS and compared to a control condition, Dohsa-hou training has the potential to enhance the bimanual coordination, thus contributing to improved motor control of children with DS. [ABSTRACT FROM AUTHOR]

To enhance smooth muscle contraction and relaxation during rehabilitation and sports activities, a comprehensive understanding of the motor control mechanisms within the central nervous system is necessary. However, current knowledge on these aspects is insufficient. Therefore, this study aimed to deepen our understanding of motor controls, by investigating the alterations in corticospinal excitability within cortical motor areas related to muscle contraction and relaxation using motor imagery with a reaction time task paradigm. Transcranial magnetic stimulation was used to measure the motor‐evoked potentials in the first dorsal interosseous muscle of the right hand after the 'go' signal. Static weak muscle contraction (Experiment 1: 18 healthy participants) and resting state (Experiment 2: 16 healthy participants) were applied as background factors, and a trial without motor imagery was performed as a control. Muscle contraction was maintained in the background in the contraction motor imagery. A decrease in excitability in the relaxation motor imagery task occurred compared with the control. When the muscles were at rest, an increase in excitability in the contraction motor imagery and a transient increase in excitability in the relaxation motor imagery occurred compared with the control condition. Hence, the excitability of contraction and relaxation motor imagery is characterized by a continuous increase in excitability, transient increase and subsequent decrease in excitability, respectively. These results suggest that muscle contraction sensory information in the background condition may be necessary for muscle relaxation. Matching the background conditions may be crucial when utilizing motor imagery for rehabilitation or sports training. [ABSTRACT FROM AUTHOR]

Background: Yoga has been known as an alternative therapeutic modality for reducing pain. The benefits of yoga for reducing pain have been proven. Women often suffer pain due to dysmenorrhea. The effect of Yoga on dysmenorrhea pain has not been widely studiedObjectives: This study aimed to investigate the effect of hatha yoga on pain in primary dysmenorrhea (PD). Methods: This was a randomized controlled study (RCT) involving 50 female students, 25 each in control (C) and yoga group (Y). PD was diagnosed by Working ability, Location, Intensity (Wong-Baker scale), and Days of the Pain of Dysmenorrhea (WaLIDD) questionnaire. Pain intensity was assessed by the Numeric Rating Scale (NRS). Hatha yoga training was conducted for 12 weeks. The unpaired t-test, ANOVA and Tukey post hoc, and Pearson correlation test was applied. Significance was set at p. Results: The characteristics between groups were not different. ANOVA indicated the NRS score in control was not changed, while yoga was diminished (p=0.02). Tukey post hoc showed that the second and third NRS were lower than basal NRS (p=0.038 and 0.01, respectively). The third was also lower than the second NRS (p=0.039). The second and the third NRS in yoga were lower than in control (p=0.027 and 1.92 ±2.4 vs. 3.09 ± 2.8, p=0.018). The magnitude of NRS changes in the first (0.06±1.1 vs. 1.92±2.4, p=0.013) and second (0.02 ± 1.6 vs. 3.09 ± 2.8, p= 0.004) in yoga was significantly greater than the control. NRS score was not correlated with age, BMI, and age of menarche. Conclusions: Hatha yoga exercise ameliorate pain intensity in primary dysmenorrhea among female university students.

Study Design Prospective randomized controlled study. Purpose This study aimed to assess the effects of a different combination of anesthetic techniques in lumbar and thoracolumbar spinal surgeries in terms of muscle relaxation and surgical field in addition to hemodynamic parameters. Overview of Literature Adequate relaxation of the erector spinae muscle and good surgical fields are preferred in lumbar spine surgeries. The effects of anesthetic techniques on these parameters have not been evaluated from a surgeon’s perspective to date. We propose a novel combined anesthetic technique that improves the working conditions from a surgeon’s perspective as we hypothesize that combining general anesthesia (GA) with regional anesthesia (RA) might provide benefits for both techniques. Methods A prospective randomized study of 76 patients who underwent lumbar and thoracolumbar surgeries was conducted by randomly allocating patients into three anesthetic groups: GA alone, GA with spinal anesthesia (SA), and GA with erector spinae plane block (ESPB) by the allocation concealment method to avoid selection bias. The working conditions were assessed by the same operating surgeon who was blinded by the type of anesthesia to eliminate the assessment bias. Muscle relaxation and surgical field were compared among the three groups along with other hemodynamic parameters to identify any significant differences. Results Significantly better muscle relaxation, surgeon satisfaction, postoperative analgesia, and blood pressure (BP) were observed in the GA+RA when compared to GA alone (p0.05). Complications were only observed in the GA+SA group (19%). Conclusions The study results suggest that the addition of RA to GA may provide better working conditions and surgeon’s satisfaction by improving relaxation of the erector spinae in addition to decreasing the BP and postoperative pain in contrast to the use of GA alone. The combined GA and ESPB techniques may be a viable anesthetic alternative to provide better working conditions for surgeons.

Abstract Background Vocal cord polyp is common otorhinolaryngological disease, traditionally treated by vocal cord polypectomy under a supporting laryngoscope with general anaesthesia. Although it is safe and controllable, it would cause some anaesthesia complications. Moreover, the complex process of general anaesthesia may significantly reduce surgical efficiency. Avoiding these problems remains an important issue. Methods All patients were subjected to the standard non-intubated deep paralysis (NIDP) protocol consisting of four phases. An emergency plan was launched when NIDP cannot be implemented successfully. Patient characteristics, blood gas and monitoring data were collected during NIDP. Data concerning satisfaction, complications and duration of anaesthesia and recovery were collected to assess its effectiveness. Result Among 20 enrolled patients, the success rate of NIDP was 95%. Only one patient failed in completing NIDP. Blood gas analysis revealed that the partial pressure of oxygen and carbon dioxide was maintained at safe levels. Monitoring during NIDP revealed fluctuations in mean arterial pressure between 110 and 70 mmHg, and the heart rate was stable at 60–100 beats per minute. The duration of anaesthesia and postoperative recovery were 13.0 ± 2.84 and 5.47 ± 1.97 min, respectively. All patients and surgeons were satisfied with NIDP, and no complications were detected before discharge. Conclusion NIDP can be safely applied to patients and can replace general anaesthesia in vocal cord polypectomy. It can significantly reduce the duration of anaesthesia and postoperative recovery. No anaesthesia complications occurred without intubation, and patients and surgeons were satisfied with NIDP. Trial registrations This single-centre, prospective study was registered on clinicaltrial.gov (NCT04247412) on 30th July 2020.

Movement and muscle control are crucial for the survival of all free-living organisms. This study aimed to explore differential patterns of cortical and subcortical activation across different stages of muscle control using functional magnetic resonance imaging (fMRI). An event-related design was employed. In each trial, participants (n = 10) were instructed to gently press a button with their right index finger, hold it naturally for several seconds, and then relax the finger. Neural activation in these temporally separated stages was analyzed using a General Linear Model. Our findings revealed that a widely distributed cortical network, including the supplementary motor area and insula, was implicated not only in the pressing stage, but also in the relaxation stage, while only parts of the network were involved in the steady holding stage. Moreover, supporting the direct/indirect pathway model of the subcortical basal ganglia, their substructures played distinct roles in different stages of muscle control. The caudate nucleus exhibited greater involvement in muscle contraction, whereas the putamen demonstrated a stronger association with muscle relaxation; both structures were implicated in the pressing stage. Furthermore, the subthalamic nucleus was exclusively engaged during the muscle relaxation stage. We conclude that even the control of simple muscle movements involves intricate automatic higher sensory–motor integration at a neural level, particularly when coordinating relative muscle movements, including both muscle contraction and muscle relaxation; the cortical and subcortical regions assume distinct yet coordinated roles across different stages of muscle control.

Specific phobia is frequently unrecognized or untreated unless it causes significant impairment. In this report, we documented a rare case of a pregnant patient who had a specific fear related to vaginal penetration. Due to abnormal fetal cardiac development in the second trimester, the patient was admitted for termination of pregnancy. The patient's persistent request for surgical termination via cesarean delivery prompted the obstetrician to seek psychiatric consultation for tokophobia, a labor- and childbirth-related phobia. The consulting psychiatrist discovered that the patient had developed a significant fear of vaginal penetration during adolescence. Throughout the extended period of this specific phobia, the patient established a range of avoidance strategies. Had it not been for the unforeseen need for abortion, her phobia may not have been identified. Psychoeducation on specific phobias, exposure therapy, muscle relaxation techniques, and the administration of anxiolytics were implemented. The pregnancy was terminated through a vaginal labor induction procedure 2 days later. Collaboration across disciplines is necessary to support a thorough assessment of obstetric patients who express hesitancy toward vaginal delivery. [ABSTRACT FROM AUTHOR]

Skeletal muscles contain large numbers of high-molecular-mass protein complexes in elaborate membrane systems. Integral membrane proteins are involved in diverse cellular functions including the regulation of ion handling, membrane homeostasis, energy metabolism and force transmission. The proteomic profiling of membrane proteins and large protein assemblies in skeletal muscles are outlined in this article. This includes a critical overview of the main biochemical separation techniques and the mass spectrometric approaches taken to study membrane proteins. As an illustrative example of an analytically challenging large protein complex, the proteomic detection and characterization of the Ca2+-ATPase of the sarcoplasmic reticulum is discussed. The biological role of this large protein complex during normal muscle functioning, in the context of fiber type diversity and in relation to mechanisms of physiological adaptations and pathophysiological abnormalities is evaluated from a proteomics perspective. Mass spectrometry-based muscle proteomics has decisively advanced the field of basic and applied myology. Although it is technically challenging to study membrane proteins, innovations in protein separation methodology in combination with sensitive mass spectrometry and improved systems bioinformatics has allowed the detailed proteomic detection and characterization of skeletal muscle membrane protein complexes, such as Ca2+-pump proteins of the sarcoplasmic reticulum. [ABSTRACT FROM AUTHOR]

Abstract Background Caring for patients with coronavirus disease 2019 (COVID-19) challenges nurses and causes them to experience stress and anxiety. From this perspective, it is of utmost importance to develop quick and effective intervention strategies to prevent numerous complications. This study aimed to investigate the effect of the progressive muscle relaxation technique, using the demonstration method on the stress and anxiety of nurses who care for COVID-19 patients. Methods This randomized clinical trial was conducted in 2021. Forty-six nurses working in two referral hospitals with wards for COVID-19 patients in Tehran, Iran recruited by convenience sampling method and then randomly assigned to experimental or control groups. The nurses in the experimental group educated the progressive muscle relaxation by the demonstration method, and they were encouraged to practice it. The Depression Anxiety Stress Scale-21 was utilized to measure the stress and anxiety levels in the nurses. Results Before the intervention, the levels of stress in the experimental and control groups were 13.91 ± 2.41 vs. 14.34 ± 2.74 (p = 0.571), and their anxiety was 13.34 ± 3.41 vs. 12.78 ± 2.21 (p = 0.510), respectively. After the intervention, the levels of stress in the experimental and control groups were 10.95 ± 2.01 vs. 14.17 ± 2.34 (p 0.05). Conclusion Concerning the effectiveness of the progressive muscle relaxation technique in relieving the stress and anxiety of the nurses caring for COVID-19 patients, it is suggested to include this relaxation technique in nursing courses.

• TMS can induce muscle relaxation by abruptly halting corticospinal drive. • TMS can aid in detecting impaired muscle relaxation in specific myopathies. • TMS-induced muscle relaxation could serve as a diagnostic tool and an outcome measure in clinical trials. Impaired muscle relaxation is a notable feature in specific myopathies. Transcranial magnetic stimulation (TMS) of the motor cortex can induce muscle relaxation by abruptly halting corticospinal drive. Our aim was to quantify muscle relaxation using TMS in different myopathies with symptoms of muscle stiffness, contractures/cramps, and myalgia and explore the technique's diagnostic potential. In men, normalized peak relaxation rate was lower in Brody disease (n = 4) (-3.5 ± 1.3 s-1), nemaline myopathy type 6 (NEM6; n = 5) (-7.5 ± 1.0 s-1), and myotonic dystrophy type 2 (DM2; n = 5) (-10.2 ± 2.0 s-1) compared to healthy (n = 14) (-13.7 ± 2.1 s-1; all P ≤ 0.01) and symptomatic controls (n = 9) (-13.7 ± 1.6 s-1; all P ≤ 0.02). In women, NEM6 (n = 5) (-5.7 ± 2.1 s-1) and McArdle patients (n = 4) (-6.6 ± 1.4 s-1) had lower relaxation rate compared to healthy (n = 10) (-11.7 ± 1.6 s-1; both P ≤ 0.002) and symptomatic controls (n = 8) (-11.3 ± 1.8 s-1; both P ≤ 0.008). TMS-induced muscle relaxation achieved a high level of diagnostic accuracy (area under the curve = 0.94 (M) and 0.92 (F)) to differentiate symptomatic controls from myopathy patients. Muscle relaxation assessed using TMS has the potential to serve as a diagnostic tool, an in-vivo functional test to confirm the pathogenicity of unknown variants, an outcome measure in clinical trials, and monitor disease progression. [ABSTRACT FROM AUTHOR]

Background and Objectives Hypothyroidism is one of the causes of mental disorders such as depression and anxiety, especially in pregnant women. One of the ways to prevent the occurrence of such disorders is the use of non-pharmacological methods such as muscle relaxation, which can be taught to pregnant women either face-to-face or face-to-face. Therefore, the present study was conducted with the aim of comparing the effectiveness of muscle relaxation training in two ways, face-to-face and remotely, on the level of stress and anxiety of pregnant women with hypothyroidism. Subjects and Methods This semi-experimental study was conducted with a pre-test and post-test design in the year 2019 in selected centers of comprehensive health services in Najafabad. The research sample included 66 pregnant women with hypothyroidism. In this research, easy sampling method and random allocation of samples in two groups were used. Data collection tools were Spielberger anxiety and stress questionnaires spp-14. The data were described and analyzed with SPSS version 21 software at a significance level of less than 0.05. Results The results showed that face-to-face training is an effective method in muscle relaxation training as a safe and effective intervention in reducing stress and anxiety in pregnant women. Conclusion Based on the findings of the present study, face-to-face training is an effective method for muscle relaxation training as a safe and effective intervention in reducing stress and anxiety in pregnant women. [ABSTRACT FROM AUTHOR]

Background: Vocal cord polyp is common otorhinolaryngological disease, traditionally treated by vocal cord polypectomy under a supporting laryngoscope with general anaesthesia. Although it is safe and controllable, it would cause some anaesthesia complications. Moreover, the complex process of general anaesthesia may significantly reduce surgical efficiency. Avoiding these problems remains an important issue. Methods: All patients were subjected to the standard non-intubated deep paralysis (NIDP) protocol consisting of four phases. An emergency plan was launched when NIDP cannot be implemented successfully. Patient characteristics, blood gas and monitoring data were collected during NIDP. Data concerning satisfaction, complications and duration of anaesthesia and recovery were collected to assess its effectiveness. Result: Among 20 enrolled patients, the success rate of NIDP was 95%. Only one patient failed in completing NIDP. Blood gas analysis revealed that the partial pressure of oxygen and carbon dioxide was maintained at safe levels. Monitoring during NIDP revealed fluctuations in mean arterial pressure between 110 and 70 mmHg, and the heart rate was stable at 60–100 beats per minute. The duration of anaesthesia and postoperative recovery were 13.0 ± 2.84 and 5.47 ± 1.97 min, respectively. All patients and surgeons were satisfied with NIDP, and no complications were detected before discharge. Conclusion: NIDP can be safely applied to patients and can replace general anaesthesia in vocal cord polypectomy. It can significantly reduce the duration of anaesthesia and postoperative recovery. No anaesthesia complications occurred without intubation, and patients and surgeons were satisfied with NIDP. Trial registrations: This single-centre, prospective study was registered on clinicaltrial.gov (NCT04247412) on 30th July 2020. [ABSTRACT FROM AUTHOR]

Study Design: Prospective randomized controlled study. Purpose: This study aimed to assess the effects of a different combination of anesthetic techniques in lumbar and thoracolumbar spinal surgeries in terms of muscle relaxation and surgical field in addition to hemodynamic parameters. Overview of Literature: Adequate relaxation of the erector spinae muscle and good surgical fields are preferred in lumbar spine surgeries. The effects of anesthetic techniques on these parameters have not been evaluated from a surgeon's perspective to date. We propose a novel combined anesthetic technique that improves the working conditions from a surgeon's perspective as we hypothesize that combining general anesthesia (GA) with regional anesthesia (RA) might provide benefits for both techniques. Methods: A prospective randomized study of 76 patients who underwent lumbar and thoracolumbar surgeries was conducted by randomly allocating patients into three anesthetic groups: GA alone, GA with spinal anesthesia (SA), and GA with erector spinae plane block (ESPB) by the allocation concealment method to avoid selection bias. The working conditions were assessed by the same operating surgeon who was blinded by the type of anesthesia to eliminate the assessment bias. Muscle relaxation and surgical field were compared among the three groups along with other hemodynamic parameters to identify any significant differences. Results: Significantly better muscle relaxation, surgeon satisfaction, postoperative analgesia, and blood pressure (BP) were observed in the GA+RA when compared to GA alone (p <0.01), whereas no difference was observed between the GA+SA and GA+ESPB groups (p >0.05). Complications were only observed in the GA+SA group (19%). Conclusions: The study results suggest that the addition of RA to GA may provide better working conditions and surgeon's satisfaction by improving relaxation of the erector spinae in addition to decreasing the BP and postoperative pain in contrast to the use of GA alone. The combined GA and ESPB techniques may be a viable anesthetic alternative to provide better working conditions for surgeons. [ABSTRACT FROM AUTHOR]

This study was executed in the clinical setup to investigate the effects of Rocuronium and its reversal by Neostigmine and Glycopyrrolate (Myopyrolate) combination in Propofol-Isoflurane anaesthetized dogs. Rocuronium-induced neuromuscular blockade was applied to 21 clinical cases. Out of which, 19 cases were of orthopaedic surgeries and 2 cases of ovariohysterectomy. After the animal had stabilized on the mixture of isoflurane and oxygen, the relaxation of muscle was induced using Rocuronium @ 0.5 mg/kg b.wt. Immediately IPPV was provided in volume control mode. Neuromuscular blockade was reversed using a single syringe combination drug having both Neostigmine and Glycopyrrolate (Myopyrolate) @ 0.05 mg/kg b.wt and @ 0.01 mg/kg b.wt, respectively. Rocuronium caused the centering of the ocular globe gradually in less than 30 sec. During orthopaedic surgeries, the reduction of fractured ends became easy without much tissue trauma. In ovariohysterectomy surgeries, the appropriate level of abdominal muscle relaxation further helped in the easy exteriorization of the ovarian stump. The onset time for Rocuronium was 17.64±1.10 sec and its duration of action was 27.82±0.72 min. The use of Rocuronium along with IPPV caused minimal alteration of the physiological parameters with no clinical consequences and thus can be considered a complication-free anaesthetic protocol for interventions demanding muscle relaxation.

Background: Montgomery thyroplasty type I is a surgical technique indicated in vocal cord paralysis which consists of the paralyzed cord medialization, improving the voice quality. The objective of the study is to describe in detail the anesthetic method to obtain optimal post-medialization voice results. Methodology: Retrospective case series study including patients who underwent medialization thyroplasty using the modified Montgomery technique at the General University Hospital of Valencia between 2011 and 2021. The anesthetic technique consisted of general anesthesia with neuromuscular relaxation and a laryngeal mask. Pre- and post-surgical vocal functional data of maximum phonation times (MPT), G score, and Voice Handicap Index-30 (VHI-30) were evaluated. Results: All the patients presented an improvement in voice results, increasing MPT after surgery and a decrease in VHI-30 and G score postoperatively, with statistically significant differences between the pre- and post-surgical results (p-value < 0.05). There were no complications related to anesthesia or surgery. Conclusions: The use of general anesthesia with muscle relaxation in modified Montgomery thyroplasty may be a good option to consider. The use of a laryngeal mask for ventilation combined with a fiberoptic check allows direct visualization of the vocal cords intraoperatively, providing good functional voice results. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Caring for patients with coronavirus disease 2019 (COVID-19) challenges nurses and causes them to experience stress and anxiety. From this perspective, it is of utmost importance to develop quick and effective intervention strategies to prevent numerous complications. This study aimed to investigate the effect of the progressive muscle relaxation technique, using the demonstration method on the stress and anxiety of nurses who care for COVID-19 patients. Methods: This randomized clinical trial was conducted in 2021. Forty-six nurses working in two referral hospitals with wards for COVID-19 patients in Tehran, Iran recruited by convenience sampling method and then randomly assigned to experimental or control groups. The nurses in the experimental group educated the progressive muscle relaxation by the demonstration method, and they were encouraged to practice it. The Depression Anxiety Stress Scale-21 was utilized to measure the stress and anxiety levels in the nurses. Results: Before the intervention, the levels of stress in the experimental and control groups were 13.91 ± 2.41 vs. 14.34 ± 2.74 (p = 0.571), and their anxiety was 13.34 ± 3.41 vs. 12.78 ± 2.21 (p = 0.510), respectively. After the intervention, the levels of stress in the experimental and control groups were 10.95 ± 2.01 vs. 14.17 ± 2.34 (p < 0.001), and their anxiety was 9.47 ± 2.37 vs. 12.91 ± 1.85 (p < 0.001), respectively. Moreover, the levels of stress and anxiety in the experimental group significantly diminished after intervention (p < 0.001), but no significant changes were observed in the control group (p > 0.05). Conclusion: Concerning the effectiveness of the progressive muscle relaxation technique in relieving the stress and anxiety of the nurses caring for COVID-19 patients, it is suggested to include this relaxation technique in nursing courses. [ABSTRACT FROM AUTHOR]

Background and Aims: In emergency and non-fasting patients posted for laparotomy under general anaesthesia, rapid sequence induction (RSI) is preferred, and it is routinely done by using succinylcholine or rocuronium. Using higher doses of atracurium [i.e. 3-4 times the 95% effective dose (ED95)] can provide acceptable intubating conditions in a short time. The primary objective of our study was to compare two different higher doses of atracurium to achieve good intubating conditions for RSI without using a priming dose. The secondary objective was to compare the duration of muscle relaxation using neuromuscular monitoring and haemodynamic responses during and after intubation. Methods: Sixty patients were enroled and randomly assigned into two groups:-, group A1 (atracurium: 0.75 mg/kg) and group A2 (atracurium: 1 mg/kg). After premedication, anaesthesia was induced with propofol 2-2.5 mg/kg and atracurium injections, followed by intubation within a minute by trained anaesthesiologists. Meanwhile, intubating conditions, neuromuscular monitoring using train-of-four (TOF) measurements and post-tetanic-count and haemodynamics were recorded. Data were analysed statistically by using the Chi-square test and Student's t-test. Results: Excellent intubation conditions (without coughing or bucking) were attained in 56.7% of cases in group A2 and in 13.3% in group A1 (P < 0.001). Duration of muscle relaxation, measured by time until TOF is two, was more prolonged in group A2 (79.2 ± 9.2 min) than in group A1 (60.13 ± 8.7 min, P < 0.001). Conclusion: Acceptable intubating conditions can be achieved in a minute with the use of a high dose of atracurium (1 mg/kg) during RSI. Hence, atracurium can be used as an alternative drug for RSI. [ABSTRACT FROM AUTHOR]

Background and Aims: In emergency and non-fasting patients posted for laparotomy under general anaesthesia, rapid sequence induction (RSI) is preferred, and it is routinely done by using succinylcholine or rocuronium. Using higher doses of atracurium [i.e. 3-4 times the 95% effective dose (ED95)] can provide acceptable intubating conditions in a short time. The primary objective of our study was to compare two different higher doses of atracurium to achieve good intubating conditions for RSI without using a priming dose. The secondary objective was to compare the duration of muscle relaxation using neuromuscular monitoring and haemodynamic responses during and after intubation. Methods: Sixty patients were enroled and randomly assigned into two groups:-, group A1 (atracurium: 0.75 mg/kg) and group A2 (atracurium: 1 mg/kg). After premedication, anaesthesia was induced with propofol 2-2.5 mg/kg and atracurium injections, followed by intubation within a minute by trained anaesthesiologists. Meanwhile, intubating conditions, neuromuscular monitoring using train-of-four (TOF) measurements and post-tetanic-count and haemodynamics were recorded. Data were analysed statistically by using the Chi-square test and Student's t-test. Results: Excellent intubation conditions (without coughing or bucking) were attained in 56.7% of cases in group A2 and in 13.3% in group A1 (P < 0.001). Duration of muscle relaxation, measured by time until TOF is two, was more prolonged in group A2 (79.2 ± 9.2 min) than in group A1 (60.13 ± 8.7 min, P < 0.001). Conclusion: Acceptable intubating conditions can be achieved in a minute with the use of a high dose of atracurium (1 mg/kg) during RSI. Hence, atracurium can be used as an alternative drug for RSI.

The article considers a clinical case of treatment of one of the variants of myofascial pain syndrome – piriformis syndrome without signs of sciatic nerve neuropathy. The peculiarity of the case is the comorbidity of the opioid syndrome with diabetic sensorimotor polyneuropathy and osteoporosis, which required the appointment of complex therapy. The diagnosis was confirmed by additional research methods: spondylography, MRI of the lumbosacral spine, ultrasound of the piriformis muscle, electroneuromyography. A patient management tactic was chosen based on federal clinical guidelines for the treatment of patients with nonspecific back pain. Treatment included non-medicinal and medicinal methods. In order to relieve pain, dexketoprofen was prescribed 2 ml intramuscularly per 2 ml of 0.5% lidocaine solution – 1 time а day No. 2 – under navigation by ultrasound. Subsequently, the transfer was made to oral administration of 25 mg 3 times а day for 3 days. A step-by-step scheme of prescribing dexketoprofen: its introduction into the piriformis muscle with subsequent transfer to oral administration allowed to significantly reduce the severity of pain after 5 days of treatment. The complex effect on the spasmodic piriformis muscle with the help of a tableted muscle relaxant in combination with postisometric relaxation made it possible to quickly stop the pain syndrome and prevent its chronization. The administration of the preparation of thioctic acid pursued two goals: to improve the metabolism of the spasmodic muscle and restore the energy metabolism of peripheral nerves. As a result of the use of complex, pathogenetically based therapy, a positive effect was achieved.

Introduction: Patients with dental anxiety avoid receiving medical care. This anxiety poses a threat to oral health. The present study aimed to investigate the effectiveness of muscle relaxation training and mindfulness training on fear and resilience in patients with dental anxiety. Methods: This was a clinical trial (pretest-posttest design and a control group). The statistical population comprised all patients with dental anxiety who went to dental clinics in the city of Ahvaz in 2018-2019. The research sample included 45 patients with dental anxiety selected through convenience sampling. The participants were randomly divided into two experimental (muscle relaxation training and mindfulness training) and one control group (n=15 each). The research tools included the Dental Fear Survey (DFS), the Connor-Davidson Resilience Scale (CD-RISC), and the Modified Dental Anxiety Scale (MDAS). Multivariate analysis of covariance was used to analyze the data. Results: The mean±standard deviation (SD) of the post-test scores of fear and resilience were 49.53±9.67 and 84.80±7.89 in the muscle relaxation training group and 58.26±12.67 and 55.60±8.83 in the mindfulness training group, which were significantly different from the control groups (83.80±3.50 and 40.46±5.65). Muscle relaxation training reduced fear and increased resilience in patients with dental anxiety in the experimental groups compared to the control group (P

Transcranial magnetic stimulation (TMS) of the motor cortex can be used during a voluntary contraction to inhibit corticospinal drive to the muscle and consequently induce involuntary muscle relaxation. Our aim was to evaluate the reproducibility and the effect of varying experimental conditions (robustness) of TMS‐induced muscle relaxation. Relaxation of deep finger flexors was assessed in 10 healthy subjects (5 M, 5 F) using handgrip dynamometry with normalized peak relaxation rate as main outcome measure, that is, peak relaxation rate divided by (voluntary plus TMS‐evoked)force prior to relaxation. Both interday and interrater reliability of relaxation rate were high with intraclass correlation coefficient of 0.88 and 0.92 and coefficient of variation of 3.8 and 3.7%, respectively. Target forces of 37.5% of maximal voluntary force or higher resulted in similar relaxation rate. From 50% of maximal stimulator output and higher relaxation rate remained the same. Only the most lateral position (>2 cm from the vertex) rendered lower relaxation rate (mean ± SD: 11.1 ± 3.0 s−1, 95% CI: 9.0–13.3 s−1) compared to stimulation at the vertex (12.8 ± 1.89 s−1, 95% CI: 11.6–14.1 s−1). Within the range of baseline skin temperatures, an average change of 0.5 ± 0.2 s−1 in normalized peak relaxation rate was measured per 1°C change in skin temperature. In conclusion, interday and interrater reproducibility and reliability of TMS‐induced muscle relaxation of the finger flexors were high. Furthermore, this technique is robust with limited effect of target force, stimulation intensity, and coil position. Muscle relaxation is strongly affected by skin temperature; however, this effect is marginal within the normal skin temperature range. We deem this technique well suited for clinical and scientific assessment of muscle relaxation. [ABSTRACT FROM AUTHOR]

How does our brain manage to process vast quantities of sensory information that define movement performance? By extracting the required movement parameters for which brain dynamics are, inter alia, assumed to be functionally related to, we used electroencephalography to investigate motor-related brain oscillations. Visually guided movement (i.e., motor) tasks at explosive, medium and slow rates of force development (RFD) revealed increased broad-band activity at explosive RFD, whereas decreasing activity could be observed during both intermediate and slow RFD. Moreover, a continuously decreasing activity pattern from faster to slower RFD and a return to baseline activity after full muscle relaxation was found. We suggest oscillatory activity to desynchronize in sensorimotor demanding tasks, whereas task-specific synchronization mirrors movement acceleration. The pre/post-stimulus activity steady state may indicate an inhibitory baseline that provides attentional focus and timing. [ABSTRACT FROM AUTHOR]

This study aimed to compare the effect of sugammadex and neostigmine on neuromuscular block reversal and the incidence of postoperative pulmonary complications in patients undergoing lung cancer resection. A double-blind, randomized, prospective study. A single major urban teaching and university hospital. One hundred adult patients underwent elective radical resection of lung cancer under general anesthesia. Patients were assigned into neostigmine (0.05 mg/kg) + atropine 0.02 mg/kg group and sugammadex (2 mg/kg) group. The primary outcomes were the incidence of any postoperative pulmonary complications, and the time to achieve 90% of train-of-four (TOF) after the administration of sugammadex or neostigmine. The secondary endpoints were the number of patients with TOF ratio (TOFr) <0.9 at the time of tracheal extubation, the incidence of readmission 30 days after discharge, and specific postoperative pulmonary complications. Results showed that the average time of recovery to TOFr ≥0.9 with sugammadex was 164.5 ± 27.7 seconds versus 562.9 ± 59.7 seconds with neostigmine + atropine treatment. Fewer sugammadex-treated patients did not achieve TOFr of 0.9 at the time of tracheal extubation than did neostigmine-treated participants. Patients in the sugammadex group had lower incidence of postoperative lung complications, and shorter durations of postanesthesia care unit stay and postoperative hospital stay than those in the neostigmine group. There was no significant difference in the incidence of readmission between the 2 groups. Administration of sugammadex provided faster recovery of rocuronium-induced neuromuscular block when compared with neostigmine. Moreover, for patients undergoing lung cancer resection, administration of sugammadex could reduce the incidence of postoperative pulmonary complications and duration of postoperative hospital stay. [ABSTRACT FROM AUTHOR]

PURPOSE This study aimed to examine changes in pulmonary function induced by an internal nasal dilator (IND) and to determine whether an IND enhances exercise performance. METHODS Young, healthy men (n=13) were randomly assigned either an IND or control (CON) session to perform a pulmonary function test (PFT). All participants then completed treadmill exercise tests that consisted of maximal and submaximal running with or without an IND. RESULTS Some variables of PFTs were increased in men that used INDs compared to those in the CON group (p

Abstract Transcranial magnetic stimulation (TMS) of the motor cortex can be used during a voluntary contraction to inhibit corticospinal drive to the muscle and consequently induce involuntary muscle relaxation. Our aim was to evaluate the reproducibility and the effect of varying experimental conditions (robustness) of TMS‐induced muscle relaxation. Relaxation of deep finger flexors was assessed in 10 healthy subjects (5 M, 5 F) using handgrip dynamometry with normalized peak relaxation rate as main outcome measure, that is, peak relaxation rate divided by (voluntary plus TMS‐evoked)force prior to relaxation. Both interday and interrater reliability of relaxation rate were high with intraclass correlation coefficient of 0.88 and 0.92 and coefficient of variation of 3.8 and 3.7%, respectively. Target forces of 37.5% of maximal voluntary force or higher resulted in similar relaxation rate. From 50% of maximal stimulator output and higher relaxation rate remained the same. Only the most lateral position (>2 cm from the vertex) rendered lower relaxation rate (mean ± SD: 11.1 ± 3.0 s−1, 95% CI: 9.0–13.3 s−1) compared to stimulation at the vertex (12.8 ± 1.89 s−1, 95% CI: 11.6–14.1 s−1). Within the range of baseline skin temperatures, an average change of 0.5 ± 0.2 s−1 in normalized peak relaxation rate was measured per 1°C change in skin temperature. In conclusion, interday and interrater reproducibility and reliability of TMS‐induced muscle relaxation of the finger flexors were high. Furthermore, this technique is robust with limited effect of target force, stimulation intensity, and coil position. Muscle relaxation is strongly affected by skin temperature; however, this effect is marginal within the normal skin temperature range. We deem this technique well suited for clinical and scientific assessment of muscle relaxation.

Introduction and Hypothesis: The aim of this study is to develop and validate a new integral parameter, the Biomechanical Integrity score (BI-score), for the characterization of the female pelvic floor. Methods: A total of 253 subjects with normal and pelvic organ prolapse (POP) conditions were included in the multi-site observational, case-control study; 125 subjects had normal pelvic floor conditions, and 128 subjects had POP stage II or higher. A Vaginal Tactile Imager (VTI) was used to acquire and automatically calculate 52 biomechanical parameters for eight VTI test procedures (probe insertion, elevation, rotation, Valsalva maneuver, voluntary muscle contractions in two planes, relaxation, and reflex contraction). Statistical methods were applied (t-test, correlation) to identify the VTI parameters sensitive to the pelvic conditions. Results: Twenty-six parameters were identified as statistically sensitive to POP development. They were subdivided into five groups to characterize (1) tissue elasticity, (2) pelvic support, (3) pelvic muscle contraction, (4) involuntary muscle relaxation, and (5) pelvic muscle mobility. Every parameter was transformed to its standard deviation units against the patient age similar to T-score for bone density. Linear combinations with specified weights led to the composition of five component parameters for groups (1)–(5) and the BI-score in standard deviation units. The p-value for the BI-score has p = 4.3 × 10−31 for POP versus normal conditions. A reference BI-score curve against age for normal pelvic floor conditions was defined. Conclusions: Quantitative transformations of the pelvic tissues, support structures, and functions under diseased conditions may be studied with the BI-score in future research and practical applications. [ABSTRACT FROM AUTHOR]

[Display omitted] Neuromuscular blocking agents (NMBAs) are widely used in anesthesia for intubation and surgical muscle relaxation. Novel atracurium and mivacurium derivatives were developed, with compounds 18c , 18d , and 29a showing mivacurium-like relaxation at 27.27 nmol/kg, and 15b , 15c , 15e , and 15h having a shorter duration at 272.7 nmol/kg. The structure–activity and configuration-activity relationships of these derivatives and 29a 's binding to nicotinic acetylcholine receptors were analyzed through molecular docking. Rabbit trials showed 29a has a shorter duration compared to mivacurium. This suggests that linker properties, ammonium group substituents, and configuration are crucial for NMBA activity and duration, with compound 29a emerging as a potential ultra-short-acting NMBA. [ABSTRACT FROM AUTHOR]

Introduction: According to studies, Covid_19 patients have a low psychological tolerance capacity and due to the current state of the disease in the world, these people are highly exposed to psychological disorders such as anxiety and depression as well as other negative thoughts. The aim of this study was to evaluate the effectiveness of muscle relaxation therapy along with mental imagery on the rate of anxiety and depression in physically and mentally handicapped patients with mild coronary heart disease "Covid_19." Materials and Methods: The present research method is a pre-test-post-test design with a control group. The research population includes the physically and mentally handicapped in the Fatah al-Mubin girls' rehabilitation center in Mashhad. From the statistical population of the study, 30 people were selected by convenience sampling. Then, they were randomly divided into two groups of 15 people. Before performing the program, the experimental and control groups completed the Beck Anxiety and Depression Inventory "BAI" as a criterion for the pre-test before the sessions. The experimental group underwent muscle relaxation and mental imaging for one hour a day for two months. Results: After the treatment intervention "muscle relaxation and mental imaging", the results show that there is a significant difference between the experimental and control groups in the variables of anxiety and depression (P = 0.000). Also in the experimental group, there was a significant difference in the variables of anxiety and depression before and after the treatment intervention (P = 0.000). Conclusion: Based on the results, the two methods of muscle relaxation and mental imaging simultaneously reduce anxiety and depression in the disabled and improve Covid 19 disease. It seems that considering the positive effect of this complementary treatment approach, which is a simple, low-cost and applicable method for the disabled, an effective step can be taken to reduce the psychological problems of the disabled during postcoronary and quarantine conditions. [ABSTRACT FROM AUTHOR]

One of the most important cytosolic Ca2þ buffers present in mouse fast-twitch myofibers, but not in human myofibers, is parvalbumin (PV). Previous work using conventional PV gene (PV) knockout (PV-KO) mice suggests that lifelong PV ablation increases fatigue resistance, possibly due to compensations in mitochondrial volume. In this work, PV ablation was induced only in adult mice (PV-KO), and contractile and cytosolic Ca2þ responses during fatigue were studied in isolated muscle and intact single myofibers. Results were compared with control littermates (PV-Ctr). We hypothesized that the reduced myofiber cytosolic Ca2þ buffering developed only in adult PV-KO mice leads to a larger cytosolic free Ca2þ concentration ([Ca2þ]c) during repetitive contractions, increasing myofiber fatigue resistance. Extensor digitorum longus (EDL) muscles from PV-KO mice had higher force in unfused stimulations (-50%, P < 0.05) and slowed relaxation (-46% higher relaxation time, P < 0.05) versus PV-Ctr, but muscle fatigue resistance or fatigue-induced changes in relaxation were not different between genotypes (P > 0.05). In intact single myofibers from flexor digitorum brevis (FDB) muscles, basal and tetanic [Ca2þ]c during fatiguing contractions were higher in PVKO (P < 0.05), accompanied by a greater slowing in estimated sarcoplasmic reticulum (SR) Ca2þ-pumping versus PV-Ctr myofibers (-84% reduction, P < 0.05), but myofiber fatigue resistance was not different between genotypes (P > 0.05). Our results demonstrate that although the estimated SR Ca2þ uptake was accelerated in PV-KO, the total energy demand by the major energy consumers in myofibers, the cross-bridges, and SR Ca2þ ATPase were not altered enough to affect the energy supply for contractions, and therefore fatigue resistance remained unaffected. NEW & NOTEWORTHY Parvalbumin (PV) is a cytosolic Ca2þ buffer that is present in mouse myofibers but not in human muscle. We show that inducible knockout of PV leads to increases in myofiber cytosolic free Ca2þ concentrations and slowing of Ca2þ pumping during fatigue versus control mice. However, PV ablation does not interfere with fatigue-induced slowing in relaxation or fatigue resistance. These data support the use of mouse muscle as a suitable model to investigate human muscle fatigue. [ABSTRACT FROM AUTHOR]

The human hand can make precise movements utilizing several joints of various articular types. To understand hand movements more accurately, it is essential to view the actual movements of bones and muscles considering the X, Y, and Z axes in the joints. This study aimed to investigate the joint movements in a hand using movable surface models, including these axes. These movable surface models of the hand will improve medical students’ understanding of hand movements around the joints.To achieve this aim, 70 surface models were adopted from a Visible Korean model. Using Maya software, 20 virtual joints with X, Y, and Z axes included nine distal and proximal interphalangeal joints, five metacarpophalangeal joints, five carpometacarpal joints, and one wrist joint were created. Bone surface models were elaborately polished to maintain their original shape during movement. Muscle surface models were also processed to display the deformation of the muscle shape during movement. The surface models of the hand joints were moved by virtual control of the joints. We saved 87 movable surface models of the hand, including bones, muscles, and joint axes in stereolithography format, and compiled a Portable Document Format (PDF) file.Using the PDF file, the joint movements in a hand could be observed considering the X, Y, and Z axes alongside the stereoscopic shapes of the bones and muscles.These movable surface models of the hand will improve medical students’ understanding of hand movements around the joints. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to determine the effects of mindful breath awareness & muscle relaxation (MBMR) and transcranial electrical stimulation (tCES) techniques on improving the systolic and diastolic blood pressure status in patients with type 2 diabetes.Methods: The research method was randomized controlled trial (RCT) using split-plot ANOVA (SPANOVA). Thirty patients were selected through purposive sampling from Bonab County Diabetes Association (Iran) and were randomly divided into three 10-member groups, namely MBMR, tCES, and MBMR+tCES groups. Participants received their group interventions in 10 individual sessions. All patients were evaluated for systolic and diastolic blood pressure at two stages, before and immediately after each session. SPANOVA and Bonferroni pairwise comparison tests were used for data analysis.Results: The results indicated that the MBMR and tCES techniques, alone and in combination, had significant and equal effects on reducing diastolic blood pressure, but the MBMR treatment was more effective in the systolic blood pressure than the tCES.Conclusions: The MBMR and tCES techniques were effective and safe in treating hypertension in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objektif: Kecemasan sering terjadi oleh siapapun, terutama yang memiliki riwayat penyakit akan memiliki tingkat kecemasan yang lebih tinggi. Progressive muscle relaxation merupakan salah satu pengobatan non farmakologis yang dapat digunakan untuk menurunkan kecemasan. Tujuan dari penelitian ini untuk mengetahui efektivitas progressive muscle relaxation dalam menurunkan kecemasan. Metode: Menggunakan meta-analysis berupa review literatur 14 jurnal penelitian internasional. Total partisipan sebanyak 1.022 yang terdiri dari kelompok kontrol sebesar 516 dan kelompok eksperimen sebesar 506. Analisis data menggunakan website Meta-mar. Peneliti menggunakan pedoman dari PRISMA dan MARS. Temuan: Dengan menggunakan analisis statistik cohen’s d effect size, diperoleh hasil pengolahan data yaitu mean (M), standar deviasi (SD), dan sample size (N) menghasilkan effect size dengan menggunakan random effect dengan Hedges'g sebesar 0.81, 95%CI=0,224 sampai 1.401 dengan nilai Inconsistency (I2)= 94,5%. yang berarti bahwa progressive muscle relaxation memiliki efek yang besar untuk menurunkan kecemasan. Kesimpulan: Progressive muscle relaxation memberikan efek yang besar dalam menurunkan kecemasan.

Background: Inadequate pain management and sleep disturbances of patients undergoing gynecological surgery are associated with delayed recovery time. This study aimed to assess the effect of Jacobson's Progressive Relaxation Technique (JPRT) on postoperative pain, activity tolerance, and sleeping quality in patients undergoing gynecological surgery. Materials and Methods: A randomized controlled clinical trial conducted at Obstetrics and Gynecology Department/Damanhour educational institute, Elbehira, Egypt. The study sample involved 116 patients undergoing gynecological surgery who were equally distributed between intervention and control groups. Data collected from April to September 2019. Four tools were used for data collection: Demographic data interview schedule, pain analog scale, activity tolerance questionnaire, and the Groningen sleeping quality scale. For the intervention group, the women were asked to perform JPRT for 30 min on the second and third postoperative day, three times a day. SPSS 23.0 is used to analyze data using Chi-square, Fisher's exact, independent t-test, and Analysis of Covariance (ANCOVA). A significance level considered at p < 0.05. Results: The study results showed that JPRT significantly improves pain, sleep quality, and activity tolerance mean scores among the intervention group compared to the control group (F1 = 119.13, p < 0.001), (F1 = 361.49, p < 0.001), and (F1 = 157.49, p < 0.001), respectively. ANCOVA results showed that 33% of the decreased pain score, 12% of decreased sleeping quality score, and 26% of improved activity tolerance score are due to JPRT. Conclusion: JPRT should be offered as a part of standard postoperative nursing care for patients undergoing gynecological surgery to control pain and improve sleeping quality and activity tolerance.

Background/Aim. Phytochemical and pharmacological investigations of essential oils isolated from plant species of the genus Seseli have been intensified recently. These plant species have long-term use in nutrition and traditional medicine in the treatment of various disorders. Volatile secondary metabolites of Seseli gracile Waldst. & Kit (Apiaceae) have not been pharmacologically examined so far. The aim of the conducted research was to assess the antiradical, antimicrobial and spasmolytic activities of S. gracile essential oil isolated from the aerial parts of the plant. Methods. The antiradical activity was determined using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging test, antimicrobial activity using broth microdilution method with standard strains of Gram (+), Gram (-) bacteria and yeast, while spasmolytic activity was evaluated on isolated rat ileum, pre-contracted with a high concentration of potassium. Results. The results showed moderate antiradical (SC50 = 78.60 μg/mL) and good spasmolytic activity (IC50 = 271.4 nL/mL) of S. gracile essential oil. In the range of tested concentrations, minimal inhibitory concentration (MIC) was determined only for the strain of Escherichia coli (500 μg/mL). Conclusion. Results obtained in this study justify the need for further studies to elucidate exact molecular mechanism underlay this spasmolytic effect of S. gracile herb essential oil.