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Purpose: To examine the effect of dryland training during an 11-week lockdown period due to COVID-19 on swimming performance. Methods: Twelve competitive swimmers performed 50- and 300-m maximum-effort tests in their preferred stroke and 200-, 400-, and four 50-m front crawl sprints (4 × 50 m) before and after the lockdown period. Critical speed as an index of aerobic endurance was calculated using (1) 50-, 300-, and (2) 200-, 400-m tests. Blood lactate concentration was measured after the 400- and 4 × 50-m tests. To evaluate strength-related abilities, the dryland tests included handgrip and shoulder isometric strength. Tethered swimming force was measured during a 10-second sprint. During the lockdown period, dryland training was applied, and the session rating of perceived exertion training (sRPE) load was recorded daily. Results: sRPE training load during the lockdown was decreased by 78% (16%), and critical speed was reduced 4.7% to 4.9% compared to prelockdown period (P P P > .05). Tethered force increased 9% (10%) (P P > .05). Blood lactate concentration decreased 19% (21%) after the 400-m test and was unchanged following the 4 × 50-m tests (P > .05). Conclusions: Performance deterioration in the 200, 300, and 400 m indicates reduced aerobic fitness and impaired technical ability, while strength and repeated-sprint ability were maintained. When a long abstention from swimming training is forced, dryland training may facilitate preservation in short-distance but not middle-distance swimming performance.

Spiliopoulou, P, Zaras, N, Methenitis, S, Papadimas, G, Papadopoulos, C, Bogdanis, GC, and Terzis, G. Effect of concurrent power training and high-intensity interval cycling on muscle morphology and performance. J Strength Cond Res 35(9): 2464-2471, 2021-The aim of the study was to examine the effect of performing high-intensity interval cycling on muscle morphology and performance immediately after power training (PT). Twenty healthy female physical education students were assigned into 2 training groups. One group performed PT, and the other group performed the same PT followed by high-intensity interval aerobic training on a cycle ergometer (PTC). Training was performed 3 days per week for 6 weeks. Countermovement jump (CMJ) height and CMJ power, half-squat maximal strength (1 repetition maximum), maximum aerobic power, vastus lateralis muscle fiber composition, and cross-sectional area (CSA) were evaluated before and after the intervention. Countermovement jump height increased after PT (10.1 ± 6.6%, p = 0.002) but not after PTC (-5.1 ± 10.5%, p = 0.099), with significant difference between groups (p = 0.001). Countermovement jump power increased after PT (4.5 ± 4.9%, p = 0.021) but not after PTC (-2.4 ± 6.4, p = 0.278), with significant difference between groups (p = 0.017). One repetition maximum increased similarly in both groups. Muscle fiber composition was not altered after either PT or PTC. Vastus lateralis muscle fiber CSA increased significantly and similarly after both PT (I: 16.9 ± 16.2%, p = 0.035, ΙΙΑ: 12.7 ± 10.9%, p = 0.008,ΙΙΧ: 15.5 ± 17.1%, p = 0.021) and PTC (Ι: 18.0 ± 23.7%, p = 0.033,ΙΙΑ: 18.2 ± 11.4%, p = 0.001,ΙΙΧ: 25.5 ± 19.6%, p = 0.003). These results suggest that the addition of high-intensity interval cycling to PT inhibits the anticipated increase in jumping performance induced by PT per se. This inhibition is not explained by changes in muscle fiber type composition or vastus lateralis muscle fiber CSA adaptations.

Anousaki, E, Zaras, N, Stasinaki A-N, Panidi, I, Terzis, T, and Karampatsos, G. Effects of a 25-week periodized training macrocycle on muscle strength, power, muscle architecture, and performance in well-trained track and field throwers. J Strength Cond Res 35(10): 2728-2736, 2021-The purpose of the study was to investigate the effect of a 25-week macrocycle on strength, power, vastus lateralis (VL) muscle architecture, and competitive track and field throwing performance, in well-trained track and field throwers. Twelve well-trained throwers (age: 24.3 ± 5.5 years, mass: 96.6 ± 9.9 kg, and height: 1.82 ± 0.02 m), participated in the study. All athletes followed a 25-week periodized training program divided into 3 training phases: the hypertrophy/maximum strength phase, the maximum strength/power phase, and the power/speed phase. Measurements were performed at the beginning of the training period (T1), after the first training phase (T2), and after the end of the training period (T3). Measurements included the following: competitive track and field throwing performance; shot put throws; maximum strength (1-RM) in snatch, clean, and squat; countermovement jump (CMJ); and VL muscle architecture. Competitive track and field throwing performance and shot put throws increased from T1 to T3 by 10.9 ± 3.2% (p = 0.001) and 5.1 ± 6.4% (P = 0.049), respectively. 1 RM strength in snatch and squat increased significantly from T1 to T3 by 9.7 ± 8.9% (p = 0.001) and 9.9 ± 7.1% (p = 0.002), respectively. Countermovement jump height increased only from T1 to T2 by 10.9 ± 11.8% (p = 0.026). A significant increase was found for VL fascicle length between T1 and T3 (9.6 ± 11.1%, p = 0.049). Strong correlations were found between the percentage increase of competitive track and field throwing performance with 1 RM snatch (r = 0.571, p = 0.046) and with shot put throws (r = 0.715, p = 0.001). Twenty five weeks of training may increase performance and VL fascicle length, whereas increases in 1 RM snatch and in shot put throws are associated with competitive track and field throwing performance in well-trained throwers.

Purpose: The purpose of the present study was to investigate the relationship between weightlifting performance and the rate of force development (RFD), muscle architecture, and body composition in elite Olympic weightlifters. Methods: Six male Olympic weightlifters (age 23.3 [3.4] y, body mass 88.7 [10.2] kg, body height 1.76 [0.07] m, snatch 146.7 [15.4] kg, clean and jerk 179.4 [22.1] kg), all members of the national team, participated in the study. Athletes completed a 16-week periodized training program aiming to maximize their performance at the national competition event. Measurements, including maximal strength (1-repetition maximum) in snatch, clean and jerk, back and front squat, isometric leg press RFD and peak force, countermovement jump, vastus lateralis muscle architecture, and body composition, were performed before and after the training period. Results: Weightlifting performance increased significantly after training (P P P P P P > .05). Significant correlations were observed between performance in snatch and clean and jerk with isometric leg press RFD, at all time windows, as well as with lean body mass and squat 1-repetition maximum. Conclusions: These results suggest that regular examination of RFD, lean body mass, and lower extremities’ 1-repetition maximum may be useful performance predictors in elite Olympic weightlifters.

Background Myotonic dystrophy type 2 (DM2) is a neuromuscular disorder characterized by myotonia and muscle weakness, with no medical treatment to prevent a decline in decline. It is unknown whether exercise training is effective in DM2. The aim of this study was to investigate the effect of exercise training on functional capacity and body composition in these patients. Methods Body composition and functional capacity were evaluated at the beginning (T1) and end (T2) of a 12 wk control period, and again after 16 wk of exercise training (T3) in 10 patients. Results No changes were recorded after the control period. Handgrip strength, 5× sit to stand, timed up and go, 6 min walk distance, lean body mass (LBM), and bone mineral density (BMD) increased while arterial pressure decreased after training. Conclusions These results suggest that supervised exercise training improves functional capacity, LBM, and BMD in ambulatory DM2 patients.

Thomas, K, Spyridon, M, Nikolaos, Z, Angeliki-Nikolleta, S, Giorgos, K, Giorgos, G, and Gerasimos, T. Effects of complex vs. compound training on competitive throwing performance. J Strength Cond Res 36(7): 1866-1874, 2022-The purpose of this study was to investigate the effects of complex (CPX; strength and power exercises in pairs) vs. compound (CPD; strength and power exercises in different days) training on competitive track and field throwing performance. Ten well-trained throwers (7 male throwers and 3 female throwers) followed a 34-week periodized training program including 2 preparation periods. During the winter 4-week, precompetition phase, athletes were randomly assigned to CPX or CPD groups, while the opposite assignment was performed during the spring precompetition phase (counterbalanced design). Before and after each training period competitive track and field throwing performance, shot put throws, snatch, squat and bench press 1 repetition maximum (1RM), vertical jumps, rate of force development (RFD), and body composition were evaluated. Competitive track and field throwing performance increased significantly by 5.4 ± 2.9% and 1.9 ± 1.7%, after CPX and CPD, respectively, with a significant difference between groups (p0.001). Shot put throws and 1RM strength in bench press increased similarly after both programs (p0.05), but vertical jumps increased only after CPX training. CPX induced greater increases in 1RM strength in snatch and squat, RFD, and lean body mass compared with CPD (p0.005). The linear combination of training-induced changes in RFD 150ms, 1RM in squat, snatch, and total lean mass explained the 80% of the percentage increase in competitive track and field throwing performance (p = 0.007). These results suggest that 4 weeks of CPX training during the precompetition period induce greater increases in competitive track and field throwing performance, 1RM strength, power, and RFD compared with CPD training.

Pompe disease is a rare autosomal recessive disorder caused by the deficiency of acid α-glycosidase resulting in accumulation of glycogen in the lysosomes. The late-onset form of the disease (LOPD) causes primarily progressive muscle weakness and respiratory insufficiency. Enzyme replacement therapy (ERT) introduced in 2006, showed mild improvement or stabilization of the symptoms although long-term data are limited. Aim of the study was to describe the progression of body composition and walking ability in LOPD patients receiving ERT consistently for 9 years.Lean body mass, bone mineral density, body fat and 6 min walking distance were assessed in three male and three female LOPD patients (height 165.8 ± 11.2 cm, age 42.3 ± 11.8yrs, body mass 71.1 ± 20.8 kg, at study entry), every three years, for 9 years since ERT initiation (T0, T3, T6, T9).Total body and upper extremities' lean mass remained unchanged (The current data show that enzyme replacement therapy may preserve lean body mass, bone mineral density and walking capacity in LOPD patients.

A malunited distal radius fracture can lead to symptomatic ulnar impaction syndrome, which is a common cause for ulnar-sided wrist pain. If conservative treatment fails and symptoms persist after an arthroscopic ulnocarpal debridement, ulnar shortening osteotomy (USO) is the treatment of choice. Since the first USO described by Milch in 1941 after a malunited Colles fracture, many techniques have been described varying in surgical approach, type of osteotomy and osteosynthesis material used. Many studies demonstrated good to very good functional results after USO, reporting, however, a delayed union or non-union rate up to 18%. A modern, low profile, locking plate showed in our short-term study very good functional results and no implant-associated complications, in particular no non-union.

This study examined changes in movement velocity and surface electromyographic (sEMG) activity of the pectoralis major (PM) and triceps brachii (TB) muscles during the bench press exercise to failure against different loads. Fourteen men performed a set to failure with maximum intended velocity, against low (40%-1 repetition maximum-RM), moderate (60%-1RM), and heavy loads (80%-1RM). Number of repetitions, volume load, mean and peak velocity, and total time increased with decreasing load (40% > 60% > 80%, p

Bogdanis, GC, Tsoukos, A, Kaloheri, O, Terzis, G, Veligekas, P, and Brown, LE. Comparison between unilateral and bilateral plyometric training on single- and double-leg jumping performance and strength. J Strength Cond Res 33(3): 633-640, 2019-This study compared the effects of unilateral and bilateral plyometric training on single- and double-leg jumping performance, maximal strength, and rate of force development (RFD). Fifteen moderately trained subjects were randomly assigned to either a unilateral (U, n = 7) or bilateral group (B, n = 8). Both groups performed maximal effort plyometric leg exercises 2 times per week for 6 weeks. The B group performed all exercises with both legs, whereas the U group performed half the repetitions with each leg, so that total exercise volume was the same. Jumping performance was assessed by countermovement jumps (CMJs) and drop jumps (DJs), whereas maximal isometric leg press strength and RFD were measured before and after training for each leg separately and both legs together. Countermovement jump improvement with both legs was not significantly different between U (12.1 ± 7.2%) and B (11.0 ± 5.5%) groups. However, the sum of right- and left-leg CMJ only improved in the U group (19.0 ± 7.1%, p < 0.001) and was unchanged in the B group (3.4 ± 8.4%, p = 0.80). Maximal isometric leg press force with both legs was increased similarly between groups (B: 20.1 ± 6.5%, U: 19.9 ± 6.2%). However, the sum of right- and left-leg maximal force increased more in U compared with B group (23.8 ± 9.1% vs. 11.9 ± 6.2%, p = 0.009, respectively). Similarly, the sum of right- and left-leg RFD0-50 and RFD0-100 were improved only in the U group (34-36%, p < 0.01). Unilateral plyometric training was more effective at increasing both single- and double-leg jumping performance, isometric leg press maximal force, and RFD when compared with bilateral training.

Muscle fascicle length and muscle fibre conduction velocity (MFCV) are thought to be important parameters for power performance. It might be expected that faster muscle fibre conduction velocities would compensate for longer fascicle lengths to increase the speed of action potential propagation along the elongated fibres. However, the relationship between muscle fascicle length and MFCV remains unknown. The aim of the present study was to explore the relationship between average vastus lateralis MFCV and average fascicle length. In 17 moderately trained, healthy, male, physical education students (age, 23.4 ± 3.1 years; body height, 178 ± 5.5 cm; body mass, 82.7 ± 6.9 kg; body mass index, 24.6 ± 1.5 kg·m−2) resting MFCV was measured with intramuscular microelectrodes while muscle architecture was evaluated with ultrasonography. Fascicle length was highly correlated with total MFCV (r = 0.923, p = 0.000), maximum MFCV (r = 0.949, p = 0.000), and MFCV of the fastest (r = 0.709, p = 0.001), but not of the slowest fibres (r = 0.131, p = 0.616). No significant correlations were also found between vastus lateralis thickness or fascicle angle with any of MFCV parameters (r = 0.145–0.430; R2 < 0.130; p > 0.05). These data indicate that average MFCV is associated with average fascicle length in vastus lateralis muscle in different individuals. It seems that participants with longer fascicle lengths have also higher MFCVs.

This study aimed to evaluate the effects of 7-month intradialytic exercise training (IDE) on vastus lateralis (VL) muscle architecture, functional capacity and quality of life in stable haemodialysis (HD) patients.44 HD patients were randomly assigned into an Exercise Group (EG = 21), which they received 7 months of IET, at 60% of pre-assessed maximum aerobic power, 3/week) or into a Control Group (CG = 23, no exercise). VL architecture was evaluated with ultrasonography, functional capacity was assessed using a series of functional tests (6 min walking test, 5 repetitions sit-to-stand, sit-to-stand 60 s, handgrip strength), and maximal aerobic power determined with a modified version of the Åstrand test. Quality of life and fatigue levels were evaluated using validated questionnaires.VL fascicle angle and length did not change significantly in both groups (P 0.05). Muscle thickness decreased in CG (P = 0.02) while it was fully preserved in the EG. Functional capacity increased only in the EG (6 min walking test 15.79 ± 12.35%, P 0.001; max aerobic power 26.36 ± 1.24%, P 0.001; STS-60rep: 10.23 ± 1.60%, P 0.000; hand grip strength: 5.14 ± 28.30%, P 0.02).Intradialytic aerobic exercise training, improves functional capacity and prevents thigh muscle mass loss in HD patients. It is evident that muscle ultrasonography could play a pivotal role in assessing muscle quality changes in haemodialysis patients. A higher level of training intensity or combination with resistance exercises may be required to further improve anabolism and influence muscle architecture in this patient population.NCT03905551.

Background: Mediterranean diet was evaluated on erectile performance and cardiovascular hemodynamics, in chronic heart failure patients. Methods: 150 male stable heart failure patients were enrolled in the study (62 &plusmn, 10 years, New York Heart Association (NYHA) classes I&ndash, II, ejection fraction &le, 40%). A detailed echocardiographic evaluation including estimation of the global longitudinal strain of the left ventricle and the systolic tissue doppler velocity of the tricuspid annulus was performed. Erectile dysfunction severity was assessed by the Sexual Health Inventory for Men-5 (SHIM-5) score. Adherence to the Mediterranean diet was evaluated by the MedDietScore. Results: The SHIM-5 score was positively correlated with the MedDietScore (p = 0.006) and augmentation index (p = 0.031) and inversely correlated with age (p = 0.002). MedDietScore was negatively associated with intima-media-thickness (p &lt, 0.001) and serum prolactin levels (p = 0.05). Multi-adjusted analysis revealed that the inverse relation of SHIM-5 and prolactin levels remained significant only among patients with low adherence to the Mediterranean diet (p = 0.012). Conclusion: Consumption of Mediterranean diet benefits cardiovascular hemodynamics, while suppressing serum prolactin levels. Such physiology may enhance erectile ability independently of the of the left ventricle ejection fraction.

Kelekian, GK, Zaras, N, Stasinaki, AN, Spiliopoulou, P, Karampatsos, G, Bogdanis, G, and Terzis, G. Preconditioning strategies before maximum clean performance in female weightlifters. J Strength Cond Res 36(8): 2318-2321, 2022-The aim of the study was to examine the acute effect of performing clean pulls with either 85% or 120% one repetition maximum (1RM), on subsequent clean performance, in female Olympic weightlifters. Eight competitive female Olympic weightlifters (age, 22.9 ± 5.8 years; height, 1.67 ± 0.06 m; training experience, 6.1 ± 3.9 years; clean performance, 66.3 ± 3.9 kg), performed clean pulls either with 85% or with 120% 1RM, 3 minutes before their maximum effort in clean, in 2 different days, in a counterbalanced order. The rate of perceived exertion (RPE) was provided after each intervention. Body composition (dual x-ray absorptiometry), countermovement jumping (CMJ) performance, leg press isometric rate of force development (RFD), and peak force (PF) were also evaluated on different days. Clean performance was increased by 6.1 ± 3.6% ( p = 0.002) after preconditioning with 85% 1RM and 4.7 ± 3.1% ( p = 0.004) after 120% 1RM. Rate of perceived exertion was lower after preconditioning with 85% 1RM, compared with 120% 1RM ( p = 0.015). No significant correlation was found between the changes in clean performance after 85% or 120% 1RM, with lean body mass, CMJ performance, and isometric leg press RFD, and leg press PF. These data suggest that lifting either 85% or 120% 1RM in clean pulls is an effective strategy for acute increase of clean performance in female Olympic weightlifters, whereas the use of 85% 1RM load may be performed with less exertion.

Tsoukos, A, Brown, LE, Terzis, G, Veligekas, P, and Bogdanis, GC. Potentiation of bench press throw performance using a heavy load and velocity-based repetition control. J Strength Cond Res 35(2S): S72-S79, 2021-The acute effects of heavy load bench press exercise on subsequent bench press throw (BPT) performance and surface electromyographic (sEMG) activity were examined using movement velocity control. Eleven resistance-trained men completed 3 conditions in randomized and counterbalanced order. In 2 conditions, bench press was performed as fast as possible against a load of 80% of 1 repetition maximum, until mean velocity dropped to 90% (C90) or 70% (C70) of the fastest repetition. In the control condition, no bench press was performed. Single maximal BPT efforts were performed in all conditions after warm-up and throughout the 12 minutes of subsequent recovery. Mean propulsive velocity (MPV), peak velocity (PV), and sEMG activity of the prime mover muscles were measured during the BPT efforts. The total number of repetitions and volume load during bench press were significantly greater in C70 compared with C90 (6.5 ± 1.9 vs. 3.4 ± 0.9 repetitions and 557.8 ± 177.8 vs. 293.8 ± 95.7 kg, p < 0.01). In C90, MPV was increased 5.3-7.4% (p < 0.01) for a prolonged period (4-12 minutes), while in C70, MPV increased only at 10 minutes (+5.9%, p < 0.01) and 12 minutes (+4.3%, p < 0.01). Peak velocity was improved only in the C90 at 8-12th min by 3.6-4.7% (p ≤ 0.05). Surface electromyographic activity of the pectoralis major muscle was significantly greater than baseline at 10 minutes of recovery only in the C90 (p < 0.01). Performance gains may be optimized by taking into account the individual fatigue profiles, allowing a percentage drop of only 10% in movement velocity during the conditioning bench press exercise.

Late onset Pompe disease (LOPD) is a slowly progressive metabolic myopathy with variable clinical severity. The advent of enzyme replacement therapy (ERT) has modified the natural course of the disease, though the treatment effect on adult patients is modest compared to infants with the classic form. This study aims to describe the long-term clinical outcome of the Greek LOPD cohort, as assessed by 6 min walk test, muscle strength using MRC grading scale and spirometry. ERT efficacy was estimated using statistical methodology that is novel in the context of Pompe disease, which at the same time is well-suited to longitudinal studies with small samples and missing data (local non-linear regression analysis). Improvement over baseline was significant at 1 year for motor performance and muscle strength (p0.05), and at 2 years for FVC-U and FVC-S (p0.05). A subgroup analysis showed that the onset of the disease before adulthood (18 years), a male gender, and a latency of more than 2 years between the onset of symptoms and ERT administration are unfavorable prognostic factors. Conclusively, this study presents longitudinal data from the Greek LOPD cohort supporting previous observations, that therapeutic delay is related to worse prognosis and treatment effects may decline after several years of ERT.

This study aimed to investigate the effect of 3 different eccentric-only power training volumes on muscle fiber type composition and power performance. Twenty-nine females were assigned into 3 groups and performed 10 weeks of either 3 (low volume), 6 (moderate volume), or 9 (high volume) sets/session of 4 fast-velocity eccentric-only half-squats against 70% of concentric 1-repetition maximum (1RM), followed by 3 maximum countermovement jumps (CMJs) after each set. Half-squat 1RM, CMJ height/power, maximum isometric force, rate of force development (RFD) and muscle fiber cross-sectional area (CSA) were increased in all groups (p = 0.001). Low-volume training induced higher increases in CMJ height/power and early RFD, compared with the moderate- and high-volume training programs (p < 0.001). Significant reductions in type IIx muscle fiber percentages and %CSAs were found after moderate- and high-volume training, with concomitant increases in type IIa fibers (p = 0.001). Significant correlations were found between the changes in type IIa and type IIx percentages, fiber CSA, %CSA, and the changes in performance (r: –0.787 to 0.792; p < 0.05). These results suggest that relatively large eccentric power training volumes may result in detrimental neuromuscular adaptations, minimal changes in early RFD, and a reduction of type IIx muscle fiber percentage. Novelty Low but not high volume of power training maintains type IIx muscle fibers. Early rate of force development increases after a low- or moderate-power training volume, but not after a high-power training volume. Training-induced changes in type IIx muscle fiber percentage is related with changes in early rate of force development.

Metacarpal and phalangeal fractures are the second most frequent fractures of the upper extremity. Treatment goal is to restore the function of the injured hand. Due to better understanding of anatomy and biomechanics as well as the development of locking and low-profile implants for osteosynthesis of such fractures, there is a growing safety when choosing the operative treatment for the correct indication. Nevertheless, conservative treatment of these injuries still plays an important role.Mittelhand- und Phalangenfrakturen sind in der Summe die zweithäufigsten Frakturen der oberen Extremität. Die korrekte Therapie und Nachbehandlung sind essenziell für die Wiederherstellung der Funktion der verletzten Hand. Das bessere Verständnis von Anatomie und Biomechanik der Mittelhand und Phalangen sowie die Entwicklung moderner Implantate erlauben gute Ergebnisse bei der operativen Versorgung, wenn auch die konservative Therapie einen großen Stellenwert hat.

The effects of high intensity interval training (HIIT) frequency on cardiometabolic health and quality of life were examined in 35 healthy inactive adults (age: 31.7±2.6 yrs, VO2peak: 32.7±7.4 ml·kg−1 ·min−1). Participants were randomly assigned to a control (CON) and two training groups, which performed 10×60-s cycling at ~83% of peak power, two (HIIT-2) or three times per week (HIIT-3) for eight weeks. Compared with CON, both training regimes resulted in similar improvements in VO2peak (HIIT-2: 10.8%, p=0.048, HIIT-3: 13.6%, p=0.017), waist circumference (HIIT-2: -1.4 cm, p=0.048, HIIT-3: -2.4 cm, p=0.028), thigh cross-sectional area (HIIT-2: 11.4 cm2, p=0.001, HIIT-3: 9.3 cm2, p=0.001) and the physical health component of quality of life (HIIT-2: 8.4, p=0.001, HIIT-3: 12.2, p=0.001). However, HIIT-3 conferred additional health-related benefits by reducing total body and trunk fat percentage (p

The ubiquitin–proteasome system (UPS) is the main cellular proteolytic system responsible for the degradation of normal and abnormal (e.g. oxidised) proteins. Under catabolic conditions characterised by chronic inflammation, the UPS is activated resulting in proteolysis, muscle wasting and impaired muscle function. Milk proteins provide sulphur-containing amino acid and have been proposed to affect muscle inflammation. However, the response of the UPS to aseptic inflammation and protein supplementation is largely unknown. The aim of this study was to investigate how milk protein supplementation affects UPS activity and skeletal muscle function under conditions of aseptic injury induced by intense, eccentric exercise. In a double-blind, cross-over, repeated measures design, eleven men received either placebo (PLA) or milk protein concentrate (PRO, 4×20 g on exercise day and 20 g/d for the following 8 days), following an acute bout of eccentric exercise (twenty sets of fifteen eccentric contractions at 30°/s) on an isokinetic dynamometer. In each trial, muscle biopsies were obtained from the vastus lateralis muscle at baseline, as well as at 2 and 8 d post exercise, whereas blood samples were collected before exercise and at 6 h, 1 d, 2 d and 8 d post exercise. Muscle strength and soreness were assessed before exercise, 6 h post exercise and then daily for 8 consecutive days. PRO preserved chymotrypsin-like activity and attenuated the decrease of strength, facilitating its recovery. PRO also prevented the increase of NF-κB phosphorylation and HSP70 expression throughout recovery. We conclude that milk PRO supplementation following exercise-induced muscle trauma preserves proteasome activity and attenuates strength decline during the pro-inflammatory phase.

Characterization of the least number of muscle fibers analyzed for a quick and reliable, evaluation of intramuscular fiber conduction velocity (MFCV) is of importance for sport scientists. Aim of the present study was to evaluate the reliability of vastus lateralis’ intramuscular MFCV measuring either 25 or 50 different muscle fibers per participant, as well as to compare intramuscular MFCV measured in 25 (C25), 50 (C50) or 140 (C140) muscle fibers. Resting vastus lateralis’ MFCV was measured in twenty-one young healthy males (age 22.1 ± 2.4 yrs) using intramuscular microelectrodes in different days. Test-retest reliability of MFCV's parameters were calculated for C25 and C50 while MFCV was compared among C25, C50 and C140. Significant differences of MFCV parameters were observed between C25 condition and those of C50 and C140. The differences in MFCV values between conditions C50 and C140 were non-significant. A close correlation was found for MFCV between C50 and C140 (r = 0.884 - 0.988, p = 0.000). All reliability measures of MFCV measured with 50 fibers were high (e.g. ICC = 0.813 - 0.980, p = 0.000), in contrast to C25 (e.g. ICC = 0.023 - 0.580 p > 0.05). In conclusion, an average of 50 different fibers per subject is sufficient to provide a quick and reliable intramuscular evaluation of vastus lateralis MFCV. This article is protected by copyright. All rights reserved.

Karampatsos, GP, Korfiatis, PG, Zaras, ND, Georgiadis, GV, and Terzis, GD. Acute effect of countermovement jumping on throwing performance in track and field athletes during competition. J Strength Cond Res 32(1): 359-364, 2017-The purpose of the study was to investigate whether performing 3 consecutive countermovement jumps (CMJs) just before an attempt enhances performance in track and field throwers during competition. Twelve shot putters, 8 hammer throwers, 9 discus throwers, and 3 javelin throwers of both sexes participated in the study. They performed 3 maximal CMJs 85 ± 12 seconds before the second, fourth, and sixth attempt during 3 different official competitions of national level. Maximal strength (1 repetition maximum [1RM]) in squat and bench press was measured 1 week after the competition. Mean throwing performance was significantly higher after the CMJs intervention (2.66 ± 4.3%, range of increase 0.02-18.98%, p = 0.0001). Similarly, maximum throwing performance was significantly higher after the CMJs (2.76 ± 3.29%, range of increase 0.09-13.93%, p = 0.0009). All but 2 athletes increased their best performance after the CMJs. The percentage increase in performance was similar between sexes (male athletes 2.56 ± 3.01%; female athletes 3.06 ± 3.76%, p = 0.677), but it was higher for the "lighter throws" (discus and javelin throw: 4.66 ± 4.11%) compared with the "heavier throws" (shot and hammer throw: 1.62 ± 2.04%, p = 0.008). The percentage increase in performance was not significantly correlated with 1RM squat or bench press, anthropometric characteristics, and personal best performance. These results suggest that performing 3 CMJs approximately 1 minute before an attempt may increase track and field throwing performance during competition.

The effectiveness of high-intensity interval training (HIIT) in inducing positive physiological adaptations is well documented. However, its impact on perceptual responses and on future physical activity (PA) engagement is less evaluated. The present study aimed to examine the effects of HIIT frequency on perceptual responses, health-related quality of life (HRQOL), and its influence in future PA participation. Thirty-five inactive adults were randomly assigned to a control (CON) and to 2 training groups that performed HIIT (10 × 60 s cycling, ∼83% peak power output) for 2 (HIIT-2) or 3 (HIIT-3) times per week for 8 weeks. Following the HIIT intervention, exercise enjoyment, HRQOL, and the intention to implement HIIT in the future were evaluated. Eight weeks after cessation of training, follow-up evaluations of HRQOL and PA were performed. Following the intervention, both training frequencies induced high levels of enjoyment (HIIT-2: 6.0 ± 1.1, HIIT-3: 6.0 ± 1.1, scale 1–7), improved HRQOL (HIIT-2: p = 0.040; HIIT-3: p = 0.024), and reported intention to implement HIIT in the future (HIIT-3: 100%, HIIT-2: 93% of participants). At follow-up, HIIT-3 participants reported higher completion of HIIT compared with HIIT-2 and CON (p < 0.05). Both training groups sustained improved HRQOL and increased vigorous and total PA (p < 0.05). This study showed that performing HIIT either 2 or 3 times per week is an enjoyable exercise modality that promotes a sustainable increase in habitual PA levels and improves HRQOL. Moreover, the higher training frequency resulted in greater HIIT completion in the 8-week period following the cessation of training.

Fractures of the scaphoid bone are common but can easily be overlooked in standard X‑rays. Inadequate diagnostics and therefore inappropriate treatment of scaphoid fractures often leads to problems in healing with formation of non-union and painful osteoarthritis of the wrist.This review summarizes the current practical recommendations in the diagnostics and treatment of acute scaphoid fractures.An analysis and review of selected literature including the current S3 guidelines were performed.The main statements are that in cases of a clinically suspected scaphoid fracture, staged diagnostics including radiographs, computed tomography (CT) and when necessary magnetic resonance imaging (MRI) should be applied to confirm or exclude a fracture. Further treatment in the case of a fracture is planned according to a CT-based classification. There are fracture types that can be treated either conservatively or operatively and there are other fracture types that always require operative fixation. The operative technique depends on the exact fracture geometry. For osteosynthesis, cannulated headless compression screws are mostly used.

The aim of this study was to explore the relationship between muscle fiber conduction velocity (MFCV), fiber type composition, and power performance in participants with different training background.Thirty-eight young males with different training background participated: sedentary (n = 10), endurance runners (n = 9), power trained (n = 10), and strength trained (n = 9). They performed maximal countermovement jumps (CMJ) and maximal isometric leg press for the measurement of the rate of force development (RFD). Resting vastus lateralis MFCV was measured with intramuscular microelectrodes on a different occasion, whereas muscle fiber type and cross-sectional area (CSA) of vastus lateralis were evaluated through muscle biopsies 1wk later.MFCV, CMJ power, RFD, and % CSA of type II and type IIx fibers were higher for the power-trained group (P0.001). No difference was found between sedentary participants and endurance runners in these variables, but both of these groups performed worse than strength/power participants. Close correlations were found between MFCV and fiber CSA as well as the % CSA of all fiber types as well as with RFD and CMJ power (r = 0.712-0.943, P0.005). Partial correlations revealed that the % CSA of IIx fibers dictates a large part of the correlation between MFCV and RFD, power performance. Significant models for the prediction of the % CSA of type IIa and type II as well as the CSA of all muscle fibers based upon MFCV, RFD, and CMJ were revealed (P = 0.000).MFCV is closely associated with muscle fiber % CSA. RFD and jumping power are associated with the propagation of the action potentials along the muscle fibers. This link is regulated by the size and the distribution of type II, and especially type IIx muscle fibers.

Tsoukos, A, Bogdanis, GC, Terzis, G, and Veligekas, P. Acute improvement of vertical jump performance after isometric squats depends on knee angle and vertical jumping ability. J Strength Cond Res 30(8): 2250-2257, 2016-This study examined the acute effects of maximum isometric squats at 2 different knee angles (90 or 140°) on countermovement jump (CMJ) performance in power athletes. Fourteen national-level male track and field power athletes completed 3 main trials (2 experimental and 1 control) in a randomized and counterbalanced order 1 week apart. Countermovement jump performance was evaluated using a force-plate before and 15 seconds, 3, 6, 9, and 12 minutes after 3 sets of 3 seconds maximum isometric contractions with 1-minute rest in between, from a squat position with knee angle set at 90 or 140°. Countermovement jump performance was improved compared with baseline only in the 140° condition by 3.8 ± 1.2% on the 12th minute of recovery (p = 0.027), whereas there was no change in CMJ height in the 90° condition. In the control condition, there was a decrease in CMJ performance over time, reaching -3.6 ± 1.2% (p = 0.049) after 12 minutes of recovery. To determine the possible effects of baseline jump performance on subsequent CMJ performance, subjects were divided into 2 groups ("high jumpers" and "low jumpers"). The baseline CMJ values of "high jumpers" and "low jumpers" differed significantly (CMJ: 45.1 ± 2.2 vs. 37.1 ± 3.9 cm, respectively, p = 0.001). Countermovement jump was increased only in the "high jumpers" group by 5.4 ± 1.4% (p = 0.001) and 7.4 ± 1.2% (p = 0.001) at the knee angles of 90 and 140°, respectively. This improvement was larger at the 140° angle (p = 0.049). Knee angle during isometric squats and vertical jumping ability are important determinants of the acute CMJ performance increase observed after a conditioning activity.

Chronic aerobic exercise training is associated with improved endothelial function and arterial stiffness and favourable long-term cardiovascular effects.We investigated the acute effects of continuous moderate intensity aerobic exercise (CAE) and high intensity interval aerobic exercise (hIAE) on endothelial function and arterial stiffness in healthy participants.Twenty healthy men were recruited to this cross-over study. They participated in two exercise sessions: (a) CAE, volume at 50% of maximum aerobic work for 30 minutes; and (b) hIAE, interval maximum aerobic work for 30 minutes. Endothelial function was evaluated by flow-mediated dilation in the brachial artery. The carotid femoral pulse wave velocity and the femoral dorsalis pedis pulse wave velocity were measured as indices of central aortic and peripheral arterial stiffness. Measurements were carried out before and immediately after each exercise session.There was no statistically significant difference in the baseline measurements before CAE and hIAE with respect to flow-mediated dilation, the carotid femoral pulse wave velocity and the femoral dorsalis pedis pulse wave velocity (p = NS). Both CAE and hIAE significantly improved the flow-mediated dilation compared with baseline (p 0.001). Similarly, the femoral dorsalis pedis pulse wave velocity was improved after CAE and hIAE (p 0.005), whereas the carotid femoral pulse wave velocity was not significantly affected (p = NS).Both CAE and hIAE can favourably affect endothelial function, suggesting another cardioprotective effect of acute exercise. These types of aerobic exercise have a different impact on the central and peripheral arterial stiffness.

This study compared knee angle-specific neuromuscular adaptations after two low-volume isometric leg press complex training programmes performed at different muscle lengths. Fifteen young males were divided into two groups and trained three times per week for 6 weeks. One group (n = 8) performed 5-7 sets of 3 s maximum isometric leg press exercise, with 4 min recovery, with knee angle at 85° ± 2° (longer muscle-tendon unit length; L-MTU). The other group (n = 7) performed the same isometric training at a knee angle of 145° ± 2° (180° = full extension; shorter muscle-tendon unit length; S-MTU). During the recovery after each set of isometric exercise, participants performed two CMJ every minute, as a form of complex training. Maximum isometric force (MIF) and rate of force development (RFD) were measured over a wide range of knee angles. Countermovement jump (CMJ) performance and maximum half-squat strength (1RM) were also assessed. Training at S-MTU induced a large increase of MIF (22-58%, p < 0.02) and RFD (18-43%, p < 0.05 to 0.001) at knee angles close to the training angle and resulted in a 14° ± 9° shift of the force vs. knee joint angle relationship towards extended knee joint angles (p = 0.001). In contrast, training at L-MTU, resulted in a moderate and similar (≈12.3%, p = 0.028) improvement of force at all knee angles. CMJ performance and 1RM were equally increased in both groups after training by 10.4% ± 8.3% and 7.8% ± 4.7% (p < 0.001), respectively. Low-volume maximal isometric leg-press complex training at S-MTU causes angle-specific adaptations in isometric strength and RFD, while dynamic muscle performance is independent of muscle length during training.

IMPORTANCE: Current Parkinson disease (PD) measures are subjective, rater-dependent, and assessed in clinic. Smartphones can measure PD features, yet no smartphone-derived rating score exists to assess motor symptom severity in real-world settings. OBJECTIVES: To develop an objective measure of PD severity and test construct validity by evaluating the ability of the measure to capture intraday symptom fluctuations, correlate with current standard PD outcome measures, and respond to dopaminergic therapy. DESIGN, SETTING, AND PARTICIPANTS: This observational study assessed individuals with PD who remotely completed 5 tasks (voice, finger tapping, gait, balance, and reaction time) on the smartphone application. We used a novel machine-learning-based approach to generate a mobile Parkinson disease score (mPDS) that objectively weighs features derived from each smartphone activity (eg, stride length from the gait activity) and is scaled from 0 to 100 (where higher scores indicate greater severity). Individuals with and without PD additionally completed standard in-person assessments of PD with smartphone assessments during a period of 6 months. MAIN OUTCOMES AND MEASURES: Ability of the mPDS to detect intraday symptom fluctuations, the correlation between the mPDS and standard measures, and the ability of the mPDS to respond to dopaminergic medication. RESULTS: The mPDS was derived from 6148 smartphone activity assessments from 129 individuals (mean [SD] age, 58.7 [8.6] years; 56 [43.4%] women). Gait features contributed most to the total mPDS (33.4%). In addition, 23 individuals with PD (mean [SD] age, 64.6 [11.5] years; 11 [48%] women) and 17 without PD (mean [SD] age 54.2 [16.5] years; 12 [71%] women) completed in-clinic assessments. The mPDS detected symptom fluctuations with a mean (SD) intraday change of 13.9 (10.3) points on a scale of 0 to 100. The measure correlated well with the Movement Disorder Society Unified Parkinson Disease's Rating Scale total (r = 0.81; P < .001) and part III only (r = 0.88; P < .001), the Timed Up and Go assessment (r = 0.72; P = .002), and the Hoehn and Yahr stage (r = 0.91; P < .001). The mPDS improved by a mean (SD) of 16.3 (5.6) points in response to dopaminergic therapy. CONCLUSIONS AND RELEVANCE: Using a novel machine-learning approach, we created and demonstrated construct validity of an objective PD severity score derived from smartphone assessments. This score complements standard PD measures by providing frequent, objective, real-world assessments that could enhance clinical care and evaluation of novel therapeutics.

Summary Objectives The purpose of this retrospective study is to present our results with peroneal nerve lesions, to examine the relative significance of various factors, to assess their effect on outcome, and to establish guidelines of treatment for the microsurgical management of these difficult lesions. Methods Over a 33-year period, a total of 62 patients were treated at McGill University and the Microsurgical Research Center, Eastern Virginia Medical School. The clinical records of all patients treated for peroneal nerve lesions were reviewed for retrospective analysis. Results Of 62 patients, 35 had microneurolysis and nerve decompression of the common peroneal nerve (CPn) as the only surgical procedure while 27 required reconstruction with nerve grafting. Postoperatively muscle power was graded from M + 4 to M − 5 in 27 patients, from M − 4 to M4 in 26 patients, from M − 3 to M + 3 in 8 patients, and from M − 2 to M + 2 in 1 patient. The behavioral video data showed a mean preoperative ankle dorsiflexion of 6.79° ± 5.6 and postoperative ankle dorsiflexion of 37.9° ± 9.3. Overall, excellent functional results were achieved in 27 of 62 patients (43%) with peroneal palsy who underwent microsurgical reconstruction, and good results were observed in 25 patients (40%). Conclusions Despite previous widespread pessimism, the surgical repair of CPn lesion is worthwhile, yielding good to excellent results in the majority of patients, after a careful preoperative consultation, establishment of a sound strategy of reconstruction and using aggressive and atraumatic microsurgery.

Extra-articular shortening of the distal ulna in order to decompress the ulnocarpal joint.Congenital or posttraumatic, symptomatic ulnar impaction syndrome.Osteoarthritis or deformation of the distal radioulnar joint.Exactly defined oblique osteotomy in the distal third of the ulna using the saw guide, closing of the osteotomy gap using the compression spindle, osteosynthesis with the locking plate.Palmar forearm thermoplastic cast or splint for 3 weeks, load bearing after bony union.Between June 2016 and March 2018 ulnar shortening was performed in 17 patients using the new locking plate. In all, 15 patients were reevaluated with complete follow-up data. Postoperatively patients experienced significant pain reduction (Visual Analog Scale 0-10) by 65% (7 before and 2.5 after surgery; p 0.05) and a significant improvement of function (Disabilities of Arm, Shoulder and Hand 0-100) by 49% (47 before and 24 after surgery; p 0.05). Bony union was observed in all patients after a mean time of 4 months. Overall patient satisfaction was high.

Background The challenges of today’s society call for more knowledge about how to maintain all aspects of cognitive health, such as speed/attention, memory/learning, visuospatial ability, language, executive capacity and social cognition during the life course. Main text Medical advances have improved treatments of numerous diseases, but the cognitive implications have not been sufficiently addressed. Disability induced by cognitive dysfunction is also a major issue in groups of patients not suffering from Alzheimer’s disease or related disorders. Recent studies indicate that several negative lifestyle factors can contribute to the development of cognitive impairment, but intervention and prevention strategies have not been implemented. Disability due to cognitive failure among the workforce has become a major challenge. Globally, the changing aging pyramid results in increased prevalence of cognitive disorders, and the diversity of cultures influences the expression, manifestation and consequences of cognitive dysfunction. Conclusions Major tasks in the field of cognitive medicine are basic neuroscience research to uncover diverse disease mechanisms, determinations of the prevalence of cognitive dysfunction, health-economical evaluations, and intervention studies. Raising awareness for cognitive medicine as a clinical topic would also highlight the importance of specialized health care units for an integrative approach to the treatment of cognitive dysfunctions.

The purpose of this study was to examine the effects of a short-term fast eccentric and ballistic complex training program on muscle power, rate of force development (RFD), muscle fiber composition, and cross-sectional area (CSA).Sixteen male physical education students were randomly assigned to either a training group (TG, n = 8) or a control group (n = 8). The TG followed a 6-wk low volume training program, including fast eccentric squat training with an individually optimized load of 74% ± 7% of maximal half-squat strength (1RM) twice per week and a ballistic training session with loaded (30% 1RM) and unloaded jump squats, once per week, all combined with unloaded plyometric jumps.Half squat 1RM was increased in the TG from 1.87 ± 0.28 to 2.14 ± 0.31 kg per kilogram body mass (14.4% ± 9.3%, P = 0.01). The percentage of types I, IIA, and IIX fibers were similar in the two groups at pretesting and did not change after the intervention period (P = 0.53-0.89). Muscle fiber CSA increased in all fiber types by 8.3% to 11.6% (P = 0.02 to 0.001) in TG only. Countermovement jump height and peak power measured at five different external loads (0%-65% of 1RM) only increased in the TG by approximately 20% to 36% (P0.01) and approximately 16% to 22% (P0.01), respectively. Peak ground reaction force during jump squats remained unchanged in both groups, whereas RFD increased in the TG only (40%-107%, P = 0.001).A combination of low-volume fast eccentric and ballistic jump squat training with plyometric jumps in a strength-power potentiation complex format, induced substantial increases in peak leg muscle power, RFD, and maximal strength, accompanied by gains in CSA of all muscle fiber types, without a reduction in fast twitch fiber composition.

The cytokine granulocyte colony-stimulating factor (G-CSF) binds to its receptor (G-CSFR) to stimulate hematopoietic stem cell mobilization, myelopoiesis, and the production and activation of neutrophils. In response to exercise-induced muscle damage, G-CSF is increased in circulation and G-CSFR has recently been identified in skeletal muscle cells. While G-CSF/G-CSFR activation mediates pro- and anti-inflammatory responses, our understanding of the role and regulation in the muscle is limited. The aim of this study was to investigate, in vitro and in vivo, the role and regulation of G-CSF and G-CSFR in skeletal muscle under conditions of muscle inflammation and damage. First, C2C12 myotubes were treated with lipopolysaccharide (LPS) with and without G-CSF to determine if G-CSF modulates the inflammatory response. Second, the regulation of G-CSF and its receptor was measured following eccentric exercise-induced muscle damage and the expression levels we investigated for redox sensitivity by administering the antioxidant N-acetylcysteine (NAC). LPS stimulation of C2C12 myotubes resulted in increases in G-CSF, interleukin (IL)-6, monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor-α (TNFα) messenger RNA (mRNA) and an increase in G-CSF, IL-6, and MCP-1 release from C2C12 myotubes. The addition of G-CSF following LPS stimulation of C2C12 myotubes increased IL-6 mRNA and cytokine release into the media, however it did not affect MCP-1 or TNFα. Following eccentric exercise-induced muscle damage in humans, G-CSF levels were either marginally increased in circulation or remain unaltered in skeletal muscle. Similarly, G-CSFR levels remained unchanged in response to damaging exercise and G-CSF/G-CSFR did not change in response to NAC. Collectively, these findings suggest that G-CSF may cooperate with IL-6 and potentially promote muscle regeneration in vitro, whereas in vivo aseptic inflammation induced by exercise did not change G-CSF and G-CSFR responses. These observations suggest that different models of inflammation produce a different G-CSF response.

A growing number of studies have examined the “immigrant paradox” with respect to health behaviors in the United States. However, little research attention has been afforded to the study of adverse childhood experiences (ACE; neglect, physical and sexual abuse, and witnessing violence) among immigrants in the United States. The present study, using Waves I and II data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), aims to address these gaps by comparing forms of ACE of first- and second-generation immigrants with native-born American adults in the United States. We also examined the latent structure of ACE among immigrants and conducted analyses to assess the psychiatric correlates of identified latent classes. With the exception of neglect, the prevalence of ACE was markedly higher among native-born Americans and second-generation immigrants compared with first-generation immigrants. Four latent classes were identified—limited adverse experience ( n = 3,497), emotional and physical abuse ( n = 1,262), family violence ( n = 358), and global adversity ( n = 246). The latter three classes evinced greater likelihood of being diagnosed with a mood, anxiety, personality, and substance use disorder, and to report violent and non-violent antisocial behavior. Consistent with prior research examining the associations between the immigrant paradox and health outcomes, results suggest that first-generation immigrants to the United States are less likely to have experienced physical and sexual abuse and witness domestic violence. However, likely due to cultural circumstances, first-generation immigrants were more likely to report experiences that are deemed neglectful by Western standards.

Methenitis, S, Spengos, K, Zaras, N, Stasinaki, A-N, Papadimas, G, Karampatsos, G, Arnaoutis, G, and Terzis, G. Fiber type composition and rate of force development in endurance- and resistance-trained individuals. J Strength Cond Res 33(9): 2388-2397, 2019-The purpose of the study was to investigate the relationship between muscle fiber composition and the rate of force development (RFD) in well-trained individuals with different training background. Thirty-eight young men with different training background participated: 9 endurance runners, 10 power-trained individuals, 9 strength-trained individuals, and 10 sedentary individuals. They performed maximal isometric leg press for the measurement of RFD. Body composition (dual x-ray absorptiometry) and vastus lateralis fiber type composition were also evaluated. When all participants were examined as a group, moderate correlations were found between the percent of type II muscle fibers and RFD between 100 and 600 milliseconds (r = 0.321-0.497; p ≤ 0.05). The correlation coefficients were higher for the cross-sectional area (CSA) and the %CSA of type II and IIx muscle fibers (r = 0.599-0.847; p < 0.001). For the power group, RFD up to 250 milliseconds highly correlated with % type IIx muscle fibers and type IIx fiber CSA (r = 0.670-0.826; p ≤ 0.05), as well as with %CSA of type IIx fibers (r = 0.714-0.975; p ≤ 0.05). Significant correlations were found between the relative RFD (·kg lower extremities lean mass) and CSA-%CSA of type II and IIx fibers for the power group (r = 0.676-0.903; p ≤ 0.05). No significant correlations were found between muscle morphology and RFD for the other groups. In conclusion, the present data suggest that there is a strong link between the type IIx muscle fibers and early RFD and relative RFD in power-trained participants. Type II fibers seem to be moderately linked with RFD in non-power-trained individuals.

This study investigated the effects of muscle action type during conditioning activity (half-squat) on subsequent vertical jump performance. Fourteen track and field athletes (relative half-squat of 2.3 ± 0.3 times their body weight) completed 4 main trials in a randomized and counterbalanced order 5-7 days apart: (a) concentric (CON) half-squats: 7.5 ± 1.2 repetitions against 90% of 1 repetition maximum (1RM), (b) eccentric (ECC) half-squats: 9.3 ± 1.5 repetitions against 70% of 1RM, and (c) 3 sets of 3-second maximal isometric (ISO) half-squats, (d) a control (CTRL) trial, where subjects rested for 10 minutes. The number of repetitions in CON and ECC was adjusted so that the impulse of the vertical ground reaction force was similar to ISO. Countermovement vertical jump (CMJ) performance was evaluated for 21 minutes after each main trial. Countermovement vertical jump performance in ISO was higher than CTRL from the second to the 10th minute of recovery, whereas CMJ performance in ECC was higher than CTRL from the sixth and 10th minute of recovery. Analysis of the peak individual responses revealed an increase in CMJ performance compared with baseline only in ISO (3.0 ± 1.2%; p = 0.045), whereas no significant increases were observed in ECC and CON. Peak CMJ performance for all subjects in ISO and ECC was achieved within 2-10 minutes after the conditioning muscle actions. Isometric were more effective than CON and ECC muscle actions in increasing explosive leg performance when the impulse of the ground reaction force of the conditioning exercise was equated.

Summary Background The present study demonstrates our experience with a novel use of the Platysma in facial reanimation, as a balancing procedure by counteracting an overactive free muscle transfer, and improving oral continence by re-establishing the oral sphincter mechanism. Material and methods Twelve patients, nine female (75%) and three male (25%), with a mean age of thirty-eight years (range: 2–66) are presented. Of these, in seven patients (58%) who had excessive excursion of the free muscle, the contralateral pedicled platysma was transferred to counteract the excessive pull. Four patients (33%) underwent bilateral platysma transfer for oral sphincter restoration, while one (8%) had ipsilateral platysma transfer. Evaluation of aesthetic and functional results was performed by a panel of three independent observers, and the long term efficacy of the procedure was assessed through a patient questionnaire. Results All patients demonstrated significant upgrading of their oral competence associated with eating, drinking and smiling, as it was confirmed by the behavioural analysis ( p Six of the ten patients that were available, responded to the Quality of Life Questionnaire. Five out of six were satisfied with their mouth appearance when they smile and five patients have a regular diet and without drooling. Conclusion A novel use of Platysma transposition is described that can substitute for a paralysed orbicularis oris muscle in restoring oral sphincter function or to counter balance an excessively active free muscle that was previously transferred for smile restoration. This novel Platysma transfer technique is intended to be used as an adjunct to other reanimation procedures.

Promoting neurological recovery requires strategies that simultaneously provide protection to injured neurons and increase the numbers of neurons that extend axons while inducing more rapid and extensive axon regeneration across long nerve gaps. An agent that facilitates the speed and success of reinnervation will have direct applicability to the clinical management of severe peripheral nerve injuries. The immunosuppressive drug FK506 has been proven to have neuroprotective and neurotrophic actions in experimental models, increasing neurite elongation and accelerating the rate of nerve regeneration in vitro and in vivo. This review examines the role played by FK506, with primary focus on its role as a neurotrophic agent and its potential clinical use as a promoter of neurological recovery following peripheral nerve injuries.

Pompe disease is an autosomal recessive disorder caused by the deficiency of acid α-glucosidase resulting in lysosomal accumulation of glycogen and abnormal autophagic function. The late-onset form of the disease is characterized by progressive skeletal and respiratory muscle dysfunction. Enzyme replacement therapy (ERT, Genzyme Corporation, Cambridge, MA, USA) was recently introduced and resulted in significant prolongation of the life expectancy of the patients with the infantile form while the results were less significant for the late-onset form. It has been postulated that the weak influence of ERT in late-onset patients might be due to a non-effective delivery of the recombinant enzyme to the skeletal muscles perhaps due to the relatively low blood flow to the resting skeletal muscles during infusion. Exercise training acutely increases the blood flow to the exercising muscles. Thus, it was hypothesized that exercise training during enzyme infusion might increase the effectiveness of the ERT therapy. Five late-onset Pompe disease patients receiving ERT and following regular exercise training for approximately 10 months, followed a 6-month period of exercise training during infusion of the recombinant enzyme. Before and after this period, body composition, isometric strength and 6 minute walking distance were determined. Analysis of the results revealed that none of these parameters changed significantly after the 6-month intervention period (e.g. 6 minute walking distance before: 532 ± 31 m, vs. after: 527 ± 29 m, P = 0.246). These results suggest that exercise training during infusion may not add significant functional changes in late-onset Pompe patients receiving ERT and undergoing regular exercise training.

Aim of the study was to investigate whether high-intensity interval cycling performed immediately after resistance training would inhibit muscle strength increase and hypertrophy expected from resistance training per se. Twenty-two young men were assigned into either resistance training (RE; N = 11) or resistance training plus high-intensity interval cycling (REC; N = 11). Lower body muscle strength and rate of force development (RFD), quadriceps cross-sectional area (CSA) and vastus lateralis muscle architecture, muscle fiber type composition and capillarization, and estimated aerobic capacity were evaluated before and after 8 weeks of training (2 times per week). Muscle strength and quadriceps CSA were significantly and similarly increased after both interventions. Fiber CSA increased significantly and similarly after both RE (type I: 13.6 ± 3.7%, type IIA: 17.6 ± 4.4%, type IIX: 23.2 ± 5.7%, P

Background : Falls at home are common and potentially fatal for disabled older adults. To address this problem, we created an academic–community partnership involving disabled, urban-dwelling older adults and their families, the housing authority, a Tai Chi master, and a university. Objectives : We conducted a pilot to assess safety, acceptability, and feasibility of a Wii-based exergame designed to increase disabled older adults’ strength and balance. Methods : A working prototype was developed and evaluated. Then, we piloted a refined version with 19 disabled urban-dwelling older adults. Results : The program was enjoyable, feasible, and acceptable. Participants described multiple functional improvements. Of the 16 who completed at least three gaming sessions, average balance score increased 25% and gait speed increased 19%. Conclusions : This pilot showed promising results for improving strength and balance in the home setting, and yielded valuable lessons about health technology development with community partners.

The aim of the study was to examine the correlation between muscle morphology and jumping, sprinting, and throwing performance in participants with different power training duration experience. Thirty-six power-trained young men were assigned to 3 groups according to the length of their power training: less experienced (

Summary Synkinetic movements comprise abnormal involuntary contractions of one or more facial muscle groups which follow the desired contraction of another facial muscle group. They are frequently encountered in patients with long standing facial paralysis and seriously affect their psychological status due to the impairment of their facial appearance, function and emotional expressivity. Patients and methods Eleven pediatric patients (2 male and 9 female) presenting with post-facial paralysis synkinesis were included in the study. Mean age was 10.3 ± 4 years and mean denervation time 72.5 months. Results Patients underwent the following types of treatment: - Cross facial nerve grafting (CFNG) and secondary microcoaptations with botulinum toxin injection which had an improvement of 100% (3 in the 3 grade synkinesis scale) ( n = 2). - Cross facial nerve grafting (CFNG) and secondary microcoaptations without botulinum toxin injection which had an improvement of 66%(2 in the 3 grade synkinesis scale) ( n = 5). - CFNG and direct muscle neurotization with ( n = 2) or without ( n = 1) botulinum toxin injection where the improvement was 33%. - Contralateral nasalis muscle myectomy was performed in one patient along with CFNG and secondary microcoaptations which resulted in 66% synkinesis improvement. Biofeedback was invariably undertaken by all patients. Postoperative improvement in eye closure and smile was also noted in the respective cases treated for synkinesis ranging from 25 to 50%, with all patients achieving optimum functional return. Conclusion CFNG with secondary microcoaptations and botulinum toxin injections was found to be a very efficient surgical modality addressing post-facial palsy synkinesis with high improvement in facial function and symmetry. Facial neuromuscular re-education contributes considerably in the treatment.

The aim of this study was to present the authors' experience with facial reanimation in adult patients following tumor extirpation and to analyze the functional outcomes.From 1978 to 2006, 60 adult patients underwent facial reanimation for facial paralysis following tumor extirpation. There was one patient with bilateral facial paralysis. Thus, evaluation was carried out in 61 hemifaces. Three independent assessors evaluated the preoperative and postoperative videos using the Terzis grading scale for eye closure, smile, depressor, and overall aesthetic and functional outcomes. Preoperative and postoperative electromyographic interpretations and the effect of demographic variables were also evaluated.There was significant improvement regarding preoperative versus postoperative outcomes for overall aesthesis and function. Good and excellent results were observed in 72.14 percent of the hemifaces (n = 44). The difference between preoperative and postoperative electromyographic results was of statistical significance (p0.0001) for each target reinnervated. Better results were observed in younger patients (≤ 35 years) (p = 0.023) and in early cases (p = 0.019).: The results of this present series illustrate that age and denervation time correlate with the final functional outcome. Cross-facial nerve grafts should ideally be used in patients with denervation time less than 6 months or more than 2 years combined with muscle transfers. In patients with a denervation time between 6 months and 2 years, the use of the babysitter procedure can yield a superior outcome.Therapeutic, IV.

Facial synkinesis comprises unwanted facial muscle contractions in different facial muscle groups following voluntary ones, in cases of incomplete recovery from facial paralysis. Facial expressivity and function are impaired, and the psychological integrity of the patients is seriously affected.Thirty-one adult patients (older than 18 years) presenting with post-facial paralysis synkinesis were included in this study. The mean patient age was 39.6 years and the mean denervation time was 124 months.There were five patient groups. Group A (n = 9) underwent cross-facial nerve grafting and secondary microcoaptations. Group B (n = 8) had cross-facial nerve grafting, secondary microcoaptations, and botulinum toxin type A injections. Group C (n = 6) received cross-facial nerve grafting, secondary microcoaptations, botulinum toxin type A, and selective neurectomies. Group D (n = 2) underwent cross-facial nerve grafting, direct muscle neurotization, and botulinum toxin type A. Group E underwent other means of treating synkinesis (n = 6), such as botulinum injections alone (n = 1), biofeedback alone (n = 2), biofeedback with selective neurectomies and myectomies (n = 2), and biofeedback and botulinum injections (n = 1). Group B had the highest synkinesis improvement (100 percent), followed by groups A and C (66 percent). Functional results were improved, with smile improvement being higher in group C and eye closure being higher in groups A, B, and E.Meticulous patient selection and evaluation followed by an individualized form of treatment, most frequently including cross-facial nerve grafting and secondary microcoaptations along with botulinum toxin type A and biofeedback including facial muscle retraining, constitute an effective and reliable methodology with which to combat post-facial paralysis synkinesis.Therapeutic, IV.

Although long-term weight gain has been associated with cardiovascular risk and intima-media thickening (IMT), no sufficient data exist on possible associations of such weight changes with more advanced stages of subclinical atherosclerosis. Moreover, the value of self-reported weight changes, a more practical approach to assess long-term history in adiposity status, is still a matter of debate. In this longitudinal study, long-term changes in BMI and overweight status were assessed in 106 healthy young adults (age 40.5 ± 1.1 years, 60 males). These were a subgroup of adolescent school students who had originally been examined in 1983 initially aiming to assess cardiovascular risk factor prevalence. Markers of early (carotid IMT) and advanced (presence of plaques in the carotid and femoral arteries and ankle-brachial index, ABI) subclinical atherosclerosis were measured in all individuals. By multivariate analysis, among other risk factors, IMT and the presence of plaques were independently determined by BMI change, while a low ABI was also determined by changes in overweight status. An adverse long term adiposity profile change (≥ +4 kg/m(2) and/or change into overweight/obese status from normal weight since adolescence) incrementally determined a low ABI over current risk factors. Self-reported and actual BMI changes were correlated (r = 0.587) but their means significantly differed, while the former significantly correlated with IMT only (P = 0.032). In conclusion, an adverse long term adiposity status change was more prominently associated with advanced subclinical atherosclerosis and particularly low ABI. These results also suggest that the utility of self-reported weight changes may be limited in primary prevention practice.

Summary Restoration of elbow flexion is one of the priorities in brachial plexus palsy, as this function brings the hand to the mouth. This study analyses the results of musculocutaneous nerve reconstruction in 194 patients with devastating paralysis. Results were analyzed in relation to denervation time, severity score, length of nerve grafts, and donor nerves used. Between 1978 and 2006, 194 post-traumatic plexopathy patients underwent musculocutaneous nerve reconstruction. 298 motor donors were used in 175 patients while 19 patients had microneurolysis. There were 104 intraplexus motor donors; 124 intercostal nerves were transferred in 39 patients; direct coaptation was performed in 31 patients and three or more intercostals were transferred in 33 patients; 16 patients underwent musculocutaneous to musculocutaneous repair. 144 patients had interposition nerve grafts. The mean follow-up was 4.48 ± 2.78 years. Results were good or excellent (≥M3+) in 52.53% of patients with more than 70° of elbow flexion. Patients, who were operated on less than 4 months from injury, with high severity score, attained significant better results than late cases with multiple root avulsions. Intraplexus donors have direct influence on biceps recovery, achieving significant better results than extraplexus donors. Intercostal nerves are an alternative source in avulsion injuries. The use of 3 intercostals with direct coaptation yielded optimal elbow flexion. Musculocutaneous nerve reconstruction is one of the priorities in upper limb reanimation. Functional outcomes are influenced by the age of the patient, severity of plexus lesion, denervation time, and type of reconstruction. Early surgery is recommended.

PURPOSE: The aim of the study was to investigate the effects of low-intensity running performed immediately after lower-body power-training sessions on power development.METHODS: Twenty young females participated in 6 weeks, 3/week, of either lower body power training (PT) or lower body power training followed by 30 min of low-intensity running (PET) eliciting 60-70 % of maximal heart rate. The following were measured before and after the training period: counter-movement jump, isometric leg press force and rate of force development (RFD), half squat 1-RM, vastus lateralis fiber type composition and cross sectional area, resting intramuscular fiber conduction velocity (MFCV), and heart rate during the modified Bruce treadmill test.RESULTS: Counter-movement jump height and peak power increased after PT (10.7 ± 6.2 and 12.9 ± 18.7 %, p < 0.05) but not after PET (3.4 ± 7.6 and 5.11 ± 10.94 %, p > 0.05). Maximum isometric force, RFD, and half squat 1-RM increased similarly in both groups. Muscle fiber type composition was not altered in either group. Muscle fiber cross sectional area increased only after PT (17.5 ± 17.4, 14.5 ± 10.4, 20.36 ± 11.3 %, in type I, IIA, and IIX fibers, respectively, p < 0.05). Likewise, mean MFCV increased with PT only (before: 4.53 ± 0.38 m s(-1), after: 5.09 ± 0.39 m s(-1), p = 0.027). Submaximal heart rate during the Bruce treadmill test remained unchanged after PT but decreased after PET.CONCLUSION: These results suggest that low-intensity running performed after lower-body power training impairs the exercise-induced adaptation in stretch-shortening cycle jumping performance (vertical jump height, peak power), during the first 6 weeks of training, which may be partially linked to inhibited muscle fiber hypertrophy and muscle fiber conduction velocity.

Objectives: Whilst physical activity is linked to cardiovascular health, it has lately been recognized that different types of exercise exert diverse effects on the cardiovascular system. Therefore, we investigated the acute effects of continuous moderate-intensity aerobic exercise (CAE) and high-intensity interval aerobic exercise (hIAE) on arterial function and inflammation. Methods: Twenty healthy men (mean age 22.6 ± 3.3 years) were recruited in this crossover study. Each of the 20 volunteers participated in two separate sessions (hIAE and CAE). The augmentation index (AIx) of aortic pressure waveforms and serum levels of interleukin-17 (IL-17) were measured before and after each exercise session. Results: There were no significant differences in baseline hemodynamic and inflammatory measurements before CAE and hIAE. Compared to baseline, AIx was significantly improved after CAE (p = 0.04), while there was no significant change after hIAE (p = 0.65). Serum levels of IL-17 were significantly elevated after CAE (p = 0.042), while hIAE had no significant effect on IL-17 levels (p = 0.47). Interestingly, there was an inverse association between the elevation of IL-17 levels and the AIx improvement after CAE (p = 0.05). Conclusion: These findings provide additional evidence concerning the cardiovascular effects of different types of exercise training through modification of peripheral hemodynamics and the inflammatory process.