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Background: Sarcopenia is a common condition in women with breast cancer, however still presents limitations for an effective diagnosis. This study aimed to evaluate the agreement and diagnostic accuracy of an anthropometric equation in diagnosing sarcopenia in women with breast cancer based on different constructs. Methods: Cross-sectional study carried out with women with breast cancer aged ≥ 20 years. Sarcopenia was identified according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle strength was obtained by the handgrip strength test (HGS) and muscle mass (MM) by dual-energy x-ray absorptiometry (DXA) and by the anthropometric predictive equation. For the diagnosis of sarcopenia, eight constructs were proposed based on the MM assessment method (equation or DXA) and different cutoff points. Agreement analyses using Cohen's Kappa test and diagnostic performance measures were performed. The significance level for all tests was 5%. Results: A total of 122 women, with a mean age of 55.3 ± 11.4 years, were evaluated. There was a predominance of brown participants (50.8%), insufficiently active (57.4%), with diagnosis time ≤ 3 months (54.1%), and with invasive breast carcinoma (69.7%). The prevalence of sarcopenia ranged from 3.3 to 8.2%, depending on the construct used. The constructs determined from the cutoff points < 16.0 kg/< 7.58 m² and < 23.0 kg/< 7.58 m² were the ones that showed the best ability to detect sarcopenia. Conclusion: The anthropometric equation showed sufficient diagnostic capacity to be used as an alternative in identifying sarcopenia in women with breast cancer. [ABSTRACT FROM AUTHOR]

Background: Focal entrapment of the common fibular (peroneal) nerve (CFN) is the most common nerve entrapment in the lower extremity. Accurate diagnosis can be difficult due to co-existent pathology such as low back pathology. A 1% lidocaine block of CFN is often used to confirm the local entrapment pathology and demonstrate possibility of pain relief. A surprising, unexpected and temporary strengthening of CFN supplied ankle and foot muscles is occasionally produced, termed the Phoenix sign. Aetiology of this phenomenon has been puzzling, but restoration of neural circulation and nutrition via improved local blood flow has been postulated to be responsible. Methods: This is a double-blinded, randomized, prospective controlled trial of 20 patients, comparing 2 vasodilating agents and their ability to produce the Phoenix effect. Ultrasound guided infiltration of 0.3 mL 1% lidocaine or papaverine HCl 10 mg/mL was executed adjacent to CFN. Motor strength pre- infiltration and 4 min post-infiltration were measured for anterior compartment muscles utilizing MRC manual motor testing reported on a 0–5 scale. The extensor hallucis longus (EHL) muscle proved to be the most significant. Results: Average motor strength of the EHL improved from 2.2 (+/-0.40) to 4.9 (+/-0.32).) in the lidocaine group. In the papaverine group, pre-infiltration EHL motor strength averaging 2.1 (+/-0.93) improved to 4.4 (+/- 1.01) post-infiltration. Papaverine and lidocaine produced similar statistically significant increases in muscle strength (p = < 0.05). Conclusion: There was no difference between small local infiltrations of lidocaine or papaverine in production of increased anterior compartment EHL motor strength. It is most likely that the Phoenix Effect is explained by temporary local improvements in the microcirculation of the CFN vasa nervorum. Trial Registration: NCT06637046 10/10/2024 Retrospectively registered. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsKnowledge gaps exist regarding the effects of interventions due to continuing respiratory symptoms in patients with post-COVID condition. The aim of the present study was to present the clinical outcomes of individualised treatments for patients with remaining respiratory symptoms due to post-COVID condition.This prospective longitudinal study included a consecutive series of 57 patients with remaining respiratory post-COVID symptoms. Breathing pattern, thoracic pain/mobility, occurrence of cough, and respiratory muscle strength were assessed before and after the administration of individually tailored physiotherapy interventions.The median treatment duration was 3 months (range 1–36 months). Dysfunctional breathing pattern was the most common symptom (n = 55/57) at inclusion. After treatment, 95% of patients had a normalised or improved breathing pattern (p < 0.001). The treatments for pain, productive and unproductive cough, and respiratory muscle strength resulted in significantly improved symptoms (p < 0.01). With other targeted treatments, inspiratory muscle strength improved by 20 cmH2O and expiratory muscle strength by 11 cmH2O (both p < 0.001).This study indicates positive outcomes of physiotherapy treatment based on the patient’s symptomatology and test results. Therefore, individualised physiotherapy treatment of post-COVID conditions may have an impact on recovery. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusion The worldwide prevalence of diabetes is increasing, particularly among older adults. Understanding the association between muscle strength and mortality in this population is crucial for developing targeted exercise recommendations.To assess the prospective association of muscle strength with mortality in older adults with diabetes.From the Survey of Health, Ageing and Retirement in Europe (SHARE) study, spanning 28 countries, we included 16 149 diabetic adults aged 50 years and older (mean age 68.2 [standard deviation, SD, 9.2] years). Participants fulfilled two criteria: (1) diabetes diagnosis (ever) and (2) current use of diabetes medication. Muscle strength was assessed using handgrip dynamometry (unit: kg). Using time‐varying Cox regression with restricted cubic splines, we determined the prospective association of muscle strength with all‐cause and cause‐specific mortality, controlling for various confounders.Over a mean follow‐up of 5.9 years (SD 3.8), 2754 participants died (17%). Using the median level of muscle strength as reference (30 kg), lower and higher levels were associated in a curvilinear fashion with higher and lower all‐cause mortality risk, respectively. The 10th percentile of muscle strength (17 kg) showed a hazard ratio (HR) of 1.65 (95% confidence interval (CI) 1.53–1.79). The 90th percentile (47 kg) of muscle strength showed a HR of 0.55 (95% CI 0.49–0.63). A somewhat similar pattern, with varying strength of associations, was seen for mortality due to cardiovascular disease (CVD), respiratory disease, severe infectious disease, digestive system disease and cancer.Muscle strength is gradually and inversely associated with all‐cause and cause‐specific mortality risk in older adults with diabetes. As muscle strength is highly adaptable to resistance training at all ages, the present findings highlight the importance of improving muscle strength in older adults with diabetes. [ABSTRACT FROM AUTHOR]

Background: The knee adduction moment(KAM) of both lower limbs in patients with unilateral knee osteoarthritis(KOA) exhibits asymmetry during walking, but the factors influencing this asymmetry remain unclear. This study aimed to explore the influencing factors of KAM asymmetry in patients with unilateral KOA. Methods: A total of 148 patients with unilateral medial compartment KOA were selected for this retrospective study, and general data such as gender, age, and duration of disease were collected. The hip-knee-ankle (HKA) angle, degree of pain, and knee-extension muscle strength on the affected side were assessed through radiographic outcomes, the visual analog scale(VAS), and the Biodex isokinetic system. The peak KAM of both lower limbs was analyzed using a BTS motion-capture system and force platform. The asymmetry index(ASI) of KAM was calculated, and the patients were further categorized into the KAM symmetry group(ASI value ≤ 10%) and the KAM asymmetry group(ASI value>10%).Binary logistic regression analysis was employed to analyze the factors influencing the asymmetry of KAM. Results: 90 patients were categorized into the KAM asymmetry group, representing 60.8% of the cohort. A significant difference in the ASI value of KAM was observed between the two groups. Correlation analysis identified nine factors, including sex, age, and BMI, that were positively correlated with the ASI value of KAM. In contrast, knee-extension muscle strength and per-capita monthly household income were negatively correlated with the ASI value of KAM. Regression analysis revealed that being female(OR = 1.752), older age(OR = 2.472), increased BMI(OR = 1.535), larger varus angle(OR = 3.965), higher VAS score(OR = 2.617), Kellgren-Lawrence(K-L) grade IV(OR = 4.474), history of knee joint trauma(OR = 5.684), and living in a rural location(OR = 1.554) increased the risk of KAM asymmetry. Conversely, increased knee-extension muscle strength(OR = 0.758) and a per-capita monthly household income of 3000 ~ 6000 yuan(OR = 0.814) decreased the risk of KAM asymmetry. Conclusion: Female gender, older age, increased BMI, larger varus angle, higher VAS score, K-L grade IV, history of knee joint trauma, and living in a rural location are identified as risk factors for KAM asymmetry. Conversely, increased knee-extension muscle strength and a per-capita monthly household income of 3000 ~ 6000 yuan serve as protective factors against this asymmetry. [ABSTRACT FROM AUTHOR]

Background: Patients with cancer (PwC) who undergo specific treatments reported greater fatigue and reduced functional capacity as predominant outcomes, compromising their QoL during and following the treatment. Prehabilitation intervention, provided after diagnosis and before treatments, is to optimize the physiological reserve and address modifiable risk factors before surgery or chemotherapy to improve post-treatment results. The primary aim of this study is to obtain a common line of efficacy compared with prehabilitation treatment; the secondary endpoint is to assess the methodological quality of the studies eligible in the review. Methods: The systematic review was conducted from September to February 2024, in accordance with PRISMA guidelines. Databases consulted were MEDLINE, Scopus, Web of science and CINAHL, RCTs related to Prehabilitation intervention on PwC were included. The methodological quality of the included studies was assessed through the RoB2 Cochrane tool and the PEDro scale. Meta-analysis was performed to estimate relative treatment effects among evaluated outcomes. Results: Forty-two studies were included in the systematic review, 13 were included in the quantitative analysis. The results of the studies reporting reduced postoperative hospital stay, improved endurance, muscle strength, respiratory function, quality of life, and urinary incontinence. Critical analysis of the articles using the PEDro scale revealed 28 RCTs with a good rating, 9 with a fair rating, and 5 with a poor rating; in contrast, the Cochrane RoB2 tool revealed that all articles were at high risk of bias. Meta-analysis showed statistically significant values for 6MWT (38.53, 95%CI 33.03 - 44.04); HADS-depression (-0.71, 95%CI -0.93 -0.49) and HADS-anxiety (-0.49, 95%CI -0.76 -0.23). Conclusions: Prehabilitation represents a specific intervention that aims to improve postoperative outcomes in fragile patients undergoing surgery, increasing their preoperative physiological reserve in anticipation of the stress they will face and facilitating the postoperative recovery of functional capacity. Prehabilitation is a good intervention to use, especially in terms of functional capacity and mental health, the latter being very impactful in terms of reduced levels of anxiety and depression. These data make it possible to justify supportive intervention by physical therapists aimed at improving and restoring health-related QoL especially in the short term. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Methods Results Conclusion Temporomandibular dysfunctions (TMDs) have the potential to cause changes in cervical muscle strength, muscle endurance and position sense by changing muscle activation patterns, especially as a result of forward head posture. The effects of TMDs on cervical joint position sense (CJPS) and head posture remain controversial.The aim of this study was to evaluate the head posture and CJPS of individuals with TMDs and compare them with healthy individuals.This research, which was designed as a case‐control study, was concluded with the inclusion of total of 84 participants (42 individuals diagnosed with myogenic TMDs, 42 controls). The assessment of participants included pain severity, neck and jaw functionality and disability, CJPS, head posture and temporomandibular joint (TMJ) range of motion (ROM).Individuals with TMDs exhibited higher angular deviation in CJPS during flexion and extension (p < 0.001). Additionally, individuals with TMDs demonstrated higher TMJ pain, limitation and dysfunction severity, as well as a more limited TMJ ROM (p < 0.001). Head posture was similar between groups (p > 0.05). There is a significant relationship between VAS‐TMJ with VAS‐cervical, FAI, NDI, JFLS‐8 and TMJ ROM (p < 0.05). Moreover, a significant correlation was observed between NDI with FAI and TMJ ROM (p < 0.05).These results indicate that in addition to higher pain severity, disability and lower jaw ROM, CJPS of individuals with TMDs is also negatively affected. Also, parameters related to disability and functionality of cervical and TMJ were significantly correlated. Further studies are needed to determine the factors contributing to these results. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a geriatric disease characterized by loss of muscle mass and strength. Although combined exercise and nutrition intervention are known to be effective for sarcopenia, clinical trials involving outpatients with sarcopenia in primary care are scarce. We describe a protocol for a trial to examine the effects of a 12-week combined exercise and nutrition intervention in Korean older adults with possible sarcopenia in community-based primary care. Methods: This multicenter, randomized, controlled trial will include 94 community-dwelling older outpatients aged 65–85 years with possible sarcopenia (47 participants in the intervention and control groups each). Resistance exercises, which incorporate concentric and eccentric exercises, will consist of an introductory phase (3 weeks: twice-weekly supervised exercise sessions and once-weekly home exercises; contraction exercises), an expanded phase (3 weeks: twice-weekly supervised exercise sessions and once-weekly home exercises; eccentric exercises), and a maintenance phase (6 weeks: once-weekly supervised exercise sessions and twice-weekly home exercises; power/eccentric exercises). Nutritional supplementation will be provided according to the nutritional status of the participants using a Mini-Nutritional Assessment. Participants will be assessed at baseline, 12 and 24 weeks, and the primary outcome will be the 5-times chair stand test results. Discussion: To the best of our knowledge, this will be the first clinical trial to evaluate the efficacy of a combined exercise and nutritional supplementation intervention in older outpatients with possible sarcopenia in community-based primary care clinics. These findings will provide new insights to clinicians regarding the long-term usability for doctors and outpatients with possible sarcopenia in community-based primary care. Trial registration: This trial was prospectively registered at ClinicalTrials.gov on September 16, 2023 (registration number: NCT06049914). [ABSTRACT FROM AUTHOR]

Thyroid hormones (THs) may affect chronic thyrotoxic myopathy (CTM). The relationship between TH sensitivity and CTM is inconsistent. We aimed to investigate the associations between TH sensitivity and the risk of CTM and to screen potential CTMs with strength and function tests. A total of 162 Chinese patients (36.58% men) with Graves' disease were enrolled and divided into CTM and non-CTM groups. TH and sensitivity indices were measured. Muscle power and function were assessed by grip, upper-limb fatigue (ULFT), lower-limb fatigue (LLFT), and squat-up (SUT) tests, and walking pace. Association between sensitivity to TH indices and the risk of developing CTM was assessed via multivariate logistic regression. The diagnostic effectiveness of muscle power and function for predicting CTM was evaluated via receiver operating characteristic (ROC) curves. Thyroid feedback quantile-based index FT3 (TFQIFT3) and the parametric TFQIFT3 (PTFQIFT3), TFQIFT4, and PTFQIFT4 were positively associated with CTM risk by using inverse probability of treatment weighting multivariate logistic regression. For each 1-SD increase in TFQIFT3 and PTFQIFT3, TFQIFT4 and PTFQIFT4, the odds ratios for CTM were 1.67 (95% CI = 1.17–2.48) ,1.64 (95% CI = 1.51–2.93), 1.60 (95%CI = 1.12–2.32), 1.58 (95%CI = 1.11–2.30), respectively. LLFT and SUT best predicted male/female CTM, respectively (AUC = 0.89/0.85). In Graves' disease patients, TH sensitivity is associated with CTM development, which can be predicted by SUT and LLFT results. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the intrasession reliability of the rate of force development (RFD) in different time windows in squat jumps (SJ) performed at different knee starting angles, and identify the relationship of RFD with vertical jump height (VJH). Twenty male volleyball and basketball players participated. Athletes randomly performed SJ from four different knee-flexion angles. The RFD was analyzed from six different windows, from force onset to instant peak force, in each position using the ground reaction forces. Reliability analysis was performed based on the intraclass correlation coefficient (ICC) and coefficient of variation (CV%); Spearman’s rho was used to test the relationship between RFD and VJH. The results demonstrated that RFD0-PF was the only variable assumed to be reliable, demonstrating an ICC > 0.84 and CV < 8.5% in all positions, and significant correlations between RFD metrics and VJH were observed at SJ70 and SJPREF. Some variables were underpowered due to the small sample size, as a limitation of the study. [ABSTRACT FROM AUTHOR]

Although there are some studies that have linked fitness parameters and sports injuries, the literature remains controversial. The aim of the study was to prospectively analyze the influence of initial physical condition parameters on the development of injury in the first three months of the sports season in futsal players. A total of 68 players (24.26±4.63 years old) were assessed before the start of the sports season in relation to certain physical condition parameters, such as body composition (bioimpedance), lower limb power (countermovement jump, CMJ) and muscle strength (isokinetic dynamometer). The injured players showed significantly worse initial performance in the CMJ compared to the uninjured players (p< 0.001). There were no significant differences between groups in body composition and muscle strength. Lower power values were associated with a higher risk of injury in the first few months of the sports season (OR=0.92; 95% CI=0.88–0.99). Muscle power was an independent predictor of injury in the first few months of the sports season in futsal players, indicating that improving players' physical condition could help reduce the number of injuries. [ABSTRACT FROM AUTHOR]

Symptoms such as impairment of postural balance, mobility and muscle strength can last up to 12 months post COVID-19 hospitalization, need to be better understood, as they can have repercussions in activities of daily living. What happens to postural balance, mobility, and handgrip strength of COVID-19 patients after hospitalization? A prospective cohort study was conducted with patients of both sexes, aged ≥18, admitted to hospital diagnosed with COVID-19. Outcomes were assessed at 1, 4, 6, and 12 months post-discharge, including: postural balance - Brief-Balance Evaluation Systems Test, mobility - Timed "Up & Go" Test, and handgrip strength – dynamometry. Prevalence values of impaired postural balance and mobility and lower-than-expected handgrip strength were calculated by point estimate and 95 % confidence interval. Shapiro-Wilk test showed that our data did not have a normal distribution, so the Friedman Test and the test of proportions were used for the statistical analysis. Performance on postural balance was improved after four months of hospital discharge, but the improvement in mobility and handgrip strength only occurred after six months. After six months of discharge, the proportion of individuals with impairments began to decrease. A higher prevalence of impairments in postural balance and mobility occurred at one month post-discharge, which reduced over time. However, the values of impairments for postural balance and mobility were still high after 12 months of follow-up. There was a high prevalence of postural balance and mobility impairment 1 month after discharge, which was still high 12 months after discharge. The prevalence of lower-than-expected handgrip strength demonstrated limited change over time. Results highlight the need for assessment of postural balance, mobility and hand grip strength in post COVID-19 related hospitalization protocols, and long-term physical therapy interventions to address these impairments when identified to improve long term outcomes. • There was a high prevalence of mobility impairment after COVID-19 hospitalization. • Postural balance impairment can last one year after hospitalization due to COVID-19. • Balance and mobility screening are important after hospital discharge. • Lower muscle strength was observed after COVID-19 hospitalization. [ABSTRACT FROM AUTHOR]

Background: Fat infiltration in skeletal muscle is related to declining muscle strength, whereas excess subcutaneous fat is implicated in the development of metabolic diseases. Methods: Using multi-slice axial T2-weighted (T2w) MR images, this retrospective study characterized muscle fat infiltration (MFI) and fat distribution in the lower extremity of 107 subjects (64M/43F, age 11–79 years) with diverse ethnicities (including White, Black, Latino, and Asian subjects). Results: MRI data analysis shows that MFI, evaluated by the relative intensities of the pixel histogram profile in the calf muscle, tends to increase with both age and BMI. However, statistical significance was found only for the age correlation in women (p < 0.002), and the BMI correlation in men (p = 0.04). Sex disparities were also seen in the fat distribution, which was assessed according to subcutaneous fat thickness (SFT) and the fibula bone marrow cross-sectional area (BMA). SFT tends to decrease with age in men (p < 0.01), whereas SFT tends to increase with BMI only in women (p < 0.01). In contrast, BMA tends to increase with age in women (p < 0.01) and with BMI in men (p = 0.04). Additionally, MFI is positively correlated with BMA but not with SFT, suggesting that compromised bone structure may contribute to fat infiltration in the surrounding skeletal muscle. Conclusions: The findings of this study highlight a sex factor affecting MFI and fat distribution, which may offer valuable insights into effective strategies to prevent and treat MFI in women versus men. [ABSTRACT FROM AUTHOR]

Background/Objective: Parkinson's disease (PD), a prevalent neurodegenerative disorder, leads to motor and non-motor impairments, affecting quality of life. Camptocormia can be one of the motor signs of PD, characterized by a severe and abnormal forward flexion of the thoracolumbar spine that typically occurs when walking or standing. The following study aims to verify whether postural gymnastics can be an effective treatment for trunk control, balance, activities of daily living, and general well-being in patients with early-stage PD and camptocormia. Methods: Nine participants (mean age 67.7 ± 7.8) with early PD (Hoehn and Yahr Scale ≤ 2) received 10 biweekly physiotherapy sessions. Outcomes were measured using the Parkinson's Disease Questionnaire (PDQ-39) and Berg Balance Scale (BBS) along with trunk mobility and muscle tests according to the Medical Research Council (MRC) scale. Results: Statistically significant results were noted in the PDQ-39 mobility, ADLs and emotional well-being subscales and in the BBS; statistically significant improvements were also seen in trunk mobility and muscle strength. Conclusions: This study shows that the postural gymnastic treatment, according to Souchard, in patients with PD's camptocormia has obtained good results and has the potential timprove mobility and balance, encouraging and motivating patients in their rehabilitation journeys. [ABSTRACT FROM AUTHOR]

Objective: Although the indications for reverse shoulder arthroplasty (RSA) are expanding, an improvement in muscle strength in each patient following RSA remains unclear. The objective was to investigate whether or not improvement in muscle strength for shoulder elevation in patients who underwent RSA was influenced by pre- or postoperative deltoid muscle stiffness measured using shear wave elastography (SWE). Methods: Sixty-five patients who underwent RSA over a 12-month follow-up period were included. Patient characteristics and clinical and radiologic measurements were recorded. Preoperatively and at 3, 6, 9, and 12 months after surgery, deltoid muscle stiffness and muscle strength for scapular-plane abduction were sequentially measured using SWE and a portable dynamometer. In each quarterly period (3–6, 6–9, and 9–12 months), patients were assessed for an improvement in muscle strength and separated into two groups: improved and non-improved. To assess the risk of lack of improvement in each quarterly period, the variables were compared between the groups. Results: Improvement in muscle strength was observed in 52 patients (80%) at 3–6 months, 46 patients (71%) at 6–9 months, and 39 patients (60%) at 9–12 months. Notably, SWE measurements at the beginning of each period showed significantly greater values in the non-improved group than in the improved group during the subsequent quarterly period. A receiver operating characteristic (ROC) curve analysis suggested that SWE values >45.1–50.0 kPa might be associated with a lack of muscle strength improvement over 3 months with 73–87% specificity and 73–85% sensitivity. Conclusions: Our study demonstrated that increased deltoid muscle stiffness negatively correlated with an improvement in muscle strength following RSA. According to our results, a postoperative assessment with SWE may be useful for not only improving muscle strength after RSA but also facilitating postoperative improvement by preventing excessive stiffness in the deltoid muscle. [ABSTRACT FROM AUTHOR]

Magnesium (Mg) is a vital element for various metabolic and physiological functions in the human body, including its crucial role in skeletal muscle health. Hypomagnesaemia is frequently reported in many muscle diseases, and it also seems to contribute to the pathogenesis of skeletal muscle impairment in patients with neuromuscular diseases. The aim of this scoping review is to analyze the role of Mg in skeletal muscle, particularly its biological effects on muscle tissue in neuromuscular diseases (NMDs) in terms of biological effects and clinical implications. This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. From the 305 studies identified, 20 studies were included: 4 preclinical and 16 clinical studies. Preclinical research has demonstrated that Mg plays a critical role in modulating pathways affecting skeletal muscle homeostasis and oxidative stress in muscles. Clinical studies have shown that Mg supplementation can improve muscle mass, respiratory muscle strength, and exercise recovery and reduce muscle soreness and inflammation in athletes and patients with various conditions. Despite the significant role of Mg in muscle health, there is a lack of research on Mg supplementation in NMDs. Given the potential similarities in pathogenic mechanisms between NMDs and Mg deficiency, further studies on the effects of Mg supplementation in NMDs are warranted. Overall, maintaining optimal Mg levels through dietary intake or supplementation may have important implications for improving muscle health and function, particularly in conditions associated with muscle weakness and atrophy. [ABSTRACT FROM AUTHOR]

AbstractThere is evidence that substance use and smoking cause some adverse effects on the respiratory system. The aim of this study was to assess dyspnea severity, respiratory muscle strength, cough capacity, and sleep quality in people with substance use disorder (SUD). Forty eight individuals with SUD and 28 active cigarette smokers participated in the study. Participants’ dyspnea severity was assessed using the Modified Medical Research Council Scale, respiratory muscle strength was measured with a portable electronic mouth pressure device, peak cough flow was assessed with a Peak Flow Meter, and sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI). The amount of daily cigarette smoking and dyspnea severity were significantly higher in individuals with SUD (p < .001). Peak cough flow values, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), MIP (%predicted), and MEP (%predicted) were not significantly different between the SUD patients and the active cigarette smokers (p > .05). However, PSQI sub-parameters such as subjective sleep quality, sleep latency, habitual sleep efficiency, use of sleeping medication, and total scores showed significant differences between the SUD patients and the active cigarette smokers (p < .05, p < .001, p = .03, p < .001, p < .001, respectively). Individuals with SUD were found to have higher dyspnea and poorer sleep quality than active smokers. However, respiratory muscle strength and cough capacities were similar. [ABSTRACT FROM AUTHOR]

Objective: Research to date has not provided a clear understanding of how different grades and majors affect the physical fitness of college students. It is postulated that there are significant disparities in physical health among college students of different grades and majors. The purpose of this study was to evidence these health disparities and to engage in an extensive analysis and discussion thereof. Methods: A sample of 8,772 (2,404 boys and 6,368 girls) Chinese college students from freshman to junior years, aged 17–22, including 12 different majors in four colleges, were recruited in Jiangxi Province. All seven physical fitness indicators (body mass index (BMI), forced vital capacity, 50-m dash, standing long jump, sit and reach, upper body muscle strength, and endurance runs) were conducted for all participants. One-way ANOVA and LSD tests were conducted to compare the physical fitness scores of different grades in the same major. Independent sample t-tests were utilized to compare the differences in every physical fitness indicator for different majors. Pearson's correlations among 12 majors for every grade were conducted to study the significant corrections between the two physical fitness indicators. The body mass index (BMI) and physical fitness indicator (PFI) for college students of different grade were investigated using a nonlinear regression model. Results: The current state of physical fitness among college students is concerning, as the majority of students were barely passing (with a passing rate of 75.3%). Specifically, junior students exhibited lower scores than freshman and sophomore students across all 12 majors. From freshman to junior year, majors of music (78.01±4.58), English (79.29±5.03), and education (76.26±4.81) had the highest scores, respectively, but major art consistently scored the lowest, which were 73.85±6.02, 74.97±5.53, and 72.59±4.84, respectively. Pairwise comparisons revealed more significant differences in individual physical fitness indicators among the three grades in humanities than in sciences. Pearson's correlations showed significant correlations among seven physical fitness indicators in all three grades. PFI had a parabolic trend with BMI both for boy and girl college students in Jiangxi province. Conclusion: The physical fitness indicators of college students in Jiangxi province significantly differed in grades and majors, showing undesirable phenomena. The physical fitness of senior and humanities major college students was much weaker and needs sufficient attention. The relationship between BMI and PFI presented an inverted "U"-shaped change characteristic. Continued nationwide interventions are needed to promote physical activity and other healthy lifestyle behaviors in China. [ABSTRACT FROM AUTHOR]

The aim of our study was to assess the association between muscle mass and strength and depression through a cross-sectional study of the National Health and Nutrition Examination Survey from 2011 to 2014. Muscle mass was calculated by summing the lean body mass of the limbs and muscle strength was assessed by grip strength. Depression was determined by The 9-item Patient Health Questionnaire. We used weighted multivariate logistic regression models to explore the relationship between muscle mass and strength and depression. Generalized additive models were used to test for the presence of nonlinear associations. We then constructed a two-piece-wise linear regression model and performed a recursive algorithm to calculate inflection points. In addition, subgroup analyses and interaction tests were performed. The study recruited 4871 adults from the United States. In regression models adjusted for all confounding variables, the OR (95 % CI) for the association between grip strength and appendicular lean mass (ALM) and depression were 0.943 (0.903, 0.985), 0.945 (0.908, 0.983), respectively. There was a non-linear association between grip strength and depression with a turning point of 46.3. The OR (95 % CI) before the turning point was 0.920 (0.872, 0.972). The interaction was statistically significant only in the age analysis. There was also a nonlinear association between ALM and depression, but no significant turning point was found. The interaction was statistically significant in the gender and BMI analyses. Grip strength and ALM are negatively associated with an increased likelihood of depression in US adults. Exercises for muscle mass and strength may help prevent depression. • There is a negative correlation between ALM and depression. • There is a negative correlation between grip strength and depression. • There was a nonlinear association between grip strength and depression. [ABSTRACT FROM AUTHOR]

We compared the effects of varied and constant resistance exercises on muscular adaptations in young women. Seventy young women (21.8 ± 3.4 yrs, 62.0 ± 12.3 kg, 162.3 ± 5.7 cm) were randomly divided into two groups: constant resistance exercises (CON-RE, n = 38) or varied resistance exercises (VAR-RE, n = 32). The resistance training (RT) was performed thrice a week over 10 weeks. CON-RE performed a 45º leg press and stiff-leg deadlift in every training session, while VAR-RE performed 45º leg press and stiff-leg deadlift in the first training session of the week, hack squat and prone leg curl in the second, and Smith machine squat and seated-leg curl in the third. Both groups performed two sets of 10–15 repetitions maximum per resistance exercise. We measured the muscle thickness of the thigh’s anterior, lateral, and posterior aspects by ultrasonography at different muscle sites (proximo-distal). Muscular strength was analyzed from the one-repetition maximum (1RM) tests in the 45° leg press and leg extension (non-trained exercise). The muscle thickness increased similarly in both groups for all muscles and sites (CON-RE: +7.8–17.7% vs. VAR-RE: +7.5–19.3%, p > .05). The 1RM increased similarly in both groups (CON-RE: +24.4–32.1% vs. VAR-RE: +29.0–30.1%, p > .05). Both RT routines resulted in virtually similar muscular strength gains and hypertrophy. Therefore, both strategies should be considered for the improvement of strength and muscle growth. [ABSTRACT FROM AUTHOR]

Background/objectives: Considering the diverse symptomatology of COVID-19—ranging from mild to severe cases—multi-professional interventions are crucial for enhancing physical recovery, nutritional status, and mental health outcomes in affected patients. Thus, this study aimed to investigate the effects of such an intervention on health-related physical fitness and biomarkers in overweight COVID-19 survivors with varying degrees of symptom severity after 8 weeks and 16 weeks. Methods: This non-randomized clinical trial included 59 overweight COVID-19 survivors (32 males and 27 females) divided into three groups: mild (n = 31), moderate (n = 13), and severe/critical (n = 15). The participants underwent a multi-professional program and were assessed for anthropometric and body composition (primary outcome), as well as physical fitness and biochemical markers (secondary outcome) 8 and 16 weeks before the intervention. Results: After 8 weeks, time effects were observed for the maximum isometric handgrip strength (p < 0.001), maximum isometric lumbar-traction strength (p = 0.01), flexibility (p < 0.001), abdominal strength–endurance (p < 0.001), the sit-and-stand test (p < 0.001), maximum oxygen consumption (p < 0.001), and distance covered in the 6 min walk test (p < 0.001). Additionally, time effects were also observed for fat mass (p = 0.03), body fat percentage (p = 0.02), abdominal circumference (p = 0.01), total cholesterol (p < 0.001), low-density lipoproteins (p < 0.001), and glycated hemoglobin (p < 0.001), with lower values after multi-professional interventions. After 16 weeks, the systolic and diastolic blood pressure showed significant reductions independently of the intervention group (p < 0.001). Conclusion: These findings suggest that multi-professional interventions can provide substantial benefits for post-COVID-19 patients, regardless of the severity of their initial symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Physical inactivity and sedentary behavior both increase the risk of chronic disease and mortality. Regular participation in physical activity and reducing sedentary behavior play important roles in maintaining physical health and disease prevention. Objective: The purpose of this study was to investigate the effect of programed walking exercise using a wearable hip exoskeleton, Bot Fit on muscle strength, muscle effort, and the kinematics of the pelvis in younger adults. Methods: We designed three parallel experimental conditions and randomly assigned participants to one of three groups: those assigned to exercise using an interval program of Bot Fit (interval group), those who used a power program of Bot Fit (power group), and a control group who exercised without Bot Fit. A total of 45 young adults participated in 18 exercise-intervention sessions over six weeks, and all participants were assessed at two time points: before and after the 18 exercise sessions. Each assessment evaluated muscle strength, muscle effort, and the kinematics of the pelvis during walking. In addition, the number of steps, distance, energy expenditure, and heart rate for 30 min during the exercise sessions were recorded. Results: A significant increase in the maximum voluntary contraction (MVC) of the left biceps femoris (BF) was evident in the interval group, while significant changes in the MVC of the bilateral BF were seen in the power group after Bot Fit exercise. A significant decrease of muscle effort in the right BF in the interval group and right lumbar erector spinae and bilateral BF in the power group were also observed. In addition, the symmetry index of pelvic tilt significantly improved in the interval group, and greater exercise volume and intensity in both the interval and power groups compared with the control group were confirmed as measured by the number of steps, distance, energy expenditure, and heart rate. Conclusions: The results of this study confirmed the beneficial effect of programed walking exercise using the Bot Fit on muscle strength of trunk and lower extremities, muscle effort, and pelvic movement symmetry in younger adults. Personalized exercise programs can be provided for younger adults using various resistance or assistance modes of robotic device with the Bot Fit. Trial Registration: ClinicalTrials.gov, NCT05862077. Registered 22 March 2022, https://register.clinicaltrials.gov/. Key Points: • Bot Fit exercise offers several key advantages over exercise without a Bot Fit in terms of muscle strength, muscle effort, and pelvic symmetry during walking in younger adults. • Greater exercise volume and intensity in interval and power groups who exercised with Bot Fit were confirmed through number of steps, distance, energy expenditure, and heart rate compared to control group who exercised without Bot Fit. [ABSTRACT FROM AUTHOR]

Background and objective: The global aging population has led to increased noncommunicable diseases, often linked to poor diet and declining muscle strength and mass. This study assessed leucine intake and sarcopenia indicators among 181 adults aged 60–80 in Santiago, Chile, participating in the Program for Complementary Food in Older People (PACAM), with 80% being women. Methods: Sarcopenia was evaluated through muscle strength and mass using the EWGSOP2 criteria for its identification. Results: 78.45% of participants did not meet the recommended leucine intake of 3 g per day and sarcopenia was identified in 17.13% of them. The skeletal muscle index was 48.07%, and hand grip strength was 26.52%, with men showing significantly higher grip strength (48.60% vs. 28.80%, p = 0.00). Inadequate leucine intake was more common in those aged 60–75 (85.9%) than those over 75 (p = 0.03). No significant differences in BMI, grip strength, or muscle mass were found between those with adequate and inadequate leucine intake, and PACAM food consumption did not significantly affect these parameters. A sub-analysis showed significant differences in grip strength among powdered dairy drink consumers (35.20% vs. 17.80%, p = 0.01). Conclusions: Chilean elderly participating in PACAM present a high prevalence of sarcopenia and leucine deficiency among with no notable benefits from PACAM foods intake. Despite the limitations of the local body composition assessment method, this research addresses a critical public health issue in Chile. Future studies should evaluate physical performance and focus on leucine supplementation to clarify its effects on sarcopenia. [ABSTRACT FROM AUTHOR]

Growth hormone (GH) deficiency (GHD) in children and adolescents can vary in severity and origin, with GH replacement therapy proving effective in achieving genetic target height. Optimal outcomes are seen in those treated early and with higher doses. As patients approach adult height, priorities shift towards optimizing metabolic effects, maintaining body composition, and enhancing bone mass and muscle strength. Transitioning from pediatric to adult care presents challenges, including accurately identifying candidates for continued GH therapy, reevaluating persistent GHD, and preventing treatment discontinuation. Assessing readiness for transition and self-management skills is crucial. This Policy and Practice Review provides a comprehensive overview of current policies, regulations, and guidelines pertinent to managing GHD transition in Belgium. We integrate perspectives from national academic and nonacademic clinical stakeholders in pediatric and adult endocrine care to provide an updated policy framework. This framework underscores the importance of sustained GH therapy during transition, particularly for individuals with persistent GHD, with the goal of optimizing practices and improving outcomes during this critical period. [ABSTRACT FROM AUTHOR]

Background: A newly developed technique, the Triglyceride-glucose (TyG) index, supplies a more straightforward method to identify IR than the HOMAIR (Homeostasis Model Assessment of Insulin Resistance). Yet no methodical analysis has looked into the link involving the TyG index and low muscle mass (LMM), low muscle strength (LMS), and sarcopenia within the US. Thus, this study intended to find any connection concerning the TyG index and LMM, LMS, and sarcopenia. Methods: Between 2011 to 2014, data from the NHANES were used to conduct a nationally representative study involving 2,504 participants. LMM, LMS, and sarcopenia were the outcome variables. Moreover, this positive correlation persists irrespective of age and gender. Results: The TyG index revealed a significant correlation with the prevalence of developing LMM (OR = 1.63(1.26-2.11), p=0.001), LMS (OR = 1.61(1.36-1.91), p<0.001) and sarcopenia (OR = 1.59 (1.23-2.07), p<0.001), after correcting for all variables. Utilizing smooth curve fitting alongside two-piecewise linear regression models, an inverted U-shaped correlation between the TyG index and the prevalence of LMM, LMS, and sarcopenia. Finally, subgroup analysis revealed that the association between the TyG index and LMM, LMS, and sarcopenia was particularly evident in all gender, age subgroups, and individuals with a normal BMI of 25. Conclusion: Sarcopenia and the TyG index reveal an essential positive link. It highlights the potential utility of the TyG index as a screening tool for identifying individuals at risk of sarcopenia earlier. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency has been linked to poor muscle function, cartilage degeneration, and the development of knee osteoarthritis. However, the impact of serum 25-hydroxyvitamin D [25(OH)D] level on quadriceps muscle strength remains inconclusive, largely due to variations in study designs, differences in study populations, and the influence of confounding factors such as co-supplementation with other vitamins. The existing literature presents mixed findings, highlighting the need for a comprehensive evaluation of the available evidence. Purpose: This systematic review and meta-analysis aim to summarise. Study design: Systematic review; Level of evidence, 4. Methods: Searches were conducted using Medline (Ovid), Embase (Ovid), CINAHL (EBSCOhost), and SPORTDiscus (EBSCOhost), which aimed to summarise recent (published after 2000 and before March 1st, 2024) studies reporting the effects of serum 25(OH)D levels on quadriceps strength. Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional studies and Quality in Prognosis Studies (QUIPS) for longitudinal studies. Results from the AXIS and QUIPS tools were used for GRADE quality assessment. The review was carried out using PRIMSA guidelines and registered in PROSPERO (ID: CRD42022313240). Results: Four hundred studies were screened and 28 studies with 5752 participants were included. 28 published studies (24 cross-sectional and 4 longitudinal) were identified. Key results supported the significant positive correlation between serum 25(OH)D levels and isokinetic quadriceps strength at 180°/s in elderly and athletic populations with a correlation coefficient of 0.245 (95%CI: 0.078–0.398, p = 0.004). However, no significant correlation was found with isometric quadriceps strength or isokinetic strength at 60°/s (r = 0.190, p = 0.085). There was only a weak negative correlation with MVC. Conclusion: This review found a statistically significant positive correlation between serum 25(OH)D levels and isokinetic quadriceps strength. This has important clinical implications, especially in the elderly cohort, with higher 25(OH)D levels being associated with a reduced incidence of falls and fragility fractures. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) exhibits high prevalence and heritability despite causing negative impacts on fertility and fecundity. Previous hypotheses have postulated that some PCOS-associated traits, especially above-average levels of testosterone, were associated with benefits in ancestral environments. As such, PCOS would represent, in part, a maladaptive extreme of adaptations related to relatively high testosterone. To evaluate this hypothesis, we conducted a series of systematic literature reviews on the associations of testosterone levels, and prenatal testosterone metrics, with measures of strength, robustness, muscularity, and athleticism in females. We also systematically reviewed the literature on associations of testosterone with dominance in females and reviewed archaeological evidence concerning female strength and muscularity and its correlates. The main findings were fivefold: (1) elevated testosterone levels were generally associated with higher strength, muscularity and athleticism in females; (2) females with PCOS showed notable evidence of increased strength, muscularity, and athleticism compared to controls; (3) females with higher testosterone levels exhibited clear evidence of high dominance, (4) despite evidence that higher testosterone is linked with higher bone mineral density in healthy females, PCOS was not clearly associated with this phenotype; and (5) archaeological evidence from osteology, and data from some current small-scale societies, indicated that females often exhibit substantial levels of muscularity. Overall, the hypothesis that relatively high levels of testosterone are associated with benefits to females in some contexts was largely supported. These results provide evidence for the "maladaptive extremes of adaptation" model, with implications for treatment of females with PCOS and for future research. [ABSTRACT FROM AUTHOR]

Background: Physical health (PH), including muscle strength, endurance, and the ability to perform daily physical tasks, gradually declines with increasing age, leading to disability and an increased disease burden. Both the urban community environment (UCE) and physical activity (PA) were linked to PH. Methods: A total of 625 participants aged 55 years and older from Haidian and Chaoyang Districts in Beijing, China, were included in the study from September to December 2023.PH was assessed by a combined score of four tests, including BMI, chronic disease, depression and self-rated health.The Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A), Center for Epidemiological Survey-Depression Scale (CES-D), Physical Activity Scale for Elderly (PASE) and Social Support Rate Score (SSRS) were collected. The analysis was carried out with SPSS v.20 and Amos 24, and the results were validated via structural equation modeling (SEM). Results: The urban community environment was positively associated with the health level of older adults. Specifically, the standardized path coefficients indicate that the influence of the built environment (0.72–0.88) was greater than that of the social environment (0.43–0.55) and personal attributes (0.22–0.37) on older adults' health. Physical activity demonstrated both a mediating effect and an indirect effect, highlighting its significant value as a mediating variable. Conclusions: The urban community environment has a positive impact on promoting the physical health of older adults, with the influence of the built environment being greater than that of the social environment and personal attributes on their physical health. Physical activity acts as a mediator between the urban community environment and the physical health of older adults. [ABSTRACT FROM AUTHOR]

The proposition of a minimal dose of resistance training (RT) to elicit health benefits, encompassing physiological and psychological aspects, has garnered attention. While empirical investigations have demonstrated the efficacy of low-volume RT protocols in inducing adaptations such as enhanced strength and functional capacity, further exploration of the effects of this paradigm across a broader spectrum of variables is warranted. Thus, this study aimed to investigate the effects of minimal dose RT on strength and functional capacity, cardiac autonomic modulation, and hemodynamic parameters in menopausal women. Twenty-six women were randomly assigned to the training (TG: 63.2 ± 9.3 years) or control group (CG: 59.3 ± 7.6 years). Anthropometric measurements, strength and functional performance tests, cardiac autonomic assessment, and hemodynamic parameters were performed before and after four weeks of intervention. The TG performed the minimum dose RT twice weekly for four weeks (2 sets of 8–12 repetitions in three dynamic exercises, plus three 1-min isometric planks), and the CG had a weekly meeting with lectures and stretching. Two-way ANOVA with repeated measures was applied to each variable. Regarding time comparisons, there was a significant increase for LniRR (F = 4.78; ω2 = 0.046; p = 0.04), one repetition maximum (1RM) bench press (F = 8.06; ω2 = 0,013; p = 0.01), and 1RM leg press (F = 17.3; ω2 = 0,098; p < 0.01). There was a group*time interaction only for the index LnRMSSD (F = 5.11; ω2 = 0.042; p = 0.03), and 1RM bench press (F = 9.52; ω2 = 0,016; p = 0.01). No between-group main effect for any variable was found. The minimal dose RT protocol improved muscle strength, while cardiac autonomic and hemodynamic variables, as well as functional capacity, remained stable over 4 weeks in menopausal women. [ABSTRACT FROM AUTHOR]

Purpose: Muscle Quality Index (MQI), defined as the muscle strength per unit of muscle mass, is considered an emerging indicator of health and physical function. This study aims to explore the relationship between MQI and the risk of depression among non-elderly US adults. Methods: This cross-sectional study collected data from participants aged between 20 and 59 years old, utilizing the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The MQI was calculated by dividing the handgrip strength (HGS, kg) by the arm and appendicular skeletal muscle mass (ASM, kg). Depression assessments were conducted using the Patient Health Questionnaire (PHQ-9). The relationship between MQI and the risk of depression was explored by weighted logistic regression, smooth curve fitting, and subgroup analyses. Results: A total of 4773 participants were included in this study. After adjusting for confounding factors, low MQI levels were identified as an independent risk factor for depression (OR = 0.800, 95%CI:0.668–0.957, P = 0.015). Smooth curve fitting analysis indicated a nonlinear relationship. Subgroup analysis did not identify any specific populations. Conclusions: Higher MQI levels were closely associated with a lower risk of depression among non-elderly US adults. MQI could enhance our understanding of the link between muscle and depression and might serve as a simple functional measure for evaluating and predicting depression. [ABSTRACT FROM AUTHOR]

ABSTRACT Estimation of the knee joint strength by maximum voluntary isometric contraction (MVIC) is a common practice to assess strength, coordination, safety to return to work or engage in sports after an injury, and to evaluate the efficacy of treatment modalities and rehabilitation strategies. In this study, we utilize a previously validated coupled finite element‐musculoskeletal model of the lower extremity to explore the sensitivity of output measures (posterior cruciate ligament [PCL]/muscle/contact forces and passive moments) in knee MVIC flexion exercises at seated position. To do so, at three knee flexion angles (KFA), input measures (resistance moment and contribution moments of quadriceps and gastrocnemii) were varied at four levels each using the Taguchi design of experiment. Our findings reveal significant increases in PCL forces with KFA (p < 0.01), net MVIC moment (p < 0.01), and resistance moment of quadriceps (p < 0.01). In contrast, they drop at larger activity in gastrocnemii (p < 0.01). Tibiofemoral (TF) contact forces increase with the net MVIC moment (p < 0.01). The passive knee flexion moment, while highly dependent on the location at which computed, also increases with the net MVIC moment (p < 0.01). Changes in KFA, MVIC moment, and proportions thereof carried by quadriceps and/or gastrocnemii substantially affect biomechanics of the joint. Compared with level walking and stair ascent, slightly larger contact forces/stresses and much greater PCL forces are computed. This study improves our understanding of the knee joint behavior during MVIC in effective evaluation and rehabilitation interventions. Besides, it emphasizes the importance of positioning the joint center in model studies. [ABSTRACT FROM AUTHOR]

Key points Testosterone, the major androgen, influences the reproductive and non‐reproductive systems in males and females via binding to the androgen receptor (AR). Both circulating endogenous testosterone and muscle AR protein content are positively associated with muscle mass and strength in males, but there is no such evidence in females. Here, we tested whether circulating testosterone levels were associated with muscle mass, function, or the muscle anabolic response to resistance training in pre‐menopausal females. Twenty‐seven pre‐menopausal, untrained females (aged 23.5 ± 4.8 years) underwent a 12‐week resistance training programme. Muscle strength, size, power, and plasma and urine androgen hormone levels were measured. Skeletal muscle biopsies were collected before and after the training programme to quantify the effect of resistance training on AR content and nuclear localisation. Primary muscle cell lines were cultured from a subset (n = 6) of the participants’ biopsies and treated with testosterone to investigate its effect on myotube diameter, markers of muscle protein synthesis and AR cellular localisation. Physiological levels of total testosterone were not associated with muscle mass or strength at baseline or with the changes in muscle mass and strength that occurred in response to resistance training in our cohort of pre‐menopausal females. In contrast, bioavailable testosterone and the proportion of nuclear‐localised AR were positively associated with skeletal muscle mass and strength in pre‐menopausal females. In vitro, supra‐physiological doses of testosterone increased myocyte diameter, but this did not occur via the Akt/mTOR pathway as previously suggested. Instead, we show a marked increase in AR nuclear localisation with testosterone administration in vitro. Total circulating testosterone was not related to muscle mass or strength before or after resistance training in pre‐menopausal females. Bioavailable testosterone was positively related to exercise‐induced muscle hypertrophy in pre‐menopausal females. In vivo nuclear localisation of the androgen receptor was positively related to muscle mass in pre‐menopausal females at baseline, but not to resistance training‐induced hypertrophy. Testosterone treatment induced androgen receptor nuclear translocation but did not induce mTOR signalling in primary skeletal myocytes cultured from pre‐menopausal female muscle. [ABSTRACT FROM AUTHOR]

This study aims to examine the effects of different attention focuses on muscle strength and balance performance in individuals with Generalized Joint Hypermobility (GJH). This randomized crossover trial included 32 individuals with GJH whose Beighton score was greater than 5. Subjects performed each task under external attentional focus, internal attentional focus, and neutral attentional focus condition. Knee extensor muscle strength was measured using the Isokinetic Dynamometer. Postural stability was evaluated using the Biodex Balance System, while dynamic balance was assessed using the Y Balance Test. The main effects of attentional focus on the outcomes were analyzed using repeated measures ANOVA and post-hoc corrections with a 95% confidence interval. Subjects produced significantly higher quadriceps peak torque during external focus instruction and internal focus instruction compared to neutral condition (p = .006). Postural stability performance were found to be better during external attention focus compared to the internal focus of attention and the neutral group (p = .008). In addition, an increase in Y balance composite score was observed during external condition compared to internal condition and neutral condition (p < .001). Whether internal or external, the use of attentional focus may be beneficial for optimal force production during training in individuals with GJH. External attention focus enabled better postural stability and dynamic balance performances. [ABSTRACT FROM AUTHOR]

Background and Purpose Methods Results Conclusions The efficacy and safety of ravulizumab, a terminal complement C5 inhibitor, in adults with anti‐acetylcholine receptor antibody‐positive (AChR Ab+) generalized myasthenia gravis (gMG) were demonstrated in the CHAMPION MG study (NCT03920293). This analysis aimed to characterize the latency to onset of a clinically meaningful therapeutic effect for ravulizumab.Post hoc analysis of data collected for up to 60 weeks from CHAMPION MG was performed to assess the timing of response to ravulizumab. Response was analyzed based on reductions of ≥2 and ≥3 points (minimal clinically important differences [MCIDs]) in Myasthenia Gravis–Activities of Daily Living (MG‐ADL) and Quantitative Myasthenia Gravis (QMG) total scores, respectively, and on more rigorous reductions of ≥3 and ≥5 points, respectively. Time to first response was assessed using the Kaplan–Meier product‐limit method.The median (95% confidence interval) time to first response was 2.1 (2.1–2.6) and 4.1 (2.3–10.0) weeks for reductions of ≥2 and ≥3 points in MG‐ADL total score, respectively (n = 139), and 4.1 (2.1–10.0) and 18.3 (11.0–33.4) weeks for reductions of ≥3 and ≥5 points in QMG total score, respectively (n = 134). Cumulative response rates at Week 60 (data cut‐off) were 88% and 82% for ≥2‐ and ≥3‐point MG‐ADL score reductions, respectively, and 86% and 59% for ≥3‐ and ≥5‐point QMG score reductions, respectively.The median times to MCID with ravulizumab treatment in patients with AChR Ab+ gMG were ~2 weeks and ~4 weeks based on MCID MG‐ADL and QMG total score reductions, respectively. [ABSTRACT FROM AUTHOR]

Background: Beyond being a pulmonary disease, chronic obstructive pulmonary disease (COPD) presents with extrapulmonary manifestations including reduced cognitive, cardiovascular, and muscle function. While exercise training is the cornerstone in the non-pharmacological treatment of COPD, there is a need for new exercise training methods due to suboptimal adaptations when following traditional exercise guidelines, often applying moderate-intensity continuous training (MICT). In people with COPD, short-duration high-intensity interval training (HIIT) holds the potential to induce a more optimal stimulus for training adaptations while circumventing the ventilatory burden often associated with MICT in people with COPD. We aim to determine the effects of supramaximal HIIT and MICT on extrapulmonary manifestations in people with COPD compared to matched healthy controls. Methods: COPD-HIIT is a prospective, multi-centre, randomized, controlled trial with blinded assessors and data analysts, employing a parallel-group designed trial. In phase 1, we will investigate the effects and mechanisms of a 12-week intervention of supramaximal HIIT compared to MICT in people with COPD (n = 92) and matched healthy controls (n = 70). Participants will perform watt-based cycling two to three times weekly. In phase 2, we will determine how exercise training and inflammation impact the trajectories of neurodegeneration, in people with COPD, over 24 months. In addition to the 92 participants with COPD performing HIIT or MICT, a usual care group (n = 46) is included in phase 2. In both phases, the primary outcomes are a change from baseline in cognitive function, cardiorespiratory fitness, and muscle power. Key secondary outcomes include change from baseline exercise tolerance, brain structure, and function measured by MRI, neuroinflammation measured by PET/CT, systemic inflammation, and intramuscular adaptations. Feasibility of the interventions will be comprehensively investigated. Discussion: The COPD-HIIT trial will determine the effects of supramaximal HIIT compared to MICT in people with COPD and healthy controls. We will provide evidence for a novel exercise modality that might overcome the barriers associated with MICT in people with COPD. We will also shed light on the impact of exercise at different intensities to reduce neurodegeneration. The goal of the COPD-HIIT trial is to improve the treatment of extrapulmonary manifestations of the disease. Trial registration: Clinicaltrials.gov: NCT06068322. Prospectively registered on 2023-09-28. [ABSTRACT FROM AUTHOR]

Background: The impact of the etiology of rotator cuff injury (RCI) on outcomes after rotator cuff repair remains unclear. This study aimed to evaluate the postoperative outcomes of patients with RCIs of different etiologies and identify the risk factors affecting prognosis. Methods: This study included 73 patients with RCI who underwent arthroscopic rotator cuff repair. The patients were categorized into either a traumatic group or a non-traumatic group based on their history of trauma. Preoperative and postoperative assessments included shoulder range of motion, muscle strength, and physical examination findings specific to the shoulder for both groups. Clinical differences between arthroscopic repair of traumatic and non-traumatic RCIs were evaluated using univariate analysis. Logistic regression analysis determined independent risk factors for rotator cuff repair prognosis. Results: Among the 73 patients, 31 were in the traumatic group and 42 in the non-traumatic group, with a minimum postoperative follow-up of 12 months and a mean follow-up of 13.8 months. The duration of the disease was significantly longer in the non-traumatic group compared with the traumatic group (P < 0.001). The mean tear area was more significant in the traumatic group than in the non-traumatic group (P = 0.003), and the preoperative pain level and functional scores were better in the non-traumatic group compared with the traumatic group. Postoperatively, there were no differences between the two groups regarding scores, joint mobility, strength, and complications. At 12 months postoperatively, multivariate regression analysis indicated that full-layer tear (OR = 5.106, 95% CI: 1.137–22.927, P = 0.033), fat infiltration (OR = 6.020, 95% CI: 1.113–32.554, P = 0.037), and tear area (OR = 6.038, 95% CI: 2.122–17.177, P < 0.001) significantly affected the University of California at Los Angeles (UCLA) score. Conclusion: Compared with non-traumatic RCI, traumatic RCI presents with more pronounced pain and impaired joint function preoperatively yet demonstrates comparable postoperative clinical outcomes. Full-layer tears, fat infiltration, and large tear areas are unfavorable factors affecting rotator cuff repair, and postoperative rehabilitation management of these patients should be emphasized. [ABSTRACT FROM AUTHOR]

Essential thrombocythemia (ET) is a myeloproliferative malignancy caused by the excessive proliferation of megakaryocytes in the bone marrow, resulting in the overproduction of peripheral platelets. ET can lead to thrombotic events, such as ischemic stroke (IS), though it is a rare cause of IS. Bilateral medial medullary infarction (BMMI), also known as "Y appearance" infarction due to its distinctive imaging morphology, is a rare clinical subtype of IS which typically has a poor prognosis and a high mortality rate. Herein, we report the case of a 43-year-old male with a history of ET. The patient's platelet count was poorly controlled, and he did not receive regular treatment. After developing symptoms such as dizziness, dysphagia, choking on water, slurred speech, blurred vision, and bilateral limb numbness. Head magnetic resonance imaging revealed a "Y appearance" infarction in the bilateral medial medulla. After admission, the patient was administered intravenous antiplatelet therapy with tirofiban. However, when he was switched to oral aspirin after three days, he experienced decreased muscle strength and worsening symptoms. Therefore, tirofiban was continued for 14 days. Upon discharge, the patient experienced residual limb numbness. His National Institutes of Health Stroke Scale score was 1, Modified Rankin Scale score was 0, and platelet count had decreased to the normal range. During the 9-month follow-up period after discharge, the patient still had only mild limb numbness. Our report presents a special case of "Y appearance" infarction due to ET. Owing to fluctuations in the patient's condition, he received long-term high-dose tirofiban, which ultimately led to a significant improvement in his symptoms. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The effect of post-activation potentiation on sports performance is characterized by increased muscle mobility and increased rate of muscle force generation. In this paper, Meta-analysis is used to quantitatively evaluate the effects of post-activation potentiation on sprint speed, jumping performance, and kinetic parameters (peak impulse, peak power, maximum ground reaction force, rate of force generation, etc.) after activation of relative strength levels in the lower limbs. METHODS: Electronic databases such as CNKI, WanFang, Web of Science, PubMed, and Medline were retrieved for randomized control, random crossover, or clear grouping according to the relative strength levels of the lower limbs (non-randomized controls) on the post-activation potentiation effect after activation induced by the relative strength level of the lower limbs. Free weight equipment and rapid telescopic compound exercises were used as main intervention methods in each group. The publication time of the literature was from the inception of each database until August 5, 2023. Endnote software was used to manage the literature. Literature quality assessment was conducted using the PEDro scale for randomized controlled trials and ROBINS-I 2.0 standards for nonrandomized controlled trials. Revman5.4 and Stata15.0 software were used to conduct publication bias evaluation, subgroup analysis and sensitivity analysis of the extracted data, and forest plots were produced for Meta-analysis. RESULTS: Eleven documents (seven randomized controlled trials and four non-randomized controlled trials) were finally included, including 216 subjects. Overall, the methodological quality of the literature was high. According to the grouping standard of 1-repetition maximum/body mass > 2 for the strong group and 1-repetition maximum/body mass ≤ 2 for the normal group, there were 99 subjects in the strong group and 117 subjects in the normal group, all of whom were male. The positive effect of post-activation potentiation on sprint performance in the strong group was significantly higher than that in the normal group [standardized mean difference (SMD)=-1.34, 95% confidence interval (CI): -1.74 to -0.93, P < 0.000 01]; the positive effect of post-activation potentiation on vertical jump height showed no significant difference between the strong and normal group (SMD=0.30, 95% CI: -0.07 to 0.66, P=0.11); the positive effect of post-activation potentiation showed no significant difference between the strong and normal groups in terms of peak impulse (SMD=-0.07, 95% CI:-0.62 to 0.47, P=0.61], peak power (SMD=0.21, 95% CI:-0.29 to 0.72, P=0.12), maximum ground reaction force (SMD=0.31, 95% CI: -0.20 to 0.81, P=0.16) and force generation rate (SMD=0.36, 95% CI: -0.11 to 0.82, P=0.39). CONCLUSION: The post-activation potentiation effect in the strong group can significantly increase the short-distance sprint speed. The potentiation effect after activation of the relative strength level of the lower limbs has similar effects on the kinematic and kinetic parameters, including explosive vertical jump height, peak impulse, peak power, maximum ground reaction force and force generation rate. [ABSTRACT FROM AUTHOR]

AbstractNeuromuscular properties decline with ageing and low-level physical activities. Alaska pollack protein (APP) is reportedly effective for improving skeletal muscular functions, even if the amount is small and exercise is not conducted. However, it is unclear whether APP intake without an exercise program affects neuromuscular dysfunction in community-dwelling adults conducting normal, everyday activities. This study aimed to investigate changes in motor unit firing properties by adding APP to daily meals in community-dwelling older adults. They were divided into an APP group or a placebo control (CON) group for randomised, double-blind treatment. Participants in APP (n = 15) and CON (n = 17) groups ingested 4.5 g/d APP and whey protein, respectively, added to daily meals for 3 months without a specific exercise intervention. High-density surface electromyography of the vastus lateralis to assess the individual motor unit firing rate during 70% of maximum voluntary ramp-up contraction (MVC), maximum knee extensor strength, muscle thickness, echo intensity, and a physical function test were evaluated at the baseline, as well as 1.5 and 3 months after the intervention. While muscle strength, muscle thickness, and motor function were not changed, the motor unit firing rate at 50%–70% of MVC showed a significant decline at 1.5 and 3 months in the CON group, but this decline was not observed in the APP group. These findings suggest that neuromuscular properties show a detectable decline on performing daily activities without a specific exercise intervention, but such a decline was not observed in the APP intake group. [ABSTRACT FROM AUTHOR]

Introduction. Dietary supplements with vitamin and calcium are recommended to nursing home residents in Denmark, but adherence to the recommendation is low. In a previous part of this study, we reported improved adherence by means of The Model for Improvement leading to increased awareness and change of workflows at two nursing homes. However, potential effects of this improved adherence are unknown. Objective. The objective of this substudy was to investigate if the improved adherence to the recommendation affected vitamin D status, muscle strength, and physical functioning of the residents. Methods. This was a 20‐week quasiexperimental study involving 40 residents from two Danish nursing homes. Baseline and endpoint measurements took place in October 2021 and March 2022, respectively. Outcomes were number of residents taking vitamin D and calcium supplements; vitamin D status; handgrip strength; and physical functioning with timed‐up‐and‐go test and 30‐second chair stand test. Results. Prevalence of vitamin D supplement users increased from 45 to 78% (mean dose 41 μg) and of calcium supplement users from 40 to 72% (mean dose 769 mg) (both P = 0.002). Among those having blood sampled at both baseline and endpoint (n = 30), mean vitamin D status increased from 66.6 ± 31.7 nmol/L to 82.8 ± 26.3 nmol/L (P < 0.001), and more residents were vitamin D sufficient at endpoint (90 vs. 63%, P = 0.021). Endpoint vitamin D status among supplement users was 88.2 ± 22.2 nmol/L, which was higher compared to nonsupplement users (55.3 ± 30.4 nmol/L, P < 0.01). No effects were seen on muscle strength or physical functioning. Conclusions. Increased supplementation with vitamin D using The Model for Improvement positively affected vitamin D status and prevalence of vitamin D sufficiency but did not affect muscle strength or physical functioning. Longer‐term studies involving more residents are needed to investigate effects of improved adherence on these outcomes. This trial is registered with NCT04956705. [ABSTRACT FROM AUTHOR]

Objectives: The ability to control landings and stabilize quickly is essential in sports like gymnastics and cheerleading, where landing quality impacts scores. The similarities and contrasts between these sports, where one trains primarily barefoot and the other shod, may increase understanding of the kinetic role of the foot during landings. Design: Sixteen gymnasts (GYM), sixteen cheerleaders (CHR), and sixteen non-athletes (NAT) performed single-foot shod and barefoot drop landings onto a force plate. Method: Foot muscle strength was assessed using a custom test and ultrasound imaging was used to measure six foot muscles. Group differences in muscle sizes and strength measurements were compared using one-way ANOVAs (α = 0.05). Landing mechanics metrics were evaluated using 3 x 2 between-within ANOVAs (α = 0.05). Pairwise comparisons were made using Tukey post-hoc tests. Results: Barefoot landings resulted in greater peak vertical ground reaction force (pVGRF) and lower time to pVGRF (TTpVGRF). Significant group main effect differences were found between GYM and NAT for all kinetic measures (GYM: shorter time to stability (TTS) and TTpVGRF, and greater pVGRF), while no significant differences in landing kinetics were found between CHR and either GYM or NAT. No interactions were found between group and condition. GYM and CHR had significantly greater summed foot muscle size than NAT, however, only CHR displayed significantly greater toe flexion force than NAT. Conclusions: Our data suggests that while wearing shoes does not affect groups differently, footwear reduces initial peak VGRFs but does not influence later stabilization times. [ABSTRACT FROM AUTHOR]

Background: Isokinetic normative data in females' soccer players is scarce in comparison to males. Furthermore, evaluation protocols employed to obtain those data in female's studies, strongly differ from each other, using different ranges of speeds and movement patterns, thus producing different output data. Thus, it is difficult for the researcher and the clinician to choose a correct protocol for knee isokinetic test in female soccer players. Aim of this paper is to review the literature to provide updated information on how to interpret a knee isokinetic testing in healthy females. Methods: Google Scholar, PubMed, Sport Discus, and Psych info databases were queried, and 17 papers were selected. Following PRISMA methodology and PEDro scale, we classified the retrieved papers and assessed the quality. Results: In this review some common features of isokinetic testing in female soccer players of various levels of qualification are highlighted. The isokinetic performance indexes widely accepted are the hamstring/quadriceps (H/Q) ratio and dominant/non-dominant (D/ND) ratio. It also emerges that, 3 reps at the speed of 60°/sec in knee flexion/extension are preferable due to the higher reliability and that the optimal H/Q ratio in healthy female soccer players of different level of qualification and age is 50%, while the interlimb differences (D/ND) should be below 10%. Conclusions: Normative data and methodologies reviewed can be useful for the isokinetic test of female soccer players. It emerges that simplifying test procedures limiting at few testing speed and considering selected H/Q and D/ND gives all the necessary relevant informations. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions To investigate the independent and combined effects of muscle strength and visceral adiposity on prediabetes and type 2 diabetes incidence among midlife women.In this prospective study of midlife women (mean age 56.4 years), visceral adiposity, defined as visceral adipose tissue (VAT) >131 cm2 measured by dual energy X‐ray absorptiometry, and poor combined muscle strength, defined as handgrip strength <18 kg and/or five‐time repeated chair stand test performance ≥12 s, were determined at baseline between 2014 and 2016. After 6.6 years, the effects of VAT and muscle strength on risk of incident prediabetes (fasting blood glucose 5.6–6.9 mmol/L) and type 2 diabetes (fasting blood glucose levels ≥7 mmol/L, medication use, or physician diagnosis) were examined using modified Poisson regression analysis.Among the 733 initially normoglycaemic participants, 150 (20.5%) developed prediabetes or type 2 diabetes. Women with both poor combined muscle strength and high VAT had the highest risk for both prediabetes and type 2 diabetes (adjusted relative risk [aRR] 2.63, 95% confidence interval [CI] 1.81–3.82). In comparison, high VAT alone increased risk by 1.78‐fold (95% CI 1.12–2.84). Stratification analyses showed that among women with low muscle strength, high VAT demonstrated increased risks of prediabetes and type 2 diabetes (aRR 2.84, 95% CI 1.95–4.14) compared to those with normal strength (aRR 1.66, 95% CI 1.04–2.65).Low combined muscle strength with high VAT poses a greater risk for the development of prediabetes and type 2 diabetes than high VAT alone. Muscle strengthening should be promoted alongside weight loss in diabetes prevention. [ABSTRACT FROM AUTHOR]

Introduction/Aims Methods Results Discussion The hand‐held dynamometer (HHD) is a reliable and portable tool for quantitatively assessing muscle strength. However, a number of variables, including the strength of the tester, the adequacy of stabilization, and the selected testing position, can affect the reliability of the device. The objective of the present study was to examine the reproducibility and inter‐rater reliability of strength assessments using HHD with and without a stabilization device.Strength assessments were conducted with and without the stabilization device by two independent raters. Healthy volunteers with no history of musculoskeletal disorders were included in the study. The strength of the shoulder flexion, scapula elevation, knee extension, and hip abduction muscle groups was evaluated using HHD. The reliability of the measurements was evaluated using intra‐class correlation (ICC), standard error of measurement, and minimal detectable change.Fifty‐two healthy volunteers (age 21.51 ± 2.02 years) participated in the study. The reproducibility was found to be excellent (ICC = 0.89–0.99). While reliability between the assessors was good to excellent (ICC = 0.85–0.93), reliability between assessors and device was found moderate to good (ICC = 0.48–0.78).The strength values obtained for all directions of movement with the stabilization device were found to be significantly higher than those obtained without fixation of the HHD. It can be concluded that the data obtained from the assessors and HHD with stabilization device are not comparable. Moreover, the utilization of a stabilization device may serve to enhance the reliability of the measurements by eliminating the rater effect. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this systematic review and meta-analysis was to investigates whether transcranial direct current stimulation applied during physical training increases muscle strength in comparison with sham tDCS combined with physical training. Methods: Randomized controlled trials of the effects of tDCS combined physical training intervention on muscle strength and cortical excitability were collected by searching Web of Science, Pubmed, EBSCO, CNKI. The retrieval date ends in April 2024. 11 randomized controlled trials are finally included. The total sample size of the study is 338. The experimental group was subjected to tDCS combined with physical training intervention, and the control group was physical training combined with sham tDCS intervention. Results: There is a significant increase inmaximal strength (SMD= 0.38; 95%CI: 0.09, 0.67; p = 0.01) and lower limb explosive strength (MD= 2.90; 95% CI: 1.06, 4.74; p = 0.002) when physical training was performed with tDCS, but not following physical training combined with sham tDCS. Subgroup analysis of the subject population showed an increase in muscle strength in those with training experience following tDCS combined with physical training (SMD= 0.39; 95% CI: 0.08, 0.70; p = 0.01), but not for those without training experience (SMD = 0.29; 95% CI: 0.06, 0.63; p = 0.10). Motor evoked potential (MEP) wave amplitude increased significantly following physical training with tDCS (SMD = 0.71; 95% CI: 0.18, 1.24; p = 0.008), but was not different between groups (SMD= 0.16; 95% CI: 0.33, 0.65; p=0.52). Conclusions: tDCS combined with physical training intervention can improve muscle strength, lower limb explosive strength and cerebral cortex excitability. Compared to tDCS combined with training of small muscle groups, tDCS combined with training of large muscle groups was more effective in improving muscle strength. Muscle strength was more likely to improve after tDCS combined with physical training in people with physical training experience compared with people without physical training experience. The combination of tDCS with physical training intervention and the sham-tDCS with physical training intervention both increased cortical excitability. [ABSTRACT FROM AUTHOR]

Objective: To assess the added value of caregiver-mediated exercises combined with telerehabilitation in addition to usual care compared to usual care alone on the self-reported mobility outcome after subacute stroke. Design: Multicentre, observer-blinded, parallel randomised controlled trial. An off-site researcher allocated treatments using minimisation. Setting: Four rehabilitation centres in the Netherlands. Participants: Forty-one patient–caregiver dyads within 3 months poststroke. Intervention: Eight-week blended care program with caregiver-mediated mobility exercises for 2.5 h per week supported by telerehabilitation and four face-to-face sessions in addition to usual care. Main measures: Self-reported mobility domain of the Stroke Impact Scale postintervention. Secondary outcomes were functional outcome, dyads' psychosocial wellbeing, care transition to the community postintervention and after 6 months. Results: Forty-one dyads (21 intervention, 20 control) were randomised, and 37 (N = 18; N = 19) were analysed following intention-to-treat. The Stroke Impact Scale mobility was not significantly different between groups postintervention (B 0.8, 95% CI –6.8–8.5, p = 0.826). The secondary outcomes, namely, (a) caregivers' quality of life postintervention (p = 0.013), (b) caregivers' symptoms of depression postintervention (p = 0.025), and (c) independence in leisurely activities at 6 months (p = 0.024), showed significant benefits in favour of caregiver-mediated exercises with telerehabilitation. A significant difference favouring controls was found in self-reported muscle strength at 6 months (p = 0.002). Conclusions: Caregiver-mediated exercises combined with telerehabilitation yielded no differential effect on our primary outcome self-reported mobility. Although the trial is underpowered, current findings are in line with previous trials. Future studies should further explore beneficial effects of caregiver involvement in stroke rehabilitation targeting psychosocial wellbeing. [ABSTRACT FROM AUTHOR]

Background: Lung cancer carries a high burden of systemic symptoms, including in survivors, leading to a reduced quality of life (QoL). We assessed whether a 12-week multicomponent supervised exercise programme, including muscular strength and aerobic training, was beneficial in patients who had undergone surgery for early non-small cell lung cancer (NSCLC) in terms of physical performance, QoL, and metabolic and nutritional analytical parameters. Methods: Physical performance was measured by gait speed, handgrip strength, 30 s sit-to-stand (30s-STS) test repetitions, distance covered in the 6 min walk test (6MWT), and the Short Physical Performance Battery (SPPB) score. QoL was assessed with the EORTC-QLQ-C30 questionnaire. Blood glucose, cholesterol, triglycerides, total proteins, albumin, pre-albumin, creatinine, c-reactive protein, insulin-growth factor 1 (IGF-1), and the haemoglobin and hematocrit percentages were measured before and after the intervention in order to observe any beneficial effects related to metabolic markers. Results: After the intervention, the mean scores for the 6MWT (p < 0.001), STS (p < 0.001), 6MWT (p < 0.01), and SPPB (p < 0.01) had significantly improved. However, handgrip strength and nutritional analytical were unchanged. The EORTC-QLQ-C30 functions and symptoms significantly improved after the intervention (p < 0.05 and p < 0.01, respectively). A significant decrease in cholesterol, triglycerides, and IGF-1 and a significant increase in pre-albumin in blood was also observed post-intervention (p < 0.05). Conclusions: This supervised, community-based 12-week multicomponent was feasible (adherence rate 70.35%) and provided benefits not only to physical performance but also to the quality of life of patients with NSCLC. [ABSTRACT FROM AUTHOR]

The older population often experiences a gradual age-related decline in the primary motor cortex, leading to muscle weakness that can harm their physical performances. Exercise could improve physical performance and prevent falling in older adults. However, the decrease in motor function and motor skills in older adults reduces the efficiency of fall prevention. Transcranial Direct Current Stimulation (tDCS) is a non-invasive intervention aimed at improving muscle strength in various conditions by utilizing transcranial direct current stimulation applied to the primary motor cortex (M1). Pre- and post-studies were conducted to demonstrate the effects of a single 20-minute session of tDCS alone, as well as to assess any potential side effects. Sixteen older individuals, both male and female, aged 65 years or older, with or without underlying diseases, were assessed for leg and hand grip strength, followed by physical performance tests. Subsequently, they underwent stimulation of the primary motor cortex through the placement of anodal tDCS (a-tDCS) over the left M1 for 20 min. Immediate effects were evaluated within 24 h, and side effects were recorded for up to 2 weeks after the stimulation. The results demonstrated that a single session of tDCS led to a significant increase in leg strength by 13 kg (5.9 to 20.1 kg, p < 0.01). There was also a significant correlation observed with hand grip strength (r = 0.68, p < 0.01). All physical performance tests, except the fastest speed in the 10-meter walk test, showed statistically significant improvements (p < 0.01). Participants reported no serious side effects, and the intervention will now be incorporated into prospective clinical studies involving older populations to compare its effectiveness with other treatments. [ABSTRACT FROM AUTHOR]

Introduction: Center‐based rehabilitation is limited by COVID‐19 infectivity and social distancing policy. We hypothesized that discharged patients benefit from 8‐week home‐based tele‐rehabilitation (tele‐PR) using mobile phones and low‐cost instruments. Methods: The TERCOV (Tele‐rehabilitation in COVID‐19 survivors) is an investigator‐initiated, prospective, multi‐center, real‐world study. After proper assessment, 186 discharge patients received tele‐PR by smartphone, including breathing exercise, respiratory muscle training, aerobic exercise, and resistance training. Physicians, physiotherapists, and nurses provided guidance through smartphone applications. The primary outcome was six‐minute walk distance (6MWD). The secondary outcomes included hand grip, short physical performance battery, maximal inspiratory pressure, maximal expiratory pressure, self‐rating anxiety/depression scale (SAS/SDS), 36‐item short‐form health survey (SF‐36) and international physical activity questionnaire. Results: Dyspnea subgroups were more functionally impaired. After tele‐PR, improvements were observed in exercise capacity(∆6MWD: 16.80 m, 95% CI 1.18–32.42, p < 0.0001), limb muscle function (∆SPPB 0.25 points, 95% CI 0.05–0.46), respiratory muscle strength (∆MIP 16.50 cm H2O, 95% CI 9.22–23.78, p < 0.0001; ∆MEP: 12.09 cm H2O, 95% CI 3.48–20.70, p = 0.0002), health‐related quality of life (∆SF‐36 49.85, 95% CI: 21.01–78.69, p < 0.0001), physical activity(∆HEPA 13.01%, p = 0.0029). Anxiety reduced in patients with mMRC ≥ 2 (∆SAS = −4.19 points, CI −8.16 to −0.22, p = 0.03). Greater change was seen in dyspnea patients. Implications on Physiotherapy Practice: Supervised/semi‐supervised tele‐PR is a promising option during the pandemic. Patients with Dyspnea benefit more. [ABSTRACT FROM AUTHOR]

Background: Individuals with type 2 diabetes mellitus (T2DM) are prone to musculoskeletal complications, particularly in the upper extremities (UE), which can significantly impair their grip strength and UE muscle strength. This review will provide valuable insights for developing optimized exercise interventions aimed at enhancing upper limb functionality and improving patient outcomes. Aim: To determine the effect of different exercise training on grip strength & UE muscle strength in patients suffering from T2DM. Methodology: A comprehensive search from electronic databases was performed based on the selection criteria and 13 randomized controlled trials (RCT's) were included in the study. Mean changes in grip strength and UE muscle strength were the primary outcome measures. Included studies ranked high on the PEDro rating scale and eta‐analysis was performed by Rev Man 5.4 software. Results: Meta‐analysis results indicated that there was a statistically significant improvement in UE muscle strength of experimental group when compared to control group (mean differences [MD] = 2.91, 95% confidence interval = 0.12, 5.71; p = 0.04) with moderate heterogeneity (I2 = 49%, p < 0.07). Grip strength improved significantly in the experimental group when compared to the control group with (MD = 2.93, 95% CL = −0.00, 5.86; p = 0.05) and moderate heterogeneity (I2 = 66%, p < 0.08). Conclusion: This review indicated a positive role of supervised resistance & aerobic exercises on UE muscle strength in patients with T2DM. Due to lack of RCT's, grip strength needs to be explored by further investigations in these patients. [ABSTRACT FROM AUTHOR]