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Objective: This study aimed to correlate occlusal marks on posterior teeth and cusp tips, recorded using an analog qualitative method, with digital evaluations of masseter and temporal muscle activity through electromyography indexes, comparing two normalization techniques (cotton and wax) using the standardized Percentage Overlap Coefficient of the Anterior Temporal muscle and Percentage Overlap Coefficient of the Masseter muscle indexes., Design: This is a comparative cross-sectional observational study. Occlusal contact and electromyography records of the anterior temporal and masseter muscles were detected in 30 individuals with an average age of 34.9 years. During the electromyography examination, two repetitions of normalization were performed, each with maximum voluntary clenches of 5 seconds on cotton and on wax. The average electromyography amplitude was calculated from three repetitions for each material. According to the average obtained for each pair of muscles, the muscle activity index was calculated and correlated to the number of contacts, which were converted into percentages., Results: Normalization with cotton showed a positive correlation between occlusal contacts and muscle activity (rs = 0.465, p = 0.010). The mean muscle activity index for cotton was 79.4 ± 13.9 for the masseter and 83.3 ± 9.2 for the temporal muscle, with no significant difference between the two muscles (p = 0.195). Normalization with wax showed better intra-subject repeatability with less than 5 % variation (masseter: 4.9 %, temporal: 4.2 %). There was no significant difference in muscle contraction between the different normalization materials (p = 0.902)., Conclusion: Both normalization methods demonstrated a variation of less than 10 %, with wax being considered more comfortable by the participants, indicating occlusal and muscular adaptation to the different methods. The results showed a positive correlation between posterior occlusal contacts and masticatory muscle activity, especially with cotton normalization, suggesting that occlusal contacts significantly influence muscle activity, potentially leading to muscle fatigue or hyperactivity., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: To conduct a systematic review of the literature on the effect of virtual reality (VR) on biomechanical gait parameters (BGPs) in older adults. Specifically, the spatial-temporal parameters of gait, gait velocity, kinematics, and ground reaction forces, and examine how they are affected by VR interventions. To evaluate the effectiveness and validity of VR gait training and subsequently its potential integration into rehabilitation therapies. This review is a valuable contribution to the current literature as it does not limit its focus to a particular disease. By examining a wide range of studies, we sought to provide a comprehensive analysis of the effects of VR on the BGP in older adults. Our findings can inform future research on VR gait training and its potential role in rehabilitation for older adults., Data Sources: Two authors independently conducted an electronic search from August 18, 2021, to December 17, 2021, using the PubMed, Scopus, and Web of Science databases, including articles published between January 1997 and July 2021., Study Selection: The search yielded 1226 articles, and after exclusion, 16 articles were included in the analysis., Data Extraction: The Joanna Briggs Institute appraisal tool for randomized controlled trials and experimental studies, and the Cochrane risk of bias tool, version 2, were used to assess the level of evidence and bias in the studies., Data Synthesis: In our synthesis, we included data from 9 studies with a total of 217 subjects. The range of follow-up periods across these studies was 2-10 weeks, and 40% of the studies conducted the study in community-dwelling individuals. Of the randomized controlled trials, 9 had a low-risk level, whereas 1 study had moderate risk. All studies with control groups and low bias levels demonstrated a positive effect of VR intervention on the BGP in older adults., Conclusions: Consistent evidence suggests that VR intervention has positive effects on gait performance in older adults., Competing Interests: The investigators have no financial or nonfinancial disclosures to make in relation to this project., (© 2024 The Authors.)

Methods: Physical activities and sports in nature offer opportunities for leisure, health, and well-being. A randomized clinical trial (RCT) compared the effects of training, dualtask orienteering and single-task hiking in independent older adults (n = 90) allocated into three groups: orienteering group (OG), hiking group (HG) and control group (CG). Timed Up and Go (TUG) tests, including a dual-task (TUG-DT), and cognitive tests were administered. Differences were analyzed by Generalized Estimating Equations (GEE) and the effect size (ES) was calculated. Unpaired and paired tests were used for the evaluation of basic differences and after 24 weeks of intervention., Results: This RCT highlights the interaction effects between groups and time. Only the OG in TUGDT reduced by 6 s, with change of 42% (ES=0.77). Likewise, Dual TUG + cognitive stops (TUG-DT+ CS) and Dual TUG + cognitive stops + cognitive errors (TUG-DT + CS + CE), reduced 7 (ES=0.85) and 8 (ES=0.90) seconds (<0.001). The task cost improved by 75% for OG and 24% for HG (p = 0.001), with an ES of 0.56 for OG. For cognition, there was a 49.2% increase (ES=2.00) for OG and 16.5% for HG in executive functions and visuospatial skills, a 31.4% increase (ES=1.64) for OG and 14.7% for HG in processing speed, and a 39.8% increase (ES=1.62) for OG and 6.5% for HG in memory. All interactions were <0.001., Conclusion: The orienteering demonstrated that has potential benefits in effectively improving gait performance and preventing cognitive decline in older adults. Brazilian Registry of Clinical Trials (ReBEC): RBR-99jmmpf., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2023. Published by Elsevier B.V.)

The study aimed to explore the impact of strength training on long-term memory in adult and middle-aged rodents, specifically male Wistar rats aged 9 and 20 months. These rats were divided into two groups: one sedentary (SED) and the other trained (ST) for a period of 12 weeks. The strength training involved squatting exercises using adapted equipment, while the sedentary group maintained their regular, non-exercised routine. Behavioral tasks assessing mobility, anxiety, and multiple facets of memory, such as object recognition memory (ORM), social recognition memory (SRM), and object location memory (OLM), were conducted post-training. The findings were promising, revealing a generally beneficial impact of strength training on memory tasks across both age groups. Specifically, the ORM tasks showed facilitated and improved learning in both adult and middle-aged rats that underwent training. In contrast, OLM displayed only a facilitatory effect in both age groups, meaning that while the trained rats learned the task, they did not outperform the sedentary group. For SRM, a facilitatory effect was observed only in the adult group. In addition to the cognitive benefits, strength training was found to have an anxiolytic effect in the 9-month-old rats and positively affected body mass and adipose tissue composition. Notably, the study correlated the strength gains from the training with improved performance in memory tasks. These outcomes provide crucial insights into the potential of exercise-based interventions to bolster cognitive health and mitigate age-related cognitive decline., Competing Interests: Declaration of Competing Interest We, the undersigned authors of the manuscript titled "Effect of Strength Training in Adult and Middle-Aged Rats on Long-Term Memory," submitted for publication as original research in the Behavioural Brain Research journal, hereby affirm that there are no conflicts of interest to disclose relating to the content of this manuscript. We declare that we have not received any financial benefits or support from commercial entities that may have an interest in the subject matter of the research presented in this manuscript. None of the authors have any personal or professional affiliations that could influence the objectivity, integrity, or interpretation of the study. We further confirm that the design, data collection, analysis, and interpretation of the research were carried out independently and were not influenced by any external agencies or institutions. We also attest that we have fully complied with the ethical standards and procedures required for the responsible conduct of research., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: The purpose of this study was to identify how generalized fatigue along with hormonal changes throughout the menstrual cycle affects trunk variability and local dynamic stability during gait., Methods: General fatigue was induced by an incremental test on a treadmill, and the menstrual cycle was divided into three phases: follicular, ovulatory, and luteal. Twenty-six healthy, young volunteers (aged 18 to 28 years) who did not use oral contraceptives or other hormonal drugs with a regular menstrual cycle participated in the study. They walked on the treadmill for 4 min at the preferred speed, before the incremental test, followed by four sets of 4 min alternating between walking, also at preferred speed, and resting. From trunk kinematic data, the following were extracted: the mean of the standard deviation along strides, as a measure of variability, and the maximum Lyapunov exponent, as a measure of local dynamic stability (LDS)., Results: After the incremental test, variability increased, and LDS decreased. However, they showed a tendency to return to the initial value faster in women compared to previous results for men. In the follicular phase, which has less hormonal release, the volunteers had an almost complete recovery in LDS soon after the first rest interval, suggesting that female hormones can interfere with fatigue recovery. Nevertheless, concerning the LDS, it was significantly lower in the luteal phase than in the follicular phase., Conclusion: Women that are not taking oral contraceptives should be aware that they are susceptible to increased gait instabilities in the pre-menstrual phase after strenuous activities., Competing Interests: Rafael Baptista, Ludmila Dos Anjos and Marcus Fraga Vieira are Academic Editors for PeerJ., (©2023 Dos Anjos et al.)

Introduction: Physical exercise has proven efficacy in the prevention and treatment of chronic diseases, and its anti-inflammatory effect has been evaluated as a potential preventive factor in the progression of periodontal disease, in addition to improving physiological parameters., Methods: To test this hypothesis regarding its preventive factor, we evaluated the effects of aerobic training on the progression of periodontal disease in 8-month-old Wistar rats ( n = 44). The animals underwent a swimming protocol lasting six weeks, with periodontal disease induced by ligature in the fifth week, totaling fourteen days of ligature placement. Anthropometric parameters were measured for subsequent calculations of BMI and Lee's Index. Interleukin-1β testing was performed to measure serum inflammatory parameters, and alveolar bone loss was measured using images to calculate the area of loss., Results: The trained animals showed no significant differences compared to the non-trained animals in terms of anthropometric measures. Regarding the area of bone loss, although there were significant differences between the groups with and without periodontal disease, exercise did not demonstrate an impact on rats with the disease. IL-1β analysis did not detect any measurable values in the samples in either group., Discussion: These findings indicate that the applied exercise protocol was not sufficient to attenuate the progression of periodontal disease. This study did not find an effective impact of physical exercise on the analyzed parameters; however, the results are important in highlighting that the experimental animal model for inducing periodontal disease is efficient, which may encourage further investigations to determine factors that can attenuate its progression. Similarly, the application or development of new exercise protocols that can benefit and enrich the discussion on its positive effects in this disease is important, as there is already evidence suggesting an effective relationship between exercise and disease progression., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Souza and Baptista.)

The 180° turn phase of the test may better differentiate the oldest-old regarding their history of falls. This is a case-control study designed to detect the ability of the 180° turn timed up and go (TUG) phase to detect a history of falls in the oldest-old. Sixty people aged 85 years and older were assessed in their homes. The single-task and dual-task TUG tests were performed using an inertial sensor (G-Walk). Sociodemographic data, physical activity levels, mental status, depressive symptoms, concern for falls occurrence, number of medicines in use, self-perception of balance, and the functional reach test were also assessed. The logistic regressions revealed the 180° turn phase of both the single-task and dual-task TUG was almost three times better than the full TUG test to detect a history of falls, thus providing insights that can be used to better assess functional mobility in the oldest-old.

Real-world walking requires shifting attention from different cognitive demands to adapt gait. This study aims to evaluate the effect of dual tasking on spatiotemporal gait parameters of older adults. Participants were asked to perform a primary complex single-walking task, consisting of a fast-paced linear and a curved gait. Primary task was performed separately and simultaneously with different motor and cognitive secondary tasks. Spatiotemporal gait parameters, walk ratio, and walk stability ratio were measured. Apart from stride length, which stood relatively unchanged, gait speed and cadence were strongly affected by cognitive dual tasking. Cadence seems to be the most impacted by dual tasking during curved gait as it combines challenges of both primary and secondary tasks. Also, during curved phase, walking ratio was significantly lower and stability ratio was greater demonstrating that participants adopted a cautious gait where maintenance of stability took preference over efficiency.

Introduction: There is evidence that patients with posterior crossbite (PXB) have neuromuscular changes in the masticatory muscles. However, up to the present time, the relationship among these changes on the electromyographic activity of the masticatory muscles is still unclear., Objective: To systematic review the available literature on the electromyographic activity of masticatory muscles in adults with PXB., Methods: Between August 22 and September 9, 2020, we searched the following seven electronic databases: PubMed, EMBASE, Web of Science, Cochrane Library, SciELO, LILACS, and Scopus. No restrictions were applied regarding the language and year of publication. This systematic review was registered in the Prospective Register of Systematic Reviews (PROSPERO - CRD42020205057) database and conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. After data selection and extraction, the methodological quality of the selected studies was conducted independently by two reviewers, using two different evaluation tools., Results: 6957 records were initially located after the search process. In the end, eight papers were selected. Most studies were classified as having average to low methodological quality and moderate to high risk of bias. Based on the available evidence, adult patients with PXB have electromyographic activity changes in the masticatory muscles when compared with individuals without PXB. Moreover, adult patients with unilateral posterior crossbite (UPXB) have asymmetrical electromyographic activity when the crossbite side is compared with the noncrossbite side., Conclusion: Despite the lack of studies with high methodological quality, electromyographic evaluation of masticatory muscles should be considered in the diagnosis and in the orthodontic treatment plan of patients with PXB. Prospective studies with a higher sample size and follow-up time, conducted using a rigorous scientific methodology, are necessary to reach a more reliable conclusion., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2022 Luiz Makito Osawa Gutierrez et al.)

In healthy adults, Nordic walking (NW) is known to increase the external mechanical energy fluctuations, though the external work is unaltered due to an improved pendulum-like recovery in comparison with free walking (FW). We aimed to compare mechanical, pendulum-like, and spatiotemporal parameters of gait at different speeds with and without NW poles in people with Parkinson's disease and healthy controls. The study included 11 people (aged 65.6 ± 7.0 years) with idiopathic Parkinson's disease, scoring between 1 and 1.5 on the Hoehn and Yahr scale (H&Y), and nine healthy controls (aged 70.0 ± 5.6 years). All the people were experienced Nordic walkers. Walking tests were performed at 1.8 km h -1 and 4.7 km h -1 , on eight 3D force platforms on a walkway. We found greater pendulum-like energy recovery (p < 0.05) in the Parkinson group during NW than in FW, while external mechanical work remained similar (p > 0.05). People with Parkinson's disease showed a major increase in vertical and forward energy fluctuations using poles than in healthy controls. In addition, the Parkinson group showed increased stride frequency and reduced stride length compared to controls in the NW and FW conditions. Our findings partly justify the lower walking economy in Parkinson's disease due to reduced pendulum-like mechanism at commonly used speeds. NW alters gait mechanics similarly in Parkinson group and healthy control, increasing the total mechanical work. Therefore, NW can be a compelling strategy for rehabilitation because of its potential for improving functional mobility, increasing pendulum-like mechanism in Parkinson's disease., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Gait is a complex motor skill. However, most falls in humans occur during gait, and people with lower limb amputation have an increased risk of falls. Thus, this study evaluated the stability of persons with unilateral amputation by quantifying the margin of stability (MoS) during gait, to contribute to understanding the strategies adopted by these people to reduce falls. The participants were divided into 3 groups: persons with transtibial amputations (n = 12, 32.27 ± 10.10 years, 76.9 ± 10.3 kg, 1.74 ± 0.06 m); persons with transfemoral amputations (n = 13, 32.21 ± 8.34 years, 72.55 ± 10.23 kg, 1.73 ± 0.05 m); and controls (n = 15, 32.2 ± 10.17 years, 75.4 ± 9.25 kg, 1.75 ± 0.05 m), who walked for 4 min on a level and sloped (8% down and up) treadmill. The pelvic and foot marker kinematic data were used to estimate the center of mass and base of support, and from these, the MoS was estimated. Although both groups of persons with amputations showed higher values for the ML MoS than did the control group (transtibial: 8.81 ± 1.79, 8.97 ± 1.74, 8.79 ± 1.76, transfemoral: 10.15 ± 2.03, 10.60 ± 1.98, 10.11 ± 1.75, control: 8.13 ± 1.30, 7.18 ± 1.85, 8.15 ± 1.57, level, down, and up, respectively), only the transfemoral group presented a significant higher value compared to the control group. Our findings suggest that the documented limitations in persons with amputations, especially with transfemoral amputation, are exacerbated in situations that require more skills, such as walking on sloped surfaces, triggering protective mechanisms., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The purpose of this study was to investigate the effects of different vertical positions of an asymmetrical load on the anticipatory postural adjustments phase of gait initiation. Sixty-eight college students (32 males, 36 females; age: 23.65 ± 3.21 years old; weight: 69.98 ± 8.15 kg; height: 1.74 ± 0.08 m) were enrolled in the study. Ground reaction forces and moments were collected using two force platforms. The participants completed three trials under each of the following random conditions: no-load (NL), waist uniformly distributed load (WUD), shoulder uniformly distributed load (SUD), waist stance foot load (WST), shoulder stance foot load (SST), waist swing foot load (WSW), and shoulder swing foot load (SSW). The paired Hotelling's T-square test was used to compare the experimental conditions. The center of pressure (COP) time series were significantly different for the SUD vs. NL, SST vs. NL, WST vs. NL, and WSW vs. NL comparisons. Significant differences in COP time series were observed for all comparisons between waist vs. shoulder conditions. Overall, these differences were greater when the load was positioned at the shoulders. For the center of mass (COM) time series, significant differences were found for the WUD vs. NL and WSW vs. NL conditions. However, no differences were observed with the load positioned at the shoulders. In conclusion, only asymmetrical loading at the waist produced significant differences, and the higher the extra load, the greater the effects on COP behavior. By contrast, only minor changes were observed in COM behavior, suggesting that the changes in COP (the controller) behavior are adjustments to maintain the COM (controlled object) unaltered., Competing Interests: The authors have declared that no competing interests exist.

Background: There is a paucity of available biomechanical kinetic data comparing shod and barefoot conditions in children., Research Question: Do children wearing footwear have comparable gait velocity, ground reaction forces (GRF), spatiotemporal parameters, propulsive and braking impulses when compared to children walking barefoot?, Methods: Seventy-five children were divided into four groups: Group 1 females aged 4-9 years old (n = 29). Group 2 females aged 3-5 years old (n = 16). Group 3 males aged 6-9 years old (n = 13). Group 4 males aged 4-8 years old (n = 17). Children walked at a self-selected pace over a walkway of force platforms. Each footwear and barefoot represented a separate condition. The order of conditions was randomized. A repeated-measures ANOVA was performed to investigate the effects of the footwear type on gait parameters in each group. Multiple comparisons with Bonferroni corrections were conducted when appropriate., Results: There were no statistical differences in velocity or in vertical and anteroposterior GRF across conditions for all groups. There was a significant effect of the footwear worn on time to loading response peak (p = 0.008), time to midstance force (p = 0.006), and time to propulsive peak (p < 0.001). For Group 3, there was a significant effect of the footwear worn on time to braking peak (p < 0.001) and time to propulsive peak (p < 0.001). Regarding impulses for Group 1, there was a significant effect of the footwear worn on the loading response impulse (p = 0.016) and terminal stance and pre-swing impulse (p = 0.001). For Group 4, there was a significant effect of the footwear worn on the loading response impulse (p = 0.028)., Significance: There is no influence of the evaluated children's footwear on gait velocity or GRF., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Aging-related neuromuscular and neurocognitive decline induces unsmooth movements in daily functional mobility. Here, we used a robust analysis of linear and angular spectral arc length (SPARC) in the single and dual task instrumented timed up-and-go (iTUG) test to compare functional mobility smoothness in fallers and non-fallers aged 85 and older. 64 participants aged 85 and older took part in this case control study. The case group (fallers, n = 32) had experienced falls to the ground in the 6 months prior to the assessment. SPARC analyses were conducted in all phases of the single and dual task iTUGs. We also performed correlation mapping to test the relation of socio-demographic and clinical features on SPARC metrics. The magnitude of between-group differences was calculated using D-Cohen effect size (ES). SPARC was able to distinguish fallers during the single iTUG (ES ≈ 4.18). Turning while walking in the iTUG induced pronounced unsmooth movements in the fallers (SPARC ≈ -13; ES = 3.52) and was associated with the ability to maintain balance in the functional reach task. This information is of importance in the study of functional mobility in the oldest-old and to assess the efficacy of fall-prevention programs., (Copyright © 2020 Figueiredo, Balbinot, Brauner, Schiavo, Baptista, Pagnussat, Hollands and Mestriner.)

Objective: To evaluate the relationship between physical activity and phase angle., Design: Systematic Review and Meta-analysis., Data Sources: Electronic searches of MEDLINE (via PUBMED), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), SciELO, LILACS, SPORTDiscus, Scopus, and Web of Science from inception to December 10th, 2017., Eligibility Criteria for Selecting Studies: The PICOS strategy was defined, in which "P" corresponded to participants of any age, sex or ethnicity, "I" indicated any type of physical activity program, "C" denoted lack of exercise or irregular physical activity, "O" corresponded to the phase angle obtained by bio-impedance, and "S" indicated longitudinal or cross-sectional studies., Results: In cross-sectional studies the phase angle was higher among the active individuals (MD = 0.70; 95% CI: 0.48, 0.92, P < 0.001), with low heterogeneity (I 2  = 0%; P = 0.619). In longitudinal studies, the mean of the difference of phase angles from the baseline was significantly higher for the active group than the control group (MD = 0.30; 95% CI: 0.11, 0.49, P = 0.001), with low heterogeneity (I 2  = 13%, P = 0.331). No evidence of publication bias was found and the overall risk of bias was moderate to high., Summary/conclusion: The positive association of physical activity with phase angle reinforces the importance of routinely including exercise in health care. We also identified the need for further studies to define with different types, intensities and frequencies of exercises should be conducted in order to find the best dose-effect relationship., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Objective: To compare muscle thickness and subcutaneous fat in cystic fibrosis (CF) patients and healthy controls using ultrasonography (US), and to correlate US findings with nutritional, clinical and functional variables., Methods: Patients aged 6 to 18 years old with a diagnosis of CF and healthy controls were included. Participants underwent anthropometric measurements, an ultrasonographic evaluation of muscle thickness and subcutaneous fat in the triceps, quadriceps, and gastrocnemius regions, and skinfold thickness measurements. Body fat percentage was estimated using skinfold measurement. Subjects with CF also underwent a pulmonary function assessment using spirometry., Results: We studied 39 CF patients and 45 controls. Alower body mass index was observed in CF patients (p=0.011). Body composition and muscle thickness were similar between the groups. Only calf (p=0.023) circumference and femur diameter (p<0.001) were lower in CF patients. Although there were no significant between-group differences in the comparison of US measurements of subcutaneous fat, CF patients exhibited decreased skinfold thickness in the triceps (p=0.031) and quadriceps (p=0.019). Moreover, there were weak and moderate correlations of US quadricep thickness with forced vital capacity (FVC) and lean mass, respectively. Moderate correlations of the triceps, quadriceps and gastrocnemius between US subcutaneous fat and skinfold measurements were found., Conclusions: Patients with CF presented a reduction in subcutaneous fat content. Muscle thickness correlated with FVC and nutritional parameters. In addition, US findings correlated positively with skinfold measurements.

Well-vascularized composite tissue offers improved outcomes for complex head and neck reconstruction. Patients with vessel-depleted necks and failed reconstructions require alternative reconstructive options. We describe a pedicled internal mammary artery osteomyocutaneous chimeric flap (PIMOC) for salvage head and neck reconstruction. Bilateral dissections of 35 fresh cadavers were performed to study individual tissue components and vascular pedicles to develop the PIMOC technique. The flap was then utilized in a series of patients with vessel-depleted neck anatomy. The PIMOC was dissected bilaterally in all cadavers and there were no statistical differences in vascular pedicle caliber or length with regards to laterality or gender. Five patients subsequently underwent this procedure. The flaps included a vertical rectus abdominis myocutaneous component and a 6 th or 7 th rib with adjacent muscle and skin to restore bone defects, internal lining, and external coverage. All donor sites were closed primarily. There were no flap losses and all patients gained improvements in facial contour, speech and swallow. Although technically complex, the PIMOC is reproducible and provides a safe and reliable option for salvage head and neck reconstruction. The harvest of the 6 th or 7 th rib and rectus abdominis muscle renders an acceptable donor site.

Fecal incontinence is a challenging condition with numerous available treatment modalities. Success rates vary across these modalities, and permanent colostomy is often indicated when they fail. For these cases, a novel potential therapeutic strategy is anorectal transplantation (ATx). We performed four isogeneic (Lewis-to-Lewis) and seven allogeneic (Wistar-to-Lewis) ATx procedures. The anorectum was retrieved with a vascular pedicle containing the aorta in continuity with the inferior mesenteric artery and portal vein in continuity with the inferior mesenteric vein. In the recipient, the native anorectal segment was removed and the graft was transplanted by end-to-side aorta-aorta and porto-cava anastomoses and end-to-end colorectal anastomosis. Recipients were sacrificed at the experimental endpoint on postoperative day 30. Surviving animals resumed normal body weight gain and clinical performance within 5 days of surgery. Isografts and 42.9% of allografts achieved normal clinical evolution up to the experimental endpoint. In 57.1% of allografts, signs of immunological rejection (abdominal distention, diarrhea, and anal mucosa inflammation) were observed three weeks after transplantation. Histology revealed moderate to severe rejection in allografts and no signs of rejection in isografts. We describe a feasible model of ATx in rats, which may allow further physiological and immunologic studies.

The present study investigated the effects of pubertal status on peak oxygen uptake (VO2peak), respiratory compensation point (RCP), and ventilatory threshold (VT) in young soccer players using different body size descriptors. Seventy-nine soccer players (14 prepubescent, 38 pubescent and 27 postpubescent) participated in this study. A maximal exercise test was performed to determine the VO2peak, RCP, and VT. Ultrasonography was used to measure lower limb muscle volume (LLMV). LLMV (mL-b) was rated as the most effective body size descriptor to normalize VO2peak (mLO2·mL-0.43·min-1), RCP (mLO2·mL-0.48·min-1), and VT (mLO2·mL- 0.40·min-1). The values of VO2peak, RCP, and VT relative to allometric exponents derived by LLMV were similar among groups (p > .05; 0.025 < η2 < 0.059) when the effect of chronological age was controlled. Allometric VO2peak, RCP, and VT values were: 100.1 ± 7.9, 107.5 ± 9.6, and 108.0 ± 10.3 mLO2.mL-0.43·min-1; 51.8 ± 5.3, 54.8 ± 4.7, and 57.3 ± 5.8 mLO2·mL-0.48·min-1; and 75.7 ± 7.1, 79.4 ± 7.0, and 80.9 ± 8.3 mLO2·mL- 0.40·min-1 for prepubertal, pubertal, and postpubertal groups, respectively. Maturity status showed no positive effect on VO2peak, RCP, and VT when the data were properly normalized by LLMV in young soccer players. Allometric normalization using muscle volume as a body size descriptor should be used to compare aerobic fitness between soccer players heterogeneous in chronological age, maturity status, and body size.

Objective: To evaluate postural changes and the distribution of plantar pressures in patients with cystic fibrosis (CF). We also sought to evaluate the effects of an educational guideline for physical activity on body posture in children and adolescents with CF., Study Design: This was a 2-phase study of individuals between age 7 and 20 years. Phase I was a cross-sectional study in which healthy subjects were selected for postural evaluation and baropodometry, aiming to perform a later comparison with patients with CF. In phase II, we performed a randomized controlled clinical trial to assess the influence of the exercise guideline on the postural changes. Patients were assigned to 2 groups: control and intervention. The intervention consisted of a handbook with instructions for aerobic exercise and stretching. Main outcomes were postural abnormalities, plantar pressure distribution, and lung function., Results: In phase I, 34 patients with CF and 34 healthy matched individuals were included. No significant baseline differences were identified. Children with CF presented more postural deviations compared with healthy subjects (P < .05), as to alignment of the head, shoulder girdle, and pelvis, increased cervical lordosis, and lateral chest distance. In phase II (n = 34), there were no baseline differences between groups. The intervention caused (P < .05) a decrease in cervical lordosis, thoracic kyphosis, lumbar lordosis, lateral chest distance, and abdominal protrusion, as well as in the baropodometric mean pressure and contact area., Conclusions: Children and adolescents with CF present postural changes when compared with healthy individuals. The educational guideline for exercise practice helped to improve posture, preventing the progression of some postural disorders., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Regular aerobic exercise in patients with cystic fibrosis (CF) improves aerobic conditioning and delays disease progression, resulting in better quality of life. The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test, quality of life, and the self-reported aerobic exercise practice of children and adolescents with CF., Methods: This randomized controlled trial followed guidelines for physical exercise in a CF center. Subjects were assigned to 2 groups: intervention (group 1), with 17 subjects; and control (group 2), also with 17 subjects. Data were collected from October 2010 to October 2011, and the study population comprised 7-20-y-old children and adolescents with CF. The intervention consisted of handing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in telephone calls every 2 weeks., Results: Thirty-four subjects were included in the study, 20 of whom were boys (58.5%). The groups were similar at baseline. In group 1, 6 subjects (35.2%) reported practicing physical exercises regularly. The mean age was 13.4 ± 2.8 y, the mean percent-of-predicted FEV1 was 95.5 ± 17.9%, and the mean peak oxygen uptake (V̇O2 ) relative to body mass was 34.9 ± 9.0 mL/kg/min. In group 2, 4 subjects (23.5%) reported practicing physical exercises regularly. The mean age was 12.7 ± 3.3 y, the mean percent-of-predicted FEV1 was 100.1 ± 21.2%, and the mean peak V̇O2 was 33.2 ± 8.2 mL/kg/min. In group 1, there was a significant increase in physical exercise practice as reported by subjects after 3 months of intervention compared with group 2 (P = .01). No statistically significant differences were found for the other variables., Conclusions: Verbal and written guidelines for aerobic exercise, together with supervision over the telephone, had a positive impact on the self-reported regular physical exercise practice of children and adolescents. However, no improvement was found in lung function and maximum exercise capacity or domains of the quality of life questionnaire., (Copyright © 2015 by Daedalus Enterprises.)

Background: The aging process causes alterations in body composition (decrease in lean mass and increase in fat mass), diminution of functionality (strength, mobility, and physical performance), and an increased prevalence of chronic diseases such as metabolic syndrome and obesity. The aim of this study was to investigate the association of body composition and functionality with metabolic syndrome in the elderly., Methods: A cross-sectional study was conducted in the Outpatient Clinic of the Geriatric Service of Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul (PUCRS) involving 74 patients (14 males and 60 females). The patients were separated into two groups: Group 1=elderly with metabolic syndrome [through the National Cholesterol Education Program Adult Treatment Panel III (NECP ATP III) criteria; n=34], group 2=elderly without metabolic syndrome (n=40). The variables evaluated included age, gender, body composition (circumferences, skinfold thickness, BMI, muscle and fat thickness and muscle mass), functional variables [hand grip strength, Timed Up and Go Test (TUGT), and Sit-to-Stand Test]., Results: The results showed that elderly individuals with metabolic syndrome had a higher mean of the anthropometric measures (except abdominal skinfold thickness) compared to subjects without metabolic syndrome (P<0.005). We observed significant differences for muscle mass index (higher, P=0.029), TUGT (longer time, P=0.008), and hand grip strength (lower, P=0.015) in elderly with metabolic syndrome compared with subjects without metabolic syndrome. However, when these variables were adjusted for gender, age, and body mass index (BMI), none showed a significant association with metabolic syndrome., Conclusion: We did not observe associations among metabolic syndrome, body composition, and functionality variables.

Purpose: To investigate the reproducibility of the experimental model of face allotransplantation in rats in Brazil., Methods: Eighteen rats were operated, nine-nine donors recipients. Animals underwent transplantation of the left hemiface, with periorbital and scalp. Transplants were made from donor Wistar rats to recipients Lewis rats. Flaps were based on the common carotid artery and the external jugular vein of the donor animal and the anastomosis in the recipient area was performed in common carotid artery (end-to-side) and in external jugular vein (end-to-end)., Results: Of the nine recipient animals operated, six survived and three progressed to death in the first days after surgery (survival rate = 67%). The mean time of the procedure was 252 minutes and the mean time of flap ischemia was 95 minutes. The five surviving animals were sacrificed at 14 days, in good general condition and without signs of tissue rejection., Conclusions: The experimental model of face allotransplantation in rats is reproducible in our midst. Duration of surgery, time of flap ischemia, animal survival rate and complications observed were similar to those described in the literature.

Introduction: Cardiopulmonary resuscitation (CPR) in microgravity is challenging. There are three single-person CPR techniques that can be performed in microgravity: the Evetts-Russomano (ER), Handstand (HS), and Reverse Bear Hug (RBH). All three methods have been evaluated in parabolic flights, but only the ER method has been shown to be effective in prolonged microgravity simulation. All three methods of CPR have yet to be evaluated using the current 2010 guidelines., Methods: There were 23 male subjects who were recruited to perform simulated terrestrial CPR (+1 G(z)) and the three microgravity CPR methods for four sets of external chest compressions (ECC). To simulate microgravity, the subjects used a body suspension device (BSD) and trolley system. True depth (D(T)), ECC rate, and oxygen consumption (Vo2) were measured., Results: The mean (+/- SD) D(T) for the ER (37.4 +/- 1.5 mm) and RBH methods (23.9 +/- 1.4 mm) were significantly lower than +1 G(z) CPR. However, both methods attained an ECC rate that met the guidelines (105.6 +/- 0.8; 101.3 +/- 1.5 compressions/min). The HS method achieved a superior D(T) (49.3 +/- 1.2 mm), but a poor ECC rate (91.9 +/- 2.2 compressions/min). Vo2 for ER and HS was higher than +1 Gz; however, the RBH was not., Conclusion: All three methods have merit in performing ECC in simulated microgravity; the ER and RBH have adequate ECC rates, and the HS method has adequate D(T). However, all methods failed to meet all criteria for the 2010 guidelines. Further research to evaluate the most effective method of CPR in microgravity is needed.

Background:  The lateral thoracic flap was first studied in the mid-1970s but its use has been limited because of pedicle anatomical variations. However, after the development of lymph node transfer surgery, the axilla/upper lateral thorax presented as a promising donor area. Through a detailed anatomical study, the lateral thoracic flap was evaluated regarding its vascularization and composition. Later, it was used for pedicle and free flap reconstructions., Methods:  A total of 40 flaps were dissected in fresh cadavers and the characteristics of the lateral thoracic pedicle and its relationship to the upper lateral thoracic axillary lymph nodes (LTLN) were analyzed. We performed six pedicle flap reconstructions around the shoulder area and a free lymph node transfer for lower limb lymphedema., Results:  In the cadaveric dissections, the lateral thoracic pedicle branched off the axillary vessels and was found to be a primary level I axillary lymph node irrigator before reaching the skin. The cutaneous portion of the artery was present in 87.5% of the dissections. Arterial caliber was an average of 1.3 and venous, 2.6 mm. Five to seven lymph nodes were isolated with each pedicle and a lymph fasciocutaneous flap could be designed. In seven clinical cases, all of the flaps survived. Functioning lymph nodes were visualized on lymphoscintigraphy after their transfer to the ankle. Donor area had an inconspicuous evolution., Conclusion:  Lateral thoracic flap is a feasible flap with low donor area morbidity in a concealed region that can be harvested with upper LTLN for transplantation., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Background: This original study evaluated the electromyograph (EMG) activity of four upper body muscles: triceps brachii, erector spinae, upper rectus abdominis, and pectoralis major, while external chest compressions (ECCs) were performed in simulated Martian hypogravity using a Body Suspension Device, counterweight system, and standard full body cardiopulmonary resuscitation (CPR) mannequin., Method: 20 young, healthy male subjects were recruited. One hundred compressions divided into four sets, with roughly six seconds between each set to indicate 'ventilation', were performed within approximately a 1.5 minute protocol. Chest compression rate, depth and number were measured along with the subject's heart rate (HR) and rating of perceived exertion (RPE)., Results: All mean values were used in two-tailed t-tests using SPSS to compare +1 Gz values (control) versus simulated hypogravity values. The AHA (2005) compression standards were maintained in hypogravity. RPE and HR increased by 32% (p<0.001) and 44% (p=0.002), respectively, when ECCs were performed during Mars simulation, in comparison to +1 Gz. In hypogravity, the triceps brachii showed significantly less activity (p<0.001) when compared with the other three muscles studied. The comparison of all the other muscles showed no difference at +1 Gz or in hypogravity., Conclusions: This study was among the first of its kind, however several limitations were faced which hopefully will not exist in future studies. Evaluation of a great number of muscles will allow space crews to focus on specific strengthening exercises within their current training regimes in case of a serious cardiac event in hypogravity., (Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.)

Background: Current 2010 terrestrial (1Gz) CPR guidelines have been advocated by space agencies for hypogravity and microgravity environments, but may not be feasible. The aims of this study were to (1) evaluate rescuer performance over 1.5 min of external chest compressions (ECCs) during simulated Martian hypogravity (0.38Gz) and microgravity (μG) in relation to 1Gz and rest baseline and (2) compare the physiological costs of conducting ECCs in accordance with the 2010 and 2005 CPR guidelines., Methods: Thirty healthy male volunteers, ranging from 17 to 30 years, performed four sets of 30 ECCs for 1.5 min using the 2010 and 2005 ECC guidelines during 1Gz, 0.38Gz and μG simulations (Evetts-Russomano (ER) method), achieved by the use of a body suspension device. ECC depth and rate, range of elbow flexion, post-ECC heart rate (HR), minute ventilation (VE), peak oxygen consumption (VO2peak) and rate of perceived exertion (RPE) were measured., Results: All volunteers completed the study. Mean ECC rate was achieved for all gravitational conditions, but true depth during simulated microgravity was not sufficient for the 2005 (28.5 ± 7.0 mm) and 2010 (32.9 ± 8.7 mm) guidelines, even with a mean range of elbow flexion of 15°. HR, VE and VO2peak increased to an average of 136 ± 22 bpm, 37.5 ± 10.3 L·min-1, 20.5 ± 7.6 mL·kg-1·min-1 for 0.38Gz and 161 ± 19 bpm, 58.1 ± 15.0 L·min-1, 24.1 ± 5.6 mL·kg-1·min-1 for μG from a baseline of 84 ± 15 bpm, 11.4 ± 5.9 L·min-1, 3.2 ± 1.1 mL·kg-1·min-1, respectively. RPE was the only variable to increase with the 2010 guidelines., Conclusion: No additional physiological cost using the 2010 basic life support (BLS) guidelines was needed for healthy males performing ECCs for 1.5 min, independent of gravitational environment. This cost, however, increased for each condition tested when the two guidelines were compared. Effective ECCs were not achievable for both guidelines in simulated μG using the ER BLS method. This suggests that future implementation of an ER BLS in a simulated μG instruction programme as well as upper arm strength training is required to perform effective BLS in space.

Skeletal muscle force production following repetitive contractions is preferentially reduced when muscle is evaluated with low-frequency stimulation. This selective impairment in force generation is called low-frequency fatigue (LFF) and could be dependent on the contraction type. The purpose of this study was to compare LFF after concentric and eccentric maximal and submaximal contractions of knee extensor muscles. Ten healthy male subjects (age: 23.6 +/- 4.2 years; weight: 73.8 +/- 7.7 kg; height: 1.79 +/- 0.05 m) executed maximal voluntary contractions that were measured before a fatigue test (pre-exercise), immediately after (after-exercise) and after 1 h of recovery (after-recovery). The fatigue test consisted of 60 maximal (100%) or submaximal (40%) dynamic concentric or eccentric knee extensions at an angular velocity of 60 degrees /s. The isometric torque produced by low- (20 Hz) and high- (100 Hz) frequency stimulation was also measured at these times and the 20:100 Hz ratio was calculated to assess LFF. One-way ANOVA for repeated measures followed by the Newman-Keuls post hoc test was used to determine significant (P < 0.05) differences. LFF was evident after-recovery in all trials except following submaximal eccentric contractions. LFF was not evident after-exercise, regardless of exercise intensity or contraction type. Our results suggest that low-frequency fatigue was evident after submaximal concentric but not submaximal eccentric contractions and was more pronounced after 1-h of recovery.

The development of specific training designed to enhance physiological aspects of performance relies heavily on the availability of accurate and validity physiological data. In the combat sport of Wushu, katas are used to develop aerobic fitness. It is arguably important to assess and monitor heart rate (HR) and lactate (La) responses when designing effective training programs. The aim of this pilot study was to investigate heart rate and lactate responses to forms execution among Wushu combatants. Male elite modern Wushu athletes (n = 4) from a South Brazilian regional team participated in the study. Athletes were aged 22.5 ± 2.08 years old and had at least eight years of Wushu experience. Athletes carried out the Changquan and Daoshu forms in random order, HR and La were measured pre- and post-exercise. Results indicate that HR was 176 ± 3 and 176 ± 2 bpm and La was 4.38 ± 1.3 and 5.15 ± 1.07 mmol·l(-1) for Changquan and Daoshu forms, respectively. There were no significantly differences in HR and La between the two forms. HR values represent 89.2 ± 1.1 and 89.1 ± 1.8% of age-predicted maximal heart rate and lactate was near of 4 mmol·l(-1) point. In conclusion, training programs to Wushu combatants could target the range of physiological values cited above with no differences between two forms. Key PointsHeart rate and lactate responses are not significantly different between Changquan and Daoshu forms for Wushu combatants.The Wushu katas could be used to develop aerobic fitness.