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Context: Poor knee biomechanics contribute to knee joint injuries. Neuromuscular control over knee position is partially derived from the hip. It is unknown whether isolated activation training of the gluteal muscles improves lower-extremity frontal plane mechanics. This study examined if a home-based hip muscle activation program improves performance on the Forward Step-Down Test as well as increases surface electromyography (sEMG) activation of the gluteal muscles. Design: The study utilized a single-group repeated-measures design. Methods: Thirty-five participants (24 females, mean age = 23.17 [SD 1.36] years) completed an 8-week hip muscle activation program. The Forward Step-Down Test score and sEMG of gluteus maximus and medius were assessed preintervention and postintervention. Results: Forward Step-Down Test scores improved significantly from preintervention (Mdn = 3.5) to postintervention (Mdn = 3.0, T = 109, P =.010, r =.31.), but this result did not meet clinical significance. sEMG analysis revealed a significant increase in mean gluteus maximus activation (P =.028, d = 1.19). No significant dose–response relationship existed between compliance and the Forward Step-Down Test scores or sEMG results. Conclusions: A home-based hip activation program increases gluteus maximus activation without clinically significant changes in frontal plane movement quality. Future studies may find clinical relevance by adding motor learning to the activation training program to improve functional muscle use. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Existing studies have posited that incorporating abdominal enhancement techniques during lower-extremity exercises might mitigate compensatory pelvic motions and enhance the engagement of specific hip muscles. Clinical Question: Does performing lower-extremity exercises with abdominal enhancement techniques increase hip muscle activation levels in healthy individuals? Summary of Key Finding: After the literature review, 4 cross-sectional studies met the inclusion criteria and were included in this critically appraised topic. Clinical Bottom Line: There is moderate evidence to support that prone hip extension with abdominal enhancement may increase gluteus maximus and hamstring muscle activity. Gluteus medius activity may not be affected by abdominal enhancement during hip abduction exercises. Strength and Recommendation: The collective findings from the 4 cross-sectional trials indicate that the incorporation of abdominal enhancement techniques during lower-extremity exercises may have the potential to enhance targeted muscle activation levels in healthy individuals. Further research is recommended to establish more robust conclusions. [ABSTRACT FROM AUTHOR]

Context: Anterior cruciate ligament injuries are directly related to the control of dynamic knee valgus in the landing of a jump, and this is mainly due to the correct activation and neuromuscular function of the lower-extremity muscles. The aim of the study is to assess the relationship between lower limb muscle activity during a single-legged drop jump and knee frontal plane projection angle (FPPA). Design: A correlation study. Methods: Thirty healthy collegiate female athletes were included in the study. Main outcomes measures were peak knee FPPA and muscle activity (% of maximal voluntary isometric contraction). Peak knee FPPA during a single-legged drop jump test was identified using a 2-dimensional motion analysis system. Muscle activity was assessed using a surface electromyograph for gluteus maximus, gluteus medius, biceps femoris, semitendinosus, vastus medialis quadriceps, vastus lateralis quadriceps, medial gastrocnemius, and lateral gastrocnemius. All variables were assessed for both dominant and nondominant limbs. A correlation analysis between peak knee FPPA and muscle activity was performed. Statistical significance was set at P <.05. Results: A mean peak knee FPPA of 14.52° and 13.38° was identified for dominant and nondominant limb single-legged drop jump test, respectively. Muscle activity (% of maximal voluntary isometric contraction) for muscles assessed ranged from 43.97% to 195.71% during the single-legged drop jump test. The correlation analysis found no significant correlation between any of the muscles assessed and peak knee FPPA during the single-legged drop jump test (Pearson coefficient between −.3 and.1). Conclusions: There is no association between muscle activity from the lower limb muscles and the knee FPPA during a single-legged drop jump in female athletes. Thus, different muscle properties should be assessed in order to understand such an important movement as the knee FPPA during a jump. [ABSTRACT FROM AUTHOR]

We investigated the association between the cross-sectional area (CSA) of the gluteus medius muscle (GMM) and activities of daily living in patients with hip fractures. This retrospective cohort study comprised 111 patients aged ≥65 years who underwent hip fracture rehabilitation. The CSA of the GMM was measured using computed tomography scans in the early stages of hospitalization. The group with decreased CSA of the GMM had a median GMI ≤17 cm2/m2 for male patients and ≤16 cm2/m2 for female patients. Patients in the group with decreased CSA of the GMM had lower functional independence measure gains than those in the control group. After adjusting for confounders, we found that decreased CSA of the GMM was significantly associated with lower functional independence measure gains (β: −0.432, p <.001). In patients with hip fractures, decreased CSA of the GMM was associated with decreased activities of daily living. [ABSTRACT FROM AUTHOR]

This study evaluated the relationship between the muscle mass of the gluteus medius (GM) and skeletal muscle mass index (SMI) measured in patients with hip fractures. In this study, 141 patients with hip fractures were divided into those with high or low SMI. The GM index (GMI) was calculated by dividing the GM by the square of the height in meters. The correlation between GMI and SMI was subsequently analyzed, and cutoff values for determining the loss of skeletal muscle mass were calculated using the receiver operating characteristic curve. GMI and SMI showed a positive correlation for both sexes (male: r =.890, female: r =.626, p <.001). The GMI cutoff values were 19.460 cm2/m2 for males and 17.850 cm2/m2 for females. Skeletal muscle mass evaluation of the GM could contribute to hip fracture recovery by improving mobility and facilitating the early diagnosis of loss of SMM. [ABSTRACT FROM AUTHOR]

Context: Bridge exercises are extensively used in trunk-strengthening programs. The aim of this study was to investigate the effect of bridging duration on lateral abdominal muscle thickness and gluteus maximus activation. Design: Cross-sectional. Methods: Twenty-five young males participated in this study. Transversus abdominal (TrA), external and internal oblique ultrasound thickness, gluteus maximus electromyographic activation, and sacral tilt angle were simultaneously measured for every second during 30-second bridging exercise. The contraction thickness ratio and root mean squared signal (normalized to maximum isometric contraction signal) during 6 exercise durations (from 0 to 5, 10, 15, 20, 25, and 30 s) were also calculated and compared using analysis of variance designs. Results: TrA and internal oblique contraction thickness ratio and gluteus maximus root mean squared increased during the first 8 to 10 seconds and remained elevated until the end of the 30-second exercise (P <.05). External oblique contraction thickness ratio declined during exercise (P <.05). Five-second bridging showed less TrA thickness and anteroposterior and mediolateral sacral tilt angle and a lower anteroposterior tilt variability compared with bridges, which lasted more than 10 seconds (P <.05). Conclusions: Bridge exercises longer than 10 seconds may be better for promoting TrA recruitment than bridges of shorter duration. Clinicians and exercise specialists could adjust the duration of bridge exercise based on the aims of the exercise program. [ABSTRACT FROM AUTHOR]

Context: Hip muscle imbalance, especially between gluteal muscles and tensor fasciae latae (TFL), is one of the risk factors for developing low back pain which should be considered in rehabilitation programs. This study compared the effect of exercises with gluteal-to-TFL muscle activation index above and below 50 on pain intensity, disability, and lower limbs' range of motion (ROM) in patients with nonspecific chronic low back pain. Design: A semiexperimental intervention study with a pretest and posttest. Methods: A total of 45 patients with nonspecific chronic low back pain were randomly divided into 2 experimental groups of gluteal-to-TFL muscle activation index above 50 (n = 15), below 50 (n = 15), and a control group (n = 15). Pain intensity (visual analog scale), disability (Roland–Morris Disability Questionnaire), and lower limbs' ROM including hip extension, hip abduction, hip external rotation, and knee extension (goniometer) were assessed at pretest and after 8 weeks of intervention. Results: Within-group comparison showed significant improvement of pain, disability, and ROMs in both experimental groups. No significant changes were observed in the control group. In between-group analysis, significant differences were observed in group of gluteal-to-TFL muscle activation index above 50 for only pain (P =.03) and disability (P =.01). For ROMs, although clinical improvement of lower limbs' ROMs was higher in group of gluteal-to-TFL muscle activation index above 50, no statistically significant differences were found between 2 experimental groups. Both experimental groups were superior to the control group for all outcomes. Conclusions: Findings indicate the statistically and clinically superior effectiveness of exercises with a gluteal-to-TFL muscle activation index above 50 in the reduction of pain and disability. Based on the clinical significance of exercises with a gluteal-to-TFL muscle activation index above 50 for improving ROMs, utilizing specific exercises that more activated gluteal muscle compared to TFL is recommended for patient with restricted lower limbs' ROMs. [ABSTRACT FROM AUTHOR]

Context: Excessive hip adduction and internal rotation are abnormal movements that may lead to the onset and progression of patellofemoral pain. Previous studies have reported that lower dynamic frontal plane hip joint stiffness in the gait of women is associated with the magnitude of hip adduction and internal rotation angles. However, the factors contributing to the lack of dynamic frontal plane hip joint stiffness in the gait of young women are unclear. This study aims to investigate the factors affecting dynamic frontal plane hip joint stiffness during the weight-acceptance phase of the gait of healthy young women. Design: Cross-sectional study. Methods: This study included 30 healthy women between the ages of 18 and 30 years. The pelvic width/femur length ratio was calculated by dividing the pelvic width by the femur length. Data on hip kinematics and kinetics and activation of the gluteus maximus and medius, tensor fasciae latae, and adductor longus muscles during gait were collected using a motion capture system, force plates, and surface electromyography. Stepwise multiple regression analysis was conducted to determine the extent to which each independent factor affected dynamic frontal plane hip joint stiffness. Results: In healthy young women, decreased dynamic frontal plane hip joint stiffness was associated with decreased muscle activity of the gluteus maximus during the gait, as well as greater pelvic width/femur length ratio. Conclusions: Women with a relatively great pelvic width relative to femur length may have more difficulty in producing dynamic frontal plane hip joint stiffness. However, increasing the muscle activity of the gluteus maximus may contribute to increased dynamic frontal plane hip joint stiffness. [ABSTRACT FROM AUTHOR]

The aim of this study is to compare the efficacy of different exercise interventions for adult flexible flatfoot. Nine databases (PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), SCOPUS, PRDro, Google Scholar, China National Knowledge Infrastructure(CNKI) and Wanfang data) were systematically searched from their inception until February 2024. The search resulted in 2112 records, with 11 studies included. All networks revealed low heterogeneity and non-significant inconsistency (I2 ≤ 25.0%). Three network plots were formed for navicular drop. Firstly, compared with the control group, strengthening the posterior tibial muscle + stretching the iliopsoas muscle + TCE (MD: 3.32, 95% CI: 1.78, 4.89), PNF (MD: 1.81, 95%CI: -0.05, 3.70), SFE (MD: 1.23, 95%CI: 1.02, 1.44) all showed better effects. And strengthening the posterior tibial muscle + stretching the iliopsoas muscle + TCE exercise is considered to be the most effective intervention, with SUCRA of 0.97. Secondly, compared with the control group, hip-focused neuromuscular exercise (MD: 6.22, 95% CI: -1.69, 14.12), SFE with EMG biofeedback (MD: -0.81, 95%CI: -1.59, 3.21) all showed better effects. And hip-focused neuromuscular exercise is considered to be the most effective intervention, with SUCRA of 0.92. Thirdly, the internal foot muscle training combined with gluteus muscle strengthening is significantly better than the other two groups, with SUCRA of 0.99. For the foot posture index, comprehensive reinforcement (MD: 1.95, 95% CI − 0.19, 4.03) showed better effects compared with the control group. In the probability ranking table, comprehensive reinforcement is significantly better than the other two groups, with SUCRA of 0.98. For the foot function index, orthoses wear + stretching + eccentric progressive resistive exercise of tibialis posterior is significantly better than the other two groups, with SUCRA of 0.92. In conclusion, various exercise therapies improve the arch shape and function of patients with flexible flatfoot, particularly hip muscle and lower limb overall muscle training. [ABSTRACT FROM AUTHOR]

This study aimed to characterize muscle activity in male soccer players with a history of hamstring strain injuries (HSI) during accelerated sprinting. Thirteen patients each in the HSI group (history of HSI) and in the healthy group (with no history of HSI) were included. 26 male soccer players of which 13 with and 13 without HSI history were included in this study. Ten muscles were evaluated on electromyography activity during overground sprinting. The testing protocol consisted of a maximal sprint over a distance of 30 meters. One running stride was divided into the early stance phase, late stance phase, early swing phase, mid-swing phase, and late swing phase, and the average muscle activity per phase and the timing of the peak root-mean-square value appearance during each stride were calculated. Statistical analysis was performed using repeated-measures two-way ANOVA (group x phase), and multiple comparison tests were performed using the Bonferroni method when the interaction or main effect was significant. The statistical significance level was set at p < 0.05. Gluteus maximus (Gmax), gluteus medius (Gmed), and external oblique (EO) showed activity differences based on HSI history. Gmax was 30% lower, EO was 20% lower, and Gmed was 40% higher in HSI group. This study suggests that, despite previous findings that HSI is most likely during the late swing phase, the HSI group shows a higher injury risk in the early stance phase. This is due to differences in trunk and gluteal muscle activity between the late swing and early stance phases compared to the healthy group. In summary, HSI group had lower activity in the muscles contributing to trunk instability, especially EO and Gmax, before and after ground impact during accelerated sprinting, compared to Healthy. [ABSTRACT FROM AUTHOR]

Limited information exists regarding abductor muscle quality variation across its length and which locations are most representative of overall muscle quality. This is exacerbated by time-intensive processes for manual muscle segmentation, which limits feasibility of large cohort analyses. The purpose of this study was to develop an automated and localized analysis pipeline that accurately estimates hip abductor muscle quality and size in individuals with mild-to-moderate hip osteoarthritis (OA) and identifies regions of each muscle which provide best estimates of overall muscle quality. Forty-four participants (age 52.7 ± 16.1 years, BMI 23.7 ± 3.4 kg/m2, 14 males) with and without mild-to-moderate radiographic hip OA were recruited for this study. Unilateral hip magnetic resonance (MR) images were acquired on a 3.0 T MR scanner and included axial T 1 -weighted fast spin echo and 3D axial Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation (IDEAL-IQ) spoiled gradient-recalled echo (SPGR) with multi-peak fat spectrum modeling and single T 2 * correction. A three dimensional (3D) V-Net convolutional neural network was trained to automatically segment the gluteus medius (GMED), gluteus minimus (GMIN), and tensor fascia lata (TFL) on axial IDEAL-IQ. Agreement between manual and automatic segmentation and associations between axial fat fraction (FF) estimated from IDEAL-IQ and overall muscle FF were evaluated. Dice scores for automatic segmentation were 0.94, 0.87, and 0.91 for GMED, GMIN, and TFL, respectively. GMED, GMIN, and TFL volumetric and FF measures were strongly correlated (r: 0.92–0.99) between automatic and manual segmentations, where all values fell within the 95% limits of agreement of [−9.79 cm3, 17.43 cm3] and [−1.99%, 2.89%], respectively. Axial FF was significantly associated with overall FF with the strongest correlations at 50%, 50%, and 65% the length of the GMED, GMIN, and TFL muscles, respectively (r: 0.93–0.97). An automated and localized analysis can provide efficient and accurate estimates of hip abductor muscle quality and size across muscle length. Specific regions of the muscle may be used to estimate overall muscle quality in an abbreviated evaluation of muscle quality. [ABSTRACT FROM AUTHOR]

Gluteus medius tendon pathology, encompassing tendinopathy and tears, is a significant source of lateral hip pain and functional impairment. Traditional diagnostic approaches have relied on clinical examination and magnetic resonance imaging (MRI). However, the advent of diagnostic musculoskeletal ultrasound MSKUS has transformed the evaluation process. Musculoskeletal ultrasound MSKUS has emerged as a highly valuable diagnostic tool in the evaluation of gluteus medius tendon pathology, offering a non-invasive, cost-effective, and dynamic assessment method. This modality provides real-time visualization of soft tissue, enabling the detailed examination of tendon structure, vascularity, and associated musculature. For rehabilitation providers, understanding the application, strengths, and limitations of diagnostic MSKUS can enhance clinical decision-making, facilitate targeted therapeutic interventions, and potentially expedite the recovery process. This article reviews the application of MSKUS in diagnosing gluteus medius tendon pathology and its implications for rehabilitation practice. This should help to equip rehabilitation professionals with knowledge to better integrate this diagnostic tool into their clinical repertoire. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATION FOR REHABILITATIONThis study investigated the effects of using the LiftCar-150 track-based stair-climbing robot on muscle activity, usability, and psychological anxiety. While stair-climbing robots enhance mobility for individuals with physical disabilities, existing research has predominantly focused on engineering perspectives, with limited attention to user-centered outcomes. Ten healthy participants and an 80 kg dummy rider completed stair-climbing tasks at slow (5 m/min) and fast (7 m/min) speeds. Muscle activity in the middle trapezius (MT), erector spinae (ES), multifidus (MF), gluteus maximus (Gmax), gluteus medius (Gmed), and anterior deltoid (AD) muscles was recorded by electromyography. Usability was evaluated in terms of safety, efficiency, and satisfaction using a 5-point Likert scale, while psychological anxiety was assessed with a visual analog scale (VAS) ranging from 0 to 10. Results showed that during stair ascent, activities of the back extensors (ES and MF) and gluteus muscles (Gmax and Gmed) significantly increased compared to descent, while anterior deltoid activity was higher during descent. Usability scores averaged 4.05 for stability, 4.1 for efficiency, and 3.7 for satisfaction. Perceived psychological anxiety scores were 4.2 ± 0.3 and 5.4 ± 0.5 at slow speed, and 3.5 ± 0.2 and 5.7 ± 0.4 at fast speed during ascent and descent, respectively. While operators recognized the robot’s stability and efficiency, satisfaction levels were neutral, and specific muscle activation was increased. These findings provide essential insights into optimizing the design and usability of stair-climbing robots to better address user needs.The proposed user-centered approach in this study can be used to improve performance and user satisfaction of a wide range of mobility device.To reduce extensor muscle activity caused by forward bending during initial stair climbing, it is necessary to modify the fixed handle design to allow adjustable handle height.Additionally, exploring options for weight reduction and repositioning the power button may further optimize the LiftCar-150, contributing to increased usability and satisfaction for operators.The proposed user-centered approach in this study can be used to improve performance and user satisfaction of a wide range of mobility device.To reduce extensor muscle activity caused by forward bending during initial stair climbing, it is necessary to modify the fixed handle design to allow adjustable handle height.Additionally, exploring options for weight reduction and repositioning the power button may further optimize the LiftCar-150, contributing to increased usability and satisfaction for operators. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine if surface electromyography (sEMG) demonstrates differences in muscle activation between normal and dogs recovering from spinal cord injury due to intervertebral disk extrusion. Animals: Two groups of client-owned small-breed chondrodysplastic-type dogs were tested. Group 1 consisted of seven ambulatory paraparetic dogs that had undergone a hemilaminectomy procedure in the T3-L3 region for intervertebral disk extrusion 1 month prior. Group 2 was made up of seven normal dogs that had no history of intervertebral disk disease or spinal surgery. Procedures: Each subject walked 10 feet on a nonslip surface for at least five gait cycles for the sEMG to capture muscle activation of the vastus lateralis and gluteus medius, bilaterally. Muscle activation was quantified as the total myoelectric output area under the curve, averaged across all gait cycles. Results: Muscle activation was significantly greater in the post-operative hemilaminectomy group (p = 0.012). There was a significant difference in muscle activation between each hindlimb in the post-operative hemilaminectomy group, but not in the normal group. The muscle activation was significantly lower on the side that underwent surgery compared to the opposite limb (p = 0.0034). Conclusion and clinical importance: Post-operative hemilaminectomy dogs have greater hindlimb muscle activation compared to normal dogs, which likely represents a lack of descending inhibition secondary to upper motor neuron syndrome. The side of surgery is correlated with decreased muscle activation. Surface EMG can be used to evaluate muscle activity in dogs recovering from spinal decompression surgery. [ABSTRACT FROM AUTHOR]

Background: Snapping hip syndrome (SHS) is characterized by snapping sensation and pain and affects up to 10% of the general population. External snapping hip syndrome (ESHS), the most common form, is often due to repetitive movements in sports or anatomical predispositions. Conservative treatment includes physiotherapy and corticosteroid injections, while surgery is considered if conservative measures fail. Open surgical techniques carry several risks, while modern arthroscopic techniques offer less invasive options, such as endoscopic iliotibial band release (ITB) and gluteus maximus tenotomy. Materials and methods: A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) was used to analyze the retrospective studies. This paper was registered in the International Prospective Registry of Systematic Reviews (PROSPERO). Results: Out of 9 included studies, 403 patients with 689 hips underwent endoscopic treatment. ITB release and his variations were the main surgical techniques. Gluteus maximus tenotomy was also used in some studies. Postoperative rehabilitation protocols varied. Patients generally experienced significant improvements in symptoms and functional outcomes, with low rates of recurrence (1.02%) and revision (0.15%). Complications were minimal. Conclusions: Endoscopic treatment of ESH shows favorable results, improving functional outcomes and returning patients to pre-injury activity levels. Long-term efficacy and costeffectiveness need to be evaluated, emphasizing the importance of large-scale prospective randomized trials to clarify surgery's benefits in refractory ESH cases. [ABSTRACT FROM AUTHOR]

Excessive hip adduction and internal rotation are common movement impairments associated with patellofemoral pain (PFP). As such, strengthening of the hip abductors and external rotators commonly is recommended. Because tensor fascia latae (TFL) is a hip internal rotator in addition to being an abductor, it is important to select exercises that target the superior gluteus maximus (SUP-GMAX) and gluteus medius (GMED) while minimizing activation of the TFL. To identify hip-targeted exercises resulting in greater activation of the SUP-GMAX and GMED relative to the TFL in persons with PFP. Twelve individuals with PFP participated. Electromyographic (EMG) signals were obtained from the GMED, SUP-GMAX, and TFL using fine-wire electrodes while participants performed 11 hip-targeted exercises. Normalized EMG of GMED and SUP-GMAX was compared to that of the TFL for each exercise using repeated measures ANOVAs and descriptive statistics. Of the 11 hip exercises evaluated, only the clam exercise with elastic resistance resulted in significantly greater activity of both gluteal muscles (SUP-GMAX = 24.2 ± 14.4%MVIC, p =.05; GMED = 37.2 ± 19.7%MVIC, p =.008) relative to the TFL (12.5 ± 11.7%MVIC). Five exercises exhibited significantly lower activation of SUP-GMAX relative to TFL: 1) unilateral bridge: SUP-GMAX = 17.7 ± 9.8%MVIC, TFL = 34.0 ± 17.7%MVIC, p =.01; 2) bilateral bridge: SUP-GMAX = 10.0 ± 6.9%MVIC, TFL = 14.0 ± 7.5%MVIC, p =.04; 3) abduction: SUP-GMAX = 14.2 ± 11.1%MVIC, TFL = 33.0 ± 11.9%MVIC, p =.001; 4) hip hike: SUP-GMAX = 14.8 ± 12.8%MVIC, TFL = 46.8 ± 33.7%MVIC, p =.008; and 5) step-up: SUP-GMAX = 15.0 ± 5.4%MVIC, TFL = 31.7 ± 19.9 %MVIC, p =.02). No differences in gluteal activation relative to TFL were found for the remaining 6 exercises (all p >.05). The clam with elastic resistance exercise was effective at activating the SUP-GMAX and GMED greater than TFL. No other exercises achieved a similar level of muscular recruitment. When attempting to strengthen the gluteal muscles in persons with PFP, care should be taken in assuming that common hip-targeted exercises result in the desired recruitment patterns. [ABSTRACT FROM AUTHOR]

Summary: Background: Increased radiopharmaceutical uptake (IRU) in skeletal muscle in horses has been previously reported but only a few authors describe its location in detail. Objectives: To describe and document the distribution of IRU in skeletal muscle in a population of flat racing and endurance horses. Study design: Retrospective descriptive study. Methods: Bone phase nuclear skeletal scintigraphy studies of 17 endurance and 9 racehorses with IRU in skeletal muscle were reviewed. The affected muscles were described and differences between endurance and flat racing horses were analysed. Ultrasonographic appearance of the muscles with IRU was also described when available. Results: A total of 22 hindlimb scans (14 endurance horses, 8 racehorses) and 7 forelimbs scans (5 endurance horses, 2 racehorses) were analysed. In the hindlimbs, IRU was most frequently observed in the semitendinosus muscle in endurance horses (7/14, 50%) and in the gluteus medius muscle in racehorses (4/8, 50%). Bilateral IRU in the same muscle was often observed (11/22, 50%) in the hindlimbs. In 87.5% of the studies with IRU in the biceps femoris (7/8) or the semitendinosus muscles (7/8), the IRU was bilateral. In the forelimbs, IRU was most frequently observed in the triceps brachii (2/5, 40%) and latissimus dorsi (2/5, 40%) muscles in endurance horses and in the brachiocephalicus muscle in racehorses (2/2, 100%). The distribution of the skeletal muscles with IRU was more varied in endurance than in flat racehorses. No statistically significant difference was found in the distribution of the skeletal muscles with IRU between endurance and racehorses. Conclusions: Even though no statistical differences between groups could be demonstrated, this study describes the frequent location of IRU in muscle in the semitendinosus of endurance horses and in the gluteus medius of flat racehorses included in this study. The distribution of muscles with IRU was more variable in endurance horses. [ABSTRACT FROM AUTHOR]

Background: Hip fractures are a common and debilitating condition, particularly among older adults. Loss of muscle mass and strength is a common consequence of hip fractures, which further contribute to functional decline and increased disability. Assessing changes in individual thigh muscles volume in follow-up patients can provide valuable insights into the quantitative recovery process and guide rehabilitation interventions. However, accurately measuring anatomical individual thigh muscle volume can be challenging due to various, labor intensive and time-consuming. Materials and Methods: This study aimed to evaluate differences in thigh muscle volume in followed-up hip fracture patients computed tomography (CT) scans using an AI based automatic muscle segmentation model. The study included a total of 18 patients at Gyeongsang National University, who had undergone surgical treatment for a hip fracture. We utilized the automatic segmentation algorithm which we have already developed using UNETR (U-net Transformer) architecture, performance dice score = 0.84, relative absolute volume difference 0.019 ± 0.017%. Results: The results revealed intertrochanteric fractures result in more significant muscle volume loss (females: −97.4 cm3, males: –178.2 cm3) compared to femoral neck fractures (females: −83 cm3, males: −147.2 cm3). Additionally, the study uncovered substantial disparities in the susceptibility to volume loss among specific thigh muscles, including the Vastus lateralis, Adductor longus and brevis, and Gluteus maximus, particularly in cases of intertrochanteric fractures. Conclusions: The use of an automatic muscle segmentation model based on deep learning algorithms enables efficient and accurate analysis of thigh muscle volume differences in followed up hip fracture patients. Our findings emphasize the significant muscle loss tied to sarcopenia, a critical condition among the elderly. Intertrochanteric fractures resulted in greater muscle volume deformities, especially in key muscle groups, across both genders. Notably, while most muscles exhibited volume reduction following hip fractures, the sartorius, vastus and gluteus groups demonstrated more significant disparities in individuals who sustained intertrochanteric fractures. This non-invasive approach provides valuable insights into the extent of muscle atrophy following hip fracture and can inform targeted rehabilitation interventions. [ABSTRACT FROM AUTHOR]

The meat of local livestock breeds often has unique qualities and flavors. In this study, three Shanghai native pig breeds (MSZ, SWT, and SHB) exhibited better meat quality traits than globalized commercial pig breeds (DLY). Subsequently, metabolomic and lipidomic differences in the longissimus dorsi (L) and gluteus (T) muscles of the Shanghai native pig breeds and DLY pig breed were compared using liquid chromatography–mass spectrometry (LC–MS). The results demonstrated that the metabolites mainly consisted of (28.16%) lipids and lipid-like molecules, and (25.87%) organic acids and their derivatives were the two most dominant groups. Hundreds of differential expression metabolites were identified in every compared group, respectively. One-way ANOVA was applied to test the significance between multiple groups. Among the 20 most abundant differential metabolites, L-carnitine was significantly different in the muscles of the four pig breeds (p-value = 7.322 × 10−11). It was significantly higher in the L and T muscles of the two indigenous black pig breeds (MSZ and SWT) than in the DLY pigs (p-value < 0.001). Similarly, lipidomic analysis revealed the PA (18:0/18:2) was significantly more abundant in the muscle of these two black breeds than that in the DLY breed (p-value < 0.001). These specific metabolites and lipids might influence the meat quality and taste properties and lead to customer preferences. Therefore, this study provided insights into the characterization of meat metabolites and lipids in Shanghai native pig breeds. [ABSTRACT FROM AUTHOR]

In short track speed skating, there is asymmetric fatigue of the gluteus maximus (GM) muscle resulting from the technique of skating. Scientific reports confirm the relationship between muscle fatigue and its change in the slope frequency of bioelectrical activity. To investigate whether athletic experience in elite short track speed skating can distinguish the asymmetry change in slope frequency of the raw electromyographic signal (EMG) of the GM muscle, influenced by the disparity in experience between junior and senior athletes. In the research, an elite group of short track speed skating national team athletes Junior and Senior, participated. Isometric tension GM muscle was tested using the Biering-Sorensen test. The study confirmed differences in the asymmetry of slope frequences EMG signal in GM muscle between juniors and seniors in short track speed skating (p⩽ 0.001). Senior athletes showed greater slope frequences in the right GM muscle (p⩽ 0.002), while juniors showed greater in the left GM muscle (p⩽ 0.008). Intergroup analysis revealed significantly meaningful differences (p⩽ 0.001) in the level of slope frequences of the right GM muscle (juniors vs. seniors), highlighting the asymmetry resulting from experience. Statistically significant differences in the level of slope frequences of the right gluteus maximus muscle juniors vs. seniors were demonstrated, suggesting asymmetry due to experience and skating technique. [ABSTRACT FROM AUTHOR]

Background: Children with spastic diplegic cerebral palsy (CP) often demonstrate gluteus medius weakness that causes balance deficits and frequent falling during walking. Purpose: The aim of the study was to evaluate the combined effects of functional task training with electrical stimulation of bilateral hip abductor muscles on motor abilities (standing and walking) and balance in children with spastic diplegic CP. Methods: Thirty children with diplegic CP of both sexes whose ages ranged from 7 to 10 years were assigned randomly into two equal groups. For both groups, motor abilities were assessed by gross motor function measure (GMFM), and balance (static and dynamic) was assessed by the humac balance system before and after the study. The control group received a functional training program focusing on standing walking and balance exercises. While children in the study group received the same functional training program with bilateral electrical stimulation of gluteus medius muscles for 50 min. The treatment program for both groups was conducted for 3 sessions/week for 8 weeks. Results: There were statistically significant differences between the control and study group post-treatment in GMFM as well as the center of pressure test and weight shift test in favor of the study group (p < 0.05). Conclusion: Using functional task training with electrical stimulation for treatment of children with spastic diplegic CP have significant effects on improving their motor abilities and balance that suggests using it in rehabilitation for these children. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultsConclusionsRCT registration numberRegistration date\nIMPLICATIONS FOR REHABILITATIONTo investigate the effects of concurrent sensorimotor training (SMT) and transcranial direct current stimulation (tDCS) on the anticipatory and compensatory postural adjustments (APAs and CPAs) in patients with chronic low back pain (CLBP).The interventions included (1) SMT plus tDCS and (2) SMT plus sham tDCS. Outcome measures were the normalized integrals of electromyography activity (NIEMG) during the phases of anticipatory and compensatory, and muscle onset latency. The investigated muscles were ipsilateral and contralateral multifidus (MF), transversus abdominus/internal oblique (TrA/IO), and gluteus medius (GM).Between-group comparisons demonstrated that ipsilateral TrA/IO NIEMG during CPA1 (p = 0.010) and ipsilateral GM NIEMG during CPA1 (p = 0.002) and CPA2 (p = 0.025) were significantly lower in the SMT combined with tDCS than in the control group. Furthermore, this group had greater NIEMG for contralateral GM during APA1 than the control group (p = 0.032). Moreover, the onset latency of contralateral TrA/IO was significantly earlier after SMT combined with tDCS (p = 0.011).Both groups that received SMT showed positive effects, but anodal tDCS had an added value over sham stimulation for improving postural control strategies in patients with CLBP. Indeed, SMT combined with tDCS leads to stronger APA and less demand for CPA.IRCT20220228054149N12022-04-04Evidence suggests that reduced excitability in the sensory and motor cortex is linked to chronic and recurring lower back pain.Increasing the excitability of these two areas using anodal transcranial direct current stimulation (tDCS), in conjunction with sensorimotor training (SMT), may improve anticipatory and compensatory postural control strategies.This study showed that the combination of SMT with tDCS targeting the sensory and motor cortex notably enhances motor preparation and refines postural control strategies in patients with chronic unilateral lumbar radiculopathy.Rehabilitation professionals are encouraged to integrate SMT with tDCS into treatment protocols to enhance the ability of individuals with back pain to handle postural disturbances in daily life, thereby potentially alleviating the persistence of their symptoms.Incorporating brain stimulation enhances the effectiveness of SMT for patients with chronic unilateral lumbar radiculopathy.Evidence suggests that reduced excitability in the sensory and motor cortex is linked to chronic and recurring lower back pain.Increasing the excitability of these two areas using anodal transcranial direct current stimulation (tDCS), in conjunction with sensorimotor training (SMT), may improve anticipatory and compensatory postural control strategies.This study showed that the combination of SMT with tDCS targeting the sensory and motor cortex notably enhances motor preparation and refines postural control strategies in patients with chronic unilateral lumbar radiculopathy.Rehabilitation professionals are encouraged to integrate SMT with tDCS into treatment protocols to enhance the ability of individuals with back pain to handle postural disturbances in daily life, thereby potentially alleviating the persistence of their symptoms.Incorporating brain stimulation enhances the effectiveness of SMT for patients with chronic unilateral lumbar radiculopathy. [ABSTRACT FROM AUTHOR]

Background and purpose. Low back pain (LBP) is a common health problem that hinders patients' daily activities. During hip physical examination on LBP patients, gluteus medius (GMed) weakness and tenderness were found. Therefore, in patients with non-specific chronic low back pain (NSCLBP), this study examined the effect of adding specific GMed strengthening to the APTA-guided program on pain, back disability, GMed macromorphology, strength, and functional performance. Methods. This study is a randomized controlled trial involving 58 patients with NSCLBP aged between 20 and 45 years. The pain was measured by a numerical pain rating scale, functional disability was estimated by the Oswestry disability index, and Ultrasonography evaluated GMed thickness. A hand-held dynamometer measured GMed strength, and its functional performance was assessed by a single-leg squat test (SLST). Patients were randomly assigned to group A received the APTA program and group B received the same program plus selected GMed strengthening. Results. For groups A and B, the percentage of change in pain was 40%, and 66.67% and that of disability level was 45.24%, and 61.5%, in favor of group B. The between-group comparison revealed significant differences for pain (p = 0.001) but not for functional disability (p = 0.12). There was a significant difference in GMed thickness for average relaxed (p = 0.009), and average contracted (p = 0.043) in both groups post-treatment but not for activation (p = 0.063). GMed strength changed by 13.1% and 21.8% in groups A and B respectively but no significant differences were observed between groups (p = 0.44). The percentage of change in the SLST was 20.6% and 58.8% for Groups A and B respectively, with a significant between-group comparison (p = 0.04). Conclusions. GMed strengthening exercises improved GMed macromorphology, reduced disability, and pain, and enhanced functional performance. It may therefore be advised that patients with NSCLBP incorporate strengthening of the GMed muscle in their treatment program. Study registration. This study was registered in ClinicalTrials.gov (NCT05521165). [ABSTRACT FROM AUTHOR]

Background: To evaluate the function of the abductor mechanism after a gluteus maximus flap transfer due to a degeneration of the muscles after hip arthroplasty, we analyzed the post-operative functional outcome as well as radiographic effects in muscle tissue. Methods: This present study included six consecutive patients operatively treated with a gluteus maximus flap due to chronic gluteal deficiency after total hip arthroplasty. All patients presented a preoperative severe limp, hip abductor deficiency and a history of conservative treatment without the relief of symptoms. MRI scans were performed pre- and postoperatively to evaluate the muscle volume and grade of degeneration of the abductor mechanism. For clinical evaluation, the Harris hip score (HHS) was applied pre- and postoperatively. Moreover, the intensity of pain, the Trendelenburg sign, the internal rotation lag sign and the abductor muscle force were measured before and after surgery. Results: Overall, the evaluation of the Magnetic Resonance Imaging (MRI) showed no significant changes in total muscle volume during the follow-up period. Separate measurements presented a significant growth of muscle volume for the gluteus minimus and tensor fascia lata compared to preoperative imaging during the follow-up period. The amount of fat volume decreased for all the measured muscles with statistical significance for the gluteus minimus, the gluteus medius and the tensor fascia lata. No further muscle degeneration and no flap necrosis were measured. The postoperative HHS results were not statistically significant compared to the preoperative results. Conclusions: Besides fair clinical results, the radiological measurements indicate that the flap transfer enables functional muscular tissue recovery and prevents further degeneration. Given these conditions, the gluteus maximus muscle flap transfer represents a viable treatment option for patients with chronic gluteal deficiency in selected patients. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the infrared thermography, arterial Doppler ultrasound, and Doppler echocardiography in healthy adult dogs exposed to a single Whole-body vibration (WBV) at different frequencies. Sixteen (16) healthy crossbreed dogs males of ages 1 to 5 years, weighing 16.3 to 24.5 kg were enrolled in the study. The dogs were exposed to a single WBV session at frequencies of 30 Hz (5 min), 40 Hz (5 min), and 50 Hz (5 min) with intervals between each frequency exposure of 10 min. The cutaneous temperature, arterial Doppler ultrasound, and Doppler echocardiography were evaluated 10 min before the WBV session, between each frequency, and 1 min after the last frequency. The cutaneous temperature of the regions of the superficial gluteal muscle and biceps femoris muscle of both hind limbs was obtained with an infrared camera. Resistive indexes of carotid and femoral arteries were determined using Doppler ultrasound, and Doppler echocardiography was used to assess the end-systolic volume and end-diastolic volume, heart rate, aortic blood flow velocity, and pulmonary artery flow velocity. Clinical parameters, complete blood count, and serum biochemical (alanine aminotransferase, creatinine, and creatine phosphokinase) were evaluated 10 min before and 60 min after the end of the WBV session. Statistically significant differences were not found in any of the variables among the time points. In conclusion, the protocol of increasing vibration frequencies (30, 40, and 50 Hz) at short-period WBV can be considered appropriate since no change occurred in the parameters evaluated. [ABSTRACT FROM AUTHOR]

Running is one of the most popular sport practices in the world. However, to our knowledge, none of the previous research about the characteristics of outdoor running makes a distinction between the different modalities of runners. Sixty-five healthy runners classified in sprinters, middle distance and long-distance runners performed five series of 100 metres on the synthetic outdoor track at competition pace. Muscle activity of lower limb muscles at initial contact and toe-off, involving the gluteus medius (GMED), gluteus maximus (GMAX), biceps femoris (BF), rectus femoris (RF), tiabilis anterior (TA) and medial gastrocnemius (MGAS), and spatiotemporal parameters were analysed. Sprinters showed high percentages of muscle activity at initial contact, in particular, the TA activity was the highest. The RF activity was significantly the lowest activity registered. At toe-off, sprinters showed the highest activity in all muscles analysed. Middle-distance runners had the highest activity of GMAX, BF and MGAS during the initial contact. In long-distance runners, the GMED and RF activity during the initial contact is highlighted, showing the highest activity of this phase. Different patterns of lower limb muscle activity and spatiotemporal parameters exist depending on the modality of the runner. [ABSTRACT FROM AUTHOR]

Background A strong body of literature has been published outlining muscle activity differences during sports performance in groups of overhead athletes. However, there are limited studies that have directly compared the muscle activity in overhead athletes with and without history of shoulder injury during functional everyday tasks. Purpose This study aimed to identify muscle activities across fourteen upper extremity and core muscles during three functional everyday movements in athletes with and without history of shoulder injury. Study Design Cross-Sectional Study Methods Thirty-two male overhead throwing athletes (fifteen healthy and seventeen injured) were recruited and completed three everyday functional movements of high elevation, low elevation, and rotation, using their dominant arm to move an object between two fixed positions. Electromyography (EMG) was recorded for fourteen muscles including: biceps brachii, deltoids (anterior, medial, and posterior), trapezius (upper and lower), pectoralis major, latissimus dorsi, serratus anterior, infraspinatus, external obliques, and gluteus maximus (all surface electrodes) and supraspinatus (fine wire electrode). Mixed model repeated measures ANOVA and post-hoc analysis assessed mean muscle activity (%MVC) between groups and each movement phase. Results Upper trapezius elicited higher mean activity in healthy athletes during both phases of the arm rotation task (p < 0.05). No differences between groups were evident for arm elevation tasks. Qualitative analysis of muscle patterns during functional tasks reflected a temporal shift in muscle activation timings and magnitudes between athlete groups, suggesting potential compensatory mechanisms in injured athletes. [ABSTRACT FROM AUTHOR]

Introduction: Asymmetrical gait mechanics after anterior cruciate ligament reconstruction (ACLR) are associated with the development of post-traumatic knee osteoarthritis. Current measures of gait mechanics have focused on peak magnitudes of knee kinematics, kinetics, and joint contact forces; nonetheless, they have seldom considered the plantar pressure and muscular frequency content in individuals with ACLR and pronate feet (PF). The present study aimed to compare ACLR and PF with healthy controls during walking. Material & Methods: The present study was conducted based on a quasi-experimental and laboratory design. The sample of this study comprised 13 people with ACLR and PF and 13 subjects from the healthy group. The mean age scores of patients in the two groups of healthy and sick participants were 22.9±4.1 and 23.2±4.5 years, respectively. During the test, subjects walked barefoot on an 18-m runway. Peak plantar pressure variables in both groups were recorded by a foot scan system (sampling rate: 300 Hz). The electromyography activity of the tibialis anterior, gastrocnemius medialis, vastus lateralis, vastus medialis, rectus femoris, biceps femoris, semitendinosus, and gluteus medius were recorded during walking. Results:The results demonstrated that the peak midfoot region plantar pressure values (P=0.018) were higher in the ACLR/PF group than in the healthy group during walking. In addition, the results highlighted a significant difference in the muscle frequency content of the rectus femoris (P=0.012, d=0.68) and vastus latelarlis (P=0.042) during the loading response and push-off phase in the ACLR/PF group compared to the healthy group during walking. Discussion & Conclusion: Peak plantar pressure values at the midfoot region and rectus femoris and vastus lateralis muscular frequency content in the ACLR/PF group differed from that of the healthy group during walking. [ABSTRACT FROM AUTHOR]

Although gluteal tears have been observed in a substantial percentage of total hip arthroplasty (THA) patients and hip osteoarthritis (OA) has been shown to alter the function of the gluteal muscles, the association between gluteal tears and hip OA has not been characterized. Therefore, we evaluated (1) the overlap between hip OA and gluteal tears, (2) the relative risks of gluteal tears in patients who have hip OA, and (3) gluteal tear-free survival after diagnosis or treatment for hip osteoarthritis. This retrospective study sourced data from TriNetX, a research network that aggregates data from over 92 million patients. Relative risks for gluteal tears were calculated for known risk factors for gluteal tears, age ≥45 years, female sex, and obesity, as well as for hip OA, hip injections, and THA. A subgroup analysis was performed utilizing a Cox proportional hazard model for patients who were diagnosed with hip OA, received a hip injection, or underwent THA in 2015 to assess gluteal tear-free survival over a 9-year timeframe. There was a large degree of overlap between patients with hip OA and gluteal tears, as 17.9% of patients with hip OA and 27.5% of patients with a gluteal tear also had the other pathology. Hip OA was associated with a markedly increased risk of a gluteal tear compared to healthy controls (Relative risk: 26.75, 95% CI: 26.64–26.86). Upon controlling for the established risk factors of gluteal tears, patients with hip OA had a markedly more likely to subsequently be diagnosed with an abductor tear (Hazard ratio: 12.46, 95% CI: 11.75–13.22). Overall, these findings suggest a strong association between hip OA and the development of gluteal tears, in which further investigation is merited to determine the biomechanical pathophysiology underlying this potential relationship to inform prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Weakness of the gluteus muscle is associated with multiple types of injuries such as low back, hip and knee pathology. However, there is no research regarding the effect of gluteal isometric exercises on abdominals, back extensors and quadriceps muscles strength. Hence, this study aimed to demonstrate the effect of gluteal isometric exercises on abdominals, back extensors and quadriceps strength. Methods: A total of 100 healthy students aged between 18 and 25 years were recruited to participate in an 8-week program of gluteal muscle isometric exercises. The strength of the abdominal, back extensor, and quadriceps muscles was assessed both at baseline and after the 8-week intervention period. Results: A paired sample t-test revealed significant improvements in abdominal muscles, back extensor muscle strength (p<0.001), and quadriceps muscle strength (p=0.037) after an 8-week intervention. The greatest increases were observed in the abdominals (59.05%), back extensors (46.78%), and quadriceps (7.13%). Conclusion: This study demonstrates that gluteal isometric exercises had a significant positive effect on the strength of abdominals, back extensors and quadriceps muscles. [ABSTRACT FROM AUTHOR]

Anterior cruciate ligament injury prevention should focus primarily on reduction of the knee abduction moment (KAM) in landing tasks. Gluteus medius and hamstring forces are considered to decrease KAM during landing. The effects of different muscle stimulations on KAM reduction were compared using 2 electrode sizes (standard 38 cm2 and half size 19 cm2) during a landing task. Twelve young healthy female adults (22.3 [3.6] y, 1.62 [0.02] m, 50.2 [4.7] kg) were recruited. KAM was calculated under 3 conditions of muscle stimulation (gluteus medius, biceps femoris, and both gluteus medius, and biceps femoris) using 2 electrode sizes, respectively versus no stimulation during a landing task. A repeated-measures analysis of variance determined that KAM differed significantly among stimulation conditions and post hoc analysis revealed that KAM was significantly decreased in conditions of stimulating either the gluteus medius (P <.001) or the biceps femoris (P <.001) with the standard electrode size, and condition of stimulating both gluteus medius and biceps femoris with half-size electrode (P =.012) when compared with the control condition. Therefore, stimulation on the gluteus medius, the biceps femoris, or both muscles could be implemented for the examination of anterior cruciate ligament injury potential. [ABSTRACT FROM AUTHOR]

Développé à la seconde is a classic ballet movement that requires the maintenance of a high hip joint range of motion (ROM) and muscle strength. However, the contribution of these hip joint biomechanical parameters to this movement's esthetic performance is unclear. Therefore, this study evaluated hip joint biomechanical characteristics of 21 experienced ballet dancers (15–29 y old) and verified the relationship between these variables with the développé à la seconde static and dynamic performance. Correlations between age, ballet practice time, gluteus maximus and gluteus medius thicknesses, ROM, and muscle strength with absolute and relative static and dynamic performances were verified. Flexors, extensors, and internal rotators peak strength and external rotation ROM were highly correlated with absolute and relative static performances (0.5–0.7). Flexors and extensors strength and external and internal rotation ROM showed the highest correlations with the développé dynamic performance (0.49–0.67). Flexor strength and flexor and internal rotation ROM predicted 26% to 41% of this movement's static and dynamic performances. Thus, from a biomechanical perspective, clinical assessment of hip strength and ROM may be used to predict the quality of the ballet dancers' performance of the développé à la seconde and guide classical ballet training. [ABSTRACT FROM AUTHOR]

To compare and explore the characteristics of squamous cell carcinoma (SCC), adenocarcinoma (AC) and adenosquamous carcinoma (ASC), usual-type endocervical adenocarcinoma (UEA) and gastric adenocarcinoma (GAC) of cervix. A total of 728 cervical cancers (254 cases of AC, 252 cases of ASC, and 222 cases of SCC) confirmed by histopathology were retrospectively reviewed. Among AC, 119 UEA and 47 GAC were included. Clinical baseline data and tumor morphological features on MRI (including tumor location, shape, diameter and volume, margin, growth pattern, presence of fluid component or cyst, heterogenous and peritumoral enhancement) of all cases were collected and analyzed. The signal intensity (SI) of tumor and gluteus maximus muscle were measured and their ratios (SIR) were calculated based on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and contrast-enhanced T1WI at arterial and delay phases (A/DCE-T1WI). These clinical and MRI features were compared between SCC, AC and ASC, UEA and GAC, and the specific ones of each subtype were identified. There was a significant difference in SCC-Ag, CA-199, CEA, ADC value, SIR-DWI, presence of intratumor cyst and peritumoral enhancement between AC and ASC; in patient age, menopausal status, International Federation of Gynecology and Obstetrics (FIGO) stage, SCC-Ag, CA-125, CA-199, CEA, tumor shape, growth pattern, margin, presence of intratumor fluid component and cyst, tumor diameter and volume, ADC value, SIR-T1WI, SIR-T2WI, and SIR-DWI between SCC and AC, as well as SCC and ASC. Also, there was a significant difference in deep stromal invasion (DSI), peritumoral and heterogenous enhancement between SCC and AC, and in SIR-ACE-T1WI between SCC and ASC. There was a significant difference in reproductive history, menopausal status, FIGO stage, CA-199, DSI, lymph node metastasis (LNM), parametrial invasion (PMI), tumor location, shape, margin, growth pattern, presence of fluid component and cyst, tumor diameter and volume, SIR-T1WI, SIR-DWI, and heterogenous enhancement between GAC and UEA. The clinical and MRI features with significant differences among SCC, AC and ASC, and between UEA and GAC, can help to identify each subtype of cervical cancer. • The accurate and preoperative identification of cervical cancer with different subtypes holds great significance. • Cervical AC and ASC carried a more similar pattern, while SCC carried a distinctive ones. • There were multifaceted differences of clinical and MRI features among SCC, AC and ASC, and between UEA and GAC. [ABSTRACT FROM AUTHOR]

Four patients with rectal cancer required reconstruction of a defect of the posterior vaginal wall. All patients received neoadjuvant (chemo)radiotherapy, followed by an en bloc (abdomino)perineal resection of the rectum and posterior vaginal wall. The extent of the vaginal defect necessitated closure using a tissue flap with skin island. The gluteal turnover flap was used for this purpose as an alternative to conventional more invasive myocutaneous flaps (gracilis, gluteus, or rectus abdominis). The gluteal turnover flap was created through a curved incision at a maximum width of 2.5 cm from the edge of the perineal wound, thereby creating a half-moon shape skin island. The subcutaneous fat was dissected toward the gluteal muscle, and the gluteal fascia was incised. Thereafter, the flap was rotated into the defect and the skin island was sutured into the vaginal wall defect. The contralateral subcutaneous fat was mobilized for perineal closure in the midline, after which no donor site was visible.The duration of surgery varied from 77 to 392 min, and the hospital stay ranged between 3 and 16 days. A perineal wound dehiscence occurred in two patients, requiring an additional VY gluteal plasty in one patient. Complete vaginal and perineal wound healing was achieved in all patients. The gluteal turnover flap is a promising least invasive technique to reconstruct posterior vaginal wall defects after abdominoperineal resection for rectal cancer. [ABSTRACT FROM AUTHOR]

Understanding how muscle activity changes with different surface grades during canter is essential for developing training protocols in Thoroughbreds because canter is their primary gait in training and races. We measured the spatiotemporal parameters and the activation of 12 surface muscles in the leading limb side of 7 Thoroughbreds. Horses were equipped with hoof strain gauges and cantered at 10 m/s on a treadmill set to grades of −4%, 0%, 4%, and 8%, randomly, for 30 seconds each without a lead change. Integrated electromyography (iEMG) values during stance and swing phases were calculated and normalized to mean iEMG values during stride duration at 0% grade in each muscle. The iEMG values at each grade were compared using a generalized mixed model. Stride duration significantly decreased due to shorter swing duration on an 8% grade (P < 0.001) compared to all other grades, where no significant changes were observed. Compared to a 0% grade, the normalized iEMG values during the stance phase on an 8% grade in five muscles significantly increased (Musculus infraspinatus; +9%, M. longissimus dorsi (LD); +4%, M. gluteus medius (GM); +29%, M. biceps femoris; +47%, M. flexor digitorum lateralis; +16%). During the swing phase, the normalized iEMG values in six muscles significantly increased on an 8% grade compared to a 0% grade (M. splenius; +21%, M. triceps brachii; +54%, LD; +37%, GM; +24%, M. semitendinosus; +51%, M. extensor digitorum longus; +10%). No significant changes were observed in iEMG values on −4% and 4% grades compared to the 0% grade. Although +/− 4% grades had little effect on neuromuscular responses, 8% uphill canter reduced stride duration due to decreased swing duration and required increase of muscle activation during either stance and swing phase. Canter on an 8% grade might strengthen equine muscles to increase propulsive force and stride frequency. [ABSTRACT FROM AUTHOR]

Background: Both osteoporosis and sarcopenia are associated with aging, increasing the likelihood of falls in older adults and consequently raising the risk of hip fractures (HF). Aims: To explore the relationship between the size and density of muscle and subcutaneous adipose tissue (SAT) and the bone mineral density (BMD) of the proximal femur in elderly women with HF. Methods: Quantitative computed tomography (QCT) was conducted on the hips of 661 female participants who experienced low-energy acute HFs to measure both areal BMD (aBMD) and volume BMD (vBMD). Measurements were taken for the cross-sectional area (CSA) and density of the muscle around the hip and adjacent SAT. Multivariable linear regression models were applied to assess the relationship between these parameters. Results: Most increases in the density of the gluteus medius and minimus muscle (G.Med/MinM) were correlated with higher BMD in the femoral neck fracture (FNF) group with osteoporosis. In the FNF group, gluteus maximus muscle (G.MaxM) density was negatively associated with the BMD parameters of the proximal femur in individuals with osteoporosis, while they were positively associated with nonosteoporosis. In the intertrochanteric fracture (ITF) group without osteoporosis, both FN aBMD and FN vBMD showed significant correlations with G.Med/MinM density. Discussion: In women with HFs, bone and muscle are closely related. Conclusions: In older women with HFs, density but not CSA of the G.Med/MinM were associated with BMD parameters of the proximal femur. Osteoporosis may influence the relationship between G.MaxM density and proximal femur BMD in elderly women with FNF. [ABSTRACT FROM AUTHOR]

Purpose: Isometric training and pre-activation are proven to enhance acceleration performance. However, traditional strength training exercises do not mirror the acceleration-specific activation patterns of the gluteal muscles, characterized by ipsilateral hip extension during contralateral hip flexion. Therefore, the aim of the study was to determine gluteal muscle activity of acceleration-specific exercises compared to traditional strength training exercises. Methods: In a cross-sectional study design, the peak electromyographic activity of two acceleration-specific exercises was investigated and compared to two traditional strength training exercises each for the gluteus maximus and medius. Twenty-four participants from various athletic backgrounds (13 males, 11 females, 26 years, 178 cm, 77 kg) performed four gluteus maximus [half-kneeling glute squeeze (HKGS), resisted knee split (RKS), hip thrust (HT), split squat (SS)] and four gluteus medius [resisted prone hip abduction (RPHA), isometric clam (IC), side-plank with leg abduction (SP), resisted side-stepping (RSS)] exercises in a randomized order. Results: The RKS (p = 0.011, d = 0.96) and the HKGS (p = 0.064, d = 0.68) elicited higher peak gluteus maximus activity than the SS with large and moderate effects, respectively. No significant differences (p > 0.05) were found between the HT, RKS and HKGS. The RPHA elicited significantly higher gluteus medius activity with a large effect compared to RSS (p < 0.001, d = 1.41) and a moderate effect relative to the SP (p = 0.002, d = 0.78). Conclusion: The acceleration-specific exercises effectively activate the gluteal muscles for pre-activation and strength training purposes and might help improve horizontal acceleration due to their direct coordinative transfer. [ABSTRACT FROM AUTHOR]

Background Cabotegravir (CAB) + rilpivirine (RPV) dosed monthly or every 2 months is a complete long-acting (LA) regimen for the maintenance of human immunodeficiency virus type 1 virologic suppression. Across the phase 3/3b trials, the most frequently reported adverse events were injection site reactions (ISRs). Methods We present pooled ISR characteristics and outcomes for participants receiving CAB + RPV LA through week 96 of the FLAIR and ATLAS-2M studies, and survey results from healthcare providers (HCPs) giving injections (eg, injectors) in the ATLAS, FLAIR, and ATLAS-2M studies to determine optimal injection techniques. Surveys were anonymous, self-administered online questionnaires that queried provider demographics, injection experience, and techniques to minimize pre-/postinjection discomfort. Data were summarized using descriptive statistics. Results Overall, 8453 ISRs were reported by 801 participants receiving ≥1 injection of CAB LA/RPV LA. Most ISRs were mild to moderate in severity (grade 1–2, 99%), with a median duration of 3 days (interquartile range, 2–4 days), and rarely led to withdrawal (2%). Surveys were completed by 181 HCPs across 113 sites. Pushing the intramuscular injection at slow speed (66%), bringing the medication to room temperature (58%), and relaxing the gluteus muscle before injecting (53%) were ranked as effective preinjection/injection procedure practices for minimizing pain. Most injectors (60%) indicated that a prone position provided optimal patient comfort, and 41% had no preference on injection medication order. Conclusions Taken together, the data demonstrate favorable tolerability with CAB + RPV LA injections over the long term and simple techniques routinely used by injectors to help optimize the administration of CAB + RPV LA injections. [ABSTRACT FROM AUTHOR]

The gluteus maximus (GM) is a big quadrilateral musculature that lines the rear portion of the pelvis. It is innervated by the inferior gluteal nerve. The sciatic nerve, inferior gluteal nerve, and posterior cutaneous nerve of the thigh are branches of the sacral plexus. The superior and inferior gluteal arteries are the chief arterial supply to the gluteal region. In the present case, there was a dual innervation of the GM. The superior gluteal artery and the superior gluteal nerve was piercing the piriformis and the inferior gluteal artery was running between the posterior cutaneous nerve of the thigh and the inferior gluteal nerve. According to our literature review, anatomical studies in which this cadaveric procedure has been performed have not been previously reported. The anatomical variations of the gluteal region are important to surgeons, physicians, anatomists, and nurses. [ABSTRACT FROM AUTHOR]

Simple Summary: Pigs lack functional sweat glands, hence being very susceptible to heat stress. The optimum temperature in which pigs would thrive is around 20 °C, depending on age and weight. Pigs could achieve higher heat dissemination, e.g., by increasing body contact with the cooler ground and panting, but also through an undesirable reduction in feed intake. In addition, under conditions of severe heat stress, animals may become more susceptible even to immune challenges due to damage to the structure of the intestinal wall. Thus, heat stress can affect the proper functioning of metabolism, which, in addition to having implications on animal welfare, also affects the quality of meat and meat products. Cooling systems are not yet commonly seen on farms. Sprinkler systems are the most used cooling system, followed by water pads and fogging systems, for finishing pigs. As our climate continues to warm, monitoring daily feed intake and water consumption levels, along with the implementation of cooling systems, must become tools to minimize the adverse effects of hot weather. Heat stress is a significant environmental problem that has a detrimental impact on animal welfare and production efficiency in swine farms. The current study was conducted to assess the effect of low-intensity showers, provided during critical high-temperature hours daily, on body external temperature, feeding pattern, and carcass and meat quality characteristics in fattening pigs. A total of 400 animals (200 barrows and 200 gilts) were randomly allotted in 40 pens. A shower nozzle was installed over 20 pens (half barrows and half gilts) where pigs received a low-intensity shower for 2 min in 30 min intervals from 12 to 19 h (SHO group). Another group without showers was also considered (CON). Feeder occupancy measurement, thermographic measures, and carcass and meat quality parameters were studied. In the periods with higher environmental temperatures, SHO animals showed an increase in the feeder occupancy rate compared to the CON group. A decrease in temperature was observed after the shower, regardless of the anatomical location (p < 0.005). The treatment with showers led to higher values than in the CON group of 4.72%, 3.87%, 11.8%, and 15.1% for hot carcass weight, lean meat yield, and fat thickness in Longissimus Dorsi (LD) and Gluteus Medius muscles, respectively (p < 0.01). Pork from CON showed a 14.9% higher value of drip loss, and 18.9% higher malondialdehyde concentration than SHO (p < 0.01); meanwhile, intramuscular fat content was 22.8% higher in SHO than in CON (p < 0.01). On the other hand, the CON group exhibited higher L* (2.13%) and lower a* and b* values (15.8% and 8.97%) compared to the SHO group. However, the pH20h of the CON group was significantly lower than that of the SHO group (p < 0.001), indicating a softer pH decrease. Related to fatty acids in subcutaneous outer and inner layers and intramuscular fat, the CON group showed higher ΣSFA and lower ΣMUFA and Δ9-desaturase indexes than SHO (p < 0.05). In conclusion, the amelioration of heat stress through showers at critical times should be considered an interesting tool that improves both carcass and meat quality, as well as animal welfare. [ABSTRACT FROM AUTHOR]

This study examined the effect of repeated bouts of level and downhill running on physiological markers of effort and exercise-induced muscle soreness in trained female distance runners. Ten participants (Age: 24.4 ± 2.0 years; V̇O2peak: 52.9 ± 1.1 mL·kg−1·min−1), naïve to downhill running, completed six alternate 5 min trials of level and downhill running (−15%) at a 70% velocity at V̇O2peak on two occasions, three weeks apart. Perceived muscle soreness was measured upon completion and in the 72 h post exercise. V̇O2, Heart Rate (HR), Blood Lactate (BLa), and Respiratory Exchange Ratio (RER) were lower running downhill (p < 0.016, ηp2 > 0.541). For the first downhill run, Rating of Perceived Exertion (RPE) was higher compared to that for level running (p = 0.051; d = 0.447), but for the remaining trials, RPE was lower when running downhill (p < 0.004; d > 0.745). V̇O2, HR, and RER were not different in the second bout (p > 0.070, ηp2 < 0.318); however, V̇O2 was lower in each downhill trial (Δ = 1.6–2.2 mL·kg−1·min−1; d = 0.382–0.426). In the second bout, BLa was lower (p = 0.005, ηp2 = 0.602), RPE in the first trial was lower (p = 0.002; d = 0.923), and post exercise perceived soreness of the gastrocnemius, quadriceps, and hamstrings was attenuated (p < 0.002; ηp2 > 0.693). Perceived soreness of the gluteal muscles was lower in the second bout immediately post exercise, 24 h, and 48 h post exercise (p < 0.025; d > 0.922). A repeated bout of downhill running attenuated perceived muscle soreness and may modulate the physiological and perceived physical demand of a second bout of level and downhill running. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the feasibility and safety of percutaneous puncture guided by a 5th generation mobile communication technology (5G)-based telerobotic ultrasound system in phantom and animal experiments. Materials and Methods: In the phantom experiment, 10 simulated lesions were punctured, once at each of two angles for each lesion, under the guidance of a telerobotic ultrasound system and ultrasound-guided freehand puncture. Student's t test was used to compare the two methods in terms of puncture accuracy, total operation duration, and puncture duration. In the animal experiment, under the guidance of the telerobotic ultrasound system, an 18G puncture needle was used to puncture 3 target steel beads in the liver, right kidney, and right gluteal muscle, respectively. The animal experiment had no freehand ultrasound-guided control group. After puncture, a CT scan was performed to verify the position of the puncture needle in relation to the target, and the complications and puncture duration, etc., were recorded. Results: In the phantom experiment, the mean accuracies of puncture under telerobotic ultrasound guidance and conventional ultrasound guidance were 1.8 ± 0.3 mm and 1.6 ± 0.3 mm (P = 0.09), respectively; therefore, there was no significant difference in the accuracy of the two guide methods. In the animal experiment, the first-attempt puncture success (the needle tip close to the target) rate was 93%. Polypnea occurred during one puncture. No other intraoperative or postoperative complications were observed. Conclusion: Puncture guided by a 5G-based telerobotic ultrasound system has shown good feasibility and safety in phantom and animal experiments. [ABSTRACT FROM AUTHOR]

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The aim of this study was to analyze lower leg muscle forces during strength exercises such as back squats, good mornings and split squats, with a particular emphasis on females. By focusing on females, who are more vulnerable to anterior cruciate ligament injuries, we aimed to better understand muscle engagement and its role in injury prevention. Eight participants were monitored during exercises with a barbell load of 25% of body weight and, during the back squat, an additional 50% load. The analysis was conducted using personalized musculoskeletal models, electromyography (EMG) and Vicon motion capture systems to assess various muscle groups, including the m. gluteus maximus and m. gluteus medius, as well as the hamstring and quadriceps muscles. The back squat produced the highest forces for the quadriceps muscles, particularly the rectus femoris (>25 N/kg), as well as in the back leg during the split squat (>15 N/kg). The gluteal muscles were most active during good mornings and in the front leg of the split squat, especially the m. gluteus maximus medial part (>20 N/kg). The hamstrings generated the highest muscle forces in the front leg of the split squat, with the greatest forces observed in the m. semimembranosus. Our research highlights how musculoskeletal modeling helps us to understand the relationship among muscles, joint angles and anterior cruciate ligament injury risks, especially in strength training females. The results emphasize the need for personalized exercise guidance and customized models to make strength training safer and more effective. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization reports that back pain is a major cause of disorder worldwide. It is the most common musculoskeletal disorder with limited pain, muscle tension, and stiffness, and 70–80% of all individuals experience it once in their lifetime, with higher prevalence in women than in men. This study aimed to investigate the effects of gluteal muscle strengthening exercise- based core stabilization training (GSE-based CST) on pain, function, fear-avoidance patterns, and quality of life in patients with chronic back pain. Methods: This study included 34 patients with non-specific chronic low back pain. Seventeen individuals each were included in GSE-based CST and control groups. The GSE-based CST group performed GSE and CST for 15 min, three times a week for four weeks, and the control group performed CST for 30 min a day, three times a week for four weeks. The numeric pain rating scale was used to evaluate pain before and after treatment, Roland–Morris disability questionnaire was used to evaluate function, fear-avoidance beliefs questionnaire was used to evaluate fear-avoidance patterns, and quality of life was measured using the short form-36. Results: In this study, pain, function, and fear-avoidance pattern decreased significantly in both groups (All p < 0.05). During the evaluation of quality of life, both groups showed significant increase in physical and mental factors (p < 0.05). There were significant differences in pain and quality of life (p < 0.05) between the GSE-based CST and control groups. Conclusions: Therefore, GSE-based CST can be used as a basis for effective intervention to enhance pain, function, fear-avoidance patterns, and quality of life, emphasizing the need for gluteal muscle strengthening exercises in patients with non-specific chronic back pain in the future. [ABSTRACT FROM AUTHOR]

Background: Biomechanical alterations in patients with low back pain (LBP), as reduced range of motion or strength, do not appear to be exclusively related to the trunk. Thus, studies have investigated biomechanical changes in the hip, due to the proximity of this joint to the low back region. However, the relationship between hip biomechanical changes in patients with LBP is still controversial and needs to be summarized. Therefore, the aim of this study was to systematically review observational studies that used biomechanical assessments in patients with non-specific LBP. Methods: The search for observational studies that evaluated hip biomechanical variables (i.e., range of motion, kinematic, strength, and electromyography) in adults with non-specific acute, subacute, and chronic LBP was performed in the PubMed, Embase, Cinahl and Sportdiscus databases on February 22nd, 2024. Four blocks of descriptors were used: 1) type of study, 2) LBP, 3) hip and 4) biomechanical assessment. Two independent assessors selected eligible studies and extracted the following data: author, year of publication, country, study objective, participant characteristics, outcomes, and results. The methodological quality of the studies was assessed using the Epidemiological Appraisal Instrument and classified as low, moderate, and high. Due to the heterogeneity of the biomechanical assessment and, consequently, of the results among eligible studies, a descriptive analysis was performed. Results: The search strategy returned 338 articles of which 54 were included: nine articles evaluating range of motion, 16 evaluating kinematic, four strength, seven electromyography and 18 evaluating more than one outcome. The studies presented moderate and high methodological quality. Patients with LBP, regardless of symptoms, showed a significant reduction in hip range of motion, especially hip internal rotation, reduction in the time to perform functional activities such as sit-to-stance-to-sit, sit-to-stand or walking, greater activation of the hamstrings and gluteus maximus muscles and weakness of the hip abductor and extensor muscles during specific tests and functional activities compared to healthy individuals. Conclusion: Patients with LBP present changes in range of motion, task execution, activation, and hip muscle strength when compared to healthy individuals. Therefore, clinicians must pay greater attention to the assessment and management of the hip during the treatment of these patients. Systematic review registration: International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020213599). [ABSTRACT FROM AUTHOR]

Background: Degenerative lumbar spine disease (DLD) is a prevalent condition in middle-aged and elderly individuals. DLD frequently results in pain, muscle weakness, and motor impairment, which affect postural stability and functional performance in daily activities. Simulated skateboarding training could enable patients with DLD to engage in exercise with less pain and focus on single-leg weight-bearing. The purpose of this study was to investigate the effects of virtual reality (VR) skateboarding training on balance and functional performance in patients with DLD. Methods: Fourteen patients with DLD and 21 age-matched healthy individuals completed a 6-week program of VR skateboarding training. The motion capture and force platform systems were synchronized to collect data during a single-leg stance test (SLST). Musculoskeletal simulation was utilized to calculate muscle force based on the data. Four functional performance tests were conducted to evaluate the improvement after the training. A Visual Analogue Scale (VAS) was also employed for pain assessment. Results: After the training, pain intensity significantly decreased in patients with DLD (p = 0.024). Before the training, patients with DLD took longer than healthy individuals on the five times sit-to-stand test (p = 0.024). After the training, no significant between-group differences were observed in any of the functional performance tests (p > 0.05). In balance, patients with DLD were similar to healthy individuals after the training, except that the mean frequency (p = 0.014) was higher. Patients with DLD initially had higher biceps femoris force demands (p = 0.028) but shifted to increased gluteus maximus demand after the training (p = 0.037). Gluteus medius strength significantly improved in patients with DLD (p = 0.039), while healthy individuals showed consistent muscle force (p > 0.05). Conclusion: This is the first study to apply the novel VR skateboarding training to patients with DLD. VR skateboarding training enabled patients with DLD to achieve the training effects in a posture that relieves lumbar spine pressure. The results also emphasized the significant benefits to patients with DLD, such as reduced pain, enhanced balance, and improved muscle performance. [ABSTRACT FROM AUTHOR]

Les Mills BODYPUMPTM is a resistance training group exercise class with a low load, high repetition format. Squat training in BODYPUMPTM has two key variables: depth and load. The study aim was to determine the effect of these parameters on the mean and peak EMG amplitude of vastus lateralis, gluteus maximus, biceps femoris and lateral gastrocnemius. Ten female BODYPUMPTM participants (age 41 ± 9 years, height 161.9 ± 3.8 cm, mass 67.7 ± 7.0 kg) performed 1 × 7 squats under four conditions, representing every combination of two depths (90° knee angle and 125° knee angle) and two loads (23% bodyweight and 38% bodyweight). The main effect of depth was significant for mean and peak activity of vastus lateralis and gluteus maximus, and peak activity of biceps femoris and lateral gastrocnemius. The main effect of load was significant for mean and peak activity of gluteus maximus and lateral gastrocnemius. There was no depth * load interaction. These data can be used to inform BODYPUMPTM programme design and amplify the training effect of participation in group exercise classes. [ABSTRACT FROM AUTHOR]