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Exogenous nitrate ingestion can improve exercise performance. This study investigated whether an isotonic beetroot drink could improve jump and sprint performance in active individuals. Twenty-three physically active participants (17 males, 6 females) (mean ± SD; age: 26 ± 4 years; body mass index: 22.4 ± 1.9 kg/m2) completed a double-blind, randomized, cross-over study where they consumed 570mL of either beetroot juice drink (BR) or isotonic beetroot juice drink (ISO-BR) three hours before performing countermovement (CMJ) and standing broad jump (SBJ) tests and a 30-second all-out sprint on a cycle ergometer. Both drinks contained equal nitrate (12.9 mmol) and carbohydrate (6.1g per 100mL) content but differed in osmolality (BR: 420 mOsm/kg vs. ISO-BR: 315 mOsm/kg). Salivary total nitrate and nitrite concentrations (NOx) 3 hours post-ingestion were significantly higher after consuming ISO-BR than BR. ISO-BR significantly improved peak power output compared to BR by 3.9% (ISO-BR: 11.4 ± 2.5 W/kg vs. BR: 11.0 ± 2.3 W/kg, p =.04) but not time to peak power (ISO-BR: 2.8 ± 1.7 s vs. BR: 2.9 ± 1.6 s, p =.62) or mean power output (ISO-BR: 7.3 ± 1.5 W/kg vs. BR: 7.3 ± 1.5 W/kg, p =.37). There were no significant differences in CMJ or SBJ between trials (p >.05). Sensory evaluation indicated that ISO-BR was preferred by 91% (n = 21) of participants compared with BR (average score; ISO-BR: 5.52 vs. BR: 3.52, p <.05). An ISO-BR drink improved peak power output during sprint cycling but not jump performance compared with BR alone, potentially via increased NOx. [ABSTRACT FROM AUTHOR]

Context: Hip muscle strength and hop performance limb symmetries after anterior cruciate ligament reconstruction (ACLR) are not well studied. This study aimed to determine the differences in hip abductors' (ABD) and external rotators' (ER) muscle strength measures between limbs, and the relationship between hip ABD and ER muscle strengths and hop performance limb symmetry indices (LSIs) 2 years after ACLR. Design: Cross-sectional study. Methods: Forty (level I/II) men athletes 2 years after unilateral ACLR completed 4 single-legged hop tests and involved hip ABD and ER strength testing (maximum voluntary isometric contraction [MVIC]; isokinetic peak torque [PKTQ] at 60°, 180°, and 300°/s; and isotonic peak velocity at 75% of their MVICs). Muscle strength measures were normalized to body mass, and hop performances were reported as LSIs. Paired t test was used to determine strength differences between limbs, and the Pearson correlation coefficient was used to assess the relationship between involved hip muscle strength measures and hop performance LSIs. Results: Hip ER-MVIC (involved: 60.26 [12.01], uninvolved: 63.68 [13.17] N·m/kg) and ER eccentric PKTQ at 60°/s (involved: 32.59 [9.28]; uninvolved: 35.73 [10.50] N·m/kg) were significantly different between limbs (P ≤.018). Single-hop LSI correlated with hip ER-PKTQ at 180°/s (r =.354) and 300°/s (r =.324, P ≤.041), while triple-hop LSI correlated with hip ER-MVIC (r =.320), concentric ER-PKTQ at 180°/s (r =.355), eccentric ER-PKTQ at 60°/s (r =.314), and hip ABD-PKTQ at 60°/s (r =.364) and 300°/s (r =.336, P ≤.049). Conclusions: Men athletes demonstrated symmetrical hop performance and hip muscle strengths, except for ER hip's MVIC and isokinetic eccentric peak torque at 60°/s 2 years after ACLR. Hop performance LSIs had a few, yet positive moderate relationships with involved hip ABDs and ER strength measures. This may indicate that hip ABD and ER muscle strength measures contribute to athletes' hop performances 2 years after ACLR. Post-ACLR rehabilitation programs might incorporate hip muscle strengthening training to improve athletes' functional performances. [ABSTRACT FROM AUTHOR]

Eccentric quasi-isometric (EQI) contractions (maintaining a yielding contraction for as long as possible, beyond task failure) have gained interest in research and applied settings. However, little is known regarding the biomechanical profile of EQIs. Fourteen well-trained males performed four maximal effort knee-extensor EQIs, separated by 180 seconds. Angular impulse, velocity, and time-under-tension through the 30–100º range of motion (ROM), and in eight ROM brackets were quantified. Statistical parametric mapping, analyses of variance, and standardised effects (Hedges' g (ES), %Δ) detected between-contraction joint-angle-specific differences in time-normalised and absolute variables. Mean velocity was 1.34º·s−1 with most (62.5 ± 4.9%) of the angular impulse imparted between 40–70º. Most between-contraction changes occurred between 30–50º (p≤ 0.067, ES = 0.53 ± 0.31, 60 ± 52%), while measures remained constant between 50–100º (= 0.069–0.83, ES = 0.10 ± 0.26, 14.3 ± 24.6%). EQIs are a time-efficient means to impart high cumulative mechanical tension, especially at short to medium muscle lengths. However, angular impulse distribution shifts towards medium to long muscle lengths with repeat contractions. Practitioners may utilise EQIs to emphasize the initial portion of the ROM, and limit ROM, or apply EQIs in a fatigued state to emphasize longer muscle lengths. [ABSTRACT FROM AUTHOR]

ObjectiveThe objective of this study was to evaluate the efficacy and safety of isotonic and hypotonic intravenous fluids in maintenance fluid therapy for term infants.MethodsThis was a multi-centre, prospective, observational study conducted in 21 participating centres from December 30, 2020, to June 30, 2023. The study included term newborns requiring parenteral fluid therapy for maintenance (NCT04781361). The fluid treatment was divided into two groups based on the concentration of sodium in the parenteral fluid, designated as hypotonic (NaCl 145 mmol/L), and the occurrence of clinically significant changes in sodium levels (∆pNa >0.5 mmol/L/h).ResultsA total of 420 patients from 21 centers were included. The ∆pNa was negative in the hypotonic fluid group and positive in the isotonic fluid group, with a significant difference between the groups [respectively −0.07 ± 0.03 (95% CI: −0.13 to −0.02); 0.04 ± 0.03 (95%CI: −0.02 to 0.09), p = 0.04]. There was no difference between the groups in terms of the development of hypernatremia or a clinically meaningful pNa increase. The hypotonic fluid group had a higher incidence of hyponatremia and a clinically meaningful sodium decrease compared to the isotonic fluid group [7.9% vs. 1.2% (OR:6.5, p:0.03)] and [12.2% vs.4.2% (OR:2.9, p = 0.03)].ConclusionContrary to current understanding, this large-scale study is the first to demonstrate that the use of hypotonic fluids in maintenance fluid therapy for newborns poses a risk of hyponatremia development, whereas isotonic fluid therapy appears safe.

Introduction: Quadriceps weakness after knee surgery is the most common consequence that can have different consequences not only for the knee itself but also for the locomotor system in general. This study aimed to compare the results of isokinetic and isotonic exercise on torque restoration quadriceps on knee surgery. Methods: A sample of 180 subjects was analyzed and divided into two subsamples according to the type of rehabilitation protocol that was implemented. The examined group A-isokinetic consisted of 90 male subjects aged 28.54 ± 4.44 years, with a rehabilitation protocol based on the isokinetic exercise of the quadriceps. The examined group B-isotonic also consisted of 90 male subjects aged 27.93 ± 4.27 years, with a rehabilitation protocol for strengthening the quadriceps that applied an exercise program with additional resistance, i.e., isotonic exercise in the gym. Before the start of the rehabilitation treatment, an initial isokinetic test was performed at an angular speed of 60 °/s in all subjects. After 3 and 6 weeks of rehabilitation treatment, the control tests were performed in the same way as in the initial test. Results: Based on the values of MANOVA analysis and discriminative analysis, significantly better results of isokinetic tests were found in the examined group A-isokinetic compared with those in the examined group B-isotonic. At the final measurement of group A, 83 respondents (92.2%) were placed in the "biggest" class out of the 90 respondents. Conclusion: Based on the obtained research results, we conclude that isokinetic exercise is more effective in terms of physiotherapy of quadriceps hypotrophy after knee surgery. [ABSTRACT FROM AUTHOR]

Abstract Background Transient progressive weakness and disability of lower limb during the early stage after TKR will increase the risk of fall, but the superior postoperative strength training mode have not been elucidated for functional restoration. This study aimed to compare whether the isokinetic lower limb training is superior to either isotonic or home isometric exercise during early stage after TKR in older people. Methods A total of 43 recruited old participants (mean age, 68.40 years old) receiving TKR were divided randomly based on the different four-week training modes into three groups including isokinetic, isotonic, and home isometric exercise (control group). The primary outcome was set as functional performance in terms of Timed Up and Go (TUG) test and the secondary outcomes include the peak torque of knee at 60 and 120 degree/ second, Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis index (WOMAC). Results All of the peak torque measurements of the knee improved significantly in both the isokinetic and the isotonic group, but not in the control group. Although isotonic training resulted in more strength gains, a significant enhancement in TUG test was observed in the isokinetic group only (p = 0.003). However, there were no significantly improvement of TUG test after training in other two groups. SF-36 and WOMAC improved after training in all three groups, with no significant difference in the degree of improvement between groups. Conclusion Isokinetic training for 4 weeks following TKR effectively improved all the outcome parameters in this study, including the TUG test, lower limb strength, and functional scores. However, both isokinetic and isotonic training modes could be recommended after TKR because of no significant difference in the degree of improvement between these two groups. Trial registration Clinical trial registration number: NCT02938416. Level of evidence I

Background: Transient progressive weakness and disability of lower limb during the early stage after TKR will increase the risk of fall, but the superior postoperative strength training mode have not been elucidated for functional restoration. This study aimed to compare whether the isokinetic lower limb training is superior to either isotonic or home isometric exercise during early stage after TKR in older people. Methods: A total of 43 recruited old participants (mean age, 68.40 years old) receiving TKR were divided randomly based on the different four-week training modes into three groups including isokinetic, isotonic, and home isometric exercise (control group). The primary outcome was set as functional performance in terms of Timed Up and Go (TUG) test and the secondary outcomes include the peak torque of knee at 60 and 120 degree/ second, Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis index (WOMAC). Results: All of the peak torque measurements of the knee improved significantly in both the isokinetic and the isotonic group, but not in the control group. Although isotonic training resulted in more strength gains, a significant enhancement in TUG test was observed in the isokinetic group only (p = 0.003). However, there were no significantly improvement of TUG test after training in other two groups. SF-36 and WOMAC improved after training in all three groups, with no significant difference in the degree of improvement between groups. Conclusion: Isokinetic training for 4 weeks following TKR effectively improved all the outcome parameters in this study, including the TUG test, lower limb strength, and functional scores. However, both isokinetic and isotonic training modes could be recommended after TKR because of no significant difference in the degree of improvement between these two groups. Trial registration: Clinical trial registration number: NCT02938416. Level of evidence: I [ABSTRACT FROM AUTHOR]

Background: Iatrogenic hyponatremia is a common complication following intravenous maintenance fluid therapy (IV-MFT) in hospitalized children. Despite the American Academy of Pediatrics' 2018 recommendations, IV-MFT prescribing practices still vary considerably. Objectives: This meta-analysis aimed to compare the safety and efficacy of isotonic versus hypotonic IV-MFT in hospitalized children. Data sources: We searched PubMed, Scopus, Web of Science, and Cochrane Central from inception to October 1, 2022. Study eligibility criteria: We included randomized controlled trials (RCTs) comparing isotonic versus hypotonic IV-MFT in hospitalized children, either with medical or surgical conditions. Our primary outcome was hyponatremia following IV-MFT. Secondary outcomes included hypernatremia, serum sodium, serum potassium, serum osmolarity, blood pH, blood sugar, serum creatinine, serum chloride, urinary sodium, length of hospital stay, and adverse outcomes. Study appraisal and synthesis methods: Random-effects models were used to pool the extracted data. We performed our analysis based on the duration of fluid administration (i.e., ≤ 24 and > 24 h). The Grades of Recommendations Assessment Development and Evaluation (GRADE) scale was used to evaluate the strength and level of evidence for recommendations. Results: A total of 33 RCTs, comprising 5049 patients were included. Isotonic IV-MFT significantly reduced the risk of mild hyponatremia at both ≤ 24 h (RR = 0.38, 95% CI [0.30, 0.48], P < 0.00001; high quality of evidence) and > 24 h (RR = 0.47, 95% CI [0.37, 0.62], P < 0.00001; high quality of evidence). This protective effect of isotonic fluid was maintained in most examined subgroups. Isotonic IV-MFT significantly increased the risk of hypernatremia in neonates (RR = 3.74, 95% CI [1.42, 9.85], P = 0.008). In addition, it significantly increased serum creatinine at ≤ 24 h (MD = 0.89, 95% CI [0.84, 0.94], P < 0.00001) and decreased blood pH (MD = –0.05, 95% CI [–0.08 to –0.02], P = 0.0006). Mean serum sodium, serum osmolarity, and serum chloride were lower in the hypotonic group at ≤ 24 h. The two fluids were comparable in terms of serum potassium, length of hospital stay, blood sugar, and the risk of adverse outcomes. Limitations: The main limitation of our study was the heterogeneity of the included studies. Conclusions and implications of key findings: Isotonic IV-MFT was superior to the hypotonic one in reducing the risk of iatrogenic hyponatremia in hospitalized children. However, it increases the risk of hypernatremia in neonates and may lead to renal dysfunction. Given that the risk of hypernatremia is not important even in the neonates, we propose to use balanced isotonic IV-MFT in hospitalized children as it is better tolerated by the kidneys than 0.9% saline. Systematic review registration number: CRD42022372359. [ABSTRACT FROM AUTHOR]

IntroductionQuadriceps weakness after knee surgery is the most common consequence that can have different consequences not only for the knee itself but also for the locomotor system in general. This study aimed to compare the results of isokinetic and isotonic exercise on torque restoration quadriceps on knee surgery.MethodsA sample of 180 subjects was analyzed and divided into two subsamples according to the type of rehabilitation protocol that was implemented. The examined group A-isokinetic consisted of 90 male subjects aged 28.54 ± 4.44 years, with a rehabilitation protocol based on the isokinetic exercise of the quadriceps. The examined group B-isotonic also consisted of 90 male subjects aged 27.93 ± 4.27 years, with a rehabilitation protocol for strengthening the quadriceps that applied an exercise program with additional resistance, i.e., isotonic exercise in the gym. Before the start of the rehabilitation treatment, an initial isokinetic test was performed at an angular speed of 60 °/s in all subjects. After 3 and 6 weeks of rehabilitation treatment, the control tests were performed in the same way as in the initial test.ResultsBased on the values of MANOVA analysis and discriminative analysis, significantly better results of isokinetic tests were found in the examined group A-isokinetic compared with those in the examined group B-isotonic. At the final measurement of group A, 83 respondents (92.2%) were placed in the “biggest” class out of the 90 respondents.ConclusionBased on the obtained research results, we conclude that isokinetic exercise is more effective in terms of physiotherapy of quadriceps hypotrophy after knee surgery.

The purpose of this investigation was to examine neuromuscular function, muscle fatigue, rating of perceived exertion (RPE), and muscle swelling between isokinetic and isotonic leg extensions with blood flow restriction (BFR). Fourteen (21 ± 2years; 160cm ± 3.8; 61kg ± 9.1) trained women performed 75 (1 × 30,3 × 15) submaximal (30% of maximal strength), unilateral, isokinetic and isotonic leg extensions with BFR (60% of total arterial occlusion pressure). Before and after exercise, subjects performed maximal voluntary isometric contractions (MVIC) and muscle thickness (MT) was assessed with ultrasound. RPE was recorded across all sets and surface electromyography (EMG) was assessed during the MVIC muscle actions. Separate repeated measures ANOVAs were used to examine MVIC, MT, RPE and neuromuscular function. There were greater reductions in MVIC torque and EMG mean power frequency following isotonic (46.2 ± 17.1%; 16.4 ± 7.9%) than isokinetic (17.9 ± 10.9%;6.5 ± 6.3%). RPE was also higher during isotonic (7.5 ± 2.2), than isokinetic (5.7 ± 1.9). There were no differences in EMG amplitude or MT increases (20 ± 2.1%) between conditions. Isotonic BFR elicited greater fatigue-induced decreases in muscular strength and greater RPE than isokinetic BFR, but similar MT and muscle excitation responses for both conditions. Therefore, both isokinetic and isotonic may induce similar acute physiological responses, but isotonic BFR was associated with greater muscle fatigue and perceived effort. Highlights Exercise modality affects the fatigue and perceptual responses when applying blood flow restriction. Despite greater utility, isotonic blood flow restriction was associated greater fatigue and perceived effort. Isotonic and isokinetic blood flow restriction elicited comparable neural changes. [ABSTRACT FROM AUTHOR]

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Maintaining an adequate fluid balance is crucial during extended physical activity. It is currently unknown how drinking an isotonic medinilla speciosa beverage affects the autonomic regulation of heart function during and after exercise. The purpose of this study is to examine how drinking isotonic beverages affects heart rate variability (HRV) during and after intense exercise. A maximal exercise test to assess protocol loading, a control group, and an experimental group were all carried out by twenty-one young man (19.3 ± 1.2 years) over the course of three distinct protocols, with a 48-hour break in between each stage. The protocol called for 10 minutes of rest with the subject lying down, 90 minutes of treadmill work at 70% of one's maximum oxygen uptake, and 60 minutes of rest in the dorsal decubitus position. In the control group, no rehydration beverages could be consumed. No matter the level of hydration, alterations in the sympathetic nervous system (SNS) and the parasympathetic nervous system (PSNS) were seen, showing an increase in the former and a reduction in the latter. Hydration with isotonic solutions during recovery causes considerable alterations in cardiac autonomic regulation, hastening the recovery of the linear HRV index. Exerciseinduced HRV was not significantly impacted by isotonic hydration, however it does speed up the recovery of linear indices after exercise. [ABSTRACT FROM AUTHOR]

Underlying the dawn of humanity was primarily the search for food and access to drinking water. Over the course of civilization, there has been a significant increase in drinking water quality. By the average of the nutritional standards, the daily water demand is 2.5 L (also including liquid products such as tea, coffee, or soup). However, it is worth noticing that the need is strictly individual for each person and depends on two major factors, namely, epidemiological (sex, age state of health, lifestyle, and diet) and environmental (humidity and air temperature). Currently, our diet is more and more often enriched with isotonic drinks, functional drinks, or drinks bearing the hallmarks of health-promoting products. As a result, manufacturing companies compete to present more interesting beverages with complex compositions. This article will discuss both the composition of functional beverages and their impact on health. [ABSTRACT FROM AUTHOR]

Fatigue in muscles is a reason for the low skill performance of soccer players so this study sought to find out the effect of the quadriceps muscle fatigue resulting from an isotonic contraction on some kinematic variables and the accuracy of soccer players’ execution of the corner kick. A test for the accuracy of the corner kick and the leg press exercise was used on a sample of 8 international soccer players, and their means were as follows: age: 26.8 ± 2.3 years, height: 174 ± 12 cm, mass: 71 ± 6 kg, training age: 14.6 ± 1.8 years. The performance of the corner kick test was videotaped by three cameras and Kinovea program for kinematic analysis was used. The results showed a negative effect of the quadriceps muscle fatigue after isotonic contractions on kinematic variables and on the accuracy of corner kicks. The study results point to the necessity of enhancing the ability of soccer players in terms of endurance of muscle strength in the quadriceps muscle to the highest possible extent due to the importance of that element in their skillful performance, including the accuracy of the implementation of corner kicks.

Introduction: Muscle synergy is regarded as a motor control strategy deployed by the central nervous system (CNS). Clarifying the modulation of muscle synergies under different strength training modes is important for the rehabilitation of motor-impaired patients. Methods: To represent the subtle variation of neuromuscular activities from the smaller forearm muscles during wrist motion, we proposed to apply muscle synergy analysis to preprocessed high-density electromyographic data (HDEMG). Here, modulation of muscle synergies within and across the isometric and isotonic training modes for strengthening muscles across the wrist were investigated. Surface HDEMGs were recorded from healthy subjects (N = 10). Three different HDEMG electrode configurations were used for comparison and validation of the extracted muscle synergies. The cosine of principal angles (CPA) and the Euclidian distance (ED) between synergy vectors were used to evaluate the intra- and inter-mode similarity of muscle synergies. Then, how the activation coefficients modulate the excitation of specific synergy under each mode was examined by pattern recognition. Next, for a closer look at the mode-specific synergies and the synergies shared by the two training modes, k-means clustering was applied. Results: We observed high similarity of muscle synergies across different tasks within each training mode, but decreased similarity of muscle synergies across different training modes. Both intra- and intermode similarity of muscle synergies were consistently robust to electrode configurations regardless of the similarity metric used. Discussion: Overall, our findings suggest that applying muscle synergy analysis to HDEMG is feasible, and that the traditional muscle synergies defined by whole-muscle components may be broadened to include sub-muscle components represented by the HDEMG channels. This work may lead to an appropriate neuromuscular analysis method for motor function evaluation in clinical settings and provide valuable insights for the prescription of rehabilitation training therapies. [ABSTRACT FROM AUTHOR]

The purpose was to test whether inducing post-activation potentiation (PAP) altered motor unit (MU) activity during dynamic isotonic contractions. From 12 participants (3 females), 39 MUs were recorded from the anconeus (n=31) and lateral triceps brachii (n=8) with fine-wire electrodes during elbow extensions at 50 and 75% of peak power with, and without PAP. To induce PAP participants produced a 2s ramp conditioning contraction (CC) up to maximal isometric elbow extension with a 3s hold. Following the CC (~2s), independent electrical stimulation to the triceps and anconeus showed twitch torques were potentiated by 84 and 66%, respectively, (both p<0.001). Compared to baseline (i.e., without PAP), at both intensities (50 and 75%) PAP increased MU recruitment thresholds (40% and 80%, p<0.001) with lowered mean MU rates (-20 and -26%), and instantaneous rates at recruitment threshold (-26 and -25%) (all p<0.001). Firing rates increased 20% (p<0.001) from 50 to 75% power, but rates during potentiated contractions targeting 75% were lower than baseline at 50% (-10%, p<0.001). Dynamic contractions provide a more functional paradigm to assess MU activity with PAP and showed larger effects across a wider range of contractile intensities compared to previously described isometric tasks. Findings indicate that peripheral feedback from the potentiated muscle is likely not the primary mechanism in modifying MU behaviors as changes occurred at recruitment which is relatively insensitive to afferent feedback. Therefore, MU activity during dynamic contractions is responsive to activation history force potentiation and can make compensatory adjustments to optimize contractile output.

Objective: The objective of this study was to evaluate the efficacy and safety of isotonic and hypotonic intravenous fluids in maintenance fluid therapy for term infants., Methods: This was a multi-centre, prospective, observational study conducted in 21 participating centres from December 30, 2020, to June 30, 2023. The study included term newborns requiring parenteral fluid therapy for maintenance (NCT04781361). The fluid treatment was divided into two groups based on the concentration of sodium in the parenteral fluid, designated as hypotonic (NaCl <130 mmol/L) and isotonic (NaCl = 130-154 mmol/L). The primary outcomes were the change in mean plasma sodium (pNa) levels per hour (∆pNa mmol/L/h), the incidence of hyponatremia (pNa <135 mmol/L) and hypernatremia (pNa >145 mmol/L), and the occurrence of clinically significant changes in sodium levels (∆pNa >0.5 mmol/L/h)., Results: A total of 420 patients from 21 centers were included. The ∆pNa was negative in the hypotonic fluid group and positive in the isotonic fluid group, with a significant difference between the groups [respectively -0.07 ± 0.03 (95% CI: -0.13 to -0.02); 0.04 ± 0.03 (95%CI: -0.02 to 0.09), p  = 0.04]. There was no difference between the groups in terms of the development of hypernatremia or a clinically meaningful pNa increase. The hypotonic fluid group had a higher incidence of hyponatremia and a clinically meaningful sodium decrease compared to the isotonic fluid group [7.9% vs. 1.2% (OR:6.5, p:0.03)] and [12.2% vs.4.2% (OR:2.9, p  = 0.03)]., Conclusion: Contrary to current understanding, this large-scale study is the first to demonstrate that the use of hypotonic fluids in maintenance fluid therapy for newborns poses a risk of hyponatremia development, whereas isotonic fluid therapy appears safe., 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., (Copyright © 2024 Ozkan, Duman, Tuzun, Narter, Akyildiz, Altuncu, Satar, Ozdemir, Kurt, Tugcu, Konak, Uygun, Yilmaz Semerci, Dikmen, Baysal, Zeybek, Kostekci, Sahin, Tutal, Anik, Buyuktiryaki, Karagol, Tunç, Colak, Cetin, Orman, Olukman, Deveci, Sarici, Cakir and Keskinoglu.)

Background: Rebuilding the strength of the quadriceps as soon as possible after total knee replacement (TKR) is important so as to restore gait stability. To date, there are no standard postoperative strength training programs during the early recovery stage after TKR. Purpose: To compare the therapeutic effects between isokinetic and isotonic strengthening in patients after TKR. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: From April 2018 to August 2020, 37 patients met the inclusion criteria and were randomly assigned to perform either 4-week isokinetic or isotonic strength training programs. Other components of the rehabilitation program were kept the same between the 2 groups. All cases were evaluated by the Timed Up and Go (TUG) test, peak torque of knee extension and flexion (60 and 120 deg/s), 36-item Short Form Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Results: After undergoing a 4-week strength training regimen, significant improvements in the TUG test were noted in both groups; however, the time improvement in the isotonic group did not reach the minimal detectable change. All peak torque measurements improved in the isokinetic group but not in the isotonic group for knee flexion at 60 deg/s. The pain subdomain, physical domain, mental domain, total SF-36 score, and WOMAC index all improved significantly in both groups after training. Both training groups improved significantly in peak torque of knee strength, TUG test, and functional scores, but the differences between isokinetic and isotonic training were not statistically significant. Conclusion: The study findings showed that a 4-week strengthening exercise program in the early postoperative stage, involving either isokinetic or isotonic training, resulted in significant improvements in patients undergoing TKR. Registration: NCT02938416 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

Nowadays, the sector of isotonic beverages has developed its market based on fruit juices that provide a sports drink with antioxidant and biological activities in addition to their principal role of rehydration and replacement of minerals and carbohydrates during physical exercise. Consumption of grape juice is increasing worldwide because of its sensory characteristics and nutritional value. It contains mainly water, sugars, organic acids, and phenolic compounds. Phenolic compounds play a major role in prevention of various diseases through their biological activities linked to antioxidant, anti-inflammation, anticancer, anti-aging, antimicrobial, and cardioprotective properties. Several studies have demonstrated that grape juice is able to improve performances of antioxidant activity, protect against oxidative damage, and reduce inflammation during sports activities. Polyphenol content also provides a great sensory profile, mainly color which is an important indicator for consumers when choosing beverage products. The contribution of grape juice through its nutritional value and sensory properties makes it an alternative for the development of a new isotonic drink that will be a novel and healthy product in the field of healthy beverages.

Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal conditions of the upper extremity with pain and wrist extension disability. The tendon which is most affected is the extensor carpi radialis brevis (ECRB). Previous study evaluated the effect of taping technique on patient with LE, but no study investigated the changes of electromyography (EMG) on ECRB when using dynamic taping (DT) technique. Objects: The aim of this study was to investigate the effect of DT technique using dynamic tape on muscle activity of ECRB during wrist isometric extension, isotonic extension and flexion. Methods: Twenty-one healthy subjects volunteered to participate in this study. Subjects were instructed to perform wrist isometric extension, isotonic extension and flexion without and with DT on origin area of ECRB. Wrist isometric extension was performed at 75%, 50% and 25% (%maximal voluntary contraction force), respectively, based on maximum contraction force. Isotonic extension and flexion test used dumbbell. EMG data was collected from ECRB. Results: EMG of ECRB were statistically significant decrease in wrist isotonic extension after DT (p < 0.05). Significant increase in wrist isometric extension during 25% and 50% force task (p < 0.05). Conclusion: This study applied DT technique to suppress the wrist extensor muscles in 21 healthy adults in their twenties. Change in muscle activity was compared in the ECRB muscle during wrist isometric extension, isotonic extension and flexion task. Based on the results of this study, the DT technique applied to the wrist and forearm area can reduce the load on the wrist extensors when the wrist performs various movements during daily life movements or repetitive tasks, and by using these effects, excessive stress is applied to tennis elbow patients.

Underlying the dawn of humanity was primarily the search for food and access to drinking water. Over the course of civilization, there has been a significant increase in drinking water quality. By the average of the nutritional standards, the daily water demand is 2.5 L (also including liquid products such as tea, coffee, or soup). However, it is worth noticing that the need is strictly individual for each person and depends on two major factors, namely, epidemiological (sex, age state of health, lifestyle, and diet) and environmental (humidity and air temperature). Currently, our diet is more and more often enriched with isotonic drinks, functional drinks, or drinks bearing the hallmarks of health-promoting products. As a result, manufacturing companies compete to present more interesting beverages with complex compositions. This article will discuss both the composition of functional beverages and their impact on health.

Objective: We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions. Methods: The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test. Results: The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant (P ≤.001; P ≤.001; P ≤.001, and P =.048, respectively). Only Group A and Group B experienced a significant difference in nasal mucociliary clearance times (P ≤.001; P =.010, respectively). When the Sino-nasal Outcome Test-22 score and nasal mucociliary clearance time differences before and after treatment were compared between all groups, the Sino-Nasal Outcome Test-22 score difference was higher in Group A than in Groups B, C, and D, the differences were found as statistically significant (P =.010; P =.003; P ≤.001, respectively). The nasal mucociliary clearance time difference was higher in Group A than in Groups C and D, the differences were found as statistically significant (P =.010; P =.001, respectively). Conclusion: Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients. [ABSTRACT FROM AUTHOR]

Methods are proposed for spline estimation of monotone regression surfaces, without additivity assumptions and allowing for linear covariate effects. The surfaces are estimated by a continuous piecewise warped-plane spline with linear inequality constraints. Surface and covariate effects are estimated simultaneously with cone projection, leading to useful inference methods. For surfaces in two predictors, a cube-root convergence rate is attained, and conditions for square-root convergence of the linear terms are derived. Pointwise confidence intervals for the surfaces incorporate mixtures of covariance matrices, with the mixing parameters estimation by simulations. The methods are implemented in the R package cgam. [ABSTRACT FROM AUTHOR]

[Display omitted] The mechanics of collagenous soft tissues, such as skin, are sensitive to heat. Thus, quantifying and modeling thermo-mechanical coupling of skin is critical to our understanding of skin's physiology, pathophysiology, and its treatment. However, key gaps persist in our knowledge about skin's coupled thermo-mechanics. Among them, we haven't quantified the role of skin's microstructural organization in its response to superphysiological loading. To fill this gap, we conducted a comprehensive set of experiments in which we combined biaxial mechanical testing with histology and two-photon imaging under liquid heat treatment at temperatures ranging from 37 ∘ C to 95 ∘ C lasting between 2 seconds and 5 minutes. Among other observations, we found that unconstrained skin, when exposed to high temperatures, shrinks anisotropically with the principal direction of shrinkage being aligned with collagen's principal orientation. Additionally, we found that when skin is isometrically constrained, it produces significant forces during denaturation that are also anisotropic. Finally, we found that denaturation significantly alters the mechanical behavior of skin. For short exposure times, this alteration is reflected in a reduction of stiffness at high strains. At long exposure times, the tissue softened to a point where it became untestable. We supplemented our findings with confirmation of collagen denaturation in skin via loss of birefringence and second harmonic generation. Finally, we captured all time-, temperature-, and direction-dependent experimental findings in a hypothetical model. Thus, this work fills a fundamental gap in our current understanding of skin thermo-mechanics and will support future developments in thermal injury prevention, thermal injury management, and thermal therapeutics of skin. Our work experimentally explores how skin reacts to being heated. That is, it measures how much skin shrinks, what forces it produces, and how its mechanical properties change; all as a function of temperature, but also of direction and time. Additionally, our work connects these measurements to changes in skin's microscopic make-up. This knowledge is important to our understanding of skin's function and dysfunction, especially during burn injuries or heat-dependent treatments. [ABSTRACT FROM AUTHOR]

Hypotonic fluids have been traditionally used in newborns. National Institute for Health and Clinical Excellence-2015 (NICE) fluid therapy guideline recommends the use of isotonic fluids as maintenance fluid therapy in term newborns. However, there is no clear evidence supporting this recommendation. This study aims to compare isotonic (5% dextrose in 0.9% sodium chloride (NaCl)) and hypotonic (5% dextrose in 0.45% NaCl) parenteral fluid therapies in hospitalized term newborns with regard to changes in plasma Na (pNa) and complications related with fluid therapy. This was a retrospective cohort study performed in a tertiary university hospital NICU between January 2016 and April 2018. Term newborns who were initially isonatremic or mildly dysnatremic (pNa <130 or >155 meq/L) and receiving fluid therapy for maintenance or replacement therapy after 48th postnatal hours were eligible for the study. Infants having specific diagnoses requiring extraordinary fluids were excluded. The primary outcome evaluated was the change in mean plasma Na (ΔpNa meq/L/h) at 24 h or at the end of intravenous (i.v.) fluid therapy. Secondary outcomes evaluated were the risk of hyponatremia, hypernatremia, and adverse events attributable to fluid administration. Among the 108 included newborns, 57 received hypotonic fluid (5% dextrose solution in 0.45% NaCl) and the remaining received isotonic fluid (5% dextrose solution in 0.9% NaCl) therapy. The hypotonic fluid group showed a greater ΔpNa compared to the isotonic group (0.48 ± 0.28 vs. 0.27 ± 0.21 meq/L/h, p =.001). The risk of experiencing unsafe plasma Na decrease in the hypotonic fluid group (ΔpNa >0.5 meq/L/h) was higher than the isotonic fluid group (odd ratio: 8.46; 95% confidence interval (CI): 2.3–30.06). Six mildly hypernatremic babies between 48 and 72 h of postnatal age showed insufficient Na reduction despite the appropriate amount of fluid. No significant difference was found between the two groups in terms of other outcomes. The results of this study suggested that as maintenance or replacement fluid therapy in the newborn, hypotonic fluids, even 5% dextrose in 0.45% NaCl, can lead to unsafe plasma Na decreases in term newborns, while isotonic fluids are safe when started after the first few days of life. Although the results parallel NICE guidelines, before making recommendations regarding the removal of hypotonic fluids entirely from clinical practice in term newborns following the renal adaptation period; larger randomized controlled studies involving a wide range of babies are needed. [ABSTRACT FROM AUTHOR]

Hyponatraemia is a known complication in hospitalised children receiving maintenance intravenous fluid. Several studies have been published to investigate the efficacy and safety of intravenous fluids in children. However, there is still an ongoing debate regarding the ideal solution to be used in the paediatric population. Therefore, the aim of this meta-analysis was to investigate the safety and efficacy of administering isotonic versus hypotonic intravenous maintenance fluid in hospitalised children. An extensive search was undertaken on PubMed, Web of Science, Scopus, ScienceDirect, Google Scholar and Cochrane Library on 28 December 2020. Only randomised controlled trials (RCTs) were included. We used the random-effects model for all analyses. Risk ratio (RR) and mean difference with 95% confidence intervals (CIs) were used for dichotomous and continuous outcomes, respectively. The quality of each study was assessed using the Joanna Briggs Institute critical appraisal tool for RCTs. This study is registered with PROSPERO (CRD42021229067). Twenty-two RCTs with a total of 3795 participants were included. The studies encompassed surgical and medical patients admitted to intensive care unit as well as to general wards. We found that hypotonic fluid significantly increases the risk of hyponatremia at both ≤24 h (RR 0.34; 95% CI: 0.26–0.43, p < 0.00001) and >24 h (RR 0.48; 95% CI: 0.36–0.64, p < 0.00001). Isotonic fluid increases the risk of hypernatraemia at ≤24 h (RR 2.15; 95% CI: 1.24–3.73, p = 0.006). The prevalence of hyponatraemia was also higher in the hypotonic group at both ≤24 h (5.7% vs. 23.3%) and >24 h (6.0% vs. 26.3%). There was no statistically significant difference in the risk of developing adverse outcomes between the two groups. Mean serum and urine sodium as well as serum osmolality/osmolarity was lower in the hypotonic group. Isotonic solution is protective against the development of hyponatraemia while hypotonic solution increases the risk of hyponatraemia. [ABSTRACT FROM AUTHOR]

Continuous flow enteral fluid therapy with isotonic and hypotonic enteral electrolyte solutions are as safe and effective as intravenous fluid therapy. The aim of this study was to carry out a comparative assessment between continuous flow enteral and intravenous (IV) fluid therapy in adult experimentally dehydrated horses. Six experimentally dehydrated adult mares were used in a study carried out in a 6 × 3 crossover design, which each animal received three different treatments (isotonic enteral fluid therapy—EsISO, hypotonic enteral fluid therapy—EsHYPO and intravenous fluid therapy with Lactate Ringer Solution—LR IV, all in continuous flow). Solutions were administered at a rate of 15 mL−1.kg−1.h−1 for 8 h, after 36 h of water and food deprivation. Serum and urinary biochemical assessment; urinary volume, pH and specific gravity; and blood gas analysis were measured at −36, 0, 2, 4, 6, and 8 h. The dehydration period (DP) caused discrete hydroelectrolytic and acid base imbalances. The EsISO, EsHYPO and LR IV increased blood volume. Enteral solutions restored the imbalances yielded by the DP and all treatments increased urine volume. Also, the EsHYPO and LR IV showed no effects in acid base balance, while EsISO showed slightly acidifying effect. The present study certifies the efficacy and safety of isotonic and hypotonic continuous flow enteral fluid therapy in comparison to IV fluid therapy in dehydrated horses.

In the face of climate change, water deficit and increasing soil salinity pose an even greater challenge to olive cultivation in the Mediterranean basin. Due to its tolerance to abiotic stresses, wild olive (Olea europaea subsp. europaea var. sylvestris) presents a good candidate in breeding climate-resilient olive varieties. In this study, the early response of the native Croatian wild olive genotype (WOG) to salinity was evaluated and compared with that of well-known cultivars (cv.) Leccino and Koroneiki. Potted olive plants were exposed either to 150 mM NaCl or 300 mM mannitol for 3 weeks to distinguish between the osmotic and ionic components of salt stress. To determine the impact of the plant age on salinity, 1-, 2-, and 3-year-old WOG plants were used in the study. The growth parameters of both the cultivars and WOG of different ages decreased in response to the mannitol treatment. In contrast to cv. Leccino, the NaCl treatment did not significantly affect the growth of cv. Koroneiki or WOG of any age. The contents of Na+ and Cl− were considerably higher in the salt-treated WOG, regardless of age, compared with the cultivars. However, while both treatments significantly reduced the K+ content of cv. Koroneiki, that nutrient was not significantly affected in either cv. Leccino or WOG. Unlike the cultivars and older WOG, the NaCl treatment caused a significant decline of photosynthetic pigments in the 1-year-old WOG. The cultivars and WOG of different ages experienced a similar drop in the chlorophyll a content under the isotonic mannitol treatment. The absence of lipid peroxidation, modulation of superoxide dismutase, and guaiacol peroxidase activity were noted in all WOG ages under both stressors. These data suggest that WOG resilience to salinity is associated with its large leaf capacity for Na+ and Cl− accumulation, K+ retention, and its adaptable antioxidative mechanisms. The results are promising with regard to obtaining a new olive cultivar with better resilience to soil salinity.

In the face of climate change, water deficit and increasing soil salinity pose an even greater challenge to olive cultivation in the Mediterranean basin. Due to its tolerance to abiotic stresses, wild olive (Olea europaea subsp. europaea var. sylvestris) presents a good candidate in breeding climate-resilient olive varieties. In this study, the early response of the native Croatian wild olive genotype (WOG) to salinity was evaluated and compared with that of well-known cultivars (cv.) Leccino and Koroneiki. Potted olive plants were exposed either to 150 mM NaCl or 300 mM mannitol for 3 weeks to distinguish between the osmotic and ionic components of salt stress. To determine the impact of the plant age on salinity, 1-, 2-, and 3-year-old WOG plants were used in the study. The growth parameters of both the cultivars and WOG of different ages decreased in response to the mannitol treatment. In contrast to cv. Leccino, the NaCl treatment did not significantly affect the growth of cv. Koroneiki or WOG of any age. The contents of Na+ and Cl− were considerably higher in the salt-treated WOG, regardless of age, compared with the cultivars. However, while both treatments significantly reduced the K+ content of cv. Koroneiki, that nutrient was not significantly affected in either cv. Leccino or WOG. Unlike the cultivars and older WOG, the NaCl treatment caused a significant decline of photosynthetic pigments in the 1-year-old WOG. The cultivars and WOG of different ages experienced a similar drop in the chlorophyll a content under the isotonic mannitol treatment. The absence of lipid peroxidation, modulation of superoxide dismutase, and guaiacol peroxidase activity were noted in all WOG ages under both stressors. These data suggest that WOG resilience to salinity is associated with its large leaf capacity for Na+ and Cl− accumulation, K+ retention, and its adaptable antioxidative mechanisms. The results are promising with regard to obtaining a new olive cultivar with better resilience to soil salinity. [ABSTRACT FROM AUTHOR]

Background and aims: Increased capillary filtration may paradoxically accelerate vascular refill of both fluid and albumin from the interstitial space, which is claimed to be edema-preventing. We characterized this proposed mechanism, called "interstitial washdown", by kinetic analyses of the hemodilution induced by intravenous infusion of crystalloid fluid during 3 distinct physiological states. Methods: Greater plasma dilution of hemoglobin as compared to albumin during fluid therapy indicated recruitment of albumin, which was compared to the flow of interstitial fluid to the plasma as indicated by population volume kinetic analysis. Data for the comparison were derived from 24 infusions of crystalloid fluid in conscious volunteers, 30 in anesthetized patients, and 31 in patients with ketoacidosis from hyperglycemia. Results: "Interstitial washdown" increased the plasma albumin concentration by between 0.3 and 1.0 g/L in the three series of infusions. The initial albumin concentration in the interstitial fluid returning to the plasma was estimated to between 22 g/L and 29 g/L, which decreased to an average of 50–75% lower during the subsequent 2–3 h. Kinetic simulations show that pronounced washdown was associated with increased capillary filtration (high k12) and, in conscious subjects, with greater plasma and interstitial volume expansion and restricted urine flow. During anesthesia, the main effect was an increase in the non-exchangeable fluid volume ("third-spacing"). Conclusions: Crystalloid fluid accelerates lymphatic flow that moderately increases plasma albumin, but more clearly helps to maintain the intravascular volume. This "interstitial washdown" mechanism becomes exhausted after a few hours. [ABSTRACT FROM AUTHOR]

Porcine epidemic diarrhea virus (PEDV) causes immensely large economic losses worldwide in the swine industry. PEDV attacks the intestine, disrupts intestinal epithelium morphology and barrier integrity, and results in profound diarrhea and high mortality. A commercially available isotonic protein solution (IPS) (Tonisity Px) has anecdotally been reported to be effective in supportive treatment of piglets with active PEDV infections. This study evaluated the effects of supplementing (or not) the drinking water of 14 day old PEDV-infected piglets with the IPS on the content of E-cadherin, fibronectin, interferon-alpha (IFN-α), and matrix metalloproteinase 9 (MMP-9) in duodenal tissue. The content of PEDV DNA in feces was also measured. Though both groups had similar PEDV shedding at day 1, IPS piglets had significantly lower PEDV shedding at day 5, 14 and 21. The IPS group also had a shorter duration of PEDV virus shedding. Levels of E-cadherin and fibronectin, both of which are structural proteins in the intestine, remained unchanged from baseline in the IPS group, whereas the same molecules decreased significantly in the control group. IFN-α, an antiviral cytokine, and MMP-9, an enzyme that aids in tissue remodeling, were increased at days 5 and 14 post infection, and then decreased at day 21 post-infection in the IPS group compared to control. Overall, the IPS used in this study enhanced epithelial intercellular adhesion (E-cadherin) and extracellular matrix structure (fibronectin), resulted in significantand favorable changes in MMP-9 activity, and favorably modulated IFN-α production. This is the first report of this panel of biomarkers, especially MMP-9 and IFN-α, in the face of in vivo PEDV infection. This is also the first report to investigate a commercially available swine product that does not need to be administered in solid feed, and that is already registered for use throughout Asia, Europe, South America, and North America. Overall, the results of this study serve to clarify the behavior of 4 key biomarkers in the presence of in vivo PEDV infection. The results also indicate that IPS (Tonisity Px) supplementation is a viable intervention to modulate the porcine intestinal immune response with favorable effects on the intestine. [Display omitted] • The Porcine Epidemic Diarrhea Virus (PEDV) results in significant losses in the pig industry globally. • An intervention was tested in the form of a commercially available Isotonic Protein Solution (Tonisity Px; IPS). • Two groups of PEDV-infected pigs (n=16/group) were either administered IPS or not. The IPS significantly enhanced. • Cell adhesion and gutintegrity markers as well as immune response and gut remodeling markers. • The IPS significantly reduced PEDV shedding in vivo. [ABSTRACT FROM AUTHOR]

It is known that high intensity dynamic resistance training which involves eccentric and concentric contractions is one of the effective method for maximizing strength. Although, it is postulated that eccentric and concentric contractions provide different physiological adaptations, previous studies comparing the short-term effects of these two contractions have reported contradictory findings, with some studies reporting greater strength development with eccentric, some with concentric and some with similar within both training (18). Methodological differences may be of critical importance to the reported different findings, when focusing on the underlying reasons for these effects are discussed. The majority of previous studies on this topic have used isokinetic equipment to compare eccentric with concentric training, however there are also several studies which used isotonic method which is the most common type of resistance training. Since the effects of these two methods can form different physiological adaptations (9), it may not be proper to review the studies related to eccentric and concentric comparisons without taking into account training method variable. In isokinetic, contraction velocity can be controlled by the dynamometer however it is hard to standardize the movement velocity of isotonic training. And also previous studies showed that movement velocity of resistance training may affect strength development (11). At this juncture, the aim of this paper was to review the studies investigating eccentric and concentric resistance training and discuss the reported findings by considering methodological differences (training type and movement velocity). Although it was difficult to present certain implications due to only few studies including same methods in terms of contraction types and training methods, some highlights from this paper can be very informative to further studies. One of them is that the effects of eccentric and concentric resistance training might be different according to training types. The effects of movement velocity of resistance training on strength may also be different in terms of isotonic or isokinetic training methods.

At relatively low effort level tasks, surface electromyogram (sEMG) spectral parameters have demonstrated an inconsistent ability to monitor localized muscle fatigue and predict endurance capacity. The main purpose of this study was to assess the potential of the endurance time (Tend) prediction using logarithmic parameters compared to raw data. Ten healthy subjects performed five sets of voluntary isotonic contractions until their exhaustion at 20% of their maximum voluntary contraction (MVC) level. We extracted five sEMG spectral parameters namely the power in the low frequency band (LFB), the mean power frequency (MPF), the high-to-low ratio between two frequency bands (H/L-FB), the Dimitrov spectral index (DSI), and the high-to-low ratio between two spectral moments (H/L-SM), and then converted them to logarithms. Changes in these ten parameters were monitored using area ratio and linear regressive slope as statistical predictors and estimating from onset at every 10% of Tend. Significant correlations (r > 0.5) were found between log(Tend) and the linear regressive slopes in the logarithmic H/L-SM at every 10% of Tend. In conclusion, logarithmic parameters can be used to describe changes in the fatigue content of sEMG and can be employed as a better predictor of Tend in comparison to the raw parameters. [ABSTRACT FROM AUTHOR]

Background: The study examined the effects of a 4-week intensive isometric and isotonic stabilization exercise program on dimensions of health-related quality of life (HRQL) in women with chronic low back pain (CLBP). Methods: A total of 39 women (27-72 years old) provided data in an experimental study with a 9-month follow-up. Random allocation was undertaken for the two treatment groups out of the 3 groups: isometric stabilization (n = 13), isotonic stabilization (n = 13), and a control group (n = 13) that did not participate in any form of exercise. Health-related quality of life measures using the Short-Form 36 Health Survey were assessed before program initiation, immediately after program termination, and 4 times postintervention for a period of 9 months. Results: The isometric stabilization group displayed large improvements in bodily pain and vitality for women with CLBP attending a 4-week intensive isometric stabilization exercise program. The effects were retained for a period of 9 months after program termination. Conclusions: Isometric stabilization exercises reduce pain and enhance vitality as dimensions of HRQL among women with chronic low back pain with such effects lasting for at least 9 months. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: QTc fluctuations, in rest and exercise lead to arrhythmias and sudden cardiac death. Caffeine is an energy source and it may moderate this bad fluctuation. The purpose of this study was to compare the effect of caffeine on QTc and blood pressure during isometric and isotonic contractions in athletic and non-athletic men. METHODS: in this semi-experimental study, 20 healthy men were randomly selected and placed in two groups of athletes and non-athletes. Pre-test: at first, each subject pressed the dynamometer handle at maximum power for 30s (isometric). After 25 min rest, the isotonic activity was performed in 15 repetitions of 5 seconds. At the end, each subject takes 400 mg of caffeine, and after 60min, the post-test similarly, was repeated as a pre-test. QTc changes and blood pressure were checked before and after the test. FINDINGS: The average weight of individuals was 76±13.93 kg. Caffeine in the athlete group resulted in a decrease in QTc during isometric and isotonic contractions of 11.5 ms and 15ms respectively. But in nonathlete groups, QTc during isometric and isotonic contractions were respectively 0.7ms increase and 4.1 ms decrease. There was no significant correlation between QTc in both groups, but diastolic blood pressure increased significantly (p=0.02). CONCLUSION: The results of the study showed that caffeine consumption had no significant effect on QTc interval but it affected diastolic blood pressure

The present research work explains formulating, refining and testing an in-situ combigel ion-activated ocular formulation. It consists of gatifloxacin and ketorolac for bacterial conjunctivitis to resolve patient pain, replacement of precorneal medications, improvement in effectiveness, distorted vision and frequently instilled eye drops and ointments. Gellan gum as an ion-enabled phase transition polymer was developed and HPMC K100 M as release retardant. Instant gel forming in simulated lacrimal fluid was demonstrated (pH 7.4), and its rheology, inflammation, in vitro release, trans cord permeation, and antimicrobial activity were further evaluated. In the formulation with the viscosity 55 cps in sol form and 330 cps with a pseudo plastic action with a consistency of 216.50gm.sec, power 28.320gm, viscosity indices 37.425gm.sec and cohesiveness 17.782gm, 0.6% gellanic gum and 0,4% HPMC K100 M is optimised. The formulations produced demonstrated a persistent and long in-vitro release and permeation profile in 80.1 percent of gatifloxacin and 89.7 percent of ketorolac in 8 hours, with a non-irritant score of 13.21. Due to its higher inhibition environment, its ability to improve residence time and subsequently ocular bioavailability with lower administration rates due to sluggish, protracted diffusion of the medication from the polymer solutions, this formulation is an effective medicine. [ABSTRACT FROM AUTHOR]

The aim of this research is to develop the muscular ability and its effect on the performance of volleyball and the development of isotonic training method (movement), and the researchers supposed that the impact of the method in the development of muscle capacity and accuracy of the performance of the skill of transmission, they used the experimental method, Al-Muqdadiya Youth Sports Club in Diyala Governorate (15) players were chosen in a deliberate manner. The method was prepared by the researchers and the candidate tests were used. The results were processed using the statistics. The most important recommendations are the use of the isotonic training method to develop the muscular ability of all practitioners of the game. Whether students or professional or amateur, taking into account that the level and the ability of the sample as well as the need to emphasize the conduct of continuous and regular tests to test the physical and skill capabilities of the players to know their level and try to develop them to the best. [ABSTRACT FROM AUTHOR]

Investigates the effects of 4 weeks of creatine supplementation after 4 weeks of resistance training in previously nonresistance-trained humans on isokinetic, isometric, and isotonic strength in the field of sport nutrition and exercise metabolism as of December 2003. Strategies on enhancing creatine uptake with creatine supplementation; Physical characteristics of the two groups of subjects; Significant difference in strength post-supplementation compared to baseline.

Hyponatraemia is a known complication in hospitalised children receiving maintenance intravenous fluid. Several studies have been published to investigate the efficacy and safety of intravenous fluids in children. However, there is still an ongoing debate regarding the ideal solution to be used in the paediatric population. Therefore, the aim of this meta-analysis was to investigate the safety and efficacy of administering isotonic versus hypotonic intravenous maintenance fluid in hospitalised children. An extensive search was undertaken on PubMed, Web of Science, Scopus, ScienceDirect, Google Scholar and Cochrane Library on 28 December 2020. Only randomised controlled trials (RCTs) were included. We used the random-effects model for all analyses. Risk ratio (RR) and mean difference with 95% confidence intervals (CIs) were used for dichotomous and continuous outcomes, respectively. The quality of each study was assessed using the Joanna Briggs Institute critical appraisal tool for RCTs. This study is registered with PROSPERO (CRD42021229067). Twenty-two RCTs with a total of 3795 participants were included. The studies encompassed surgical and medical patients admitted to intensive care unit as well as to general wards. We found that hypotonic fluid significantly increases the risk of hyponatremia at both ≤24 h (RR 0.34; 95% CI: 0.26–0.43, p < 0.00001) and >24 h (RR 0.48; 95% CI: 0.36–0.64, p < 0.00001). Isotonic fluid increases the risk of hypernatraemia at ≤24 h (RR 2.15; 95% CI: 1.24–3.73, p = 0.006). The prevalence of hyponatraemia was also higher in the hypotonic group at both ≤24 h (5.7% vs. 23.3%) and >24 h (6.0% vs. 26.3%). There was no statistically significant difference in the risk of developing adverse outcomes between the two groups. Mean serum and urine sodium as well as serum osmolality/osmolarity was lower in the hypotonic group. Isotonic solution is protective against the development of hyponatraemia while hypotonic solution increases the risk of hyponatraemia.