Muscles, Volume 4, Issue 3 (September 2025) – 16 articles

Baicalin is a natural flavonoid that has anti-apoptotic and anti-inflammatory effects. It shows some beneficial effects on muscle atrophy. However, its effects on age-related muscle atrophy are poorly understood. In this paper, we investigated whether baicalin exerts protective effect against skeletal muscle atrophy and its underlying mechanisms in aged mice using the grip strength test, histological analysis, and Western blots. Baicalin increased total muscle mass and strength in aged mice. Consistently, the cross-sectional area of quadriceps (QD) muscle significantly increased in both baicalin-administrated groups. Moreover, baicalin induced a shift in muscle fiber size distribution toward large fibers in both groups of mice. Expression levels of muscle atrophic factors, such as myostatin (MSTN) and atrogin-1, as well as pro-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), were elevated in aged mice, but these increases were reduced by baicalin. While mitochondrial fission regulator, dynamin-related protein 1 (DRP-1), and apoptosis-related protein (apoptotic protease activating factor 1 (Apaf-1)) expressions were higher in aged mice than young mice, and their expression were downregulated following baicalin administration. The comprehensive results of this study suggest that baicalin provides beneficial effects on the treatment of sarcopenia not only by suppressing muscle atrophic factor expression and inflammation but also attenuating DRP-1-mediated mitochondrial fission and apoptosis. Full article

Background: Blood Flow Restriction (BFR) training may be an alternative when traditional heavy-load training is unsuitable. This study compared BFR with light loads to traditional strength training for shoulder muscle development proximal to the occlusion site; Methods: A total of 22 healthy adults were randomized into Group A: BFR training (30% 1RM; n = 12) and Group B: Traditional strength training (70% 1RM; n = 10). Four-week protocol (2 sessions/week) included shoulder abduction and lateral rotation, and dumbbell overhead press. Arm circumference, Single Arm Seated Shot-Put Test (SAASPT), vertical lift strength (VLS) and Shoulder Endurance Test were assessed at baseline and at the end of the protocol. Cohen’s d effect size was calculated for significant outcomes; Results: Significant gains occurred in both groups across most parameters. The magnitude of effects was, in Group A, large on Arm circumference and SASSPT (Cohen’s d = 0.870 and 1.158, respectively) and very large in VLS and SET (Cohen’s d = 1.284 and 1.301, respectively). In Group B, the magnitude of effects was large in SASSPT and VLS (Cohen’s d = 0.962 and 0.922, respectively) and very large in SET (Cohen’s d = 1.238); Conclusion: BFR training with light loads effectively improved musculature proximal to the occlusion site, demonstrating comparable strength gains to heavy-load training in healthy individuals. Full article

Static stretching (SS) is commonly used in athletic programs, and the intensity of SS has recently been examined for its effects on range of motion (ROM), strength and passive stiffness. However, the reliability of high-intensity SS across multiple testing sessions has not been investigated. The purpose of this investigation was to examine the reliability of high-intensity SS of the hamstrings across five laboratory visits on ROM, strength, power and passive stiffness. Thirteen physically active males (age: 26 ± 4 years, height: 180 ± 8 cm, body mass: 81 ± 10 Kg) underwent five repeated measures of laboratory SS on an isokinetic dynamometer where point of discomfort (POD) was measured, followed by a 30 s stretch at 120% POD. Across the visits, the pooled intraclass correlation coefficient was good for knee extension ROM (0.82), knee flexion strength (0.81) and passive stiffness (0.81). The ROM achieved to determine the POD before the SS was not different for the five visits (p = 0.370). These findings suggest high-intensity SS to 120% POD on an isokinetic dynamometer is reliable across multiple testing sessions. It is not clear if high-intensity static stretching is also reliable within applied scenarios and warrants further investigation. Full article

The main research question of this review involved the identification of the various physiological and physical determinants of flat-water kayaking. A systematic search was conducted using three databases (PubMed, Google Scholar, and Microsoft Academic) between 1991 and December 2022. Quality assessment was performed using a version of the National Heart, Lung and Blood Institute checklist tailored for cross-sectional and observational studies. A total of 169 articles were identified in the initial screening. After duplicate removal and further screening for relevance, a total of 17 articles were included in the review. Altogether, it was found that flat-water kayaking performance was strongly correlated with maximum oxygen uptake (VO_2max), aerobic and anaerobic thresholds, peak aerobic and anaerobic capacity measure in lab and on the water, and upper and lower-body strength and power, which were measured using heavy resistance, as well as isometric and isokinetic implements. What is less clear is the association between total lean mass and flat-water kayaking performance. However, this may largely be due to the differences in when the measurements were taken. Full article

Background: In recent years, botulinum toxin (BoNT) has been increasingly employed not only as a corrective aesthetic intervention but also as a proactive strategy to delay the visible signs of facial aging. This systematic review aims to evaluate the scientific evidence supporting the preventive role of BoNT in facial aging, focusing on its long-term effects, mechanisms of action, and clinical outcomes when used in younger, pre-symptomatic populations. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science databases. Inclusion criteria encompassed clinical trials and observational studies addressing the use of BoNT for proactive aesthetic strategies. Results: Evidence suggests that early BoNT application may reduce muscle hyperactivity, delay the formation of dynamic wrinkles, and minimize the development of static lines over time. Histological studies indicate a potential remodeling effect on dermal collagen. However, data remain heterogeneous, and long-term safety and efficacy outcomes are not yet fully established. Conclusion: Preventive BoNT injections represent a promising tool in the proactive management of facial aging. Further longitudinal, high-quality studies are needed to substantiate its role within evidence-based aesthetic protocols. Full article

This systematic review and meta-analysis was conducted to evaluate the effectiveness of the FIFA 11+ injury prevention programme, a neuromuscular training intervention involving muscular strength, proprioception, balance, and plyometric exercises, in reducing ankle injury incidence among football players. Included are randomised controlled trials (RCTs) involving players of any age, sex, or competition level, comparing the FIFA 11+ programme with standard warm-up routines. Studies were eligible if they had a minimum follow-up of five months and reported at least two of the following: number of ankle injuries, incidence rate, and exposure hours. Searches were conducted in PubMed, MEDLINE (via OVID), Scopus, and SPORTDiscus up to October 2024. Risk of bias was assessed using the revised Cochrane Risk of Bias tool (RoB 2), and a random-effects meta-analysis was conducted. Three RCTs, involving 3833 participants and 286,827 exposure hours, met the inclusion criteria. The pooled analysis showed that the FIFA 11+ programme significantly reduced ankle injury rates compared to control groups (rate ratio (RR) = 0.67, 95% confidence interval (CI): 0.46–0.96, p = 0.03, I² = 52%), reflecting a 33% lower risk. The certainty of the evidence was rated as moderate due to bias in two studies. In conclusion, the FIFA 11+ programme significantly reduces ankle injury incidence and supports implementation at all levels. However, further research is needed to examine long-term effects, optimal doses, and applicability across diverse football populations. Full article

This work investigates the macroscopic behavior of skeletal muscles from a system-theoretic perspective. Based on data available in the literature, we propose an initial evaluation model for isometric force generation, i.e., force produced at a constant muscle length or in quasi-static conditions, as a function of muscle length and neuronal excitation frequency. This model enables a more physics-inspired representation of isometric force by employing a nonlinear spring framework with controllable properties such as stiffness and rest length. Finally, we introduce a hybrid dynamical filter model to describe components of the sensory system responsible for relaying information about muscle length and its rate of change back to the Central Nervous System. As an application case, we present the modeling of the oculomotor system, highlighting the relevance of the proposed modeling approach in a physiologically meaningful control task. Full article

Background: The reliable assessment of cervical muscle morphology is essential for both clinical and research use. However, evidence on the reliability of ultrasound measurements remains limited. Objective: To investigate the intra-rater and test–retest reliability of morphological measurements of the Longus Colli, Sternocleidomastoid, Multifidus Cervicis, and Semispinalis Capitis muscles using musculoskeletal ultrasound. Methods: Cross-sectional area, anteroposterior, and lateral dimensions were assessed using B-mode ultrasound. Anterior neck muscles were scanned in the supine position, while posterior neck muscles were scanned in the prone position. Each muscle was measured three times (to assess intra-rater reliability), which was repeated after 30 min (to assess test–retest reliability). Measurements were also normalized according to BMI and neck circumference. Results: Intra-rater reliability was found to be good to excellent for the Longus Colli (ICC = 0.77–0.92), excellent for the Sternocleidomastoid (ICC = 0.93–0.99), good to excellent for the Semispinalis Capitis (ICC = 0.89–0.97), and moderate to excellent for the Multifidus Cervicis (ICC = 0.69–0.92). Test–retest reliability was found to be moderate to good for the Longus Colli (ICC = 0.73–0.87), good to excellent for the Sternocleidomastoid (ICC = 0.84–0.98), good to excellent for the Semispinalis Capitis (ICC = 0.78–0.95), and good to excellent for the Multifidus Cervicis (ICC = 0.80–0.92). Conclusions: Musculoskeletal ultrasound demonstrates strong reliability for cervical muscle assessment, supporting its clinical use. Full article

Chronic musculoskeletal pain negatively affects patients’ quality of life, and pain perceptions may significantly influence rehabilitation outcomes. This study investigated the relationships among pain intensity, pain perceptions, and kinesiophobia in individuals with chronic musculoskeletal pain. No previous studies have examined these variables in combination. A cross-sectional observational study was conducted with 37 participants with non-specific chronic musculoskeletal pain for at least 6 months, affecting the neck (n = 8), lower back (n = 18), upper limbs (n = 5), lower limbs (n = 5), or shoulder (n = 1). The following validated tools were used: (a) Pain Beliefs and Perceptions Inventory (PBPI), (b) the Tampa Scale for Kinesiophobia (TSK), and (c) the Short-Form McGill Pain Questionnaire (SF-MPQ). Spearman r correlation analyses were performed. Total kinesiophobia scores were positively correlated with (a) total pain intensity (McGill score) (r = 0.37, p = 0.022), (b) present pain intensity (PPI) (r = 0.52, p = 0.001), (c) pain duration (r = 0.51, p = 0.001), (d) the “mystery” factor of pain perception (r = 0.41, p = 0.013), and (e) the Visual Analogue Scale (VAS) (r = 0.42, p = 0.009). The total pain perception scores were positively associated with the “fear of injury” factor of kinesiophobia (r = 0.36, p = 0.028). The McGill pain scores were strongly correlated with both PPI (r = 0.63, p = 0.001) and VAS (r = 0.51, p = 0.001). There is a significant relationship between pain perception and kinesiophobia levels in patients with chronic musculoskeletal pain. Limitations of the study include a small and heterogeneous sample regarding pain localization. Further research is required using larger, more homogeneous populations to confirm the present findings. Full article

Skeletal muscle aging and related diseases are characterized by progressive loss of muscle mass, strength, and metabolic function. Central to these processes is mitochondrial dysfunction, which impairs energy metabolism, redox homeostasis, and proteostasis. In addition, non-mitochondrial factors such as muscle stem cell exhaustion, neuromuscular junction remodeling, and chronic inflammation also contribute significantly to muscle degeneration. This review integrates recent advances in understanding mitochondrial and non-mitochondrial mechanisms underlying muscle aging and disease. Additionally, we discuss emerging therapeutic approaches targeting these pathways to preserve muscle health and promote healthy aging. Full article

Limb–girdle muscular dystrophy (LGMD) encompasses a heterogeneous group disease, genetic and phenotypically. There are more than 30 subtypes divided into two groups: autosomal dominant and recessive. LGMDs are characterised by muscle weakness; however, psychosocial factors seem to be affected too, such as HRQoL. Given the lack of literature in this respect, the present cross-sectional study aimed to create a patient profile comparing both dominant and recessive forms by analysing HRQoL through the INQoL, and sociodemographic data. The LGMD-recessive group had a worse HRQoL compared to the dominant group, specifically in the dimensions of muscle weakness (p = 0.007), emotion (p = 0.046), independence (p = 0.029), and body image (p = 0.022). In addition, in the LGMD-dominant group, 77.9% of the relational indicator was explained by age (B = 0.907, p = 0.012), which can be understood as a limitation in their social role due to the disease progression. In contrast, no sociodemographic variables were found to be predictive of the HRQoL of patients with recessive forms of LGMD. These results are relevant for clinical practice, as they reflect the most affected areas of HRQoL in LGMD patients, differentiating between recessive and dominant forms. Full article

Ergogenic supplements are becoming increasingly popular in the diet of trained individuals, due to their potential benefits. Ashwagandha (Withania somnifera) is one of the supplements that has recently grown in popularity. Despite growing interest, its scientific background remains limited and sometimes inconsistent. Objective: This overview of systematic reviews aimed to evaluate the effects of Ashwagandha supplementation on sports performance and health-related outcomes. Methods: A systematic literature search was carried out on the following electronic databases: PUBMed, Scopus, Academic Search Complete, SPORTDiscus, Web of Science, and Google Scholar, using the search terms “ashwagandha” and “systematic review” in the title or abstract of the publication in July 2024. The eligibility of the articles was assessed using the PICOS (Population, Intervention, Comparator, Outcomes, and Study Design) approach, and risk of bias was assessed using the AMSTAR-2 checklist. Results: Of the 2388 systematic reviews found, 11 met the inclusion criteria, which included 151 original studies representing 9005 individuals. Findings suggest that Ashwagandha supplementation may improve various aspects of sports performance, such as endurance and muscular strength, as well as health-related outcomes, including anxiety reduction, improved sleep quality, and enhanced sexual function. The most commonly used doses of Ashwagandha supplementation are between 500 mg and 1000 mg a day. Conclusion: While current evidence indicates promising effects of Ashwagandha on physical and psychological parameters, further high-quality randomized controlled trials are needed. Therefore, its use in athletes or healthy individuals should be considered with caution and based on individual needs. Full article

Background: Expression of maximal and rapid force in the hip, knee, and plantar flexors is important for athletic performance in female soccer. This study was designed to determine the effect of relative isometric strength in the isometric mid-thigh pull (IMTP) on countermovement jump (CMJ) and rebound jump (CMJ-R) performance in female youth soccer players. Methods: Ninety-six female soccer players (age: 14.1 ± 2.3 years, height: 160.5 ± 9.7 cm, mass: 55.0 ± 10.3 kg) completed three trials of the IMTP, CMJ, and CMJ-R using force plates. Players were categorized as stronger (top quartile, n = 19) and weaker players (bottom quartile, n = 23) based on IMTP relative net peak force. One-way Bayesian independent t-tests were performed between stronger and weaker players. Results: Very large difference in lower limb strength between groups (g = 5.05). Moderate to very strong evidence to support that stronger players had greater countermovement depth and time to take-off with similar jump heights than weaker players. Strong evidence was observed for CMJ-R height, with stronger players falling from a greater height and executing similar ground contact times compared to weaker players. Conclusions: Relative strength has implications for CMJ-R, highlighting the importance of developing relative strength in hip, knee, and plantar extensors. Full article

Amyotrophic lateral sclerosis (ALS) is a progressive disease that degeneratively damages both upper and lower motor neurons, eventually resulting in muscular paralysis and death. Although ALS is broad in scope and commonly thought of as a motor neuron disease, more active research sheds light on the that role skeletal muscle plays in the development and progression of the disease. Muscle tissue in ALS patients and in animal models demonstrates severe regenerative deficits, including impaired myogenesis and impaired myoblast fusion. In ALS, muscle stem cells, known as satellite cells, show poor performance in activation, proliferation, and differentiation and thus contribute to ALS muscle wasting. Moreover, the pathological tissue environment that inhibits myoblast fusion is made up of proinflammatory cytokines, oxidative stress, and a lack of trophic signals from the neuromuscular junction, which greatly disrupts homeostatic regulation. It is likely that skeletal muscle is instead a dynamic player, fueling neuromuscular degeneration as opposed to a passive responder to denervation. One must appreciate the cellular and molecular changes that complicate muscle regeneration in ALS for effective treatment to be developed, permitting simultaneous interventions with both muscle and neurons. Full article

Service-Learning (SL) is an innovative educational methodology that integrates academic learning with active community engagement, fostering both technical and transversal competencies. This pilot study explores the implementation of an SL-based experience within the Physiotherapy Degree at the University of Extremadura. The primary objective was to design and deliver therapeutic exercise programs targeting patients with cardiorespiratory conditions, utilizing local community resources. A total of 44 third-year physiotherapy students participated in the design and simulated the implementation of community-based interventions targeting muscular strength, postural control, balance, and endurance. A mixed-methods approach was used, combining descriptive statistics (SPSS v23) and thematic analysis of student reflections to assess the impact of SL on the development of specific professional competencies, including clinical reasoning, patient communication, therapeutic planning, and adaptation of interventions to diverse environments. The results show a significant improvement in students’ theoretical and practical understanding, with over 70% of participants rating their learning experience between 8 and 10 (on a 0–10 scale) in aspects such as pathology description, clinical assessment, and exercise planning. Additionally, 92% reported improved teamwork, 89% noted better adaptability, and 87% reported enhanced decision-making skills. The findings suggest that SL can enhance perceived learning in musculoskeletal rehabilitation and support the transition from academic training to clinical practice. However, the study is exploratory and based on perceived outcomes, and future research should include validated tools and real patients to assess its impact more rigorously. This pilot study highlights the value of integrating musculoskeletal-focused training—targeting strength, balance, and endurance—into physiotherapy education through Service-Learning methodology. The study highlights SL’s potential to enrich physiotherapy education while leveraging community spaces—such as those in Extremadura, a region with three UNESCO World Heritage Sites—as dynamic learning environments. Full article

This study aimed to describe and compare the serratus anterior (SA) and latissimus dorsi (LD) muscle activity during six hypopressive exercise (HE) positions performed in open and closed kinetic chains. While previous studies analyzed abdominal and pelvic muscle activity during HE, research on scapular stabilizers like SA and LD remains underreported. Twenty-five healthy adults (mean age, 42.9 ± 8.4 years; BMI, 22.1 ± 2.4 kg/m²) with prior HE experience performed three open and three closed-chain HE positions. Surface electromyography recorded bilateral SA and LD activity, normalized to maximum voluntary isometric contraction (MVIC). SA showed greater activation than LD across all positions, with moderate activation levels (20–40% MVIC), while LD activation remained mild (<20% MVIC). Significant differences were found across positions and kinetic chain conditions. SA activation was higher during closed-chain standing (W = 41; p < 0.001; r = −0.74) and kneeling (W = 9; p < 0.001; r = −0.94), while LD activity increased significantly in the seated closed-chain position (left LD: W = 26; p < 0.001; r = −0.84; right LD: W = 20; p < 0.001; r = −0.87). These findings suggest body and kinetic chain positioning influence scapular muscle recruitment during HE. Further research is warranted to determine clinical applications. Full article