Journal Description
Muscles
Muscles
is an international, peer-reviewed, open access journal on muscle biology and physiology published quarterly online by MDPI. The Korean Society of Physical Medicine (KSPM) is affiliated with Muscles and its members receive discounts on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), Scopus and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.9 days after submission; acceptance to publication is undertaken in 3.7 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Latest Articles
An Exploratory Study of Biceps Brachii Electromyographic Activity During Traditional Dumbbell Versus Bayesian Cable Curls
Muscles 2025, 4(4), 45; https://doi.org/10.3390/muscles4040045 - 13 Oct 2025
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Although previous studies have examined various factors that influence biceps brachii activation, such as grip position, load, and exercise variation, to our knowledge, no prior studies have compared muscle activation during a traditional biceps curl and a Bayesian cable curl. Therefore, this study
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Although previous studies have examined various factors that influence biceps brachii activation, such as grip position, load, and exercise variation, to our knowledge, no prior studies have compared muscle activation during a traditional biceps curl and a Bayesian cable curl. Therefore, this study aimed to examine the differences in biceps brachii muscle activation between these two training modalities. Data from eleven volunteers (age: 25 ± 6 y; weight: 86 ± 13 kg; height: 177 ± 8 cm) were included in the analysis. Muscle activity was assessed using the normalized root mean square (RMS) values obtained from surface electromyography (sEMG). A within-subjects, counterbalanced design was utilized where all participants completed both testing conditions in a randomized order to control for potential order effects. Participants visited the laboratory and fitness center on two occasions. On the first day, anthropometric measurements were obtained, along with one repetition maximum (1-RM) for both the dumbbell biceps curl and the Bayesian curl. On the second day, participants performed an isometric maximal voluntary contraction (MVC), followed by electromyographic assessment of muscle activity during the dumbbell biceps curl and the Bayesian curl, each performed at 80% of their respective 1-RM. When the normal distribution was confirmed via the Shapiro–Wilk test (p > 0.05), a paired t-test was used for statistical analysis. On the other hand, when normality was not confirmed, the Wilcoxon test was utilized. Statistically significant differences (p = 0.003) were observed in the EMG amplitude (%) between the biceps curl (111.46 ± 26.80) and the Bayesian curl (93.39 ± 15.65) with a large effect size (d = 0.82). Based on the EMG analysis, the dumbbell biceps curl elicited significantly greater muscle activation compared to the Bayesian curl, suggesting that the conventional movement places a higher mechanical and neuromuscular demand on the biceps brachii.
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Open AccessArticle
Hamstring Strength and Architectural Properties Are Associated with Running Biomechanics
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Nicholas Ripley, Christopher Bramah, Paul Comfort and John McMahon
Muscles 2025, 4(4), 44; https://doi.org/10.3390/muscles4040044 - 13 Oct 2025
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Applied muscular strain and hamstring strain capacity have a joint interaction on hamstring strain injury (HSI) with modifiable risk factors frequently assessed. However, to date there is limited observations on the interaction between these factors. The purpose of the present study was to
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Applied muscular strain and hamstring strain capacity have a joint interaction on hamstring strain injury (HSI) with modifiable risk factors frequently assessed. However, to date there is limited observations on the interaction between these factors. The purpose of the present study was to observe if spatiotemporal characteristics, running kinematics and muscle activation were related to modifiable risk factors of HSI. Twenty-two competitive team sport athletes (24.7 ± 4.3 years, 1.82 ± 0.07 m, 84.9 ± 8.5 kg) participated whereby the Bicep femoris long head (BFLH) fascicle length assessed via ultrasound and isokinetic eccentric hamstring strength was assessed. With running assessment performed at 18 km/h, capturing running kinematics and muscle activation. Multiple linear regressions were used to examine the relationship of running kinematics and muscle activation on the modifiable risk factors of HSI on. The overall model (F2,19) was statistically significant for both relative eccentric hamstring strength (F = 23.58, p < 0.001) and BFLH fascicle length (F = 18.87, p < 0.001) highlighting spatiotemporal characteristics, running kinematics and hamstring activation were found to be significantly related to the modifiable risk factors. There is a complex interrelationship between running mechanics and hamstring muscle properties, with the potential of either cause or consequence association.
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Open AccessArticle
AppER: Design and Validation of a Mobile Application for Caregivers of Patients with Duchenne Muscular Dystrophy and Their Families in Spain and Latin America
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Jaume Barrera, Imanol Amayra, David Contreras, Alicia Aurora Rodríguez, Nicole Passi, Javiera Ortega and Óscar Martínez
Muscles 2025, 4(4), 43; https://doi.org/10.3390/muscles4040043 - 10 Oct 2025
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Aim: The study developed and validated AppER, an mHealth tool for informal caregivers of children with Duchenne Muscular Dystrophy, and examined differences between app users and non-users. Methods: Four phases were followed: (1) focus groups with experts and caregivers to identify care-related domains;
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Aim: The study developed and validated AppER, an mHealth tool for informal caregivers of children with Duchenne Muscular Dystrophy, and examined differences between app users and non-users. Methods: Four phases were followed: (1) focus groups with experts and caregivers to identify care-related domains; (2) prototype development and validity testing (CVR, I-CVI, I-FVI) using the MARS scale; (3) implementation of the final app; and (4) psychosocial profiling of 88 caregivers (42 users and 46 non-users) measuring quality of life, dependency, somatic symptoms, and coping strategies. Results: AppER showed high content and face validity, surpassing reference thresholds. In the psychosocial analysis, users reported lower perceived quality of life than non-users, despite no significant differences in dependency, somatic symptoms, or coping strategies. Conclusions: Employment patterns differed: more users were dedicated to household tasks, while more non-users were self-employed, suggesting economic factors may affect app uptake and quality of life perceptions. Findings indicate AppER is a valid, well-rated support tool, and that caregivers with lower perceived quality of life may be more inclined to adopt digital health solutions, potentially to address complex care demands. Designing targeted digital interventions may be particularly valuable for those in less favorable socioeconomic contexts. Because of the small sample and between-group imbalances, results are exploratory and warrant confirmation in larger, balanced samples.
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Open AccessArticle
Guidelines for Sport Compressive Garments Design: Finite Element Simulations Approach
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Alessandro Cudicio, Marta Cogliati and Gianluca Rizzi
Muscles 2025, 4(4), 42; https://doi.org/10.3390/muscles4040042 - 9 Oct 2025
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Purpose: Despite significant attention being paid to compression garments (CG) in the sports field, there remains ongoing debate regarding their actual effectiveness in enhancing athletic performance and expediting post-exercise recovery. This article examines their various aspects, with a focus on CG design and
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Purpose: Despite significant attention being paid to compression garments (CG) in the sports field, there remains ongoing debate regarding their actual effectiveness in enhancing athletic performance and expediting post-exercise recovery. This article examines their various aspects, with a focus on CG design and the materials they are made of, aiming to analyze the importance of personalized compression strategies based on individual anthropometric measurements and non-linear compression designs. Methods: Using anthropometric analysis of 40 healthy participants, this study examines the morphological characteristics of the lower limb and their implications for CG design. Results: Measurements of limb length and circumferences revealed complex interactions among anatomical variables, emphasizing the need for customized and adaptable device design. Finite element simulations clarified the challenges in achieving uniform pressure gradients along the lower limb, highlighting the limitations of one-piece devices and suggesting tailored segmented designs for individual limb segments. Conclusion: The results demonstrate that one-piece devices often fail to provide optimal compression due to non-linear variations in limb dimensions. Conversely, segmented devices, particularly those with bilinear progression, exhibited superior performance in applying targeted compression across different limb segments. This more detailed approach to customization could significantly contribute to optimizing outcomes and user comfort.
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Open AccessArticle
Psoas Muscle Index Predicts Perioperative Mortality in Patients Undergoing LVAD Implantation
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Steven Hopkins, Paulomi Gohel, Sakshi Gandhi, Moiz Nasir, William Stallings and Eman Hamad
Muscles 2025, 4(3), 41; https://doi.org/10.3390/muscles4030041 - 22 Sep 2025
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Background: Sarcopenia is associated with adverse surgical outcomes across multiple specialties. The psoas muscle index (PMI), a radiologic marker of sarcopenia, may offer prognostic value in patients undergoing left ventricular assist device (LVAD) implantation, a population frequently characterized by frailty and high perioperative
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Background: Sarcopenia is associated with adverse surgical outcomes across multiple specialties. The psoas muscle index (PMI), a radiologic marker of sarcopenia, may offer prognostic value in patients undergoing left ventricular assist device (LVAD) implantation, a population frequently characterized by frailty and high perioperative risk. Methods: We conducted a single-center retrospective study of 32 patients who underwent LVAD implantation between 2017 and 2022 and had preoperative CT imaging within 45 days. PMI was calculated from bilateral psoas muscle area at the L3 vertebral level, normalized to height. Sarcopenia was defined as the lowest sex-specific quartile of PMI. Primary outcomes were overall survival (OS), 90-day mortality, and postoperative length of stay (LOS). Results: Eight patients (25%) met criteria for sarcopenia. Sarcopenic and non-sarcopenic groups had similar demographics, comorbidities, and nutritional status. While there were no significant differences in overall, 90-day, or 1-year mortality between groups, among those who died post-implantation, the sarcopenic group had significantly shorter OS (median 38 vs. 597 days, p = 0.006). All sarcopenic deaths occurred within 90 days post-implant. LOS did not differ significantly between groups. Conclusions: PMI-defined sarcopenia was associated with early postoperative mortality among LVAD recipients, though not with overall or long-term mortality.
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Open AccessArticle
Neck Pain in Dental Education: A Cross-Sectional Analysis of Neck Strength Differences
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Manuel B. Almeida, Marion Moreira, Paula Moleirinho-Alves and Raúl Oliveira
Muscles 2025, 4(3), 40; https://doi.org/10.3390/muscles4030040 - 17 Sep 2025
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This study aimed to investigate if there are differences in neck strength between dental students in their fourth and fifth years, with and without neck pain. Neck muscle strength was assessed in flexion, extension, and lateral flexion to both sides using a handheld
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This study aimed to investigate if there are differences in neck strength between dental students in their fourth and fifth years, with and without neck pain. Neck muscle strength was assessed in flexion, extension, and lateral flexion to both sides using a handheld dynamometer while participants performed maximum voluntary isometric contractions with a make test procedure. Differences between groups were evaluated through a one-way analysis of variance followed by Tukey’s post hoc comparison. Forty-three students (twenty-one fourth-year and twenty-two fifth-year students) participated in the study. Fifth-year students with neck pain (P5) (n = 14) showed less strength (p = 0.018) compared to the no-pain group (NP) (n = 15) in neck flexion and lateral flexion for both sides (p < 0.001). The fourth-year symptomatic students (P4) (n = 14) showed reduced right lateral flexion strength compared to the NP group (p = 0.035). No significant differences were observed in neck extension across all groups (p = 0.085). Our research indicates a progressive decline in neck muscle strength in flexion and lateral flexion among students with neck pain over their training years. Our findings suggest that this may be linked to the increasing mechanical demands of clinical practice during training, potentially affecting muscle balance and cervical function. This pain could be associated with changes in motor behavior and reduced cervical muscle strength.
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Open AccessArticle
Annular Ligament Instability in Lateral Elbow Pathology: Objective Confirmation Through a Cadaveric Study
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Daniel Berlanga de Mingo, Guillem Paz Ramírez, Arnau Moreno Garcia, Maria Tibau Alberdi, Diana Noriego Muñoz, Miguel Pérez Abad, Giacomo Rossettini, Jorge Hugo Villafañe, César Abellán Miralles, Montserrat del Valle Jou, Àngel Ferreres Claramunt and Alfonso Rodríguez Baeza
Muscles 2025, 4(3), 39; https://doi.org/10.3390/muscles4030039 - 15 Sep 2025
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Background: The annular ligament is a key secondary stabilizer of the elbow, but its biomechanical behavior during forearm rotation has not been objectively quantified. This study aimed to assess interindividual variability in annular ligament tension, validate prior arthroscopic observations, and explore associations with
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Background: The annular ligament is a key secondary stabilizer of the elbow, but its biomechanical behavior during forearm rotation has not been objectively quantified. This study aimed to assess interindividual variability in annular ligament tension, validate prior arthroscopic observations, and explore associations with chondral lesions in the lateral elbow compartment. Methods: In this cross-sectional anatomical study, 25 cadaveric upper limbs were analyzed following standardized dissection, preserving ligamentous and muscular integrity. Ligament displacement was measured using a custom mechanical apparatus and high-precision digital micrometer in neutral, 60° pronation, and 60° supination positions under axial tractions of 1, 2, and 3 kg. Ulnar length and presence of chondral lesions were also recorded. Results: Maximal ligament displacement occurred in supination in 80% of specimens (mean: 1.23 mm at 3 kg; range: 0.30–2.87 mm), indicating considerable interindividual variation. Significant displacement differences were observed between all forearm positions across load levels (p < 0.001). Chondral lesions were identified in three specimens with marked ligament laxity and reduced radial head coverage. Conclusions: This study provides the first objective evidence of annular ligament tension variability during forearm rotation. Ligament laxity may contribute to lateral elbow instability and cartilage degeneration, supporting the ligament’s role as a secondary stabilizer.
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Open AccessArticle
Beyond Sex Differences: Body Composition and Dietary Behaviors
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Cassandra Evans, Jaime Tartar, Jonathan Banks, Jennifer Austin and Jose Antonio
Muscles 2025, 4(3), 38; https://doi.org/10.3390/muscles4030038 - 3 Sep 2025
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Dietary behaviors influence nutrient intake and body composition, both of which are important determinants of an individual’s overall health. This study investigated sex differences in the associations between dietary behaviors and body composition. Using a cross-sectional design, adults completed the three-factor eating questionnaire
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Dietary behaviors influence nutrient intake and body composition, both of which are important determinants of an individual’s overall health. This study investigated sex differences in the associations between dietary behaviors and body composition. Using a cross-sectional design, adults completed the three-factor eating questionnaire (TFEQ-R18) and food cravings (FCI) to assess dietary behaviors. Body composition was assessed using bioelectrical impedance analysis. Relative to males, there were significantly higher levels of cognitive restraint and emotional eating in females. Males exhibited greater cravings for fatty foods and a higher frequency of acting on those cravings. Body fat percentage was positively correlated with emotional eating and cognitive restraint in both sexes. These results suggest that gender and body fat are key factors related to dietary behaviors.
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Open AccessArticle
Muscular Performance Is Not Significantly Altered Throughout Phases of the Menstrual Cycle or a Hormonal Contraceptive Cycle in Collegiate Softball Players
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Shelby L. Houchlei, Sarah N. Wood, Sarah E. Peters, Shane K. Miller, Taylor K. Dinyer-McNeely and Ryan A. Gordon
Muscles 2025, 4(3), 37; https://doi.org/10.3390/muscles4030037 - 2 Sep 2025
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Potential variability in neuromuscular function or physiology throughout the menstrual cycle (MC) or a cycle of using hormonal contraceptives may affect muscular performance variables that are relevant to exercise, training, or sport. Collegiate softball players (n = 11) that reported using and not
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Potential variability in neuromuscular function or physiology throughout the menstrual cycle (MC) or a cycle of using hormonal contraceptives may affect muscular performance variables that are relevant to exercise, training, or sport. Collegiate softball players (n = 11) that reported using and not using hormonal contraceptives completed three testing sessions during their respective early follicular, ovulatory, and mid luteal phases of the MC or early, mid, or late phases of their hormonal contraceptive cycle (HCC). Each testing session included a series of performance tests: countermovement jump on a force plate, 15-yard sprints, velocity assessment of the back squat performed at 70% of one-repetition maximum (1-RM), one-repetition maximum bench press, and 70% 1-RM repetitions to failure testing on the bench press. No significant differences were found for any of the performance tests between the three phases, though performance on most tasks peaked during the mid luteal/late phases of the MC/HCC. It is important to note that this study was underpowered and this could have masked any observed differences. Collectively, muscular performance was not significantly different throughout phases of the MC or HCC in these athletes, indicating that potential hormonal variability throughout the MC or HCC did not seem to have an effect on performance outcomes in this study.
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Open AccessArticle
πForce—Repeatability and Reliability of Peak Force and Rate of Force Development in a Portable Multi-Exercise Device
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Ricardo Pimenta and Abel Pimenta
Muscles 2025, 4(3), 36; https://doi.org/10.3390/muscles4030036 - 1 Sep 2025
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Isometric strength is widely used to monitor training adaptations, assess neuromuscular fatigue, and play a critical role in the maintenance of muscle health. This study assessed repeatability (intra-session) and reliability (inter-session) of a force production machine in different exercises: Isometric Mid-Thigh Pull (IMTP),
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Isometric strength is widely used to monitor training adaptations, assess neuromuscular fatigue, and play a critical role in the maintenance of muscle health. This study assessed repeatability (intra-session) and reliability (inter-session) of a force production machine in different exercises: Isometric Mid-Thigh Pull (IMTP), Knee Flexion (KF) at 30°, and Seated Calf Raise (SCR). Parameters measured included Peak Force (PF), RFD at 0–50, 0–100, 0–150, 0–200, 50–100, 100–150 and 150–200 ms. Thirty male individuals (IMTP = 30; KF = 11 and SCR = 30) participated (age: 20.6 ± 3.6 years, mass: 75.3 ± 7.5 kg, height: 1.80 ± 0.64 m). Repeatability and reliability were calculated for bilateral PF and RFD for IMTP and SCR, and unilateral for KF. PF demonstrated good to excellent repeatability in all exercises: IMTP (ICC = 0.93), KF (left: ICC = 0.98; right: ICC = 0.97), SCR (ICC = 0.84). RFD displayed poor to good repeatability in IMTP (ICC = 0.45–0.87) and SCR (ICC = 0.40–0.85), moderate to excellent repeatability in KF (left: ICC = 0.53–0.96; right: ICC = 0.61–0.92). PF reliability was excellent in IMTP (ICC = 0.93) and KF (left: ICC = 0.99; right: ICC = 0.97), and moderate in SCR (ICC = 0.64). RFD reliability was moderate to excellent in IMTP (ICC = 0.58–0.94), poor to good in SCR (ICC = 0.13–0.64), and poor to excellent in KF (left: ICC = 0.33–0.96; right: ICC = −0.19–0.95). This study shows that portable dynamometry can measure maximal and explosive strength in different exercises, demonstrating good reliability for most parameters in IMTP and KF.
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Open AccessArticle
Baicalin Improves Skeletal Muscle Atrophy by Attenuating DRP-1-Mediated Mitochondrial Fission in Aged Mice
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Hla Myat Mo Mo and Jong Han Lee
Muscles 2025, 4(3), 35; https://doi.org/10.3390/muscles4030035 - 19 Aug 2025
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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
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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.
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Open AccessArticle
Comparative Effects of Blood Flow Restriction and Traditional Strength Training on Proximal Shoulder Musculature: A Randomized Clinical Trial
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Lucas Ghionna, Léa Ruppel, Nuno Nogueira, Gabriela Brochado and Alice Carvalhais
Muscles 2025, 4(3), 34; https://doi.org/10.3390/muscles4030034 - 18 Aug 2025
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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
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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.
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Open AccessArticle
Reliability of Standardised High-Intensity Static Stretching on the Hamstrings over Multiple Visits
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Joseph Bryant, Darren J. Cooper, Derek M. Peters and Matthew D. Cook
Muscles 2025, 4(3), 33; https://doi.org/10.3390/muscles4030033 - 15 Aug 2025
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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
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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.
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Open AccessSystematic Review
Physiological and Physical Determinants of Flat-Water Kayaking
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Yi Shin Lee, Amelia Dingley, Danny Lum, Frankie Tan and John F. T. Fernandes
Muscles 2025, 4(3), 32; https://doi.org/10.3390/muscles4030032 - 14 Aug 2025
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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
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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 (VO2max), 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.
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Open AccessSystematic Review
Proactive Aesthetic Strategies: Evaluating the Preventive Role of Botulinum Toxin in Facial Aging
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Grazia Marinelli, Alessio Danilo Inchingolo, Irma Trilli, Carmela Pezzolla, Roberta Sardano, Francesco Inchingolo, Andrea Palermo, Cinzia Maria Norma Maspero, Gianna Dipalma and Angelo Michele Inchingolo
Muscles 2025, 4(3), 31; https://doi.org/10.3390/muscles4030031 - 13 Aug 2025
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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
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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.
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Open AccessSystematic Review
The Impact of the FIFA 11+ Neuromuscular Training Programme on Ankle Injury Reduction in Football Players: A Systematic Review and Meta-Analysis
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Can Eser, Türker Bıyıklı, Paul J. Byrne, John D. Duggan, Joseph I. Esformes and Jeremy A. Moody
Muscles 2025, 4(3), 30; https://doi.org/10.3390/muscles4030030 - 12 Aug 2025
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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
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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.
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Open AccessArticle
Modeling of Isometric Muscle Properties via Controllable Nonlinear Spring and Hybrid Model of Proprioceptive Receptors
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Mario Spirito
Muscles 2025, 4(3), 29; https://doi.org/10.3390/muscles4030029 - 11 Aug 2025
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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
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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.
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Open AccessArticle
Measurement Reliability for the Anatomical Characteristics of Cervical Muscles Using Musculoskeletal Ultrasound in Healthy Individuals
by
Georgios Sidiropoulos, Nikolaos Strimpakos, Asimakis K. Kanellopoulos, Maria Tsekoura, Konstantinos Alexiou, Olympia Papakonstantinou and Zacharias Dimitriadis
Muscles 2025, 4(3), 28; https://doi.org/10.3390/muscles4030028 - 5 Aug 2025
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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
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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.
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Open AccessArticle
Examination of the Relationship Between Pain Intensity, Pain Perceptions, and Kinesiophobia in Patients with Non-Specific Chronic Musculoskeletal Pain
by
Sofia Sgourda, Maria Loulla, Eirini Zisiopoulou, Krystalia Katsiou, Sofia Nikolaidi, Ioannis Kyrosis and Anna Christakou
Muscles 2025, 4(3), 27; https://doi.org/10.3390/muscles4030027 - 4 Aug 2025
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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
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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.
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Open AccessReview
Mechanisms Underlying Muscle-Related Diseases and Aging: Insights into Pathophysiology and Therapeutic Strategies
by
Jialin Fan, Zara Khanzada and Yunpeng Xu
Muscles 2025, 4(3), 26; https://doi.org/10.3390/muscles4030026 - 31 Jul 2025
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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,
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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.
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