Search Results (35)

Background/Objectives: Vibration foam rolling (VFR) has emerged as a popular intervention in sports and rehabilitation settings to enhance recovery and flexibility. This systematic review aimed to evaluate the effects of VFR on pain, fatigue, and range of motion (ROM) in individuals experiencing exercise-induced muscle fatigue and to assess its clinical applicability. Methods: A systematic literature search was conducted across five databases: PubMed, Cochrane Library, Embase, Web of Science, and CINAHL. Studies were included if they involved participants with muscle fatigue, applied VFR as an intervention, and measured outcomes related to pain, fatigue, or ROM. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results: Eight studies published between 2019 and 2024 met the inclusion criteria. VFR showed beneficial effects in reducing delayed onset muscle soreness, improving pressure pain threshold, and lowering subjective fatigue. Several studies also reported increased ROM in specific joints, including the hip and knee. However, findings across studies were inconsistent, particularly in physiological markers such as muscle oxygen saturation and blood flow parameters, where statistically significant differences were not always observed. Conclusions: VFR may offer potential benefits for pain relief, fatigue recovery, and ROM improvement in fatigued individuals. Nonetheless, its effects remain difficult to isolate from those of mechanical pressure and friction associated with foam rolling. Future studies with standardized intervention protocols and long-term follow-up are needed to clarify the independent role of vibration in recovery outcomes. Full article

Introduction: Elbow flexor spasticity is a common and debilitating consequence of stroke, significantly impacting patients’ quality of life. Botulinum toxin A (BoNT-A) injections have emerged as an effective treatment, but the optimal muscle selection strategy remains unclear. This study investigates the impact of different BoNT-A injection strategies targeting specific elbow flexor muscles in post-stroke patients. Materials and Methods: A non-randomized observational study was conducted on 52 participants with upper limb spasticity (pattern IV) following a stroke. Participants were divided into three groups based on the elbow flexor muscles injected with BoNT-A: biceps brachii (n = 15), brachialis (n = 9), and brachialis plus brachioradialis (n = 28). Assessments included spasticity angle, paresis angle, and active supination range of motion (ROM) measured using the Tardieu Scale and goniometry at baseline and at 4-week follow-up. Non-parametric statistical analyses were employed to compare outcomes between groups. Results: While all groups showed a general trend of decreased spasticity and improved motor control, analysis revealed statistically significant differences across the groups at baseline. The brachialis plus brachioradialis group demonstrated the most substantial improvement in paresis angle and active supination ROM. Notably, this group also exhibited greater capacity for the improvement of the paresis angle. The biceps brachii group showed comparable improvements in the paresis angle and the greatest effect on improving passive extension at slow velocity with increasing stroke onset but required higher pronator teres BoNT-A doses overall. Discussion: These findings suggest that individualized muscle selection strategies are crucial in BoNT-A treatment for elbow flexor spasticity. The superior outcomes observed in the brachialis plus brachioradialis group may be attributed to the synergistic action of these muscles in elbow flexion and forearm positioning. The higher pronator teres BoNT-A doses required in the biceps brachii group may reflect compensatory mechanisms or differences in muscle fiber recruitment patterns. Conclusions: Combining brachialis and brachioradialis muscles in BoNT-A injections appears to offer superior benefits for supination and motor control in post-stroke patients with elbow flexor spasticity, particularly those with significant elbow flexion and pronation. Full article

Background/Objectives: In this study, we aimed to examine the effect of creatine monohydrate (CrM) supplementation on recovery from eccentric exercise-induced muscle damage (EIMD) in diverse populations, including different sexes and age groups. EIMD decreases maximal voluntary contraction (MVC), restricts the range of motion (ROM), and increases muscle stiffness and delayed-onset muscle soreness, all of which negatively impact athletic performance. Therefore, developing effective recovery strategies is essential. Methods: A double-blind, randomized, placebo-controlled trial was conducted with 40 healthy male and female participants. After 33 days of supplementation with either CrM or placebo (crystalline cellulose), the participants performed eccentric exercises. Recovery indices, including MVC, muscle stiffness, subjective muscle extensive soreness, fatigue, and upper arm circumference, were measured at baseline, immediately after exercise, 48 h post-exercise, and 96 h post-exercise. Results: The creatine supplementation group (CRE) demonstrated a significantly quicker recovery of MVC than the placebo group (PLA). Furthermore, reductions in shear modulus and muscle fatigue were observed in the CRE group. Notably, females in the CRE group exhibited a significant suppression of post-exercise edema, suggesting a sex-specific response. Conclusions: These findings indicate that CrM supplementation may enhance recovery from EIMD, contributing to the maintenance of muscle function and the reduction of discomfort after exercise. CrM has the potential to serve as a practical nutritional strategy to promote recovery, not only for athletes, but also for a broader population. Full article

Micro-expressions (MEs), characterized by their brief duration and subtle facial muscle movements, pose significant challenges for accurate recognition. These ultra-fast signals, typically captured by high-speed vision sensors, require specialized computational methods to extract spatio-temporal features effectively. In this study, we propose a lightweight dual-stream network with an adaptive strategy for efficient ME recognition. Firstly, a motion magnification network based on transfer learning is employed to magnify the motion states of facial muscles in MEs. This process can generate additional samples, thereby expanding the training set. To effectively capture the dynamic changes of facial muscles, dense optical flow is extracted from the onset frame and the magnified apex frame, thereby obtaining magnified dense optical flow (MDOF). Subsequently, we design a dual-stream spatio-temporal network (DSTNet), using the magnified apex frame and MDOF as inputs for the spatial and temporal streams, respectively. An adaptive strategy that dynamically adjusts the magnification factor based on the top-1 confidence is introduced to enhance the robustness of DSTNet. Experimental results show that our proposed method outperforms existing methods in terms of $F1-score$ on the SMIC, CASME II, SAMM, and composite dataset, as well as in cross-dataset tasks. Adaptive DSTNet significantly enhances the handling of sample imbalance while demonstrating robustness and featuring a lightweight design, indicating strong potential for future edge sensor deployment. Full article

Background: Adequate nutrition is crucial for athletes to enhance performance and recovery. This study investigates the acute effects of omega-3 and whey protein supplementation before and after exercise-induced muscle damage (EIMD) on lower-body strength, explosive power, and delayed-onset muscle soreness (DOMS) in female futsal players. Method: A randomized, cross-over, placebo-controlled, double-blind study involved 15 female futsal players (Age: 22.93 ± 0.54 years; Height: 159.60 ± 1.16 cm; Weight: 56.95 ± 1.79 kg). Participants completed three conditions: pre-EIMD (1000 mg fish oil, 30 g whey protein, 2 h before EIMD), post-EIMD (same supplementation, within 2 h after EIMD), and placebo (PLA, 2 g starch). EIMD involved 200 vertical jumps with 15% body-weighted vests. Metrics including Sargent jump height (VJH), thigh swelling (Sw-T), pressure pain threshold (PPT), V-sit and reach flexibility test (VSFT), range of motion (ROM), relative peak torque (RPT), average power (AP), and maximal voluntary isometric contraction (MVIC) were recorded 48 h post-EIMD. DOMS was assessed via a visual analog scale (VAS) multiple times. A one-week washout period was employed. Results: Pre-EIMD supplementation significantly increased VJH (p = 0.001) compared to PLA and Post-EIMD (p = 0.033). MVIC45° improved significantly in Pre-EIMD vs. PLA (p = 0.001). Improvements were observed in muscle strength metrics, with significant increases in APflx60°/s (pre-EIMD vs. PLA, p = 0.001; pre-EIMD vs. post-EIMD, p = 0.008), APext60°/s (Pre-EIMD vs. PLA, p = 0.030), and APext180°/s (Post-EIMD vs. PLA, p = 0.023). DOMS was lower in both Pre-EIMD and Post-EIMD conditions immediately and at 12 h post-EIMD (p = 0.009; p = 0.030) than PLA. No significant differences were found in Sw-T, PPT, VSFT, ROM, or APflx180°/s. Conclusions: Acute omega-3 and whey protein supplementation, particularly before EIMD, improves strength and power and reduces DOMS in female futsal players. Supplement timing may be critical for optimizing recovery and performance in high-demand sports. Full article

Non-contact anterior cruciate ligament injuries (NC-ACLs) represent a significant concern in sports medicine, particularly among athletes and physically active individuals. These injuries not only result in immediate functional impairment but also predispose individuals to long-term issues such as recurrent instability and early-onset osteoarthritis. This narrative review examines the biomechanical, neuromuscular, and environmental factors that contribute to the high incidence of NC-ACLs and evaluates the effectiveness of current prevention and rehabilitation strategies. The review identifies key risk factors, including improper landing mechanics, deficits in neuromuscular control, and muscle imbalances, which are pivotal in the etiology of NC-ACLs. Prevention programs that incorporate plyometric exercises, strength training, and neuromuscular education have shown efficacy in reducing injury rates. Rehabilitation protocols that emphasize a gradual return to sport, focusing on pain management, restoration of range of motion, and progressive strengthening, are critical for successful recovery and prevention of re-injury. The evidence suggests that an integrated approach, combining prevention and rehabilitation strategies tailored to the individual, is essential for minimizing NC-ACL risk and improving outcomes in affected populations. Full article

Therapists and strength and conditioning specialists use self-myofascial release (SMR) as an intervention tool through foam rollers or massage rollers for soft tissue massage, with the purpose of improving mobility in the muscular fascia. Moreover, the use of SMR by professional and amateur athletes during warm-ups, cool downs, and workouts can have significant effects on their physical performance attributes, such as range of motion (ROM) and strength. The purpose of this study was to analyse the literature pertaining to these types of interventions and their effects found in different physical performance attributes for athletes. A systematic search was carried out using the following databases: PUBMED, ISI Web of Science, ScienceDirect, and Cochrane, including articles up to September 2023. A total of 25 articles with 517 athletes were studied in depth. SMR seems to have acute positive effects on flexibility and range of motion, without affecting muscle performance during maximal strength and power actions, but favouring recovery perception and decreasing delayed-onset muscle soreness. Some positive effects on agility and very short-range high-speed actions were identified, as well. In conclusion, although there is little evidence of its method of application due to the heterogeneity in that regard, according to our findings, SMR could be used as an intervention to improve athletes’ perceptual recovery parameters, in addition to flexibility and range of motion, without negatively affecting muscle performance. Full article

Hemophilia is an inherited hemorrhagic disorder; its main clinical manifestations being bleeding in muscles and joints. Ankles, knees, and elbows are the most frequently affected joints, followed by shoulders and hips. The clinical signs of joint involvement are reduced mobility, swelling and walking difficulties. Bleeding episodes in patients with hemophilia are usually divided into traumatic and spontaneous, but we believe that the latter are not truly spontaneous but rather the result of joint stresses owing to motion actions that create dysfunctions starting from infancy. Pharmacological prophylaxis with factor replacement therapies or non-replacement drugs markedly reduces musculoskeletal hemorrhages. However, the onset of subclinical joint stress can be reduced only by associating this therapeutic approach with the accurate observation of the child motion patterns and restoring them if dysfunctional, thereby primarily preventing subclinical bleeding and ultimately the onset or progression of hemophilic arthropathy. Full article

(1) Background: Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is characterized by late-onset cerebellar ataxia, bilateral vestibulopathy, and sensory neuronopathy mostly due to biallelic RFC1 expansion. (2) Objectives: The aim of this case series is to describe vestibular, gait, and speech alterations in CANVAS via a systematic approach. (3) Methods: All patients (n = 5) underwent a standardized clinical–instrumental examination, including the perceptual and acoustic analysis of speech, instrumental gait, and balance analysis (posturographic data were acquired using a force plate [Kistler, Winterthur, Switzerland] while 3D gait analysis, inclusive of surface electromyography, was acquired using a motion capture system [SMART DX, BTS Bioengineering, Milan, Italy], a wireless electromyograph [FreeEMG, BTS Bioengineering, Milan, Italy]), and vestibular assessment with video-oculography. (4) Results: Five patients were included in the analysis: three females (patients A, B, C) and two males (patients D and E) with a mean age at evaluation of 62 years (SD ± 15.16, range 36–74). The mean age of symptoms’ onset was 55.6 years (SD ± 15.04, range 30–68), and patients were clinically and instrumentally evaluated with a mean disease duration of 6.4 years (SD ± 0.54, range 6–7). Video-Frenzel examination documented spontaneous downbeat nystagmus enhanced on bilateral gaze in all patients, except for one presenting with slight downbeat nystagmus in the supine position. All patients exhibited different degrees of symmetrically reduced VOR gain for allsix semicircular canals on the video-head impulse test and an unexpectedly normal (“false negative”) VOR suppression, consistent with combined cerebellar dysfunction and bilateral vestibular loss. Posturographic indices were outside their age-matched normative ranges in all patients, while 3D gait analysis highlighted a reduction in ankle dorsiflexion (limited forward rotation of the tibia over the stance foot during the stance phase of gait and fatigue of the dorsiflexor muscles) and variable out-of-phase activity of plantar flexors during the swing phase. Finally, perceptual-acoustic evaluation of speech showed ataxic dysarthria in three patients. Dysdiadochokinesis, rhythm instability, and irregularity were observed in the oral diadochokinesis task. (5) Conclusions: CANVAS is a recently discovered syndrome that is gaining more and more relevance within late-onset ataxias. In this paper, we aimed to contribute to a detailed description of its phenotype. Full article

(1) Background: Atidarsagene autotemcel is a hematopoietic stem and progenitor cell gene therapy (HSPC-GT) approved to treat early-onset metachromatic leukodystrophy (MLD). The purpose of this case report is to describe the long-term management of residual gait impairment of a child with late infantile MLD treated with HSPC-GT. (2) Methods: Assessment included Gross Motor Function Measure-88, nerve conduction study, body mass index (BMI), Modified Tardieu Scale, passive range of motion, modified Medical Research Council scale, and gait analysis. Interventions included orthoses, a walker, orthopedic surgery, physiotherapy, and botulinum. (3) Results: Orthoses and a walker were fundamental to maintaining ambulation. Orthopedic surgery positively influenced gait by reducing equinovarus. Nonetheless, unilateral recurrence of varo-supination was observed, attributable to spasticity and muscle imbalance. Botulinum improved foot alignment but induced transient overall weakness. A significant increase in BMI occurred. Finally, a shift to bilateral valgopronation was observed, more easily managed with orthoses. (4) Conclusions: HSPC-GT preserved survival and locomotor abilities. Rehabilitation was then considered fundamental as a complementary treatment. Muscle imbalance and increased BMI contributed to gait deterioration in the growing phase. Caution is recommended when considering botulinum in similar subjects, as the risk of inducing overall weakness can outweigh the benefits of spasticity reduction. Full article

A randomized crossover trial was designed to investigate the influence of muscle activation and strength on functional stability/control of the knee joint, to determine whether bilateral imbalances still occur six months after successful anterior cruciate ligament reconstruction (ACLR), and to analyze whether the use of orthotic devices changes the activity onset of these muscles. Furthermore, conclusions on the feedforward and feedback mechanisms are highlighted. Therefore, twenty-eight patients will take part in a modified Back in Action (BIA) test battery at an average of six months after a primary unilateral ACLR, which used an autologous ipsilateral semitendinosus tendon graft. This includes double-leg and single-leg stability tests, double-leg and single-leg countermovement jumps, double-leg and single-leg drop jumps, a speedy jump test, and a quick feet test. During the tests, gluteus medius and semitendinosus muscle activity are analyzed using surface electromyography (sEMG). Motion analysis is conducted using Microsoft Azure DK and 3D force plates. The tests are performed while wearing knee rigid orthosis, soft brace, and with no aid, in random order. Additionally, the range of hip and knee motion and hip abductor muscle strength under isometric conditions are measured. Furthermore, patient-rated outcomes will be assessed. Full article

Neuro mechanical time delay is inevitable in the sensorimotor control of the body due to sensory, transmission, signal processing and muscle activation delays. In essence, time delay reduces stabilization efficiency, leading to system instability (e.g., falls). For this reason, estimation of time delay in patients such as people living with spinal cord injury (SCI) can help therapists and biomechanics to design more appropriate exercise or assistive technologies in the rehabilitation procedure. In this study, we aim to estimate the muscle onset activation in SCI people by four strategies on EMG data. Seven complete SCI individuals participated in this study, and they maintained their stability during seated balance after a mechanical perturbation exerting at the level of the third thoracic vertebra between the scapulas. EMG activity of eight upper limb muscles were recorded during the stability. Two strategies based on the simple filtering (first strategy) approach and TKEO technique (second strategy) in the time domain and two other approaches of cepstral analysis (third strategy) and power spectrum (fourth strategy) in the time–frequency domain were performed in order to estimate the muscle onset. The results demonstrated that the TKEO technique could efficiently remove the electrocardiogram (ECG) and motion artifacts compared with the simple classical filtering approach. However, the first and second strategies failed to find muscle onset in several trials, which shows the weakness of these two strategies. The time–frequency techniques (cepstral analysis and power spectrum) estimated longer activation onset compared with the other two strategies in the time domain, which we associate with lower-frequency movement in the maintaining of sitting stability. In addition, no correlation was found for the muscle activation sequence nor for the estimated delay value, which is most likely caused by motion redundancy and different stabilization strategies in each participant. The estimated time delay can be used in developing a sensory motor control model of the body. It not only can help therapists and biomechanics to understand the underlying mechanisms of body, but also can be useful in developing assistive technologies based on their stability mechanism. Full article

We studied the preventive effects of heat or cold therapy after repeated eccentric contraction against torque reduction, muscle soreness, and range of motion (ROM) due to delayed-onset muscle soreness (DOMS). A total of 42 healthy male subjects were randomly allocated into three groups: the HEAT group received heat therapy using an ultra-short-wave device; the ICE group received ice therapy using an ice pack; the Control group received no intervention. The measurements included maximal voluntary isometric, concentric, and eccentric elbow flexion torque, elbow extension ROM, pressure pain threshold, and muscle soreness with stretching muscle thickness and echo intensity. The measurements were taken before (pre), after (post), after (t-post), one–four days after, and seven days after the muscle damage protocol. The results showed the main effect of time on all measurements, but no significant interactions were observed. The results of this study suggest that heat or cold therapy in the first 30 min after intense eccentric exercise is insufficient to exert a preventive effect against DOMS. Full article

This study aimed to investigate the effects of cold-water immersion (CWI) and sports massage on delayed-onset muscle soreness (DOMS) in amateur athletes. Sixty male amateur athletes were randomised into four equal groups (n = 15) receiving either CWI, sports massage, their combination, or served as controls after applying plyometric training to their lower extremities. The main outcomes measures were pain, exertion, rectus femoris perimeter, knee flexion range of motion, knee extensors isometric strength and serum creatine phosphokinase (CPK) levels examined before the plyometric training, immediately after the treatment, and 24, 48 and 72 h post exercise. We observed no significant differences between study groups in the most tested variables. CWI improved pain compared to the combined application of CWI and sports massage, and the control group both on the second and third day post exercise. Sports massage combined with CWI also led to a significant reduction in pain sensation compared to the control group. In conclusion the treatment interventions used were effective in reducing pain but were unable to affect other important adaptations of DOMS. Based on the above, sports scientists should reconsider the wide use of these interventions as a recovery strategy for athletes with DOMS. Full article

Background: This study aims to determine the effects of kinesio tape (KT) application on acute-onset muscle soreness and the extensibility of the calf muscles in endurance athletes. Methods: A one-arm repeated-measures randomized cross-over controlled study design investigated 55 endurance athletes, including 10 cyclists, 30 badminton players, and 15 long-distance runners (mean age 16.40 ± 2.69) from different stadia in Delhi NCR, India. KT and sham tapes (ST) were applied randomly to right and left legs (prone position) in a cross-over manner with a gap of 72 h. Ankle dorsiflexion range of motion (ADFROM) and pain due to acute-onset muscle soreness were assessed immediately and 10 min and 30 min after treadmill running, using a universal goniometer and numeric pain rating scale (NPRS), respectively, along with the time to fatigue. Results: A statistically significant difference was observed for the NPRS when the mean scores obtained for the KT and ST groups were compared immediately after cessation of running; however, the difference was not statistically significant in the NPRS score that was recorded ten or thirty minutes after. The range of motion increased significantly after the application of both the KT and the ST. After running on a treadmill, the range of motion decreased significantly with both the KT and ST, and the decrease was similar. Conclusion: KT was more effective in reducing the pain intensity immediately after running and increased the time spent running on the treadmill before fatigue set in among endurance athletes. In addition, the two taping methods (KT or ST) were equally effective in enhancing calf muscle extensibility (for both right and left legs) immediately after application. However, both taping methods failed in limiting the decrease in ankle ADFROM after treadmill running. Full article