Search Results (680)

Background: Temporomandibular disorders are a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint with multifactorial pattern and genetic background. The aim of this observational study was to investigate the correlation between craniomandibular disorders and the presence of occlusal alterations. A clinical evaluation of the occlusal and articular status of the patients was carried out, integrating the latter with the electromyographic recording the activity of the masseter and temporalis muscles. Methods: A clinical observational study on 20 adults assessed temporomandibular disorders using DC/TMD criteria, anamnesis, clinical exams, occlusal and electromyographic analyses. Occlusion was evaluated morphologically and functionally. Electromyography tested static/dynamic muscle activity. Data were statistically analyzed using t-tests and Pearson correlation (p < 0.05). Results: Electromyographic analysis revealed significant differences between subjects with and without visual correction, suggesting that visual input influences masticatory muscle activity. Correlations emerged between occlusal asymmetries and neuromuscular parameters. These findings highlight clinical implications for mandibular function, muscle symmetry, and the potential for therapeutic rebalancing through targeted interventions. Conclusions: The study demonstrates a significant correlation between visual–motor integration and masticatory muscle efficiency. It emphasizes lateralized neuromuscular activation’s influence on occlusal contact distribution. Moreover, it identifies mandibular torsion–endfeel inverse correlation as a potential diagnostic marker for craniomandibular dysfunctions via surface electromyography. Full article

In this study, the effects of walking speed on lower limb muscle activity and gait parameters during over-ground walking were investigated in individuals with chronic stroke. Twenty-four patients with chronic stroke participated in a cross-sectional repeated-measures study, walking 20 m at three different speeds: slow (80% of self-selected speed), self-selected, and maximal speed. Surface electromyography was used to measure muscle activity in five paretic-side muscles (rectus femoris, biceps femoris, tibialis anterior, gastrocnemius, and gluteus medius), while gait parameters, including stride length, stance and swing phases, single-limb support time, and the gait asymmetry index were assessed using a triaxial accelerometer. As walking speed increased, activity in the rectus femoris, biceps femoris, and gastrocnemius muscles significantly increased during the stance and swing phases (p < 0.05), whereas the gluteus medius activity tended to decrease. Stride length on the paretic and non-paretic sides significantly increased with faster walking speed (p < 0.05); however, no significant improvements were observed in other gait parameters or gait asymmetry. These findings suggest that although increasing walking speed enhances specific muscle activities, it does not necessarily improve overall gait quality or symmetry. Therefore, rehabilitation programs should incorporate multidimensional gait training that addresses speed and neuromuscular control factors such as balance and proprioception. Full article

Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. Methods: This narrative review analyzed peer-reviewed literature from 2020–2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. Results: The review confirms rehabilitation as essential in addressing Intensive Care Unit–acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0–7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Discussion: Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Conclusions: Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally. Full article

Background: Nemaline myopathy is a rare congenital neuromuscular disease associated with progressive weakness and frequent respiratory complications. In emergency situations, families often serve as the first and only responders. The aim of this study is to explore how parents in Spain care for children with nemaline myopathy during emergency situations, focusing on the clinical responses performed at home and the organizational challenges encountered when interacting with healthcare systems. Methods: A qualitative phenomenological study was conducted with 17 parents from 10 families belonging to the Asociación Yo Nemalínica. Semi-structured interviews were performed via video calls, transcribed verbatim, and analyzed using Giorgi’s descriptive method and ATLAS.ti software (version 24). Methodological rigor was ensured through triangulation, reflexivity, and member validation. Results: Four themes were identified. First, families were described as acting under extreme pressure and in isolation during acute home emergencies, often providing cardiopulmonary resuscitation and respiratory support without professional backup. Second, families managed ambiguous signs of deterioration using clinical judgment and home monitoring tools, often preventing fatal outcomes. Third, parents frequently assumed guiding roles in emergency departments due to a lack of clinician familiarity with the disease, leading to delays or errors. Finally, the transition to the Pediatric Intensive Care Unit was marked by emotional distress and rapid decision-making, with families often participating in critical choices about invasive procedures. These findings underscore the complex, multidisciplinary nature of caregiving. Conclusions: Parents play an active clinical role during emergencies and episodes of deterioration. Their lived experience should be formally integrated into emergency protocols and the continuity of care strategies to improve safety and outcomes. Full article

Background: Botulinum toxin type A (BoNT/A) is widely used in both clinical and aesthetic settings to induce temporary neuromuscular paralysis by inhibiting acetylcholine release. Although generally regarded as safe and effective, complications such as iatrogenic ptosis or facial asymmetry may occur and persist for several weeks or even months, with no standardized method currently available to accelerate recovery. Objective: This article explores the hypothesis that photobiomodulation (PBM)—a non-invasive modality recognized for its neuroregenerative potential—may facilitate the reversal of BoNT/A-induced neuromuscular blockade. Discussion: PBM enhances mitochondrial activity by stimulating cytochrome c oxidase in nerve and muscle tissues, thereby increasing ATP production and modulating intracellular signaling pathways associated with neuroplasticity, cell survival, and synaptogenesis. Preclinical studies have demonstrated that PBM can upregulate neurotrophic factors (e.g., BDNF, NGF), enhance SNAP-25 expression, and promote structural remodeling of neurons in both young and aged brains. These mechanisms are biologically consistent with the regenerative processes required for recovery from BoNT/A-induced effects. While controlled clinical trials for this specific application are currently lacking, anecdotal clinical reports suggest that PBM may accelerate functional recovery in cases of BoNT/A-related complications. Conclusions: Although this approach has not yet been tested in clinical trials, we propose that photobiomodulation may hypothetically serve as a supportive strategy to promote neuromuscular recovery in patients experiencing adverse effects from BoNT/A. This hypothesis is grounded in robust preclinical evidence but requires validation through translational and clinical research. Full article

Plasmodium falciparum malaria remains a major cause of morbidity and mortality, particularly in endemic regions. We report the case of a 21-year-old male with recent travel to an endemic area (Guapi, Colombia), who presented with febrile symptoms, severe respiratory distress, and oxygen saturation below 75%, necessitating orotracheal intubation. During the procedure, he developed pulseless electrical activity cardiac arrest, achieving return of spontaneous circulation after advanced resuscitation. Diagnosis was confirmed by thick blood smear, demonstrating P. falciparum infection. The patient progressed to multiorgan failure, including acute respiratory distress syndrome with capillary leak pulmonary edema, refractory distributive shock, acute kidney injury with severe hyperkalemia, and consumptive thrombocytopenia. Management included invasive mechanical ventilation, vasopressor support, sedation-analgesia, neuromuscular blockade, methylene blue, unsuccessful hemodialysis due to hemorrhagic complications, and platelet transfusions. Despite these interventions, the patient experienced a second cardiac arrest and died. This case highlights the severity and rapid progression of severe malaria with multisystem involvement, underscoring the critical importance of early diagnosis and intensive multidisciplinary management. It also emphasizes the need for preventive strategies for travelers to endemic areas and the development of clinical protocols to improve outcomes in complicated malaria. Full article

Low-load conditioning activity with blood flow restriction has been addressed as an efficient method to enhance an individual’s performance during their main exercise activity. However, the optimal degree of blood flow restriction remains unclear. Therefore, this study investigated the acute effects of low-load conditioning activity with different degrees of blood flow restriction on muscle strength, power, and perceived exertion. Twenty recreationally trained men (20.9 ± 2.3 years) participated in a randomized crossover design including three conditions: control, low-load blood flow restriction at 50%, and 75% of total arterial occlusion pressure. Participants performed squats (three sets of ten reps) followed by isokinetic assessments of the knee flexor and extensor performance at 7 and 10-min post-exercise. The session rating of perceived exertion (SRPE) was recorded 30 min after each session. No significant effects were observed for condition, time, or their interaction on peak torque, total work, or average power (p < 0.05). However, SRPE was significantly higher in the 75% BFR condition compared to both the 50% BFR and control conditions (p < 0.05), with no difference between the 50% BFR and control. These findings suggest that low-load conditioning activity with blood flow restriction does not acutely enhance neuromuscular performance. However, a higher degree of restriction increases perceived exertion. Full article

Background: This study aimed to investigate how barbell type (elastic vs. inelastic) and lifting speed affect postural stability and lower limb muscle activation during the single-leg deadlift (SLDL), a common unilateral exercise in rehabilitation and performance training. Methods: Twenty-seven healthy adults performed SLDLs using both elastic and inelastic barbells under three lifting speeds (normal, fast, and power). Center of pressure (COP) displacement in the anterior–posterior (AP) and medial–lateral (ML) directions and electromyographic (EMG) activity of eight lower limb muscles were measured. Results: COP displacement was significantly lower when using elastic barbells (AP: F = 6.509, p = 0.017, η² = 0.200, ω² = 0.164; ML: F = 9.996, p = 0.004, η² = 0.278, ω² = 0.243). EMG activation was significantly higher for the gluteus medius, biceps femoris, semitendinosus, and gastrocnemius (all p < 0.01), especially under power conditions. Significant interactions between barbell type and speed were found for the gluteus medius (F = 13.737, p < 0.001, η² = 0.346, ω² = 0.176), semitendinosus (F = 6.757, p = 0.002, η² = 0.206, ω² = 0.080), and tibialis anterior (F = 3.617, p = 0.034, η² = 0.122, ω² = 0.029). Conclusions: The findings suggest that elastic barbells improve postural control and enhance neuromuscular activation during the SLDL, particularly at higher speeds. These results support the integration of elastic resistance in dynamic balance and injury prevention programs. Full article

Background: Resistance training (RT) promotes muscle hypertrophy and strength gains in both men and women. However, sex differences in neuromuscular performance, muscle fiber composition, and the hormonal environment influence strength and power adaptations. While men generally exhibit greater absolute and relative strength, it remains unclear to what extent these differences persist across various load intensities. A better understanding of sex-specific strength and power profiles may help optimize training strategies. The aim of this study was to compare strength and power performance during the bench press exercise in physically active males and females, relative to body mass and fat-free mass (FFM). Methods: Twenty-nine physically active individuals (16 men: 21.3 ± 4.1 years, 13 women: 22.6 ± 4.9 years) performed a one-repetition maximum (1RM) test and an incremental velocity-based assessment at 45%, 55%, 65%, 75%, and 85% of the 1RM using a Smith machine. The barbell velocity was measured via a linear transducer, with the mean propulsive velocity (MPV) recorded for each load. Power-related variables (e.g., peak force [F0], maximal velocity [V0], and maximal power [Pmax]) were analyzed. To account for differences in body composition, data were adjusted for body mass and FFM. Results: Men exhibited significantly greater strength and power than women across most loads when adjusted for both body mass and fat-free mass (FFM) (p < 0.05). These differences were particularly pronounced when normalized to FFM (45–75%1RM; p = 0.001–0.031), with large effect sizes observed (ηp² = 0.185–0.383). Notably, sex differences in mean propulsive velocity (MPV) disappeared at 85%1RM (p = 0.208; ηp² = 0.06), suggesting that maximal neuromuscular recruitment may minimize sex-related disparities at higher intensities. Furthermore, men demonstrated significantly higher values in six of the seven power-related variables, with no significant differences in the %1RM required to achieve an optimal power output. Conclusions: These findings confirm that men exhibit greater strength and power than women, even after adjusting for body composition. However, at high relative loads (≥85%1RM), sex differences in movement velocity appear to diminish, likely due to similar recruitment patterns of high-threshold motor units. These results highlight the importance of sex-specific resistance training programs, particularly in relation to load prescription and the application of velocity-based training methods. Full article

Acyl-CoA dehydrogenase 9 deficiency is considered as a rare neuromuscular syndrome with an autosomal recessive transmission. The ACAD9 protein presents two essential functions, i.e., the limiting step enzyme of the fatty acid β-oxidation pathway and one of the complex’s compounds involved in the respiratory chain complex I assembly. Thus, loss-of-function mutations are known to convey mitochondrial cytopathologies. A patient with a mild and late-onset phenotype, suffering from exercise intolerance and hypertrophic cardiomyopathy, was diagnosed as a compound heterozygote of the ACAD9 gene. The first c.1240C> T p.Arg414Cys variant has been previously reported and is known to be responsible for ACAD9 deficiency. However, the second c.1636G> A p.Val546Met variant has never been described. The goal was to investigate the eventual pathogenicity of this new genetic variant. For this purpose, molecular cloning was generated to express the ACAD9 gene with the V546M variant in a cell line (ACAD9mut) and compared to cells expressing the wild-type ACAD9. Then, the mitochondrial respiration, ATP production, the mitochondrial network, and the oxidative phosphorylation’s composition were investigated to reveal the effects of the V546M variant. While avoiding to affect the amount of the respiratory chain’s complexes, the new ACAD9 variant was entirely responsible for reducing over 50% of the mitochondrial complex I activity. Full article

Parathyroid hormone (PTH) has been studied to determine its broader role in musculoskeletal health, particularly its effects on skeletal muscle. Bone and muscle are inextricably linked via mechanical loading and biochemical signaling, with both processes playing important roles in muscular metabolism and function. Furthermore, the nervous system must maintain muscle mass and function, as neuromuscular transmission controls muscle contraction, protein synthesis, and energy metabolism. As a systemic endocrine regulator, PTH influences the physiology of skeletal muscle—both directly and through interactions with bone and the nervous system, modulating myokines, osteokines, and neuromuscular activity. The intricate relationships between PTH, muscle, bone, and nerves continue to be investigated due to their implications for aging, metabolic pathologies, and musculoskeletal disorders. Full article

This paper proposes an adaptive human–robot concurrent control scheme that achieves the appropriate gait trajectory for a robotic leg prosthesis to improve the wearer’s comfort in various tasks. To accommodate different wearers, a neuromuscular-force-based impedance method was developed using muscle activation to reshape gait trajectory. To eliminate the use of sensors for torque measurement, a disturbance observer was established to estimate the interaction force between the human residual limb and the prosthetic receptacle. The cost function was combined with the interaction force and tracking errors of the joints. We aim to reduce the cost function by minimally changing the control weight of the gait trajectory generated by the Central Pattern Generator (CPG). The control scheme was primarily based on human-in-the-loop optimization to search for a suitable control weight to regenerate the appropriate gait trajectory. To handle the uncertainties and unknown coupling of the motors, an adaptive law was designed to estimate the unknown parameters of the system. Through a stability analysis, the control framework was verified by semi-globally uniformly ultimately bounded stability. Experimental results are discussed, and the effectiveness of the adaptive control framework is demonstrated. In Case 1, the mean error (MEAN) of the tracking performance was $3.6°$ and $3.3°$, respectively. And the minimized mean square errors (MSEs) of the tracking performance were $2.3°$ and $2.8°$, respectively. In Case 2, the mean error (MEAN) of the tracking performance is $2.7°$ and $3.1°$, respectively. And the minimized mean square errors (MSEs) of the tracking performance are $1.8°$ and $2.4°$, respectively. In Case 3, the mean errors (MEANs) of the tracking performance for subject1 and 2 are $2.4°$, $2.9°$, $3.4°$, and $2.2°$, $2.8°$, $3.1°$, respectively. The minimized mean square errors (MSEs) of the tracking performance for subject1 and 2 were $1.6°$, $2.3°$, $2.6°$, and $1.3°$, $1.7°$, $2.2°$, respectively. Full article

Objective: This study aimed to investigate the efficacy of far-infrared (FIR) garments in enhancing recovery following resistance exercise in recreationally active individuals. Methods: Ten recreationally active adults (six females, four males; aged 20.7 ± 3.2 years) completed a resistance exercise protocol and were randomly selected to wear either FIR (n = 5) or placebo (n = 5) tights post-exercise. The FIR garments incorporated Celliant-based fibers emitting wavelengths in the 2.5–20 µm range. The participants’ recovery was assessed using countermovement jump (CMJ) metrics, including their jump height, takeoff velocity, and modified reactive strength index (mRSI), along with their fatigue biomarkers and subjective recovery perceptions. The CMJ performance was tested immediately post-exercise and at 24 and 48 h. Results: The FIR garments led to significant improvements in neuromuscular recovery, with greater increases in the jump height, takeoff velocity, and mRSI observed at 48 h post-exercise (p < 0.05). Notably, the mRSI showed earlier improvements at 24 h. The fatigue biomarkers did not differ between the groups (p > 0.05), suggesting localized rather than systemic recovery effects. The participants in the FIR group reported faster subjective recovery, with a readiness to resume activity perceived within 48 h, compared to slower recovery in the placebo group. Conclusions: FIR garments may enhance neuromuscular recovery and subjective recovery perceptions following resistance exercise, likely by improving the peripheral blood flow, metabolic clearance, and tissue oxygenation. These findings suggest that FIR garments may be effective in enhancing both neuromuscular and perceived recovery following resistance exercise, supporting their potential use as a post-exercise recovery tool. Full article

Whether pattern or amount of daily activity determines neuromuscular properties is the focus of this review. The fast-to-slow conversion of many properties of fast-twitch muscles, by stimulating their nerves electrically with the continuous low-frequency pattern typical of slow motoneurons, argued that muscle properties are determined by their pattern of activity. However, the composition of the motor units (MUs) in almost all muscles is heterogeneous, with the MUs grouped into slow, fast-fatigue-resistant and fast-fatigable types that match corresponding histochemical fiber types. Nonetheless, their contractile forces lie on a continuum, with MUs recruited into activity in order of their size. This ‘size principle’ of MU organization and function applies in normally innervated and reinnervated muscles and, importantly, begs the question of whether it is the amount rather than the pattern of the MU activation that determines their properties. Experimental evidence that uniform daily amounts of ~<0.5, 5%, and 50% ES, converted motoneuron, nerve, and muscle properties to one physiological and histochemical type, argued in favor of the amount of activity determining MU properties. Yet, that the properties were not confined to the expected narrow range argued that factors other than the pattern and/or amount of neuromuscular activity must be considered. These include the progressive increase in the synaptic inputs onto motoneurons. The range of the effects of endurance and intermittent exercise programs on healthy subjects and those suffering nerve injuries and disease is also consistent with the argument that factors other than pattern or amount of neuromuscular activity should be investigated. Full article

Background: Surface electromyography (sEMG) enables the non-invasive assessment of muscle activity and is widely used in orthodontics for evaluating masticatory muscles. However, little is known about the dynamic changes in facial expression muscles during orthodontic treatment. This study aimed to investigate alterations in facial muscle tone during the leveling and alignment phase in adult female patients undergoing fixed appliance therapy. Methods: The study included 30 female patients aged 20–31 years who underwent sEMG assessment at four time points: before treatment initiation (T0), at the start of appliance placement (T1), three months into treatment (T2), and six months into treatment (T3). Muscle activity was recorded during four standardized facial expressions: eye closure, nasal strain, broad smile, and lip protrusion. Electrodes were placed on the orbicularis oris, orbicularis oculi, zygomaticus major, and levator labii superioris alaeque nasi muscles. A total of 1440 measurements were analyzed using Friedman and Conover-Inman tests (α = 0.05). Results: Significant changes in muscle tone were observed during treatment. During lip protrusion, the orbicularis oris and zygomaticus major showed significant increases in peak and minimum activity (p < 0.01). Eye closure was associated with altered orbicularis oris activation bilaterally at T3 (p < 0.01). Nasal strain induced significant changes in zygomaticus and levator labii muscle tone, particularly on the right side (p < 0.05). No significant changes were noted during broad smiling. Conclusions: Orthodontic leveling and alignment influence the activity of selected facial expression muscles, demonstrating a dynamic neuromuscular adaptation during treatment. These findings highlight the importance of considering soft tissue responses in orthodontic biomechanics and suggest potential implications for facial esthetics and muscle function monitoring. Full article