Editor’s Choice Articles

Background: Musculoskeletal pain syndromes (MPSs) represent a major cause of disability and reduced quality of life, and conventional therapeutic approaches often provide only partial or temporary relief. Hyperbaric oxygen therapy (HBOT) delivered as 100% oxygen at 1.3–2.5 ATA, has been proposed to modulate inflammatory processes and enhance tissue repair. This review evaluated the effectiveness of HBOT on pain, function, quality of life, and physiological outcomes in individuals with MPS. Methods: This systematic review was conducted in different databases between June 30 and 30 September 2025, following PRISMA guidelines and was previously registered in PROSPERO (CRD420251073730). Studies published in English, Spanish, or Portuguese evaluating HBOT as a standalone or adjunctive intervention were included. Methodological quality and risk of bias were assessed using PEDro, NIH, and RoB 2.0 tools, and certainty of evidence was graded with GRADE. Results: Eighteen studies (17 RCTs and 1 case series; n = 671) were included. HBOT protocols ranged from 3 to 60 sessions, lasting 60–90 min, at approximately 1.3–2.5 ATA. Consistent reductions in pain and modest functional improvements were observed in fibromyalgia and postoperative conditions such as knee arthroplasty and peripheral nerve repair, with associated improvements in quality of life and inflammatory markers. Results for delayed-onset muscle soreness and acute ligament injuries were inconsistent. Conclusions: HBOT may provide adjunctive benefits in musculoskeletal pain syndromes, yet the current evidence remains limited. Standardized treatment protocols and high-quality trials are needed to better define its clinical applicability. Full article

Falls are a leading cause of injury and loss of independence in older adults, often linked to deficits in lower-limb muscle function and gait mechanics. Eccentric exercise can improve muscular resilience, while aquatic walking offers a safe, supportive environment to retrain gait; however, little is known about how these modalities interact at the neuromuscular level. This study compared lower-limb muscle activation during gait on land and in water, before and after an acute bout of eccentric exercise, in healthy young adults. Surface electromyography was collected from the tibialis anterior (TA), gastrocnemius medialis (GM), vastus lateralis (VL), and biceps femoris (BF) during treadmill walking on land and at equivalent speeds in chest-deep water. Results showed that aquatic walking consistently altered activation patterns relative to land walking, with increased TA activity (28%, Cohen’s d = 0.69) and reduced GM activity (−27%, Cohen’s d = −0.48) during swing, reduced VL activity during stance (−20%, Cohen’s d = −0.43), increased VL activity during swing (46%, Cohen’s d = 0.72), and increased BF activity during stance (51%, Cohen’s d = 0.63). These changes produced distinct co-activation patterns between the shank and thigh. Eccentric exercise had limited effects overall but increased thigh co-activation during swing in land walking. Findings suggest that eccentric exercise can be safely combined with aquatic walking and highlight the potential of this multimodal approach for enhancing gait mechanics relevant to fall prevention. Full article

Neuromuscular diseases (NMDs) include a heterogeneous group of progressive chronic conditions that frequently lead to substantial physical disability and loss of autonomy. Although motor and functional impairments of NMDs are well documented, the psychological burden remains underexplored. This narrative review synthesizes current literature regarding four psychological domains in individuals with NMDs: (i) anxiety, (ii) depression, (iii) coping strategies, and (iv) quality of life. Evidence indicates that anxiety and depressive symptoms are highly prevalent in the spectrum of NMDs, influenced by factors such as disease severity, onset age, and perceived social support. Maladaptive coping strategies, including avoidance and denial, are associated with poorer mental health outcomes and reduced involvement in rehabilitation. In contrast, adaptive strategies, such as acceptance and problem-focused coping, may help buffer psychological distress. Quality of life is consistently reported to be lower in people with NMDs compared to the general population, with psychosocial factors such as social support playing a role. Despite these findings, psychological care remains inconsistently integrated in NMD management. Full article

Intake of anthocyanin-rich blackcurrant extract showed muscle fibre-type specific force responses during fatigue development from combined use of voluntary maximal isometric contractions and electrically evoked twitch contractions of the m. quadriceps femoris. In the present exploratory study, we examined the fibre-type specific effects by blackcurrant extract on high-intensity intermittent treadmill running performance to exhaustion. Active males (n = 16, age: 23 ± 3 years, height: 179 ± 5 cm, body mass: 79 ± 3 kg, $\dot{V}$O_2max: 55.3 ± 5.0 mL·kg⁻¹·min⁻¹) completed a fatiguing protocol with 16 voluntary maximal isometric contractions to predict muscle fibre typology. The high-intensity intermittent running protocol was completed twice following a 7-day intake of blackcurrant extract (210 mg anthocyanins per day) and twice following a placebo (PL) in a randomized, double blind, crossover design. Heart rate and lactate were recorded at exhaustion. Data were averaged for each condition. There were no significant correlations between the percentage force decline by the repeated isometric contractions (mean ± SD: 29.3 ± 12.4%) and total and high-intensity running distance. Participants were categorized into a predominant muscle fibre type I (slow-twitch, n = 3 with the lowest isometric force decline: 12 ± 9%) and type II typology (fast-twitch, n = 3 with the highest isometric force decline: 46 ± 10%). Only the individuals with a predominant type I fibre typology improved the total running and high-intensity running distance by 17 ± 12% and 15 ± 11%. At exhaustion, there were no differences between individuals with a type I or II fibre typology for heart rate and lactate. These exploratory results suggest that the ergogenic potential of anthocyanin-rich blackcurrant extract on high-intensity intermittent exercise may depend on muscle fibre type, though larger and more robust studies are needed to confirm this observation. Future work will establish whether our exploratory results contributed to our understanding of the underpinning of inter-individual responses to the intake of anthocyanin-rich nutritional ergogenic aids. Full article

Sarcopenia, the loss of skeletal muscle mass and function, is a common and critical comorbidity in patients with conditions frequently managed by interventional radiologists, such as liver cirrhosis and hepatocellular carcinoma (HCC). Interventional radiologists are well positioned to incorporate opportunistic screening for this condition during routine preprocedural cross-sectional imaging. This review summarizes the current evidence on how sarcopenia influences patient outcomes and informs procedural planning across a spectrum of interventional radiology (IR) procedures. In transarterial embolizations for HCC, sarcopenia is a robust independent predictor of increased mortality, with meta-analyses suggesting it may also predict a lower tumor response rate. Even earlier stages of muscle loss (pre-sarcopenia) are associated with worse survival, and dynamic changes in muscle mass post-treatment can serve as a biomarker for tumor progression. For patients undergoing transjugular intrahepatic portosystemic shunt, pre-procedural sarcopenia and myosteatosis are strong, independent predictors of both mortality and the development of post-procedural hepatic encephalopathy, with the presence of both conferring the highest risk. In the context of pre-surgical portal vein embolization, sarcopenia is consistently associated with impaired volumetric liver growth, although this does not always translate to worse short-term surgical outcomes, as functional liver regeneration may be preserved. Following percutaneous liver tumor ablation, sarcopenia is a powerful predictor of overall mortality, while its role in predicting tumor recurrence remains an area of active investigation. Finally, in non-oncologic interventions for peripheral arterial disease, sarcopenia is highly prevalent and is associated with worse functional status, higher mortality, and a significantly increased risk of major amputation after endovascular therapy. In conclusion, sarcopenia is a powerful and readily available biomarker that provides crucial prognostic information—often independent of standard clinical scores—across a wide spectrum of IR procedures. The consistent evidence supports integrating sarcopenia evaluation into routine practice to enhance risk stratification, improve patient counseling, and guide multidisciplinary treatment planning. Full article

Football requires repeated sprint ability for game-changing moments; however, the demand on the skeletal muscles is unknown. The aim of the current study was to determine the muscle oxygen response during duplicate sprints in professional footballers. Eight male professional footballers (age: 29 ± 5 y; height: 181 ± 8 cm; weight: 78 ± 8 kg) were recruited. Participants wore their normal GPS unit and completed their normal match warm-up before near-infrared monitors were attached to the rectus femoris and bicep femoris muscles. Participants then completed two 30 m sprints with 10 s of recovery, while GPS data and muscle oxygenation were recorded. Max speed was unaltered across the two sprints (s1: 8.4 ± 0.3 m.s⁻¹; s2: 8.4 ± 0.4 m.s⁻¹), but max acceleration (s1: 5.0 ± 1.5 m.s⁻²; s2: 3.7 ± 1.2 m.s⁻²) and time to max acceleration (s1: 1.0 ± 0.3 s; s2: 1.8 ± 0.8 s) were significantly different in sprint 2 compared with sprint 1. Change in muscle oxygenation was greater in the bicep femoris muscle than in the rectus femoris muscle in sprint 1 (right BF: 37.0 ± 14.7%; right RF: 23.4 ± 14.8%). Time to fast delay was longer in sprint 2 than in sprint 1 in the bicep femoris muscle (right BFs1: 1.6 ± 1.2 s; right BFs2: 5.2 ± 2.3 s), reflecting different recovery kinetics in the two muscles. During duplicate sprints there is a difference in oxygen response between the two muscles, and the overall recovery of the bicep femoris is much slower. This suggests poorer conditioning of the bicep femoris muscle, which may impact injury risk in professional football players. Full article

Duchenne muscular dystrophy (DMD), which results from mutations that disrupt the expression of dystrophin proteins, is characterized by progressive muscle fiber wasting and the development of skeletal muscle fibrosis. The severe pathology leads to loss of ambulation, respiratory insufficiency, cardiomyopathy, and early death in patients. Dystrophin-focused therapies based on adeno-associated viral (AAV) vector-mediated gene addition, antisense oligonucleotide-induced repair of the transcript reading frame, and chemically driven stop codon readthrough have been conditionally approved for use in subsets of patients. From trials, it is apparent that these therapies act to stabilize the disease phenotype rather than improve it significantly, meaning that early treatment results in better outcomes. AAV-mediated delivery of a form of utrophin, a structural and functional homolog of dystrophin, GALGT2, a sarcolemmal stabilizer, and Klotho, the anti-aging hormone that is silenced in a mouse model of DMD as a result of the disease pathology, have been explored in preclinical compensatory gene addition studies. Recombinant follistatin protein has been used to target the fibrosis seen. An all-in-one type of therapy is likely to provide a synergistic effect such that efficacy of the dystrophin restoration strategy would be improved. For this, CRISPRa could hold potential through the targeting of multiple relevant genes simultaneously. The suitability of targeting these genes will be discussed, as will the stages of the development of CRISPRa for DMD. A perspective on the future prospects of CRISPRa in relation to likely issues that would need addressing and how they may be overcame will be given. Full article

Inclusion body myositis (IBM) is a late-onset, treatment-resistant inflammatory myopathy. Approximately half of IBM patients develop autoantibodies against cytosolic $5^{\prime }$-nucleotidase 1A (cN1A), but their role in disease pathogenesis remains unclear. This pilot study examined the effects of anti-cN1A-positive IBM serum on human primary myotubes’ transcriptome profile, using anti-cN1A-negative IBM and healthy sera as controls. Exposure to anti-cN1A-positive serum altered the expression of 1126 genes, with upregulation of adaptive immune response genes, notably CTSH and CTSZ, encoding cathepsins H and Z. These findings were validated using a publicly available independent dataset comprising transcriptomes from fresh muscle tissue samples. NT5C1A mRNA, which encodes cN1A, was not detected in cultured myotubes regardless of the presence of autoantibodies. The findings suggest distinct pathological mechanisms in anti-cN1A-positive IBM, independent of direct antibody-target interactions. The role of cathepsins in IBM pathogenesis warrants further investigation. Full article

Light therapy has been shown to produce several beneficial physiological effects in a wide range of tissues. The musculoskeletal system can be irradiated with deeply penetrating wavelengths in near infrared (NIR) regions. Photobiomodulation therapy (PBMT) reduces pain and inflammation and enhances physical performance. However, the mechanism(s) of cellular responses to PBMT in muscle is not clearly understood. Therefore, the goal of this study is to improve our understanding of the mechanism(s) of action of PBMT effects in exercised and sedentary muscle. In sedentary mice, PBMT using a wavelength of 830 nm increased the gene expression for muscle tissue development, including cFos, which is critical for activating interstitial and satellite cells that repair muscle. Immunostaining for cFOS expression confirmed an increase in the number of activated cells in PBMT-treated muscle. We observed that PBMT-treated mice showed increased performance on the treadmill, reduced muscle fiber damage, and altered mitochondrial structure. RNA sequencing from fatigued TA tissue suggested that PBMT treatment increased the gene expression of tissue regeneration and remodeling, suggesting tissue adaptation and muscle repair after exercise with PBMT. In conclusion, our study suggests that the 830 nm wavelength may have altered the muscle by activating regenerative genes that protect the tissue from exercise-induced cellular stress. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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

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

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

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

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

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

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

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

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

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

Boxing is a sport that has a high level of oxygen use within the Rectus Femoris muscle, with recovery between rounds important to subsequent performance. The study aimed to determine muscle oxygen use in male and female professional boxers in response to a repeated sprint stimulus. 10 male (age: 26 ± 5 years, height: 177 ± 4 cm, weight: 72 ± 6 kg) and 6 female (age: 29 ± 4 years, height: 173 ± 2 cm, weight: 73 ± 4 kg) professional boxers took part. Participants attended a single session where a Moxy near-infrared monitor was placed on the rectus femoris muscle of both legs. Participants completed 2 × 30 s Wingate-based sprint efforts with a 60 s active recovery (maintaining 60 rpm against 50 W resistance). Skeletal muscle oxygenation was recorded throughout. Significant differences were found in peak power, average speed and rate of fast desaturation between males and females (p < 0.001) in both sprints. There was a significant difference in males and females for the rate (sprint 1M: −5.6 ± 1.2%.s⁻¹, 1F: −2.3 ± 1.9%.s⁻¹, p < 0.05; sprint 2M: −4.2 ± 1.1%.s⁻¹, 2F: −1.5 ± 0.9%.s⁻¹, p < 0.05) and duration of fast desaturation (sprint 1M: 6.1 ± 1.3 s, 1F: 3.7 ± 2.8 s, p < 0.05; sprint 2M: 7.3 ± 1.6 s, 2F: 4.5 ± 1.0 s, p < 0.05) in both sprints. This study demonstrates that male professional boxers have a significantly different oxygen use and recovery in response to a high-intensity stimulus compared to female boxers. In both male and female boxers, the ability to perform subsequent high-intensity activity is dependent on the quality of the recovery from the initial high intensity activity. Therefore, there is a greater need to focus training to improve recovery kinetics in boxing. Full article

Background: Previous work has found that combining plyometric and resistance training in a single session can be effective in improving maximum strength (muscle contraction ability), vertical jumping, and sprint acceleration performance in young soccer players. However, the literature is scarce in relation to young rugby union players. Thus, the purposes of the present study were to examine the effects of a 6-week combined training (CT) programme that combined plyometric and resistance training in the same session on physical performance measures in adolescent male rugby union players and whether a 4-week period of plyometric training exclusion (Detraining) affects training adaptations. Methods: The participants (n = 15) completed a 6-week CT intervention and 4 weeks of plyometric detraining during the schoolboy rugby union in-season. A performance testing battery was conducted pre-intervention, post-intervention, and 4 weeks post-intervention. Results: A repeated measures ANOVA showed a significant effect for time on CMJ variables (mean power, mean force, and modified reactive strength index [RSI]), 3RM back squat strength, and 505 test time (p < 0.05). Pairwise comparisons revealed that CMJ variables (mean force, mean power, and peak power), 3RM back squat strength, and 505 test performance significantly increased from pre-intervention to post-intervention (p < 0.05). The 4-week plyometric detraining period significantly augmented CMJ variables (mean force, mean power, and modified RSI) and performance measures (standing broad jump [SBJ], 20 m sprint time, 505 test, and 3RM strength). Conclusions: The findings indicate that a 6-week CT programme can augment measures of lower-body power, maximal strength, and change of direction performance in adolescent male rugby union players, and a 4-week resistance training-only period (plyometric detraining) does not negatively affect performance adaptations. Full article

Benign paroxysmal torticollis (BPT) is a condition characterized by episodes of alternating head tilt in infants. Mild cases may be mistaken for Congenital Muscular Torticollis, potentially leading to unnecessary treatment. This case report describes an infant with suspected mild BPT who exhibited alternating head tilt and colic but demonstrated normal motor development. The head tilt resolved spontaneously without intervention. Physical therapists should be aware of mild benign paroxysmal torticollis and monitor such cases carefully to differentiate it from other forms of torticollis and to provide reassurance to parents. Full article

Background/Aims: The pelvic floor muscles are important structures involved in pelvic floor tone, pelvic organ support, and continence. The aim of this study was to perform an update on the pelvic floor muscle structure and function alterations of women with pelvic floor dysfunctions. Methods: A systematic search was undertaken in two electronic databases, PubMed/Medline and Ovid Discovery to find manuscripts (in English), published between 1 January 2002 and 31 July 2022, including all clinical studies using the following search terms: “muscle” or “extracellular matrix *” and “pelvic floor dysfunction *”. All clinical trials, observational, or animal studies examining the muscle and reporting pelvic floor dysfunction as a primary outcome were included. Case reports, literature reviews, conference papers and theses, and unpublished data were excluded. To ensure that no eligible articles were overlooked, the reference lists of all included papers underwent manual scrutiny. The bias level was estimated using Newcastle–Ottawa Scale (NOS) for cohort and case-control studies. A qualitative synthesis was performed. Results: The significant qualitative and quantitative heterogeneity between the studies did not allow for a quantitative analysis. Of the 30 articles selected with a total of 5592 women, 15 referred to the analysis of structural muscle defects, which included 3365 participants with urinary incontinence, pelvic organ prolapse, fecal incontinence, cistocele, rectocele, and sexual dysfunction; 10 manuscripts referred to the study of pelvic floor muscle function with a population of 2042 women, such as urinary incontinence, pelvic organ prolapse, fecal incontinence, and sexual dysfunction; and 5 papers evaluated cellular and/or molecular changes affecting the pelvic floor muscles, like urinary incontinence, pelvic organ prolapse, and rectocele, which included a total of 185 participants. Women with pelvic floor muscle defects are at greater risk of pelvic floor dysfunctions, and inversely, women with pelvic floor dysfunctions have more pelvic floor muscle defects than women without pelvic floor dysfunctions. These patients demonstrate a reduction in muscle tone, contraction strength, and resistance, a compromised neuromuscular activity, and an alteration of the normal composition and organization of the muscle cells. Conclusions: Women with pelvic floor dysfunction have anatomical muscle defects, disturbance of muscle function and cellular changes involving muscle cells and nerve fibers. Full article

Barbell (BB) and dumbbell (DB) devices are commonly used during a bench press to develop the muscles of the chest, shoulders, and upper arms. Recently, a complete upper body bar (CUBB) was designed to train the muscles of the forearm by allowing for pronation and supination while providing the same traditional training for the rest of the upper body. The purpose of this study was to investigate the effectiveness of the CUBB relating to the EMG activity of the forearm during a bench press. Methods: A total of 21 healthy college-aged men volunteered for this study. EMG sensors were placed on the anterior deltoid (AD), pectoralis major (PEC), triceps brachii (TRI), pronator teres (PRO), and supinator (SUP). The participants went through a bench press test in a series of three different randomized conditions: the DB, the BB, and the CUBB. Resistance was set at 30% of body weight. A repeated-measures ANOVA was used to analyze the normalized EMG data (alpha = 0.05). Results: For the forearm muscles, the CUBB exhibited 41% and 37% higher PRO activation than the DB and BB, respectively. In addition, the CUBB exhibited 67% and 30% more SUP activation than the BB and DB, respectively. For the shoulder and chest muscles (AD and PEC), no significant differences were found among the three conditions. Conclusions: Bench pressing with a CUBB can engage more upper body muscles and offer individuals additional training benefits. Full article

Elevated temperatures have been shown to decrease muscle force production, with potential causes including protein unfolding, enzyme denaturation, and reactive oxygen species (ROS). This study aimed to investigate whether fucoidan, a compound derived from brown seaweed, could mitigate heat-stress-induced loss of muscle function. C57BL/6 mice were orally administered fucoidan (400 mg/kg/day) from one of two different seaweed species Fucus vesiculosus (FVF) or Undaria pinnatifida (UPF) or vehicle control for seven consecutive days. Subsequently, the in vitro muscle function of the fast-twitch extensor digitorum longus (EDL) was assessed at either 25 °C (control) or 43 °C (heat stress). Functional analysis was complemented with gene analysis and the C2C12 myoblast heat-stress assay. The temperature (43 °C)-induced loss of force produced by the EDL muscle was significantly attenuated by fucoidan from FVF but not UPF. Fucoidan from UPF did not affect gene expression levels, whereas fucoidan from FVF significantly increased the expression levels of HSP90. In mouse C2C12 myoblasts, heat stress induced a significant increase in ROS production which was significantly reduced by both fucoidan species. These results suggest fucoidan extracted from Fucus vesiculosus may be an effective preventive strategy to protect against heat-induced loss of muscle strength in fast-twitch muscles. Full article

This study examined the association between knee proprioception, strength, and functional symmetry in healthy individuals using isokinetic strength tests, proprioception assessments, and hop tests. Twenty young, healthy adults (mean age 26.5 ± 4.1 years, 85% right-limb dominant) participated. Knee extensor and flexor strength were measured at 60°·s⁻¹ and 240°·s⁻¹. Proprioception was assessed by measuring passive joint position sense (JPS1: position recognition; JPS2: repositioning) and kinesthesia (threshold to detection of passive motion, TTDPM). Functional performance was evaluated using the single-leg hop test (SLH), triple-hop test (TH), and crossover hop test (COH). Symmetry was calculated using the limb symmetry index (LSI) as the ratio of non-dominant to dominant limb values. The results showed that THT (p = 0.011) and COH (p = 0.032) performance was superior on the dominant limb. A correlation analysis revealed strong positive correlations between hop test distances and knee extensor strength (r = 0.56–0.70, p < 0.001). JPS symmetry was negatively correlated with hop test symmetry (JPS1: SLH, r = −0.53; THT, r = −0.49; COH, r = −0.70). The participants with poorer position sense on the non-dominant leg were 2.7 times more likely to show LSI < 90% (p = 0.035). In conclusion, proprioception—particularly joint position sense—is associated with functional symmetry during dynamic tasks, highlighting the importance of proprioceptive assessments in rehabilitation and injury prevention. Full article

Background/Objectives: CrossFit^® is one of the most popular yet controversial training regimens. Some groups extol the positive effects of its practice, while others argue that it is unsafe and that there is limited information. The aim of this study was to investigate, through a self-reported questionnaire, the epidemiology of Portuguese CrossFit^® training practitioners. Methods: Statistical analyses, including Mann–Whitney U, chi-square, Spearman’s rho correlations, and logistic regressions, were conducted. Results: A total of 288 practitioners completed the questionnaire, with 39.9% reporting injuries. These injuries occurred mainly during training, particularly when performing gymnastics exercises. Tendon (40.9%) and shoulder (46.1%) were the most common injuries. Key risk factors for injury included male gender (OR = 2.7), years of practice (4–6 years: OR = 7.22), heavier body weight (OR = 4.76), and higher weekly training volume (4–6 times per week). Conclusions: Approximately 40% of CrossFit^® practitioners are expected to experience injuries, particularly in the shoulder and tendons. Injury risk is influenced by factors such as practice years, weekly training, sex, and body weight. These findings may help guide practitioners, coaches, and health professionals in better understanding the risk factors, mitigating injuries, and developing effective injury prevention strategies. Full article

Friedreich’s ataxia (FRDA) results from a faulty mitochondrial protein known as Frataxin. The purpose of this case report was to test whether skeletal muscle in FRDA can adapt to an endurance-based training program using neuromuscular electrical stimulation (NMES). A 36-year-old female with FRDA completed twelve training sessions, each lasting 30 min over 30 days, focused on the forearm muscles using NMES. Pre- and post-training session measurements of contractions, muscle-specific endurance, and muscle mitochondrial capacity were taken per training session. Training contractions increased from 4200 to 9420. Muscle-specific endurance increased by 14% at 2 Hz and 17% at 4 Hz. Muscle endurance at 6 Hz increased from 0% to 51%. The rate constant of mitochondrial capacity was 0.95 min⁻¹ pre- and 0.99 min⁻¹ post-training session. In conclusion, one month of NMES increased training volume and muscle-specific endurance but did not change mitochondrial capacity. Muscle adaptations to endurance training were seen in FRDA, but increased training might be needed to test if mitochondrial capacity can improve. Full article

Maximal eccentric (MES) and isometric (MIS) muscle strength may enhance vertical jump performance by facilitating preloading and reducing energy loss during the eccentric (ECC) phase of the stretch-shortening cycle (SSC). However, the contributions of ECC and isometric (ISO) strength to the countermovement (CMJ) and depth jump (DJ) remain unclear due to variability in assessment methods (e.g., dynamometry, isometric mid-thigh pull) and the limited range of metrics examined in prior research. The aim of this study was to assess correlations between multi-joint lower extremity MES and MIS, obtained using a seated multi-joint isokinetic dynamometer, and 13 vertical ground reaction force (GRF) measures derived from the performance of three maximal effort DJs and CMJs. Twenty-five healthy young adults participated in this study (age = 21.9 ± 2.9 years). Pearson r correlation coefficients were used to assess the statistical significance (α = 0.05) of the relationships between absolute (N) and body mass normalized (BN) maximal strength measures and vertical jumping metrics. Moderate-to-strong positive correlations were identified between MES and MIS with broad performance metrics in CMJ and DJ, including reactive strength index (r = 0.45–0.53, p < 0.05), modified reactive strength index (r = 0.41–0.62, p < 0.05), and jump height (r = 0.59–0.75, p < 0.05). Moderate-to-strong positive correlations were also observed between MES and MIS with CON work (r = 0.58–0.71, p < 0.05) and CON peak power (r = 0.44–0.71, p < 0.05) for both the CMJ and DJ. In contrast, moderate-to-strong negative correlations were observed between MES and MIS with ECC work (r = 0.42–0.62, p < 0.005) and ECC peak power (r = 0.45–0.60, p < 0.05). These findings suggest that enhanced neuromuscular efficiency and joint stiffness in stronger musculature reduce energy absorption during the eccentric phase, minimizing mechanical deformation and preserving elastic energy for concentric propulsion. Combined, MES and MIS optimize force application, energy utilization, and control, which are crucial for maximizing jump height. These findings underscore the role of MES and MIS in influencing jumping performance across both the ECC and CON phases of the SSC. This insight is valuable for practitioners designing training programs aimed at improving vertical jumping ability. Full article

Background: The presence of sensorimotor control deficits in adolescent idiopathic scoliosis compared to typically developed adolescents is supported by the literature but lacks reliability studies for assessment in this population. This study aimed to assess the reliability of eight sensorimotor control tests, in terms of static and dynamic balance, joint position sense (JPS) tests of the extremities and the spine, and a functional upper extremity proprioceptive test in adolescent idiopathic scoliosis subjects. Methods: Sixty adolescent idiopathic scoliosis subjects were divided into four groups. Each group underwent two tests by the same examiner, repeated at 15 min intervals. Reliability was measured using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest detectable difference (SDD). Results: The results showed high reliability for the upper extremity functional proprioception test, for the dynamic and static balance test, and for the spinal lateral flexion joint position sense test in both directions. On the other hand, the shoulder external rotation, knee extension, elbow flexion, and spinal flexion joint position sense tests demonstrated poor reliability in adolescent idiopathic scoliosis subjects. Conclusions: Therapists are recommended to use the functional upper extremity proprioception test, the Fukuda test, the static balance test using a force footplate, and the spinal lateral flexion joint position sense test for assessing treatment progress in this population. Full article

Medial gastrocnemius silent contractures (MGSCs) are prevalent, notably impacting functional status and increasing the risk of foot and ankle disorders, especially among aging populations. Although traditionally managed by podiatrists and physiotherapists, the role of rehabilitation nursing in addressing MGSCs is gaining recognition. This paper elucidates the contributions of rehabilitation nursing to the functional rehabilitation of MGSC patients and underscores its vital role within the multidisciplinary team. Initially, the paper defines the clinical and physiological characteristics of MGSCs and their implications in foot and ankle disorders. It then meticulously explores rehabilitation nursing interventions—including personalized stretching regimens, vibration therapy, balance exercises, and judicious footwear selection—emphasizing their efficacy in enhancing muscle flexibility, joint mobility, and postural stability. The emphasis is on patient-centered approaches and education to foster treatment adherence and positive rehabilitation outcomes. The significance of interdisciplinary collaboration is highlighted, focusing on how rehabilitation nursing optimizes patient care and mitigates complications. The paper advocates for recognizing and integrating rehabilitation nursing in managing MGSC-related disorders, emphasizing its importance in achieving successful functional outcomes. Full article

The Nordic hamstring exercise (NHE) is effective at decreasing hamstring strain injury risk. Limited information is available on the in vivo mechanics of the bicep femoris long head (BF_LH) during the NHE. Therefore, the purpose of this study was to observe kinematic, neuromuscular and in-vivo mechanics of the BF_LH during the NHE. Thirteen participants (24.7 ± 3.7 years, 79.56 ± 7.89 kg, 177.40 ± 12.54 cm) performed three repetitions of the NHE at three horizontal planes (0°, 20° and −20°). Dynamic ultrasound of the dominant limb BF_LH, surface electromyography (sEMG) of the contralateral hamstrings and sagittal plane motion data were simultaneously collected. Repeated measures analysis of variance with Bonferroni post hoc corrections were used on the in vivo mechanics and the kinematic and sEMG changes in performance of the NHE. Likely differences in ultrasound waveforms for the BF_LH were determined. Significant and meaningful differences in kinematics and in vivo mechanics between NHE variations were observed. Non-significant differences were observed in sEMG measures between variations. Changes to the NHE performance angle manipulates the lever arm, increasing or decreasing the amount of force required by the hamstrings at any given muscle length, potentially changing the adaptive response when training at different planes and providing logical progressions ore regressions of the NHE. All NHE variations result in a similar magnitude of fascicle lengthening, which may indicate similar positive adaptations from the utilization of any variation. Full article

Despite ongoing efforts, the relationship between groin strength and injury remains unclear. The challenge of accurately predicting injuries presents an opportunity for researchers to develop prevention strategies to reduce the occurrence of such injuries. Consequently, this issue requires further investigation to obtain insights into effective mitigation strategies. In 120 male soccer players, the maximum isometric strength of the hip muscle groups was measured, and the strength ratios were calculated. Previous injury and anthropometric data were registered. Injury data were collected following the FIFA/UEFA consensus. k-nearest neighbor (k-NN) was used to predict the incidence of injury, while the significant predictive variables of the k-NN algorithm were fitted into a multivariate logistic regression model (LR) to analyze the likelihood of players sustaining a groin injury. The LR model determined two variables as significant predictors of groin injury. Players were less likely to sustain a groin injury by 76% for each decrease of the adductor/abductor isometric strength ratio in the non-dominant limb (OR = 0.238, CI 95% = [(0.098–0.572]). Players with a history of previous injury had a 67% greater risk of sustaining an injury (OR = 0.333, CI 95% = [(0.1068–1.038]). Isometric hip adductor and abductor strength imbalances of the non-dominant lower limb and a history of previous injury were risk factors for groin injury in soccer players. Full article

Previous studies have revealed decreased proprioception and perception of joint position in elderly adults. Joint position sense, indicating an individual’s ability to perceive the position of limbs without visual aid, is essential for everyday movements. A few studies have shown a positive effect of muscle stretching on joint position sense (JPS). However, these studies have only been conducted with younger participants. The impact of stretching on JPS in elderly adults remains unclear. Therefore, the aim of this study is to compare the acute effects of muscle stretching on joint position sense in young and elderly adults. An experimental group of younger adults (n = 15; 25.4 ± 2.9 years) and an experimental group of active, healthy elderly adults (n = 15; 64 ± 3.5 years) stretched their knee flexor muscles. The absolute error (AE) of the joint position sense was calculated before and after muscle stretching. The results indicated no significant difference in the AE between groups (p > 0.05) after the stretching intervention. The similarity in the physical activity status of the subjects may have influenced the results. Even though no significant age-specific differences were found in this study, its results may not be applicable to non-active elderly adults. Full article

Exertional rhabdomyolysis (ER) is a condition where muscle breakdown occurs after intense and unaccustomed exercise in healthy individuals. It is characterized by muscle pain, weakness, and myoglobinuria, potentially leading to acute kidney injury and worsening the patients’ prognosis. Ultra-trail races (UT) necessitate high energy and extreme muscular exertion, which can result in significant muscle breakdown, leading to ER and elevated biomarkers such as creatine kinase (CK) and lactate dehydrogenase (LDH). These races involve longer durations and both uphill and downhill elevations, with the latter causing more muscle damage. This systematic review aims to analyse the effect of downhill elevation (at least 1000 m) in UT on muscle and liver damage biomarkers. We conducted a systematic review of four electronic databases (Pubmed, Web of Science, Scopus, and Sportdiscus) based on PRISMA guidelines for systematic reviews. We included a total of 15 articles out of 6670 published between January 2005 and March 2024. The total population sample included 348 subjects, comprising 294 men (84.48%) and 54 women (15.52%) with a mean age of 39.82 ± 6.89 years. Only one subject (0.28%) was diagnosed with ER. The median increase in CK post vs. pre was 5370.63 ± 7289.71%, LDH post vs. pre was 311.20 ± 164.4%, and liver damage biomarkers aspartate transaminase (AST) and alanine aminotransferase (ALT) obtained mean increases of 1009.94 ± 743.97% and 207.02 ± 92.84%, respectively. No liver injury cases were reported. These findings suggest that ER is often misdiagnosed in UT and may result in acute kidney injury under certain circumstances. Therefore, it is crucial to define and prepare the characteristics required for ultra runners to safely participate in these extreme races. Full article

The prevalence of skeletal muscle atrophy, caused by disease and aging, is rising as life expectancy increases. Exercise is the most effective treatment option; however, it is often impractical for individuals suffering from disease or bedridden. The formulation of non-exercise-based interventions is necessary. This study assessed the impact of acupuncture (AC), electro-acupuncture (EA), and electrical stimulation (ES) on muscle mass and contractile properties in a model of casting-induced muscle atrophy. Sprague-Dawley rats (n = 40) were assigned to five groups: control (CON), cast (CT), cast receiving AC (CT-AC), cast receiving EA (CT-EA), and cast receiving ES (CT-ES) (n = 8 each). Treatments were 15 min and three times/week for 14 days. Contractile properties and protein markers of atrophy and inflammation were measured. Casting decreased muscle mass and fiber cross-sectional area, but AC, EA, and ES attenuated cast-induced muscle atrophy. All treatments increased peak twitch tension compared to CT. CT increased the protein levels of MAFbx and MuRF1, while AC, EA, and ES mitigated the elevation of these proteins. Our results indicate that acupuncture, electro-acupuncture, and electrical stimulation show promise as therapeutic strategies to counteract skeletal muscle loss and dysfunction resulting from disuse atrophy caused by injury, disease, and aging. Full article

Background: Musculoskeletal pain is a non-negligible multifaceted condition affecting more than 30% of the global population. Superficial heat therapy (HT), through increasing tissue temperatures, plays a role in increasing local metabolism and function and relieving pain. Knee (KP) and sports pain represent two relevant fields of superficial HT application. Methods: In the present paper, a panel of experts performed a narrative review of the literature regarding the role of superficial HT in the management of knee and sports activity-related pain. Results: According to the reviewed literature, HT represents a therapeutic option in the management of musculoskeletal pain due to three main effects: pain relief, promotion of healing, and return to normal function and activity. Moreover, HT plays a role in sport activities both before and after exercise. Before performing sports, HT helps in preparing muscles for performance. After performing sports, it is capable to promote recovery and healing pathways. Combining and sequencing superficial heat and cold therapy represent an interesting topic of study. Overall, the application of heat wraps for superficial HT can be considered safe. Conclusions: HT has been shown to be a potentially beneficial and safe option in the management of several conditions including KP and sports. The key in the application of superficial HT is a multimodal and multidisciplinary approach. Full article

Myokines released by exercise are identified as factors that can influence a person’s health and wellbeing. While myokine secretion in response to an acute bout of endurance and resistance-type exercise has been examined, the influence of resistance-exercise training on myokines at rest is less well established. Therefore, this study was designed to evaluate a panel of myokines at rest following a 12-week resistance-exercise training program in younger and older males. Participants (n = 15) completed a 12-week progressive resistance-exercise training program supervised by a certified fitness professional. The training protocol targeted all major muscle groups of the upper and lower body. Resting blood samples were collected before and after completion of the training program to determine concentrations of apelin, fibroblast growth factor-21 (FGF-21), interleukin (IL)-4, IL-6, IL-7, IL-15, leukemia inhibitory factor (LIF), and irisin. Two-way repeated ANOVAs were used to compare variables between time-points and age groups. There was a main effect of time found for apelin (p = 0.003) and IL-15 (p < 0.001), while no main effects for group or time were found for the other myokines (all p > 0.05). Age group × training status interactions were found for IL-6 (p = 0.04) and irisin (p = 0.014) without pairwise differences for IL-6 (p > 0.05), and younger males had higher concentrations of irisin compared to older males post-training (p = 0.036). Overall, the 12-week resistance-exercise training program significantly increased apelin and IL-15 over time but did not change the other resting myokine concentrations for the younger or older males. However, the higher concentration of irisin in younger versus older males post-training suggests a potential explanation for the anabolic resistance observed with aging. Full article

Recent studies indicate a significant relationship between malnutrition, frailty, and pleural effusion (PE), highlighting the critical role of muscle mass in patient outcomes. This review investigates the association between sarcopenia—characterized by a decline in skeletal muscle mass and function—and PE, marked by fluid accumulation in the pleural space. The findings reveal that sarcopenia is prevalent in patients with PE and is linked to increased postoperative complications and mortality rates. In liver transplantation, esophagectomy, and lung cancer surgeries, sarcopenia exacerbates the risk of adverse outcomes. Notably, preoperative muscle mass assessment serves as a predictive tool for identifying patients at higher risk of complications. This review underscores the importance of early diagnosis and intervention for sarcopenia to improve clinical outcomes in PE patients. The therapeutic approach should include comprehensive nutritional evaluations and targeted muscle-strengthening interventions. By addressing sarcopenia, healthcare providers can significantly reduce PE-related complications, enhance patient recovery, and improve survival rates. This review provides a foundation for future research to develop effective strategies for the management and treatment of sarcopenia in the context of PEs, aiming to optimize patient care and quality of life. Full article

Measuring the bicep femoris long head fascicle length via the use of diagnostic ultrasound has become common practice within elite sport, using single images of between 4 and 6 cm. No study to date has compared single image estimations in terms of the varying fields of view (i.e., 4, 6, and 10 cm). Therefore, the aim of this study was to determine whether differences occur when estimating the bicep femoris long head fascicle length using short (4 cm), medium (6 cm), and long (10 cm) fields of view across three estimation equations. A total of 36 male athletes (age: 23.8 ± 3.8 years, body mass: 83.7 ± 14.0 kg, height: 1.81 ± 0.06 m) had three ultrasound images of the bicep femoris long head collected on a single occasion with the fascicle length estimated. A significant main effect was observed (p < 0.001) with moderate–very large differences (p < 0.078, d = 0.91–4.01). The smallest fields of view resulted in the greatest fascicle length. There were significant moderate–large associations between the fields of view (p < 0.001, r = 0.542–0.892). Unacceptable limits of agreement were observed, and the developed correction equations remained unacceptable. The partial measure equation is the most accurate whilst using the 10 cm fields of view, while the basic trigonometry equation had the lowest variability between fields of view and the smallest differences between fields of view; hence, this equation may be more appropriate when a <6 cm field of view is the only field of view available. Full article

Fatty infiltration of the rotator cuff muscles is very common following rotator cuff tears and is one of the most important factors in determining treatment. Current clinical practice relies on subjective evaluation of fatty infiltration through categorical scoring based on the Goutallier classification system. The Dixon magnetic resonance imaging (MRI) sequence provides flexibility in selecting echo times for water–fat separation. The Dixon method, therefore, has the potential to provide robust and high-quality fat quantification that allows for more accurate calculation of fat fraction (%Fat) of the rotator cuff muscles than the Goutallier classification system. However, significant variance exists in sequencing and post-processing methodology within the recent application of Dixon sequences to quantify rotator cuff fatty infiltration. In this paper, we conducted a systematic review to synthesize the relevant literature utilizing Dixon sequencing for the quantification of rotator cuff fatty infiltration. The literature search was extracted from 1094 articles, with 12 studies included in the final review. Regardless of the varying sequencing pattern and post-processing techniques among studies, the findings suggest the Dixon method is reliable for quantitatively calculating the fat fraction of the rotator cuff muscles, even at very low levels of fatty infiltration. In addition, a quantitative difference in fat fraction was observed between participants with different degrees of tear vs. those without any shoulder pathologies. Multi-point Dixon imaging has the potential to be utilized clinically to objectively quantify fatty infiltration and may lead to improved clinical decision making for patients with rotator cuff tears. Full article

(1) Background: Sarcopenia, or low skeletal mass index (SMI), contributes to higher lung cancer mortality. The SMI at third lumbar vertebrae (L3) is the reference standard for body composition analysis. However, there is a need to explore the validity of alternative landmarks in this population. We compared the agreement of sarcopenia identification at the first lumbar (L1) and second lumbar (L2) to L3 in non-Hispanic Black (NHB) and White (NHW) individuals with lung cancer. (2) Methods: This retrospective, cross-sectional study included 214 NHB and NHW adults with lung cancer. CT scans were analyzed to calculate the SMI at L1, L2, and L3. T-tests, chi-square, Pearson’s correlation, Cohen’s kappa, sensitivity, and specificity analysis were used. (3) Results: Subjects presented with a mean age of 68.4 ± 9.9 years and BMI of 26.3 ± 6.0 kg/m². Sarcopenia prevalence varied from 19.6% at L1 to 39.7% at L3. Cohen’s kappa coefficient was 0.46 for L1 and 0.64 for L2, indicating weak and moderate agreement for the identification of sarcopenia compared to L3. (4) Conclusions: Sarcopenia prevalence varied greatly depending on the vertebral landmark used for assessment. Using L2 or L1 alone resulted in a 16.8% and 23.8% misclassification of sarcopenia in this cohort of individuals with lung cancer. Full article