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Gait & Posture Feb 2024Children with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking....
BACKGROUND
Children with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking. Understanding the gait characteristics and lower limb muscle activation patterns of USCP children can provide an objective and quantitative basis for patient assessment and treatment plan formulation.
OBJECTIVE
This study compared the gait and lower limb muscle activation characteristics of children with USCP and with typical development (TD) during walking.
METHODS
We recorded gait and sEMG data of 20 children with USCP, and 20 with typical development. sEMG signals were acquired from the bilateral tibialis anterior (TA) and lateral gastrocnemius muscles (LG) during walking. The root mean square (RMS) value, integrated electromyographic (iEMG) value and co-contraction ratio (CR) were used to evaluate muscle activity. Student's t Test and non-parametric rank sum Test were used to compare the differences between the data groups (significance level of 0.05).
RESULTS
The stance time, step length, speed, single leg support time ratio, ground impact, pre-swing angle, and muscle strength of the affected side were significantly decreased compared to those of the unaffected side in children with USCP (P < 0.05), while the swing phase, muscle tonus of LG were significantly prolonged (P < 0.05). Compared with TD children, children with USCP exhibited reduced bilateral walking ability, particularly noticeable in their smaller pre-swing angle(P < 0.05), diminished muscle strength of the TA and LG, as well as LG spasms(P < 0.05).
SIGNIFICANCE
Children with USCP have decreased ambulatory gait stability. Step length, pull acceleration, pre-swing angle, and CR can be used as sensitive indicators for gait assessment. Strengthening the TA muscle and reducing ankle spasm may help improve gait and postural stability in children with USCP.
Topics: Child; Humans; Cerebral Palsy; Gait; Walking; Lower Extremity; Muscle, Skeletal; Electromyography
PubMed: 38100956
DOI: 10.1016/j.gaitpost.2023.12.007 -
Balkan Medical Journal Mar 2024The testis develops in the abdominal cavity and descends into the scrotum. Although numerous theories have been proposed, the mechanism of descent and the reason for its...
The testis develops in the abdominal cavity and descends into the scrotum. Although numerous theories have been proposed, the mechanism of descent and the reason for its inhibition remain unknown. Furthermore, none of the explanations account for the other occurrences related to the descent, such as failed obliteration of the processus vaginalis, or the reasons for the decrease in fertility and increase in the risk of malignancy associated with an undescended testis. The gubernaculum is a primitive mesenchymal tissue that was first described in 1786. However, the role of the gubernaculum in the descent process remains obscure. The testis descends through the processus vaginalis. Although the processus vaginalis (PV) is usually defined as a simple peritoneal protrusion, it actively develops into the gubernaculum. The gubernaculum gives rise to the smooth muscles that surround the processus vaginalis. The striated cremaster muscle (CM) is also derived from the gubernaculum. Because the testis descends through the processus vaginalis, the muscles develop to propel the testis. After propelling the testis, the smooth muscle (SM) undergoes programmed cell death. The initiation of programmed cell death through the intrinsic pathway requires activation of phospholipase C. A transient shift in the autonomic balance via a decrease in the sympathetic tonus and an increase in the parasympathetic tonus is essential for initiating this programmed cell death. Programmed cell death in the SM is the physiological pathway for the obliteration of the processus vaginalis. Differences in the timing, intensity, or duration of this physiological pathway result in pathological conditions. A shift before testicular descent diminishes the SM content that is required to propel the testis, and thus inhibits descent. The early shift persists throughout childhood and results in the decrease in fertility and increase in the risk of malignancy because of the differences in signal transduction. Despite a successful descent, persistence of the shift alters the contractility of the CM by increasing the cytosolic calcium levels. Contracted CMs retracts or even ascends the testis. Inadequate intensity or duration of the shift of autonomic tonus causes failure of the programmed cell death. Persistence of the SM hinders the obliteration of PV and gives rise to hydroceles or inguinal hernias depending on the amount of residual smooth muscles. Similar findings from different countries support these explanations. Thus, our proposed mechanism satisfactorily explains the process of descent while considering all the factors related to the process of testicular descent.
Topics: Male; Humans; Child; Cryptorchidism; Inguinal Canal; Testicular Hydrocele; Neoplasms
PubMed: 38270075
DOI: 10.4274/balkanmedj.galenos.2024.2023-12-111 -
Acta Otorhinolaryngologica Italica :... Aug 2023This investigation aimed to propose a new rehabilitation technique that combines voice exercises and instrumental postural rehabilitation for patients with muscle...
OBJECTIVES
This investigation aimed to propose a new rehabilitation technique that combines voice exercises and instrumental postural rehabilitation for patients with muscle tension dysphonia (MTD).
METHODS
We enrolled nine dysphonic patients (8 women and 1 man, aged 22-55 years). Voice assessment included strobovideolaryngoscopy, Maximum Phonation Time (MPT), perceptual evaluation by GRBAS scale and patient's self-rating by Italian version of the Voice Handicap Index (VHI). Vestibular function was evaluated by the Bed Side Examination and Video Head Impulse test (VHIT). Postural control was evaluated by Dynamic Posturography (DP) using the Sensory Organization Test (SOT) and analysing the Equilibrium Score (ES) and balance subsystems (somatosensorial, visual, vestibular).
RESULTS
All cases underwent different types of voice exercises combined with balance training based on NeuroCom Balance Master Protocols, once a week for six 35-minutes sessions. After therapy, an improvement in MPT, VHI, GRBAS scores and endoscopic laryngeal features was obtained. DP results at baseline were normal and after therapy we showed a slight improvement of ES (somatosensorial and visual components).
CONCLUSIONS
A combined rehabilitation technique for MTD, by improving the attention to postural control, allows for significant improvement in vocal symptoms.
Topics: Male; Humans; Female; Dysphonia; Muscle Tonus; Combined Modality Therapy; Voice Training; Phonation
PubMed: 37224171
DOI: 10.14639/0392-100X-N2287 -
Journal of Physical Therapy Science May 2024[Purpose] This study aimed to examine the effects of unilateral vibratory stimulation on contralateral homonymous muscle. [Participants and Methods] The study included...
Unilateral vibration stimulation decreases F-wave persistence and F/M amplitude ratio in contralateral homonymous muscle corresponding to the stimulated muscle during stimulation.
[Purpose] This study aimed to examine the effects of unilateral vibratory stimulation on contralateral homonymous muscle. [Participants and Methods] The study included 14 participants without a history of any disease. Participants were tested under three separate conditions: vibratory stimulation, pressure stimulation, and rest. F-waves were measured at two time points for 15 seconds in the rest position under each of the testing conditions. [Results] The F/M amplitude ratio analysis showed interactions between the vibratory stimulation‒pressure stimulation and vibratory stimulation‒rest conditions. The F-wave persistence analysis demonstrated interactions between the vibratory and pressure stimulation conditions. Vibratory stimulation significantly decreased the F/M amplitude ratio and F-wave persistence at two time points, before and during the stimulation. [Conclusion] The vibratory stimulation used in this study could suppress the contralateral homonymous muscle tone.
PubMed: 38694006
DOI: 10.1589/jpts.36.267 -
Narra J Apr 2024Fish transport workers in Indonesia lift loads more than the specified limits, both in weight and frequency. This could cause lactic acid accumulation, fatigue and...
Fish transport workers in Indonesia lift loads more than the specified limits, both in weight and frequency. This could cause lactic acid accumulation, fatigue and reduced physical performance. The aim of this study was to assess the effect of stretching intervention on muscle tension, fatigue, strength, and lactic acid level in fish transport workers in Indonesia. A pre-experimental study design with one group (pre- and post-test) design was conducted among male fish transport workers at the Tawang fish auction, Weleri, Central Java, Indonesia, in June 2022 for two weeks. We created a 1.5-minute stretching exercise video based on the University of New Castle's Manual Handling guideline, involving hand, feet, and shoulder movements. Participants performed these exercises independently before and during work every two hours, guided by the video. Data on lactic acid, muscle tension, fatigue, and strength were collected before and after the 2-week intervention. Data analysis was performed using Wilcoxon and paired Student t-tests to compare the outcome between post- and pre-intervention. A total of 18 fish transport workers were included in the study. The results showed a statistically significant increase in lactic acid levels following the intervention (=0.016). However, the increase in muscle tension was not statistically significant (=0.292). There was a significant increase in fatigue levels after the intervention (=0.000). This could suggest that the stretching intervention may have had an unintended effect of increasing fatigue among the participants. On the other hand, there was a statistically significant decrease in muscle strength after the intervention (=0.003). In conclusion, this study suggests that while stretching exercises can affect lactic acid accumulation, fatigue, and muscle strength, they do not influence muscle tension. Therefore, it is advised for workers to incorporate stretching exercises into their daily routine to mitigate potential injury risks.
Topics: Humans; Male; Lactic Acid; Indonesia; Adult; Muscle Stretching Exercises; Fatigue; Muscle Strength; Muscle Tonus; Muscle Fatigue
PubMed: 38798855
DOI: 10.52225/narra.v4i1.627 -
Clinical Ophthalmology (Auckland, N.Z.) 2024Acute acquired concomitant esotropia induced by excessive digital device usage, especially smartphones (SAACE), has been increasing over the past few years. Convergence...
PURPOSE
Acute acquired concomitant esotropia induced by excessive digital device usage, especially smartphones (SAACE), has been increasing over the past few years. Convergence spasm induced by excessive near work has been suggested as a mechanism. Anatomical differences could also potentially contribute to SAACE onset. The present study investigated the conformation of horizontal recti between SAACE patients and normal subjects.
PATIENTS AND METHODS
In 15 SAACE patients (SAACE group), the distances between the limbus and insertion of the horizontal recti (LI distance) and the widths of horizontal recti on the insertion (insertion width) were measured. The control group consisted of 30 patients who underwent retinal detachment surgery. Differences in LI distances and insertion widths were compared between SAACE and control groups.
RESULTS
While there were no differences between the two groups for LI distances and insertion widths of lateral recti, there were significantly shorter LI distances for the medial recti in the SAACE group (<0.05). Moreover, the SAACE group tended to exhibit larger insertion widths of the medial recti. Medial/lateral ratio of LI distances were significantly lower and insertion widths were significantly higher in the SAACE compared to the control group (<0.05).
CONCLUSION
Based on the observations of more anterior insertion and larger muscle widths, this suggests there are stronger forces of medial recti in SAACE. In addition to excessive accommodation followed by increases in medial recti tonus, the results also suggest that an anatomical imbalance between lateral and medial recti contributes to esotropia onset following excessive near work.
PubMed: 38205266
DOI: 10.2147/OPTH.S440322 -
International Journal of Molecular... Mar 2024There is a growing body of evidence that ER stress and the unfolded protein response (UPR) play a key role in numerous diseases. Impaired liver perfusion and ER stress...
There is a growing body of evidence that ER stress and the unfolded protein response (UPR) play a key role in numerous diseases. Impaired liver perfusion and ER stress often accompany each other in liver diseases. However, the exact impact of ER stress and UPR on the hepatic perfusion is not fully understood. The aim of this study was to disclose the effect of ER stress and UPR on the size of liver vessels and on the levels of Ca and nitric oxide (NO), critical regulators of vascular tonus. This study was carried out in precisely cut liver tissue slices. Confocal microscopy was used to create 3D images of vessels. NO levels were determined either using either laser scan microscopy (LSM) in cells or by NO-analyser in medium. Ca levels were analysed by LSM. We show that tunicamycin, an inducer of ER stress, acts similarly with vasodilator acetylcholine. Both exert a similar effect on the NO and Ca levels; both induce significant vasodilation. Notably, this vasodilative effect persisted despite individual inhibition of UPR pathways-ATF-6, PERK, and IRE1-despite confirming the activation of UPR. Experiments with HUVEC cells showed that elevated NO levels did not result from endothelial NO synthase (eNOS) activation. Our study suggests that tunicamycin-mediated ER stress induces liver vessel vasodilation in an NO-dependent manner, which is mediated by intracellular nitrodilator-activatable NO store (NANOS) in smooth muscle cells rather than by eNOS.
Topics: Vasodilation; Tunicamycin; Endoplasmic Reticulum Stress; Unfolded Protein Response; Liver
PubMed: 38612675
DOI: 10.3390/ijms25073865