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Scientific Reports Jun 2024Patients with brain tumors require extensive and prolonged rehabilitation efforts as they suffer from lesion-induced motor weakness as well as treatment-related side... (Randomized Controlled Trial)
Randomized Controlled Trial
Patients with brain tumors require extensive and prolonged rehabilitation efforts as they suffer from lesion-induced motor weakness as well as treatment-related side effects, often leading to a significant decline in function. Protein supplements have shown positive effects on promoting muscle strength and physical performance in various tumor etiologies. However, reports on their effects specifically in brain tumor patients remain scarce. This study aims to investigate the feasibility and efficacy of protein supplements in enhancing rehabilitative outcomes via muscle strengthening and functional gain in brain tumor patients with neurological demise. Sixty brain tumor patients were randomly assigned to either a protein supplement or a control group, receiving either protein supplements or a placebo for 6 weeks, in conjunction with conventional rehabilitation therapy. Assessments before and after the intervention included laboratory tests, anthropometric measures using bioimpedance analysis, and functional assessments, which included the MMSE, the modified Barthel Index, the Beck Depression Inventory, the Brief Fatigue Inventory, the Timed Up and Go test, the 6-min walk test, the isokinetic quadriceps muscle strength test, and the handgrip power. After the intervention, the levels of serum hemoglobin, protein, albumin, and C-reactive protein were improved in both groups, however, the change was significant only in the protein group. The muscle strength was enhanced in both groups, however, the significant increase in pinch grasp power was only noted in the protein group (P < 0.05). The distance on 6MWT was also significantly extended at follow-up in the protein group (P < 0.01). In the subgroup analysis according to nutritional status, the moderate malnutrition group showed greater augmentation of muscle mass than those with adequate nutrition (P < 0.05). Interestingly, the amelioration of malnutrition was observed only the in protein group. This study using protein supplements to promote the rehabilitative potential of brain tumor patients revealed a significant effect on improving hemodynamic nutritional indices, muscle power reimbursement, and functional improvement, especially in malnourished patients. The safety and feasibility of protein supplements in brain tumor patients were affirmative in this study. Further studies with more patients may help confirm the secondary functional gain resulting from increased muscle power.Trial registration: This study was retrospectively registered in the Clinical Research Information Service, CRIS no. KCT0009113 on Jan 12, 2024.
Topics: Humans; Male; Female; Middle Aged; Muscle Strength; Brain Neoplasms; Muscle, Skeletal; Nutritional Support; Dietary Supplements; Adult; Treatment Outcome; Dietary Proteins; Aged; Hand Strength
PubMed: 38839858
DOI: 10.1038/s41598-024-63551-5 -
International Journal of Sports... 2024Repetitive application of high forces to the shoulder and scapular musculature during the pitching motion over the course of a collegiate baseball season may lead to...
BACKGROUND
Repetitive application of high forces to the shoulder and scapular musculature during the pitching motion over the course of a collegiate baseball season may lead to changes in strength and increased fatigue, potentially predisposing pitching athletes to injury. The purpose of this study was to investigate periscapular strength profiles of Division I collegiate baseball players over the course of a season.
METHODS
This study was a retrospective data analysis of 18 Division I baseball pitchers. Isometric scapular plane abduction (scaption), external rotator, internal rotator, middle trapezius, and lower trapezius isometric strength was measured on throwing arm of each subject using a MicroFET 2 handheld dynamometer. Data were collected in a single session at the preseason, midseason, and postseason of the college baseball season, which spanned a five-month period. A repeated measures ANOVA was utilized to determine if there was a significant change in periscapular strength across the baseball season.
RESULTS
Over the three time-points, all strength values decreased for each muscle group, with decreases ranging from 3-14%. Changes in scaption strength values were statistically significant (p=0.018, partial eta squared =0.284) with an 8% reduction over the entire season, specifically with a 5% decline from mid-season to post-season. While external rotator, internal rotator, middle trapezius, and lower trapezius strength values all decreased over the course of the season (range 0.02kg to 1.8kg), these differences were not statistically significant. However, the middle trapezius strength value change (1.3kg loss) exceeded the minimal detectible change.
CONCLUSION
Periscapular muscles in baseball pitchers diminish in strength over the course of a collegiate baseball season. Understanding strength changes over the course of a season may influence training and therapeutic interventions.
LEVEL OF EVIDENCE
3b.
PubMed: 38835988
DOI: 10.26603/001c.117398 -
Trials Jun 2024Patients diagnosed with pancreatic, biliary tract, and liver cancer often suffer from a progressive loss of muscle mass. Given the considerable functional impairments in...
Blood flow restriction Exercise in the perioperative setting to Prevent loss of muscle mass in patients with pancreatic, biliary tract, and liver cancer: study protocol for the PREV-Ex randomized controlled trial.
BACKGROUND
Patients diagnosed with pancreatic, biliary tract, and liver cancer often suffer from a progressive loss of muscle mass. Given the considerable functional impairments in these patients, high musculoskeletal weight loads may not be well tolerated by all individuals. The use of blood-flow restricted resistance training (BFR-T) which only requires low training loads may allow for a faster recovery of muscle due to avoidance of high levels of mechanical muscle stress associated with high-load resistance exercise. This study aims to investigate whether BFR-T can prevent or slow down the loss of skeletal muscle mass and enhance the functional capacity and mental health of patients with pancreatic, biliary tract, and liver cancer.
METHODS
The PREV-Ex exercise trial is a multicenter two-armed randomized controlled trial. Patients will be randomized to an exercise program consisting of home-based low-load BFR-T during a combined pre- and postoperative period for a total of 6-10 weeks (prehabilitation and rehabilitation), or to a control group. Protein supplementation will be given to both groups to ensure adequate protein intake. The primary outcomes, skeletal muscle thickness and muscle cross-sectional area, will be assessed by ultrasound. Secondary outcomes include the following: (i) muscle catabolism-related and inflammatory bio-markers (molecular characteristics will be assessed from a vastus lateralis biopsy and blood samples will be obtained from a sub-sample of patients); (ii) patient-reported outcome measures (self-reported fatigue, health-related quality of life, and nutritional status will be assessed through validated questionnaires); (iii) physical fitness/performance/activity (validated tests will be used to evaluate physical function, cardiorespiratory fitness and maximal isometric muscle strength. Physical activity and sedentary behavior (assessed using an activity monitor); (iv) clinical outcomes: hospitalization rates and blood status will be recorded from the patients' medical records; (v) explorative outcomes of patients' experience of the exercise program which will be evaluated using focus group/individual interviews.
DISCUSSION
It is worthwhile to investigate new strategies that have the potential to counteract the deterioration of skeletal muscle mass, muscle function, strength, and physical function, all of which have debilitating consequences for patients with pancreatic, biliary tract, and liver cancer. The expected findings could improve prognosis, help patients stay independent for longer, and possibly reduce treatment-related costs.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05044065. Registered on September 14, 2021.
Topics: Humans; Resistance Training; Pancreatic Neoplasms; Biliary Tract Neoplasms; Muscle, Skeletal; Liver Neoplasms; Randomized Controlled Trials as Topic; Multicenter Studies as Topic; Regional Blood Flow; Treatment Outcome; Quality of Life; Muscle Strength; Time Factors; Preoperative Exercise; Muscular Atrophy; Sarcopenia
PubMed: 38835083
DOI: 10.1186/s13063-024-08207-5 -
Seminars in Oncology Nursing Jun 2024Decrements in energy were found in 67% of women who underwent breast cancer surgery. However, no information is available on chronic decrements in energy and...
OBJECTIVES
Decrements in energy were found in 67% of women who underwent breast cancer surgery. However, no information is available on chronic decrements in energy and associations with inflammation. Purposes were to identify latent classes of patients with distinct average energy profiles from prior to through 12 months after breast cancer surgery; evaluate for differences in demographic and clinical characteristics between the two extreme average energy classes; and evaluate for polymorphisms for cytokine genes associated with membership in the Low energy class.
METHODS
Women (n = 397) completed assessments of energy prior to and for 12 months following breast cancer surgery. Growth mixture modeling was used to identify classes of patients with distinct average energy profiles. Eighty-two single nucleotide polymorphisms (SNPs) among 15 cytokine genes were evaluated.
RESULTS
Three distinct energy profiles were identified (ie, Low [27.0%], Moderate [54.4%], Changing [18.6%]). Data from patients in the Low and Moderate energy classes were used in the candidate gene analyses. Five SNPs and one haplotype in six different genes remained significant in logistic regression analyses (ie, interleukin [IL]-1β rs1143623, IL1 receptor 1 rs3917332 IL4 rs2243263, IL6 HapA1 [that consisted of rs1800795, rs2069830, rs2069840, rs1554606, rs2069845, rs2069849, and rs2069861], nuclear factor kappa beta subunit 1 rs170731, tumor necrosis factor rs1799964). For several SNPs for IL6, expression quantitative trait locis were identified in subcutaneous and visceral adipose tissue and thyroid tissue. In addition, skeletal muscle was identified as an expression quantitative trait loci for nuclear factor kappa beta subunit 1.
CONCLUSIONS
Findings suggest that cytokine genes are involved in the mechanisms that underlie chronic decrements in energy in women following breast cancer surgery. Given the roles of subcutaneous and visceral adipose and thyroid tissues in metabolism and energy balance, the findings related to IL6 suggest that these polymorphisms may have a functional role in the development and maintenance of chronic decrements in energy.
PubMed: 38834449
DOI: 10.1016/j.soncn.2024.151652 -
Frontiers in Sports and Active Living 2024Neuromuscular fatigue causes a transient reduction of muscle force, and alters the mechanisms of motor control. Whether these alterations increase the risk of anterior...
INTRODUCTION
Neuromuscular fatigue causes a transient reduction of muscle force, and alters the mechanisms of motor control. Whether these alterations increase the risk of anterior cruciate ligament (ACL) injury is still debated. Here we compare the biomechanics of single-leg drop jumps before and after the execution of a fatiguing exercise, evaluating whether this exercise causes biomechanical alterations typically associated with an increased risk of ACL lesion. The intensity of the fatiguing protocol was tailored to the aerobic capacity of each participant, minimizing potential differential effects due to inter-individual variability in fitness.
METHODS
Twenty-four healthy male volunteers performed single leg drop jumps, before and after a single-set fatiguing session on a cycle ergometer until exhaustion (cadence: 65-70 revolutions per minute). For each participant, the intensity of the fatiguing exercise was set to 110% of the power achieved at their anaerobic threshold, previously identified by means of a cardiopulmonary exercise test. Joint angles and moments, as well as ground reaction forces (GRF) before and after the fatiguing exercise were compared for both the dominant and the non-dominant leg.
RESULTS
Following the fatiguing exercise, the hip joint was more extended (landing: Δ=-2.17°, = 0.005; propulsion: Δ=-1.83°, = 0.032) and more abducted (landing: Δ=-0.72°, = 0.01; propulsion: Δ=-1.12°, = 0.009). Similarly, the knee joint was more extended at landing (non-dominant leg: Δ=-2.67°, < 0.001; dominant: Δ=-1.4°, = 0.023), and more abducted at propulsion (both legs: Δ=-0.99°, < 0.001) and stabilization (both legs: Δ=-1.71°, < 0.001) hence increasing knee valgus. Fatigue also caused a significant reduction of vertical GRF upon landing (Δ=-0.21 N/kg, = 0.003), but not during propulsion. Fatigue did not affect joint moments significantly.
CONCLUSION
The increased hip and knee extension, as well as the increased knee abduction we observed after the execution of the fatiguing exercise have been previously identified as risk factors for ACL injury. These results therefore suggest an increased risk of ACL injury after the execution of the participant-tailored fatiguing protocol proposed here. However, the reduced vertical GRF upon landing and the preservation of joint moments are intriguing, as they may suggest the adoption of protective strategies in the fatigued condition to be evaluated in future studied.
PubMed: 38832309
DOI: 10.3389/fspor.2024.1418598 -
Canadian Journal of Respiratory Therapy... 2024Pilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the...
The effects of adding a six-month Pilates exercise program to three months of traditional community-based pulmonary rehabilitation in individuals with COPD: a prospective cohort study.
INTRODUCTION
Pilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the effects of adding a six-month Pilates exercise program to a three-month pulmonary rehabilitation for individuals with COPD.
METHODS
Thirty-five participants with COPD (GOLD B) were assigned to the intervention (n=14) or control (n=21) group. Both groups received an initial three months of a pulmonary rehabilitation program. The intervention group further underwent six months of pilates. Participants were evaluated at baseline and at three, six, and nine months. Lung function and strength of respiratory muscles were defined as primary outcomes. Secondary outcomes included cardiac, physical function, and exacerbation episodes.
RESULTS
There were no consistent statistically significant differences between groups for the lung function outcomes (\<0.05). Maximal inspiratory and expiratory pressure increased significantly at three months in both groups (\<0.05). It was significantly superior in the intervention group at nine months for maximal inspiratory pressure (=0.005) and six and nine months for maximal expiratory pressure (=0.027 and \<0.001, respectively). Changes in muscle strength (knee extension and handgrip) were comparable between groups (>0.05), but exercise-induced fatigue and balance were significantly superior in the intervention group at the six- and nine-month follow-ups (\<0.05).
DISCUSSION
Pilates exercise programs may be implemented to augment traditional pulmonary rehabilitation with the goal of improving the strength of respiratory muscles.
CONCLUSION
Adding a Pilates exercise program to pulmonary rehabilitation resulted in superior strength of respiratory muscles, higher resistance to exercise-induced fatigue, and improved balance.
PubMed: 38828206
DOI: 10.29390/001c.117966 -
PeerJ 2024High-intensity sprint exercises (HIS) are central to sprinter training and require careful monitoring of athlete muscle fatigue to improve performance and prevent...
BACKGROUND
High-intensity sprint exercises (HIS) are central to sprinter training and require careful monitoring of athlete muscle fatigue to improve performance and prevent injury. While the countermovement jump (CMJ) may be used to monitor neuromuscular fatigue (NMF), little is known about the specific effects from HIS. The purpose of this study is to investigate the effects of HIS on the CMJ to assess its utility for assessing NMF following HIS.
METHODS
Ten male collegiate 400 m sprinters completed a 400 m sprint fatigue protocol and underwent five CMJ-testing sessions (baseline, 3 minutes, 10 minutes, 1 hour and 24 hours) over two days. Three CMJ trials, performed on a force plate, were completed each trial, with rating of perceived exertion (RPE) recorded as a subjective fatigue measure. Changes in RPE, CMJ variables, force-time and power-time curves at baseline and post fatigue were assessed.
RESULTS
Significant changes were observed in most variables following the fatigue protocol. In particular, concentric mean power remained significantly lower after 24 hours compared to baseline. In addition, the force-time curves exhibited a significant reduction in all conditions following the fatigue protocol. This decline was most pronounced within 50-75%of the concentric phase relative to baseline measurements. Results indicate that the CMJ may be a useful tool for monitoring fatigue in at least 400 m sprinters. These data also indicate that HIS may disproportionately reduce force output in during concentric movement. These insights may improve training prescriptions and injury prevention strategies for sprint athletes.
Topics: Humans; Male; Muscle Fatigue; Young Adult; Running; Athletic Performance; Exercise Test; Muscle, Skeletal; Athletes
PubMed: 38827313
DOI: 10.7717/peerj.17443 -
Cureus May 2024Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of infections to date and has led to a worldwide pandemic. Most patients had a complete... (Review)
Review
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of infections to date and has led to a worldwide pandemic. Most patients had a complete recovery from the acute infection, however, a large number of the affected individuals experienced symptoms that persisted more than 3 months after diagnosis. These symptoms most commonly include fatigue, memory difficulties, brain fog, dyspnea, cough, and other less common ones such as headache, chest pain, paresthesias, mood changes, muscle pain, and weakness, skin rashes, and cardiac, endocrine, renal and hepatic manifestations. The treatment of this syndrome remains challenging. A multidisciplinary approach to address combinations of symptoms affecting multiple organ systems has been widely adopted. This narrative review aims to bridge the gap surrounding the broad treatment approaches by providing an overview of multidisciplinary management strategies for the most common long COVID conditions.
PubMed: 38826995
DOI: 10.7759/cureus.59478 -
Case Reports in Hepatology 2024Drug-induced liver injury resulting from herbal and dietary supplement use is increasingly common and underrecognized. We report a case of a 34-year-old male...
Drug-induced liver injury resulting from herbal and dietary supplement use is increasingly common and underrecognized. We report a case of a 34-year-old male recreational bodybuilder who presented with muscle cramping, fatigue, and diffuse itching in the setting of bodybuilding supplement use. Labs showed cholestatic liver injury, and liver biopsy revealed bland cholestasis and sinusoidal dilation. He was diagnosed with anabolic-androgenic steroid-induced liver injury. He was symptomatically managed with plasmapheresis for debilitating pruritus. This case highlights drug-induced liver injury as a complication of bodybuilding supplement use containing unlabeled anabolic-androgenic steroids. Sports medicine providers should inquire on herbal and dietary supplement use and be aware of potential contaminants.
PubMed: 38826497
DOI: 10.1155/2024/5112461 -
Journal of Musculoskeletal & Neuronal... Jun 2024The current study investigated performance fatigability (PF) and time course of changes in force, electromyographic amplitude (EMG AMP) and frequency (EMG MPF), and...
OBJECTIVES
The current study investigated performance fatigability (PF) and time course of changes in force, electromyographic amplitude (EMG AMP) and frequency (EMG MPF), and neuromuscular efficiency (NME) during a sustained, isometric, handgrip hold to failure (HTF) using the rating of perceived exertion (RPE)-Clamp Model.
METHODS
Twelve males performed a handgrip HTF anchored to RPE=5. The time to task failure (T), force (N), EMG AMP and MPF, and NME (normalized force/ normalized EMG AMP) were recorded. Analyses included a paired samples t-test for PF at an alpha of p<0.05, 1-way repeated measures ANOVA across time and post-hoc t-tests (p<0.0025) for force, EMG AMP and MPF, and NME responses.
RESULTS
The PF (pre- to post- maximal force % decline) was 38.2±11.5%. There were decreases in responses, relative to 0% T, from 40% to 100% T (force), at 30%, 60%, and 100% T (EMG AMP), from 10% to 100% T(EMP MPF), and from 50% to 65%, and 80% to 100% T (NME) (p<0.0025).
CONCLUSIONS
The RPE-Clamp Model in this study demonstrated that pacing strategies may be influenced by the integration of anticipatory, feedforward, and feedback mechanisms, and provided insights into the relationship between neuromuscular and perceptual responses, and actual force generating capacity.
Topics: Humans; Male; Hand Strength; Muscle Fatigue; Young Adult; Adult; Electromyography; Muscle, Skeletal; Isometric Contraction; Physical Exertion
PubMed: 38825993
DOI: No ID Found