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Cureus Jun 2023Facioscapulohumeral muscular dystrophy (FSHD) is the third most common type of muscular dystrophy. This disease presents as a slowly progressive asymmetric muscle... (Review)
Review
Facioscapulohumeral muscular dystrophy (FSHD) is the third most common type of muscular dystrophy. This disease presents as a slowly progressive asymmetric muscle weakness that involves the facial, scapular, and upper arm muscles mainly. Currently, there is no established consensus on this disease treatment in terms of medications. We assessed the response to the treatment of the drugs utilized in clinical trials by performing a systematic literature review in English using the preferred reporting items for systematic reviews (PRISMA) and meta-analyses. We only used human clinical trials in patients diagnosed with FSHD that received consistent pharmacological treatment. We included 11 clinical trials that fulfilled our criteria. We concluded that albuterol had statistically significant results in three out of four clinical trials, with improved elbow flexors muscle strength. Vitamin C, vitamin E, zinc gluconate, and selenomethionine showed significant improvement in the maximal voluntary contraction and endurance limit time of quadriceps muscle. At the same time, diltiazem and MYO-029 demonstrate no improvement in function, strength, or muscle mass. Losmapimod, currently in phase I of the ReDUX4 trial, showed promising results. Peradventure, more clinical trials are still needed to address this subject. Nevertheless, this review provides a clear and concise update on the treatment for this disease.
PubMed: 37404420
DOI: 10.7759/cureus.39903 -
European Journal of Physical and... Aug 2023Muscle changes after stroke cannot be explained solely on the basis of corticospinal bundle damage. Muscle-specific changes contribute to limited functional recovery but...
INTRODUCTION
Muscle changes after stroke cannot be explained solely on the basis of corticospinal bundle damage. Muscle-specific changes contribute to limited functional recovery but have been poorly characterized.
EVIDENCE ACQUISITION
We conducted a systematic review of muscular changes occurring at the histological, neuromuscular and functional levels during the first year after the onset of post-stroke hemiplegia. A literature search was performed on PubMed, Embase and CINHAL databases up to November 2022 using a keyword combination comprising cerebral stroke, hemiplegic, atrophy, muscle structure, paresis, skeletal muscle fiber type, motor unit, oxidative stress, strength, motor control.
EVIDENCE SYNTHESIS
Twenty-seven trial reports were included in the review, out of 12,798 articles screened. Structural modifications described on the paretic side include atrophy, transformation of type II fibers into type I fibers, decrease in fiber diameter and apparent myofilament disorganization from the first week post-stroke up to the fourth month. Reported biochemical changes comprise the abnormal presence of lipid droplets and glycogen granules in the subsarcolemmal region during the first month post-stroke. At the neurophysiological level, studies indicate an early decrease in the number and activity of motor units, correlated with the degree of motor impairment. All these modifications were present to a lesser degree on the non-paretic side. Although only sparse data concerning the subacute stage are available, these changes seem to appear during the first two weeks post-stroke and continue up to the third or fourth month.
CONCLUSIONS
Considering these early pathophysiological changes on both the paretic and non-paretic sides, it seems crucial to promptly stimulate central and also peripheral muscular activation after stroke through specific rehabilitation programs focused on the maintenance of muscle capacities associated with neurological recovery or plasticity.
Topics: Humans; Hemiplegia; Muscles; Databases, Factual; Paresis; PubMed; Stroke
PubMed: 37695037
DOI: 10.23736/S1973-9087.23.07844-9 -
Cancer Treatment and Research... 2022To review published scientific evidence evaluating the potential associations between muscle mass/strength and healthcare use/costs for patients with cancer. (Review)
Review
PURPOSE
To review published scientific evidence evaluating the potential associations between muscle mass/strength and healthcare use/costs for patients with cancer.
METHODS
In accordance with the predefined protocol for a systematic literature review, studies assessing potential associations between muscle mass/strength and healthcare costs/use in cancer patients were searched on MEDLINE (via Ovid) and on the NHS Economic Evaluation Database in September 2021. Study selection, data extraction and quality assessment were performed by two independent reviewers.
RESULTS
Of 613 studies identified, five met our inclusion criteria. Various outcomes were investigated: for length of hospital stay, one out of three studies reported an association between lower muscle mass and longer hospital stay; for hospital admission, the two identified studies did not highlight muscle weakness as a predictor of hospital admission; for hospital readmission, one out of two studies reported that patients with lower muscle mass had higher rates of hospital readmission; for costs and cost-effectiveness, results of two randomized controlled trials were mixed, with total costs of the intervention higher in one study and lower in the other, leading to opposite cost-effectiveness results.
CONCLUSION
Only five studies evaluating potential associations between mass/strength and healthcare use/costs have been highlighted within this systematic review. The amount of evidence is limited but the studies are also very heterogeneous in regards of study designs, sample size, and type of population included. This important heterogeneity prevents drawing strong conclusions. Because of limited data available, more high quality longitudinal studies are needed to further investigate the relationship between muscle mass/strength and healthcare costs/use.
Topics: Humans; Neoplasms; Cost-Benefit Analysis; Length of Stay; Health Care Costs; Muscles; Randomized Controlled Trials as Topic
PubMed: 36113192
DOI: 10.1016/j.ctarc.2022.100633 -
Respiratory Medicine Apr 2009Chronic obstructive pulmonary disease (COPD) can lead to peripheral muscle atrophy and weakness. Electrical stimulation (ES) is commonly used to improve muscle function... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic obstructive pulmonary disease (COPD) can lead to peripheral muscle atrophy and weakness. Electrical stimulation (ES) is commonly used to improve muscle function and structure. The purpose of this systematic review is to determine the effect of ES on muscle function, muscle size, fibre characteristics and exercise performance in patients with COPD.
METHODS
A search was performed in seven electronic databases (Cochrane Controlled Trials Register, Pubmed, CINAHL, Embase, SPORTDiscus, Web of Science, PEDro). Inclusion criteria were: (1) randomized controlled trials (RCTs), (2) on COPD patients, (3) investigating a defined protocol of ES applied to the lower extremities, (4) analysing at least one main outcome, (5) full text available. Two reviewers extracted the data and evaluated the methodological quality of the studies using the PEDro scale.
RESULTS
The initial search yielded 167 abstracts, of which five RCTs met the inclusion criteria. The mean (SD) methodological quality of the studies was 6.2+1.3 out of 10. Meta-analyses of three studies showed significant increases in muscle torque and walk distance in the ES groups compared to values in the control, sham or other treatment groups. Measures of muscle size revealed equivocal evidence. Patients with less severe COPD tended to show less improvement.
CONCLUSIONS
The modest effect sizes after ES, small n, and small number of studies provide weak evidence for the effectiveness of ES to improve lower limb muscle function in COPD patients. Further study should elucidate the optimal parameters for ES protocols and selection criteria for responders and non-responders.
Topics: Adult; Aged; Electric Stimulation Therapy; Exercise; Exercise Test; Female; Humans; Lower Extremity; Male; Middle Aged; Muscle, Skeletal; Program Evaluation; Pulmonary Disease, Chronic Obstructive; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 19091537
DOI: 10.1016/j.rmed.2008.11.008 -
Journal of Physiotherapy Jul 2016After stroke, does respiratory muscle training increase respiratory muscle strength and/or endurance? Are any benefits carried over to activity and/or participation?... (Review)
Review
QUESTION
After stroke, does respiratory muscle training increase respiratory muscle strength and/or endurance? Are any benefits carried over to activity and/or participation? Does it reduce respiratory complications?
DESIGN
Systematic review of randomised or quasi-randomised trials.
PARTICIPANTS
Adults with respiratory muscle weakness following stroke.
INTERVENTION
Respiratory muscle training aimed at increasing inspiratory and/or expiratory muscle strength.
OUTCOME MEASURES
Five outcomes were of interest: respiratory muscle strength, respiratory muscle endurance, activity, participation and respiratory complications.
RESULTS
Five trials involving 263 participants were included. The mean PEDro score was 6.4 (range 3 to 8), showing moderate methodological quality. Random-effects meta-analyses showed that respiratory muscle training increased maximal inspiratory pressure by 7 cmH2O (95% CI 1 to 14) and maximal expiratory pressure by 13 cmH2O (95% CI 1 to 25); it also decreased the risk of respiratory complications (RR 0.38, 95% CI 0.15 to 0.96) compared with no/sham respiratory intervention. Whether these effects carry over to activity and participation remains uncertain.
CONCLUSION
This systematic review provided evidence that respiratory muscle training is effective after stroke. Meta-analyses based on five trials indicated that 30minutes of respiratory muscle training, five times per week, for 5 weeks can be expected to increase respiratory muscle strength in very weak individuals after stroke. In addition, respiratory muscle training is expected to reduce the risk of respiratory complications after stroke. Further studies are warranted to investigate whether the benefits are carried over to activity and participation.
REGISTRATION
PROSPERO (CRD42015020683). [Menezes KKP, Nascimento LR, Ada L, Polese JC, Avelino PR, Teixeira-Salmela LF (2016) Respiratory muscle training increases respiratory muscle strength and reduces respiratory complications after stroke: a systematic review.Journal of Physiotherapy62: 138-144].
Topics: Breathing Exercises; Humans; Muscle Strength; Physical Endurance; Respiratory Function Tests; Respiratory Muscles; Stroke; Stroke Rehabilitation; Treatment Outcome
PubMed: 27320833
DOI: 10.1016/j.jphys.2016.05.014 -
Chinese Medical Journal Nov 2017The aim was to update the genetic and clinical advances of congenital muscular dystrophy (CMD), based on a systematic review of the literature from 1991 to 2017. (Review)
Review
OBJECTIVE
The aim was to update the genetic and clinical advances of congenital muscular dystrophy (CMD), based on a systematic review of the literature from 1991 to 2017.
DATA SOURCES
Articles in English published in PubMed from 1991 to 2017 English were searched. The terms used in the literature searches were CMD.
STUDY SELECTION
The task force initially identified citations for 98 published articles. Of the 98 articles, 52 studies were selected after further detailed review. Three articles, which were not written in English, were excluded from the study. This study referred to all the important and English literature in full.
RESULTS
CMD is a group of early-onset disorders encompassing great clinical and genetic heterogeneity. Patients present with muscle weakness typically from birth to early infancy, delay or arrest of gross motor development, and joint and/or spinal rigidity. The diagnosis of CMD relies on clinical findings, brain and muscle imaging, muscle biopsy histology, muscle and/or skin immunohistochemical staining, and molecular genetic testing.
CONCLUSIONS
Advances in next-generation sequencing and histopathological techniques have enabled the recognition of distinct CMD subtypes supported by specific gene identification. Genetic counseling and multidisciplinary management of CMD play an important role in help patients and their family. Further elucidation of the significant clinical and genetic heterogeneity, therapeutic targets, and the clinical care for patients remains our challenge for the future.
Topics: High-Throughput Nucleotide Sequencing; Humans; Muscle, Skeletal; Muscular Dystrophies; Muscular Dystrophies, Limb-Girdle
PubMed: 29067961
DOI: 10.4103/0366-6999.217091 -
The Cochrane Database of Systematic... Jun 2013Progressive muscle weakness is a main symptom of most hereditary and acquired muscle diseases. Creatine improves muscle performance in healthy individuals. This is an... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Progressive muscle weakness is a main symptom of most hereditary and acquired muscle diseases. Creatine improves muscle performance in healthy individuals. This is an update of our 2007 Cochrane review that evaluated creatine treatment in muscle disorders. Previous updates were in 2009 and 2011.
OBJECTIVES
To evaluate the efficacy of creatine compared to placebo for the treatment of muscle weakness in muscle diseases.
SEARCH METHODS
On 11 September 2012, we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL (2012, Issue 9 in The Cochrane Library), MEDLINE (January 1966 to September 2012) and EMBASE (January 1980 to September 2012) for randomised controlled trials (RCTs) of creatine used to treat muscle diseases.
SELECTION CRITERIA
RCTs or quasi-RCTs of creatine treatment compared to placebo in hereditary muscle diseases or idiopathic inflammatory myopathies.
DATA COLLECTION AND ANALYSIS
Two authors independently applied the selection criteria, assessed trial quality and extracted data. We obtained missing data from investigators.
MAIN RESULTS
A total of 14 trials, including 364 randomised participants, met the selection criteria. The risk of bias was low in most studies. Only one trial had a high risk of selection, performance and detection bias. No new studies were identified at this update.Meta-analysis of six trials in muscular dystrophies including 192 participants revealed a significant increase in muscle strength in the creatine group compared to placebo, with a mean difference of 8.47%; (95% confidence intervals (CI) 3.55 to 13.38). Pooled data of four trials including 115 participants showed that a significantly higher number of participants felt better during creatine treatment compared to placebo with a risk ratio of 4.51 (95% CI 2.33 to 8.74). One trial in 37 participants with idiopathic inflammatory myopathies also showed a significant improvement in functional performance. No trial reported any clinically relevant adverse event.In metabolic myopathies, meta-analyses of three cross-over trials including 33 participants revealed no significant difference in muscle strength. One trial reported a significant deterioration of activities of daily living (mean difference 0.54 on a 1 to 10 scale; 95% CI 0.14 to 0.93) and an increase in muscle pain during high-dose creatine treatment in McArdle disease.
AUTHORS' CONCLUSIONS
High quality evidence from RCTs shows that short- and medium-term creatine treatment increases muscle strength in muscular dystrophies. There is also evidence that creatine improves functional performance in muscular dystrophy and idiopathic inflammatory myopathy. Creatine is well tolerated in these people. High quality but limited evidence from RCTs does not show significant improvement in muscle strength in metabolic myopathies. High-dose creatine treatment impaired activities of daily living and increased muscle pain in McArdle disease.
Topics: Creatine; Dietary Supplements; Humans; Muscle Contraction; Muscle Strength; Muscular Diseases; Muscular Dystrophies; Myositis; Randomized Controlled Trials as Topic
PubMed: 23740606
DOI: 10.1002/14651858.CD004760.pub4 -
PloS One 2023Persistent symptoms are reported in patients who survive the initial stage of COVID-19, often referred to as "long COVID" or "post-acute sequelae of SARS-CoV-2... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Persistent symptoms are reported in patients who survive the initial stage of COVID-19, often referred to as "long COVID" or "post-acute sequelae of SARS-CoV-2 infection" (PASC); however, evidence on their incidence is still lacking, and symptoms relevant to pain are yet to be assessed.
METHODS
A literature search was performed using the electronic databases PubMed, EMBASE, Scopus, and CHINAL and preprint servers MedRχiv and BioRχiv through January 15, 2021. The primary outcome was pain-related symptoms such as headache or myalgia. Secondary outcomes were symptoms relevant to pain (depression or muscle weakness) and symptoms frequently reported (anosmia and dyspnea). Incidence rates of symptoms were pooled using inverse variance methods with a DerSimonian-Laird random-effects model. The source of heterogeneity was explored using meta-regression, with follow-up period, age and sex as covariates.
RESULTS
In total, 38 studies including 19,460 patients were eligible. Eight pain-related symptoms and 26 other symptoms were identified. The highest pooled incidence among pain-related symptoms was chest pain (17%, 95% confidence interval [CI], 11%-24%), followed by headache (16%, 95% CI, 9%-27%), arthralgia (13%, 95% CI, 7%-24%), neuralgia (12%, 95% CI, 3%-38%) and abdominal pain (11%, 95% CI, 7%-16%). The highest pooled incidence among other symptoms was fatigue (44%, 95% CI, 32%-57%), followed by insomnia (27%, 95% CI, 10%-55%), dyspnea (26%, 95% CI, 17%-38%), weakness (25%, 95% CI, 8%-56%) and anosmia (19%, 95% CI, 13%-27%). Substantial heterogeneity was identified (I2, 50-100%). Meta-regression analyses partially accounted for the source of heterogeneity, and yet, 53% of the symptoms remained unexplained.
CONCLUSIONS
The current meta-analysis may provide a complete picture of incidence in PASC. It remains unclear, however, whether post-COVID symptoms progress or regress over time or to what extent PASC are associated with age or sex.
Topics: Humans; COVID-19; Post-Acute COVID-19 Syndrome; Incidence; Anosmia; SARS-CoV-2; Headache; Dyspnea
PubMed: 38019841
DOI: 10.1371/journal.pone.0250909 -
Therapeutic Advances in Respiratory... 2023Upper limb (UL) muscle dysfunction is a common extrapulmonary manifestation of chronic obstructive pulmonary disease (COPD). UL muscle dysfunction is associated with... (Meta-Analysis)
Meta-Analysis Review
The effects of upper limb exercise training on upper limb muscle strength in people with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Upper limb (UL) muscle dysfunction is a common extrapulmonary manifestation of chronic obstructive pulmonary disease (COPD). UL muscle dysfunction is associated with muscle weakness, dyspnea, and exercise intolerance. Although upper limb exercise training (ULET) is typically incorporated in pulmonary rehabilitation programs, its effects on UL muscle strength remains unclear.
OBJECTIVES
The purpose of this systematic review was to investigate the effectiveness of ULET, in UL muscle strength of people with COPD.
DESIGN
This is systematic review and meta-analysis study.
DATA SOURCES AND METHODS
Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Protocols 2020 guidelines were used for this study. PubMed, Cochrane, CINAHL Plus and SPORTDiscus and clinicaltrials.gov registry were searched from inception to July 2022. Included studies were randomized controlled trials, assessing the effectiveness in muscle strength of ULET, compared with other types of upper or lower limb exercise or no exercise. The quality and risk of bias were assessed using the Physiotherapy Evidence Database (PEDro) scale and certainty of evidence with the Grading of Recommendations, Assessment, Development, and Evaluations approach. Treatment effects of ULET were calculated using standardized mean differences and 95% confidence intervals.
RESULTS
Twenty-four studies, with a total sample of 882 patients, were included. Most studies were of moderate quality and high risk of bias. Very low to low certainty evidence indicates a significant difference in UL muscle strength in favor of resistance ULET, compared with lower limb exercise alone or no exercise. No significant differences were found in different types of ULET comparisons.
CONCLUSION
The results of this review showed that resistance ULET could improve UL muscle strength in people with COPD. Most studies, however, were of moderate quality and high risk of bias. Further studies with larger sample sizes, better methodological quality, and standardized training protocols are needed to confirm these findings.
Topics: Humans; Quality of Life; Randomized Controlled Trials as Topic; Pulmonary Disease, Chronic Obstructive; Exercise; Physical Therapy Modalities; Upper Extremity; Muscle Strength
PubMed: 37165688
DOI: 10.1177/17534666231170813 -
Journal of Orthopaedic Research :... Mar 2020Image-based assessments of quadriceps muscle size facilitate examination of structural changes after anterior cruciate ligament (ACL) injury and reconstruction (ACLR)....
Image-based assessments of quadriceps muscle size facilitate examination of structural changes after anterior cruciate ligament (ACL) injury and reconstruction (ACLR). Understanding the effects of ACLR on muscle size measures may aid in clarifying the contribution of quadriceps atrophy toward quadriceps strength. The purpose of this study was to systematically review the literature examining the effects of ACLR on quadriceps muscle volume and cross-sectional area (CSA). An online database search was conducted using Web of Science, SportDISCUS, PubMed (Medline), CINHAL (EBSCO), and Cochrane Library limited to articles published after January 1, 1980. Means and standard deviations were extracted for the ACLR limb and the contralateral limb, and sample characteristics from relevant articles. Magnitude of between limb differences were assessed using pooled effect sizes (Hedge's g) and 95% confidence intervals. Eleven articles (five CSA, six muscle volume) were included in this systematic review. Included studies reported negative effective sizes, indicating that the ACLR limb was smaller in CSA or muscle volume compared with the contralateral limb; however, 36% of the included articles reported meaningful difference between the limbs. Quadriceps atrophy may occur following ACL injury and persist after rehabilitation, however, the magnitude of these reductions may not be clinically meaningful and may only partially explain the persistent quadriceps weakness that is ubiquitous among this patient population. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:598-608, 2020.
Topics: Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Humans; Muscle Strength; Muscular Atrophy; Quadriceps Muscle; Rehabilitation; Risk
PubMed: 31608490
DOI: 10.1002/jor.24489