Effectivenss of electroacupuncture for skeletal muscle pain in Parkinson's disease: a Clinical randomized controlled trial.

OBJECTIVE: To explore the effect of electroacupuncture on skeletal muscle pain in Parkinson's disease (PD). METHODS: A single-center randomized controlled trial was conducted with sixty patients with Parkinson's disease with skeletal muscle pain were randomly divided into electroacupuncture group and sham acupuncture control group with 30 patients each. The electric acupuncture group was treated with electric acupuncture, while the control group was treated with Park needle pseudoacupuncture. Both groups were treated 5 times a week for a total of 4 weeks, and both groups completed 20 treatments. King's Parkinson's Pain Scale (KPPS) and visual analog scale (VAS) were used before and after treatment to evaluate the pain degree of patients. Real-time shear wave elastography (SWE) and modified Ashworth score (MAS) were used to evaluate the changes of muscle tone. Parkinson's comprehensive Score Scale (MDS-UPDRS, including UPDRSⅡ and UPDRS Ⅲ) was used to evaluate exercise ability. Hamilton Depression Scale (HAMD) score was used to evaluate the emotional changes of patients. Spearman correlation analysis was used to explore the correlation between pain degree and muscle tone, exercise ability and emotion. RESULTS: During the study, one case fell off in the control group, and 30 cases were eventually included in the analysis and treatment group and 29 cases in the control group. After treatment, Young's modulus of biceps and quadriceps and shear wave velocity of biceps were decreased in electroacupuncture group compared with before treatment, while KPPS score, VAS score, UPDRSⅡ, UPDRS Ⅲ and modified Ashworth score were decreased, with statistical significance (P < 0.05). There was no statistical significance in control group (P > 0.05). After treatment, KPPS score, VAS score, UPDRSⅡ and UPDRS Ⅲ, MAS, HAMD score, Young's modulus of biceps and shear wave velocity in electroacupuncture group were significantly lower than those in control group (P < 0.05). Spearman correlation analysis showed that KPPS score was positively correlated with UPDRS Ⅲ (r = 0.414, P < 0.05). KPPS score was positively correlated with HAMD score (r = 0.576, P < 0.01). CONCLUSION: Electroacupuncture therapy can effectively improve skeletal muscle pain in patients with Parkinson's disease, reduce the muscle hardness of patients, improve patients' daily life ability, and improve patients' emotional disorders. The degree of skeletal muscle pain in PD patients is correlated with motor ability and emotional disorders, but there is no significant correlation between the degree of skeletal muscle pain and the muscle tone of PD patients.

Relationship of protein, calcium and vitamin D consumption with body composition and fractures in oldest-old independent people.

BACKGROUND & AIM: Some studies state that the protein intake has a protective effect against bone mass loss, while others show that the combination of low calcium intake and high protein consumption increases the risk of fractures. Perhaps this phenomenon is also altered by the consumption of vitamin D after the age 80 years. This study aimed to identify if there is an association of protein, calcium and vitamin D intake with body composition and fractures in community dwelling 80 years or older independent people. METHODS: This is a cross-sectional observational analytic study. We invited community dwelling 80 years or older independent people, with chronic diseases under control, according to the scientific guidelines. The food intake was obtained through a one-day food record (FR) and Avanutri software (4.1 version) was used to calculate the intake of total calories, calcium, protein, and other food nutrients. The body composition and bone densitometry were evaluated by whole-body Dual Energy X-ray Absorptiometry (DXA). The morphometric vertebral fractures were assessed through conventional X-ray of the vertebral, level T4 to L4, on side face position - semi quantitative technique. RESULTS: One hundred and fifty-nine 80 years or older independent people, mean age 87.0 ± 3.9 years old were studied. The mean calcium intake was 834.6 ± 374.7 mg/day and vitamin D was 6.1 ± 24.3 µg/day, in both cases they were complemented by supplements to reach the recommendations. The mean protein intake was 72.9 ± 26.8 g/day, we found that 48.4% had low muscle mass; there was a frequency of 45.3% of osteoporosis; and vertebral fractures in 24.7% of them. The estimates of the logistic regression model with the outcome variable obesity and low muscle mass with reference to "low muscle mass" showed that the 80 years or older independent people who have a fracture are more likely to be obese with low muscle mass compared to those with only low muscle mass. CONCLUSION: In the studied population of 80 years or older independent people, we observed that among all the nutrients studied, only dietary protein per g/kg/day was associated with body composition and bone mineral density, but not with fracture, although the elderly who have fracture are more likely to be obese with low muscle mass compared to those not obese with low muscle mass. More studies about nutrients intakes and its relationship with muscle and bone health in this population is necessary.

Heteropterys tomentosa and Interactions with the Musculoskeletal System: Systematic Review / Heteropterys tomentosa e Interações com o Sistema Musculoesquelético: Revisão Sistemática

Abstract Although Brazil is a country with the greatest plant biodiversity, there are still shortcomings regarding phytotherapy studies and their practical application. In Brazil alone there are 65 plants with psychoactive principles, and Heteropterys tomentosa, from the ethnobotanical point of view, is one of the most famous plants in the Midwest region, it is known for its aphrodisiac, physical and mental invigorating and depurative properties. The objective of this review was to point out the number of scientific articles published about the benefits of using the plant H. aphrodisiac in interactions with the musculoskeletal system. A consultation was performed in 10 databases: Embase, Scopus, Pubmed, Livivo, Science Direct, Web of science, Cochrane, Koreamed, Lilacs and Clinical trials for the elaboration of a systematic review, for this there was no limitation of time, language or type of study. Results: the search described found 111 articles, all primary studies; of these only 5 original studies (4.5%) were included in the review. Positive adaptations were observed in bones, tendons, muscles and hormone release, which resulted in improvements in exercise time and load, delaying fatigue and increasing functional capacity. However, the scarcity of studies, pointed out several gaps, opening space for other works. (AU)

Resumo Embora o Brasil seja um país com a maior biodiversidade vegetal, ainda existem carências com relação a estudos fitoterápicos e sua aplicação prática. Só no Brasil existem 65 plantas com princípios psicoativos, e a Heteropterys tomentosa, no ponto de vista etnobotânico, é uma das plantas mais famosas da região Centro-Oeste, ela é conhecida por propriedades afrodisíacas, de revigorante físico e mental, e depurativa. O objetivo desta revisão foi apontar a quantidade de artigos científicos publicados sobre os benefícios da utilização da planta H. aphrodisiaca em interações com o sistema musculoesquelético. Foi realizada uma consulta em 10 bases de dados, sendo elas: Embase, Scopus, Pubmed, Livivo, Science Direct, Web of science, Cochrane, Koreamed, Lilacs e Clinical trials para a elaboração de uma revisão sistemática, para isso não houve limitação de tempo, de língua ou tipo de estudo. A busca descrita encontrou 111 artigos, sendo todos estudos primários; destes apenas 5 estudos originais (4,5%) foram incluídos na revisão. Foram observadas adaptações positivas em ossos, tendões, músculos e liberação hormonal, que acarretaram melhorias no tempo e carga de exercício, retardando a fadiga e aumentando a capacidade funcional. Contudo, a escassez de estudos, apontou diversas lacunas, abrindo espaço para outros trabalhos. (AU)

Gynostemma pentaphyllum extract and Gypenoside L enhance skeletal muscle differentiation and mitochondrial metabolism by activating the PGC-1α pathway in C2C12 myotubes.

BACKGROUND/OBJECTIVES: Peroxisome proliferator-activated receptor-gamma co-activator-1α (PGC-1α) has a central role in regulating muscle differentiation and mitochondrial metabolism. PGC-1α stimulates muscle growth and muscle fiber remodeling, concomitantly regulating lactate and lipid metabolism and promoting oxidative metabolism. Gynostemma pentaphyllum (Thumb.) has been widely employed as a traditional herbal medicine and possesses antioxidant, anti-obesity, anti-inflammatory, hypolipemic, hypoglycemic, and anticancer properties. We investigated whether G. pentaphyllum extract (GPE) and its active compound, gypenoside L (GL), affect muscle differentiation and mitochondrial metabolism via activation of the PGC-1α pathway in murine C2C12 myoblast cells. MATERIALS/METHODS: C2C12 cells were treated with GPE and GL, and quantitative reverse transcription polymerase chain reaction and western blot were used to analyze the mRNA and protein expression levels. Myh1 was determined using immunocytochemistry. Mitochondrial reactive oxygen species generation was measured using the 2'7'-dichlorofluorescein diacetate assay. RESULTS: GPE and GL promoted the differentiation of myoblasts into myotubes and elevated mRNA and protein expression levels of Myh1 (type IIx). GPE and GL also significantly increased the mRNA expression levels of the PGC-1α gene (Ppargc1a), lactate metabolism-regulatory genes (Esrra and Mct1), adipocyte-browning gene fibronectin type III domain-containing 5 gene (Fndc5), glycogen synthase gene (Gys), and lipid metabolism gene carnitine palmitoyltransferase 1b gene (Cpt1b). Moreover, GPE and GL induced the phosphorylation of AMP-activated protein kinase, p38, sirtuin1, and deacetylated PGC-1α. We also observed that treatment with GPE and GL significantly stimulated the expression of genes associated with the anti-oxidative stress response, such as Ucp2, Ucp3, Nrf2, and Sod2. CONCLUSIONS: The results indicated that GPE and GL enhance exercise performance by promoting myotube differentiation and mitochondrial metabolism through the upregulation of PGC-1α in C2C12 skeletal muscle.

Efficacy of Sijunzi decoction on limb weakness in spleen Qi deficiency model rats through adenosine monophosphate-activated protein kinase/unc-51 like autophagy activating kinase 1 signaling.

OBJECTIVE: To investigate the efficacy of Sijunzi decoction () on limb weakness in a rat model of spleen Qi deficiency (SQD), and to study its effect on mitophagy in skeletal muscle through adenosine monophosphate-activated protein kinase (AMPK) / unc-51 like autophagy activating kinase 1 (ULK1) signaling. METHODS: SQD model rats were produced by fasting combined with forced swimming method for 15 d. After model assessment, rats were randomly divided into four groups of 10 [low/middle/high (L/M/H) Sijunzi decoction dose groups and a normal saline (S) group]. Limb holding power (HP) and body mass (BM) were measured after 2 weeks of treatment. Following euthanasia, quadriceps femoris were dissected and myofiber and mitochondrial morphology were observed by transmission electron microscopy (TEM). Mitochondrial membrane potential (MMP), adenosine triphosphatase (ATP) and reactive oxygen species (ROS) levels were determined using colorimetric methods, and immunoblot analysis of Microtubule-associated protein light chain 3 (LC3) and Sequestosome 1 (p62) was performed to monitor mitophagy and AMPK/ULK1 signaling. RESULTS: Compared with control (C) group rats, in the S group, HP was reduced, the myofiber Z line was disordered, mitochondria were scattered, and numerous vacuoles and mitophagy were observed. MMP and ATP levels were reduced, ROS levels were elevated, and LC3B expression, and p-AMPKα (Thr172)/AMPKα, p-ULK1 (Ser555)/ULK1, and p-Raptor (Ser792)/Raptor ratios were increased, while p62 expression and p-mTOR (Ser2448)/mTOR and p-ULK1 (Ser757)/ULK1 ratios were decreased. After treatment, compared with the S group, HP was improved in M and H groups but not in the L group. Mitophagy was reduced in M, H and L groups but the Z line was disordered and vacuolization remained in the L group. ATP levels were elevated in M, H and L groups, and MMPs were elevat-ed in M and H groups but not in the L group. ROS levels were decreased in M, H and L groups, as were LC3B expression and p-Raptor (Ser792)/Raptor ratios, while p62 expression and p-mTOR (Ser2448)/mTOR and p-ULK1 (Ser757)/ULK1 ratios were increased in M and H groups but not in the L group. p-AMPKα (Thr172)/AMPKα and p-ULK1 (Ser555)/ULK1 ratios were decreased in M, H and L groups. CONCLUSIONS: Sijunzi decoction improved HP, possibly by inhibiting mitophagy via suppression of AMPK/ULK1 signaling. This restored mitochondrial morphology and improved oxidative phosphorylation, which contributed to recovery of limb weakness in SQD model rats.

Gyejibokryeong-Hwan improves recovery of injured muscles in mouse model of muscle contusion.

OBJECTIVE: To investigate the effects of Gyejibokryeong-Hwan (Guizhifuling-wan, GBH) on muscle injury in a mouse model of muscle contusion. METHODS: C57/BL6 mouse biceps femoris muscles were injured using the drop-mass method and injured animals were treated orally with GBH (50, 100, or 500 mg/kg) once a day for 7 d. Open field and treadmill running tests were performed to assess functional recovery from muscle injury. The production of pro-inflammatory cytokines was examined by enzyme-linked immunosorbent assay and Western blotting analysis. Expression of the muscle regeneration biomarkers, myoblast determination (MyoD), myogenic factor 5 (Myf5), and smooth muscle actin (α-SMA), in the biceps femoris muscle was investigated at the protein and mRNA level by Western blotting and real time-PCR, respectively. Histological analysis was performed using hematoxylin and eosin staining. Finally, myosin heavy chain production was investigated in differentiated C2C12 myoblasts in the presence of GBH. RESULTS: GBH treatment markedly improved locomotion and running behavior. GBH significantly inhibited the secretion of monocyte chemoattractant protein-1 into the bloodstream in muscle-contused animals. The levels of MyoD, Myf5, and α-SMA protein and mRNA were significantly up-regulated by GBH in injured muscle tissue. Histological studies suggested that GBH facilitated recovery from muscle damage. However, GBH did not induce the production of myosin heavy chain in vitro. CONCLUSION: Overall, the present study suggested that GBH improves the recovery of the injured muscles in the mouse model of muscle contusion.

Effects of pueraria lobata combined with high-intensity intermittent training on skeletal muscle quality and gene expression / Efeitos da pueraria lobata combinados com treino intermitente de alta intensidade na qualidade músculoesquelética e expressão genética / Efecto de pueraria lobata y entrenamiento intermitente de alta intensidad sobre la calidad del músculo esquelético y la expresión génica

ABSTRACT Extraction of effective components from Pueraria lobata has important value for skeletal muscle quality and gene expression. The improvement effect of traditional high-intensity intermittent training on skeletal muscle has not been obvious, and it is difficult to guarantee the properties of some volatiles. Based on this, this paper analyzes the effect of high-intensity intermittent training on skeletal muscle quality and gene expression in Pueraria lobata. Based on a brief summary of extraction of Pueraria lobata, status of research on the pharmaceutical components of Pueraria lobata was summarized. Different specimens of Pueraria lobata were selected as research objects, and the process of high-intensity intermittent training was designed. High-intensity intermittent training, solvent extraction and water solvent extraction were combined together to design the fixed-bed continuous extraction scheme. According to the influence of Pueraria lobata on skeletal muscle quality, the influence of intermittent training on skeletal muscle quality was analyzed. The extraction results showed that Pueraria lobata combined with high-intensity intermittent training can effectively improve the content of skeletal muscle and ensure the effective expression of skeletal muscle gene.

RESUMO A extração de componentes eficazes da Pueraria lobata tem importante valor para a qualidade músculoesquelética e para a expressão genética. O efeito da melhoria do tradicional treinamento intervalado de alta intensidade na estrutura músculoesquelética não tem sido óbvio, e é difícil garantir as propriedades de alguns voláteis. Com base nisso, este estudo analisa o efeito do treinamento intervalado de alta intensidade na qualidade músculoesquelética e na expressão genética na Pueraria lobata. Com base num breve resumo da extração da Pueraria lobata, resumiu-se o andamento das pesquisas sobre os componentes farmacêuticos da Pueraria lobata. Diferentes amostras de Pueraria lobata foram selecionadas como objeto de pesquisa, e formulou-se o processo do treinamento intervalado de alta intensidade. O treinamento intervalado de alta intensidade, a extração de solventes e a extração de solventes à base de água foram combinadas para conceber o sistema de extração contínua de leito fixo. De acordo com a influência da Pueraria lobata na qualidade músculoesquelética, analisou-se a influência do treino intervalado na qualidade músculoesquelética. Os resultados da extração mostraram que a Pueraria lobata, combinada com treino intervalado de alta intensidade, pode melhorar, de maneira eficaz, o teor músculoesquelético e garantir a expressão eficaz da expressão genética do músculoesquelético.

RESUMEN La extracción de componentes eficaces de la Pueraria lobata tiene un importante valor para la calidad músculoesquelética y para la expresión genética. El efecto de la mejora del tradicional entrenamiento intercalado de alta intensidad en la estructura músculoesquelética no ha sido obvio, y es difícil garantizar las propriedades de algunos volátiles. Basándose en eso, este estudio analiza el efecto del entrenamiento intercalado de alta intensidad en la calidad músculoesquelética y en la expresión genética en la Pueraria lobata. Basándose en un breve resumen de la extracción de la Pueraria lobata, se resumió el andamiento de las investigaciones sobre los componentes farmacéuticos de la Pueraria lobata. Diferentes muestras de Pueraria lobata fueron seleccionadas como objeto de investigación, y se formuló el proceso del entrenamiento intercalado de alta intensidad. El entrenamiento intercalado de alta intensidad, la extracción de solventes y la extracción de solventes a base de agua fueron combinadas para concebir el sistema de extracción continua de lecho fijo. De acuerdo con la influencia de la Pueraria lobata en la calidad músculoesquelética, se analizó la influencia del entrenamiento intercalado en la calidad músculoesquelética. Los resultados de la extracción mostraron que la Pueraria lobata, combinada con entrenamiento intercalado de alta intensidad, puede mejorar, de manera eficaz, el tenor músculoesquelético y garantizar la expresión eficaz de la expresión genética del músculoesquelético.

Low-Level Laser Therapy in Different Wavelengths on the Tibialis Anterior Muscle of Wistar Rats After Nerve Compression Injury.

OBJECTIVE: Traumatic injuries are common and may promote disruption of neuromuscular communication, triggering phenomena that lead to nerve degeneration and affect muscle function. A laser accelerates tissue recovery; however, the parameters used are varied, making it difficult to compare studies. The purpose of this study was to evaluate the effect of low-level laser therapy, at 660- and 830-nm wavelengths, on the tibialis anterior muscle of Wistar rats after sciatic nerve compression. METHODS: Twenty animals were separated into 4 groups: control, sciatic nerve injury, lesion + 660-nm laser, and lesion + 830-nm laser. In the lesion groups, the right sciatic nerve was surgically exposed and compressed with hemostatic forceps for 30 seconds. After the third postoperative day, the groups with laser therapy were submitted to treatment for 2 weeks totaling 10 applications, performed directly on the surgical scar of the nerve injury. Grip strength was analyzed before and after the nerve injury and during the treatment period. The tibialis anterior muscle was processed for light microscopy, area measurement, smaller diameter, number of fibers, nuclei, and connective tissue. RESULTS: The animals submitted to the injury experienced muscular atrophy and morphological changes in the number of muscle fibers and nuclei. In the connective tissue morphometry, there was a decrease in the treated groups compared with the untreated groups. CONCLUSION: The laser treatment at different wavelengths showed no improvement in the tibialis anterior muscle of Wistar rats within the morphological and functional aspects evaluated.

Effect of constant compressive stress induced by imitating Tuina stimulation with various durations on the cell cycle, cellular secretion, apoptosis, and expression of myogenic differentiation and myogenic factor 5 of rat skeletal muscle cells in vitro.

OBJECTIVE: To investigate the effect of constant compressive stress induced by imitating Tuina stimulation with various durations on the cell cycle, cellular secretion, apoptosis, and expression of myogenic regulatory factors (MRFs), myogenic factor 5(Myf5) and myogenic differentiation (MyoD) of rat skeletal muscle cells (RSkMCs) in vitro. METHODS: Third passage RSkMCs were subjected to constant compressive stresses with various durations at 2000 strain for 15, 30, 60, 90, and 120 min via a four-point bending system. The control group (CG) was cultured in the absence of mechanical loading. Alterations of the cell cycle and apoptosis rate were detected by flow cytometry (FCM). The concentrations of interleukin 6 (IL-6) / prostaglandin E2 (PGE2) and nitric oxide (NO) in supernatants were determined by enzyme-linked immunosorbent assays and the nitrate reductase method, respectively. Expression of Myf5 and MyoD was detected by immunohistochemistry. RESULTS: Compared with the CG, a significant alteration was observed in the synthesis phase fraction (SPF) (P < 0.01). The SPF and proliferation index (PI) were reduced from 15 to 90 min, but reached levels similar to those at 120 min. Apoptosis was increased significantly at 30 min (P < 0.05) and especially at 90 and 120 min (P < 0.01). Expression of MyoD and Myf5 was increased significantly at 15, 30, and 90 min (P < 0.01). Compared with 15 and 30 min, MyoD and Myf5 expression at 60 and 120 min was decreased significantly (P < 0.01). Compared with 60 min, MyoD expression at 90 min was increased significantly (P < 0.05), whereas MyoD and Myf5 expression at 120 min was significantly lower (P < 0.05). The IL-6 concentration was increased at 60 min compared with the CG and 15 min (P < 0.05), whereas the concentrations of PGE2 and NO were the highest at 15 and 30 min, respectively, compared with the CG and other time points (P < 0.05). CONCLUSION: The cell cycle, secretion, apoptosis, and Myf5 and MyoD expression of RSkMCs were regulated by compressive stress in a time-dependent manner. SPF and PI were inhibited at short durations (< 90 min), but NO and PGE2 secretion was the highest at shorter durations (< 30 min). With the prolongation of stimulation time, SPF, PI, and apoptosis were increased, but Myf5 and MyoD expression was decreased gradually at 15-30 min.

Effects of a fermented buckwheat flower and leaf extract on the blood glucose and lipid profile of type 2 diabetic db/db mice.

OBJECTIVE: To determine the efficacy of a fermented buckwheat flower and leaf extract (EFBFL) for the reduction of blood glucose and lipid dysregulation in spontaneously obese type 2 diabetic db/db mice, and to explore the possible mechanisms involved. METHODS: Forty 9-week-old male db/db mice were randomly allocated to a high-dose EFBFL group (EFBFL-H), a low-dose EFBFL group (EFBFL-L), a metformin hydrochloride positive control group (MEG), and a db/db control group (MG), and there was also a db/m negative control group (NCG) (n = 10). Oral glucose tolerance tests (OGTT) were performed after 7 weeks of treatment. At the end of 8 weeks of treatment, random blood glucose (RBG), glycosylated hemoglobin (HbAlc), fasting plasma glucose (FPG), fasting serum insulin (FINS) , triglyceride (TG), serum total cholesterol (TC), free fatty acids (FFA), high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol (LDL-c) were measured, the homeostasis model assessment-insulin resistance (HOMA-IR) was calculated. Immunohistochemistry and western blotting measured the expression of glucose transporter4 (GLUT4) and peroxisome proliferator-activated receptor γ (PPAR-γ) by in skeletal muscle. RESULTS: The MG mice had a significantly increased in RBG, HbAlc, the HOMA-IR level, the serum of TG, TC, LDL-c, but a decreased in glucose tolerance and the protein expression of GLUT4 and PPAR-γ compared with the NCG. Compared with the MG, EFBFL groups significantly decreased RBG, HbAlc, and the HOMA-IR level, increased glucose tolerance. Meanwhile EFBFL groups reduced the serum TG, TC, and LDL-c in a dose-dependent manner. In addition, EFBFL increased the protein expression of GLUT4 and PPAR-γ in the skeletal muscle of db/db mice. There was significant difference between the MG group and EFBFL groups. CONCLUSION: These findings suggest that EFBFL has anti-diabetic effects in db/db mice, ameliorating glucose intolerance, lipid dysregulation, and insulin resistance.

[Effect of Xiaozhong Zhitong Ointment on MEF2 mRNA and protein expression in rats with gastrointestinal muscle injury].

OBJECTIVE: To investigate the effect of Xiaozhong Zhitong Ointment(XZZTO) on remodeling and repair of skeletal muscle injury in rats based on the expression mechanism of microRNA. METHODS: The rat gastrocnemius injury model was established by blunt contusion model. The expression of MEF2 gene and protein in gastrocnemius muscle was detected by quantitative PCR at 4, 7, 14 and 21 days after injury with XZZTO. The mechanism of the effect of XZZTO on the muscle remodeling and repair of rat gastrocnemius contusion model was discussed. RESULTS: The expression level of MEF2 in the treatment group was significantly higher than that of the control group and model group, which further confirmed the important role of MEF2 in inducing skeletal muscle remodeling and repair process in the topical drugs. The expression of MEF2 increased at 7 days after injury and remained at a high level until 21 days after injury. Compared with the model group, the peak expression period was about 14 days, and then returned to the general state. CONCLUSIONS: The expression level of MEF2 shows an upward trend. Even 21 days after injury, the expression of MEF2 dose not show a significant downward trend. It can be seen that XZZTO can promote the expression of MEF2. At the same time, XZZTO can regulate the regeneration and repair of skeletal muscle. Therefore, XZZTO can play a regeneration and repair role after skeletal muscle injury through gene regulation.

Effect of Xiaozhong Zhitong Ointment on MEF2 mRNA and protein expression in rats with gastrointestinal muscle injury / 中国骨伤

OBJECTIVE@#To investigate the effect of Xiaozhong Zhitong Ointment(XZZTO) on remodeling and repair of skeletal muscle injury in rats based on the expression mechanism of microRNA.@*METHODS@#The rat gastrocnemius injury model was established by blunt contusion model. The expression of MEF2 gene and protein in gastrocnemius muscle was detected by quantitative PCR at 4, 7, 14 and 21 days after injury with XZZTO. The mechanism of the effect of XZZTO on the muscle remodeling and repair of rat gastrocnemius contusion model was discussed.@*RESULTS@#The expression level of MEF2 in the treatment group was significantly higher than that of the control group and model group, which further confirmed the important role of MEF2 in inducing skeletal muscle remodeling and repair process in the topical drugs. The expression of MEF2 increased at 7 days after injury and remained at a high level until 21 days after injury. Compared with the model group, the peak expression period was about 14 days, and then returned to the general state.@*CONCLUSIONS@#The expression level of MEF2 shows an upward trend. Even 21 days after injury, the expression of MEF2 dose not show a significant downward trend. It can be seen that XZZTO can promote the expression of MEF2. At the same time, XZZTO can regulate the regeneration and repair of skeletal muscle. Therefore, XZZTO can play a regeneration and repair role after skeletal muscle injury through gene regulation.

[Musculoskeletal factors, sarcopenia and falls in old age]. / Skelettmuskuläre Faktoren, Sarkopenie und Stürze im Alter.

Falls in older adults are a major public health problem with a high incidence and severe consequences for the older individual. The age-related loss of muscle strength as well as muscle mass and muscle function (sarcopenia) are i) risk factors for falling, ii) associated with physical function and iii) markers of the frailty syndrome. Muscle function appears to play a bigger role than muscle mass. The operationalization of sarcopenia using the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm is consistently associated with falling events. Structured physical exercise plays the key role in the prevention of falls and the management of functional decline caused by sarcopenia and frailty. The combined supplementation with proteins and vitamin D supports muscle protein synthesis in undersupplied persons and improves aspects of physical function.

Isolated branched-chain amino acid intake and muscle protein synthesis in humans: a biochemical review / Consumo isolado de aminoácidos de cadeia ramificada e síntese de proteína muscular em humanos: uma revisão bioquímica

ABSTRACT Alongside a proper diet, ergogenic aids with potential direct and/or indirect physical performance enhancing effects are sought after for improved adaptation to physical training. Nutritional ergogenics include diet composition changes and/or dietary supplementation. Branched-chain amino acids valine, leucine and isoleucine are widely popular among products with ergogenic claims. Their major marketing appeal derives from allegations that branched-chain amino acids intake combined with resistance physical exercise stimulates muscle protein synthesis. Evidence supporting the efficacy of branched-chain amino acids alone for muscle hypertrophy in humans is somewhat equivocal. This brief review describes physiological and biochemical mechanisms underpinning the effects of complete protein source and branched-chain amino acid intake on skeletal muscle growth in the postabsorptive and post-exercise state. Evidence in favor of or against potential anabolic effects of isolated branched-chain amino acid intake on muscle protein synthesis in humans is also examined.

RESUMO No treinamento físico, buscam-se, além de uma dieta adequada, recursos ergogênicos que possam maximizar direta e/ou indiretamente o desempenho físico. Entre as categorias de recursos ergogênicos, o nutricional compreende a modulação da composição dietética e/ou uso de suplementação. A comercialização dos suplementos de aminoácidos de cadeia ramificada valina, leucina e isoleucina possui muita popularidade entre aqueles com alegação ergogênica. O principal marketing está na afirmação de que o consumo isolado de aminoácidos de cadeia ramificada associado ao exercício físico resistido estimula a síntese de proteína muscular. As evidências da eficácia da ingestão isolada de aminoácidos de cadeia ramificada para a hipertrofia muscular em humanos parecem equivocadas. Nesta breve revisão, apresentamos a compreensão fisiológica e bioquímica de como a ingestão de uma fonte completa de proteína e de aminoácidos de cadeia ramificada afeta o crescimento do músculo esquelético no estado pós-absortivo e pós-exercício. Mostramos também as evidências que suportam ou não a afirmação dos potenciais efeitos anabólicos na síntese de proteína muscular dos aminoácidos de cadeia ramificada quando consumidos isoladamente em humanos.

[Cachexia and sarcopenia in chronic heart failure : Change in muscle strength and muscle structure]. / Kachexie und Sarkopenie bei chronischer Herzinsuffizienz : Veränderung von Muskelkraft und Muskelaufbau.

Alterations to the body composition, i.e. the makeup of skeletal muscle, fat and bone density, are frequent in heart insufficiency. Their prevalence and clinical consequences are often underestimated. Cachexia is recognized as a complex multifactorial syndrome in chronic diseases that leads to weight loss. This point constitutes the essential differential criterion from sarcopenia. Cachexia is defined as a non-edematous weight loss of more than 5% within 12 months or less. Cachexia means weight loss, while sarcopenia means loss of muscle mass without weight loss because the functional muscle can be replaced by adipocytes. Sarcopenia is defined as a skeletal muscle mass index (SMMI) of at least 2 standard deviations below the mean value of a healthy young reference group between 20 and 30 years of the same sex and ethnic background. At the same time the walking speed is reduced to 1 m/s or the distance covered in a 6-min walk is <400m. The determination of loss of muscle mass should be carried out by whole body scanning, ideally with dual-energy x­ray absorptiometry. A reliable and simple method for measurement of performance capability is the short physical performance battery (SPPB) test. The treatment of sarcopenia and cardiac cachexia in patients with heart insufficiency is still a great challenge. Power and endurance training, nutritional supplementation and drug therapy are possible therapeutic approaches; however, the study situation is unsatisfactory.

Correlation Between Skin Temperature Over Myofascial Trigger Points in the Upper Trapezius Muscle and Range of Motion, Electromyographic Activity, and Pain in Chronic Neck Pain Patients.

OBJECTIVE: The purpose of this study was to assess the correlation between skin temperature over a myofascial trigger point in the upper trapezius muscle and range of motion of the cervical spine, electromyographic activity, and pain in patients with chronic neck pain. METHODS: This is a single-blind cross-sectional study. Forty participants of both sexes, aged 18 to 45 years, with chronic neck pain and myofascial trigger points in the upper trapezius muscle were included in the study. The participants were assessed using the Numeric Rating Scale, the Neck Disability Index, infrared thermography, algometry, fleximetry, and electromyographic activity. RESULTS: A positive association was observed between skin temperature to the right with the range of motion of cervical flexion (r = 0.322, P = .043), the median frequency of isometrics to the right (r = 0.341, P = .032), and the median frequency of rest to the left (rs = 0.427, P = .006); as were a negative association between skin temperature to the right and the root mean square of rest to the right (rs = -0.447, P = .004), and a positive association of skin temperature to the left with the median frequency of isometrics to the right (r = 0.365, P = .020), and the median frequency of rest to the left (rs = 0.573, P < .001). CONCLUSION: Patients with chronic neck pain who had reduction of skin temperature over myofascial trigger points in the upper trapezius muscle had reduced cervical range of motion for flexion, reduced median frequency at rest and during isometric contraction, and increased root mean square at rest.

Effects of beta-hydroxy-beta-methyl butyrate in muscle regeneration of rats / Efeitos do beta-hidroxi-beta-metil-butirato na regeneração muscular de ratos / Efectos de beta-hidroxi-beta-metilbutirato en la regeneración muscular de ratas

ABSTRACT Introduction: Studies have shown that beta-hydroxy-beta-methyl butyrate (HMB) supplementation increases muscle strength and mass. Objective: To evaluate the effect of HMB supplementation on the muscle regeneration process in young and sedentary rats. Methods: Twenty-four male Wistar rats two months old were divided into two groups: lesion (LE) and supplemented (S), and evaluated in two moments - seven days (LE7; S7, n=6) and 21 days (LE21; S21, n=6). The right tibialis anterior muscle was subjected to cryolesion in all animals. After the injury, the LE group remained in the vivarium without any intervention. Group S received HMB calcium supplementation diluted in water by gavage (320 mg/kg/weight per day). The injury tibialis anterior (ITA), the tibialis anterior (TA), and the left soleus (SOL) muscles were removed, weighted and divided transversally into two parts, one for the analysis of the cross-sectional area (CSA) and the area of inflammation/regeneration and the other part to measure the muscular glycogen concentration. Data were evaluated using the SAS program considering mean and standard deviation. For analysis of variance the ANOVA test was used followed by the Tukey-HSD test (p≤0.05). Results: The ITA muscle weight was higher in S21 compared to S7 (p<0.05). The groups LE21 and S21 presented greater CSA of muscle fibers area and smaller ITA regeneration/inflammation area (p<0.05) when compared with the LE7 and S7 groups. There was an increase in muscle glycogen levels in S7 group compared to LE7 and S21 groups for TA and SOL (p<0.01), as well as in S21 group compared to LE21 for SOL (p<0.05). Conclusion: HMB did not influence the muscle regeneration process and did not favor anabolic activity in the different muscular fibers of young sedentary rats. Level of Evidence II; Therapeutic studies - Investigation of treatment results.

RESUMO Introdução: Estudos demonstram que a suplementação de beta-hidroxi-beta-metil-butirato (HMB) aumenta a força e a massa muscular. Objetivo: Avaliar o efeito da suplementação com HMB no processo de regeneração muscular em ratos jovens e sedentários. Métodos: Foram utilizados 24 ratos Wistar machos com dois meses de idade, divididos nos grupos lesão (LE) e suplementado (S) e avaliados em dois momentos, em sete dias (LE7; S7, n = 6) e em 21 dias (LE21; S21, n = 6). O músculo tibial anterior direito foi submetido à criolesão em todos os animais. Após a lesão, o grupo LE permaneceu no biotério sem nenhum tipo de intervenção. O grupo S recebeu suplementação de cálcio HMB em pó diluído em água por meio de gavagem (320 mg/kg/peso por dia). Os músculos tibial anterior lesado (TAL), tibial anterior (TA) e sóleo (SOL) esquerdo foram retirados, pesados e divididos transversalmente em duas partes, sendo uma destinada à análise da área de corte transversal (ACT) e da área de inflamação/regeneração e a outra parte para medir a concentração de glicogênio muscular. A avaliação dos dados foi realizada por meio do programa SAS, considerando média e desvio padrão. Para análise de variância usou-se o teste ANOVA, seguido do teste de Tukey-HSD (p ≤ 0,05). Resultados: O peso do músculo TAL foi maior no S21 em comparação com o S7 (p < 0,05). Os grupos LE21 e S21 apresentaram maior ACT de fibras musculares e menor área de regeneração/inflamação do TAL (p < 0,05), quando comparados com os grupos LE7 e S7. Observou-se aumento nos níveis de glicogênio muscular no grupo S7 com relação a LE7 e S21 para TAE e SOL (p < 0,01), assim como no grupo S21 em comparação com LE21 no SOL (p < 0,05). Conclusão: O HMB não influenciou o processo de regeneração muscular e não favoreceu a atividade anabólica nos diferentes tipos de fibras musculares de ratos jovens e sedentários. Nível de Evidência II, Estudos terapêuticos - Investigação dos resultados do tratamento.

RESUMEN Introducción: Los estudios han demostrado que el beta-hidroxi-beta-metilbutirato (HMB) suplementario aumenta la fuerza y la masa muscular. Objetivo: Evaluar el efecto del HMB suplementario en el proceso de regeneración muscular en ratas jóvenes y sedentarias. Métodos: Se utilizaron 24 ratas Wistar machos con dos meses de edad, divididas en los grupos lesión (LE) y suplementario (S) y evaluados en dos momentos, en siete días (LE7; S7, n = 6) y en 21 días (LE21; S21, n = 6). El músculo tibial anterior derecho fue sometido a la criolesión en todos los animales. Después de la lesión, el grupo LE se mantuvo en el vivero sin ninguna intervención. El grupo S recibió calcio HMB suplementario diluido en agua por medio de alimentación forzada (320 mg/kg/peso al día). Los músculos tibial anterior lesión (TAL), tibial anterior (TA) y sóleo (SOL) izquierdo fueron retirados, pesados y divididos transversalmente en dos partes, siendo una destinada al análisis del área de corte transversal (ACT) y del área de inflamación/regeneración y otra parte para medir la concentración de glucógeno muscular. La evaluación de los datos se realizó a través del programa SAS, considerando media y desviación estándar. Para el análisis de varianza se utilizó la prueba ANOVA, seguida de la prueba de Tukey-HSD (p ≤ 0,05). Resultados: El peso del músculo TAL fue mayor en el grupo S21 en comparación con el S7 (p < 0,05). Los grupos LE21 y S21 tuvieron mayor ACT de fibras musculares y menor área de regeneración/inflamación del TAL (p < 0,05) en comparación con los grupos LE7 y S7. Se observó un aumento en los niveles de glucógeno muscular en el grupo S7 con relación a LE7 y S21 para TA y SOL (p < 0,01), así como en el grupo S21 en comparación con LE21 en el SOL (p < 0,05). Conclusión: HMB no influyó el proceso de regeneración muscular y no favoreció la actividad anabólica en los diferentes tipos de fibras musculares de ratas jóvenes y sedentarias. Nivel de Evidencia II, Estudios terapéuticos - Investigación de los resultados del tratamiento.

Jumping in aquatic environment after sciatic nerve compression: nociceptive evaluation and morphological characteristics of the soleus muscle of Wistar rats / Salto em meio aquático após compressão de nervo isquiático: avaliação nociceptiva e características morfológicas do músculo sóleo de ratos Wistar

ABSTRACT Objective To evaluate the effect of jumping in aquatic environment on nociception and in the soleus muscle of trained and not trained Wistar rats, in the treatment of compressive neuropathy of the sciatic nerve. Methods Twenty-five Wistar rats were distributed into five groups: Control, Lesion, Trained + Lesion, Lesion + Exercise, and Trained + Lesion + Exercise. The training was jumping exercise in water environment for 20 days prior to injury, and treatment after the injury. Nociception was evaluated in two occasions, before injury and seven after injury. On the last day of the experiment, the right soleus muscles were collected, processed and analyzed as to morphology and morphometry. Results In the assessment of nociception in the injury site, the Control Group had higher average than the rest, and the Lesion Group was larger than the Trained + Lesion and Lesion + Exercise Groups. The Control Group showed higher nociceptive threshold in paw, compared to the others. In the morphometric analysis, in relation to Control Group, all the injured groups showed decreased muscle fiber area, and in the Lesion Group was lower than in the Lesion + Exercise Group and Trained + Lesion Group. Considering the diameter of the muscle fiber, the Control Group had a higher average than the Trained + Lesion Group and the Trained + Lesion + Exercise Group; and the Lesion Group showed an average lower than the Trained + Lesion and Lesion + Exercise Groups. Conclusion Resistance exercise produced increased nociception. When performed prior or after nerve damage, it proved effective in avoiding hypotrophy. The combination of the two protocols led to decrease in diameter and area of the muscle fiber.

RESUMO Objetivo Avaliar os efeitos do salto em meio aquático, na nocicepção e no músculo sóleo, em ratos Wistar treinados e não treinados, no tratamento de neuropatia compressiva do nervo isquiático. Métodos Foram distribuídos em cinco grupos 25 ratos Wistar: Controle, Lesão, Treinado + Lesão, Lesão + Exercício e Treinado + Lesão + Exercício. O treino foi com exercício de salto em meio aquático durante 20 dias, prévio à lesão, e o tratamento ocorreu após a lesão. Foram realizadas avaliações da nocicepção, sendo uma pré-lesão e sete pós-lesão. No último dia de experimento, os músculos sóleos direitos foram coletados, processados e analisados por meio de morfologia e morfometria. Resultados Na avaliação da nocicepção no local da lesão, o Grupo Controle apresentou média maior que os demais, e o Grupo Lesão foi maior que os Grupos Treinado + Lesão e Lesão + Exercício. O Grupo Controle apresentou limiar nociceptivo na pata maior com relação aos demais. Nas análises morfométricas, em relação ao Grupo Controle, todos os grupos lesionados apresentaram diminuição da área da fibra muscular; o Grupo Lesão apresentou-se menor que os Grupos Treinado + Lesão e Lesão + Exercício. No diâmetro da fibra muscular, o Grupo Controle apresentou média maior que os Grupos Treinado + Lesão e Treinado + Lesão + Exercício, e o Grupo Lesão apresentou média menor que os Grupos Treinado + Lesão e Lesão + Exercício. Conclusão O exercício físico resistido produziu aumento da nocicepção. Quando realizado previamente ou após a lesão nervosa, mostrou-se eficaz em evitar a hipotrofia. A associação dos dois protocolos levou à diminuição do diâmetro e da área da fibra muscular.

Electrical stimulation attenuates morphological alterations and prevents atrophy of the denervated cranial tibial muscle / Eletroestimulação atenua alterações morfológicas e previne atrofia do músculo tibial cranial desnervado

ABSTRACT Objective To investigate if electrical stimulation through Russian current is able to maintain morphology of the cranial tibial muscle of experimentally denervated rats. Methods Thirty-six Wistar rats were divided into four groups: the Initial Control Group, Final Control Group, Experimental Denervated and Treated Group, Experimental Denervated Group. The electrostimulation was performed with a protocol of Russian current applied three times per week, for 45 days. At the end, the animals were euthanized and histological and morphometric analyses were performed. Data were submitted to statistical analysis with a significance level of p<0.05. Results The Experimental Denervated Group and the Experimental Denervated and Treated Group had cross-sectional area of smaller fiber compared to the Final Control Group. However, there was significant difference between the Experimental Denervated Group and Experimental Denervated and Treated Group, showing that electrical stimulation minimized muscle atrophy. The Experimental Denervated and Treated Group and Initial Control Group showed similar results. Conclusion Electrical stimulation through Russian current acted favorably in maintaining morphology of the cranial tibial muscle that was experimentally denervated, minimizing muscle atrophy.

RESUMO Objetivo Investigar se a estimulação elétrica pela corrente russa é capaz de manter a morfologia do músculo tibial cranial de ratos desnervados experimentalmente. Métodos Foram utilizados 36 ratos Wistar, distribuídos em quatro grupos: Grupo Controle Inicial, Grupo Controle Final, Grupo Experimental Desnervado Tratado, Grupo Experimental Desnervado. A eletroestimulação foi realizada com um protocolo de corrente russa aplicada três vezes por semanas, durante 45 dias. Ao final, os animais foram eutanasiados e, em seguida, foram realizadas as análises histológica e morfométrica. Os dados foram submetidos à análise estatística, com nível de significância de p<0,05. Resultados Os Grupos Experimental Desnervado e o Grupo Experimental Desnervado Tratado apresentaram área de secção transversal da fibra menor quando comparados ao Grupo Controle Final. Entretanto, constatou-se diferença significativa entre o Grupo Experimental Desnervado e o Grupo Experimental Desnervado Tratado, mostrando que a estimulação elétrica minimizou atrofia muscular. Ainda, observou-se que o Grupo Experimental Desnervado Tratado apresentou resultados semelhantes ao Grupo Controle Inicial. Conclusão A estimulação elétrica por meio da corrente russa foi favorável na manutenção da morfologia do músculo tibial cranial desnervado experimentalmente, minimizando a atrofia muscular.

Terapia extracorpórea por ondas de choque no tratamento da lesão muscular crônica / Extracorporeal shockwave terapy to treat chronic muscle injury

Objetivo: Avaliar o tratamento com terapia por ondas de choqueextracorpórea (TOCE) de baixa energia associada à fisioterapia notratamento das lesões musculares crônicas graus 2 e 3 nos membrosinferiores de atletas amadores. Métodos: Oito atletas com lesãomuscular do membro inferior há mais de três semanas foram tratadoscom fisioterapia e TOCE. Foram avaliados os seguintes parâmetrosdurante o tratamento: presença de gap palpável, força muscular,dor, e escala de Tegner, bem como as características de imagemultrassonográfica e a capacidade de retorno ao esporte. Resultados:O tempo médio de lesão na primeira avaliação foi de 8,75 semanas.Todos os pacientes evoluíram com força muscular grau V após oitosemanas. A dor passou de 5,75 para 0,5 pontos da escala visualanalógica de dor (EVA) ao final do tratamento. O questionário de Tegnerapós o tratamento atingiu em média seis pontos em sua escala.Os pacientes retornaram ao esporte em média após 8,14 semanas.Conclusão: TOCE associada à fisioterapia mostrou ser eficaz notratamento da lesão muscular de longa data, com boa evolução ecapacidade de retorno ao esporte de todos os pacientes avaliados.Nível de Evidência IV, Estudo Prospectivo de Série de Casos.

Objective: To evaluate the low energy extracorporeal shock wavestherapy (ESWT) associated with physical therapy in the treatmentof chronic muscle injuries classified as grades 2 and 3 in thelower limbs of amateur athletes. Methods: Eight athletes presentingwith lower limb muscle injury for more than three weeks weretreated with physiotherapy and ESWT. We evaluated the followingparameters during treatment: palpable gap, muscle strength,pain, and Tegner score, as well as ultrasound image features andthe ability to return to sports practice. Results: The average timeof the first evaluation of the injury was 8.75 weeks. All patientspresented muscle strength grade V after eight weeks. The painscore evolved from 5.75 to 0.5 points of the visual analoguescale (VAS), at the end of the treatment. The Tegner score aftertreatment was six points on average. Patients returned to sportspractice after 8.14 weeks. Conclusion: ESWT associated withphysical therapy proved to be effective to treat long-term muscleinjury, with good performance and the ability to return to sportpractice for all patients. Level of Evidence IV, Case Series,Prospective Study.