Prognostic Equations and Accuracy of a Total Score of Functional Independence Measure at Discharge for Different Diseases in a Convalescent Rehabilitation Ward.

OBJECTIVES: Prognosis and goal setting from admission in the convalescent rehabilitation ward, supported by a multidisciplinary team, enhance rehabilitation and discharge support. Predicting functional independence measure (FIM) outcomes can further optimize these processes. This study aimed to develop prognostic equations for the motor FIM at discharge for stroke, hip fracture (HF), vertebral compression fractures (VCFs), and total knee arthroplasty (TKA), which are common diseases in patients admitted to convalescent rehabilitation wards, using multiple regression analysis, and to clarify the difference in the accuracy of the predicted motor FIM according to the disease. METHODS: This study included 965 patients admitted to our hospital. The objective variable consists of the motor FIM at discharge, and the explanatory variables were age, sex, days from onset to admission, total admission motor FIM, and total admission cognitive FIM. A stepwise multiple regression analysis was performed. The analysis of the difference in the accuracy of predicted motor FIM by disease used the absolute value of the residuals. RESULTS: The total motor FIM and cognitive FIM at admission were extracted for all four diseases included in this study. The absolute value of the residuals appeared to be more accurate for TKA, HF, stroke, and VCF in that order. CONCLUSIONS: Although differences in the accuracy of the prediction equation were observed by disease, this prediction equation can be used as an approach to review the details of rehabilitation and discharge and can be tailored to each case.

Effects of lower limb vibration on hip pain and function after total hip arthroplasty: A randomized controlled trial.

BACKGROUND: A vibration roller is an effective tool for reducing muscle soreness and improving damaged muscle function. However, its efficacy in reducing hip pain and improving function after total hip arthroplasty is unclear. We investigated the effect of lower limb vibration using a vibration roller on postoperative hip pain and function after total hip arthroplasty in a randomized controlled clinical trial. METHODS: Thirty patients scheduled for total hip arthroplasty were randomly assigned to vibration and control groups. The patients in the vibration group performed lower limb vibration using a vibration roller. The patients in the control group performed sham therapy using a hot pack. Patients performed both interventions for 10 min daily on postoperative days 1-7, in addition to regular physical therapy. Primary outcome was hip pain intensity as measured using a visual analog scale. Secondary outcomes were pain-pressure threshold and serum creatine kinase and C-reactive protein levels. We also assessed physical functions, including the Harris Hip Score, range of motion of the hip joint, muscle strength, gait velocity, and timed up-and-go test. The effects of the interventions on outcome measurements in the groups were compared using a split-plot design variance analysis. RESULTS: After one week of the intervention and three weeks of follow-up, the vibration group showed statistically significant improvement in the exercise-induced hip pain, pain-pressure threshold of lateral thigh, and serum creatine kinase compared to the control group (p = 0.006, 0.003, and 0.012, respectively). No statistically significant differences were found between the groups regarding the physical functions. CONCLUSIONS: Lower limb vibration using a vibration roller after total hip arthroplasty was an effective intervention to reduce exercise-induced hip pain and improve serum creatine kinase, but there was no synergistic effect on the physical functions.

Acute Effects of Handheld Vibration Massage on Posterior Shoulder Soft Tissues.

Background: Interventions using vibration stimulation have been recognized for their potential for increasing range of motion (ROM) without compromising muscle strength. Handheld vibration massagers can efficiently deliver vibration therapy to the shoulder joint and may be a potential treatment. Purpose: To evaluate the effects of vibration massage using a handheld device on the soft tissues of the posterior shoulder joint, particularly on internal rotation (IR) passive ROM and external rotation (ER) muscle strength. Study Design: Crossover study design. Methods: A crossover study with a 5-min vibration massage and passive control condition was conducted in healthy male volunteers (mean age 20.5 ± 1.7 years). Vibration massage was applied to the posterior shoulder soft tissues of the dominant arm, with no intervention under control conditions. IR-ROM (vertebral level and in abduction) and strength of the external rotators (isometric and isokinetic) were measured before and immediately after the intervention. Vertebral levels were calculated as a ratio of lengths (ratio decreases with increased mobility). IR-ROM in abduction, the angle was measured. Statistical analysis was performed with two-way repeated measures ANOVA and paired t-test (Bonferroni correction). Results: Vibration application decreased (improved) vertebral level IR ROM by -4.1% (p < 0.01, d = 0.445) and increased abduction position IR ROM by 11.4° (p < 0.01, d = 0.694). These changes exceeded the 95% confidence interval for the minimum detectable change. By contrast, the control condition produced no changes. IR-ROM (vertebral level and abduction) immediately after the intervention showed significant differences between the control and vibration conditions (p = 0.036, d = 0.273; p = 0.048, d = 0.483, respectively). Muscle strength did not show any interaction, time, or between-condition effects. Conclusions: A massage using a handheld vibration massager applied to the posterior shoulder soft tissues increased IR-ROM without negatively affecting muscle strength, suggesting its potential use as a means of warming up. Level of Evidence: Level 3.

Relationship Between the Flexion Torque of the First Metatarsophalangeal Joint and Intrinsic Foot Muscles Depends on the Ankle Joint Position.

Background: Clinicians and researchers are beginning to pay attention to the importance of the intrinsic foot muscles (IFMs). Among IFMs, the abductor hallucis (AbH) is associated with foot disorders. However, so far no method for assessing the strength of the AbH has been established. In addition, previous studies have shown increased IFM activity in the plantarflexed position of the ankle. Therefore, this study tests the hypothesis that a correlation will be found between the cross-sectional area (CSA) of the AbH and the flexion torque and that the first metatarsophalangeal (MTP) joint would be stronger in the plantarflexed (PF) position of the ankle joint than in the neutral (N) position. Methods: Eight male and 8 female patients (16 lower limbs) were included in this study to measure the CSA of IFM and the extrinsic foot muscles of the lower leg. Furthermore, the flexion torque of the first MTP joint was measured using a handheld dynamometer at the N and PF positions of the ankle joint. Correlation analysis was performed to examine the relationship between the CSA of each muscle and the flexion torque of the first MTP joint in the N and PF positions. Results: In the N position, a correlation was found between the flexion torque of the first MTP joint and the CSA of the AbH (r = 0.818), flexor hallucis brevis (r = 0.730), and flexor hallucis longus (r = 0.726). In the PF position, a correlation was found between the flexion torque of the first MTP joint and the CSA of the AbH (r = 0.863) and flexor hallucis brevis (r = 0.680). (P < .05). Conclusion: Overall, this study suggested that by measuring flexion torque of the first MTP joint in the PF position, AbH strength can be estimated without using any expensive equipment. Level of Evidence: Level V, mechanism-baced reasoning.

Comparison of the Effects of a Roller Massager Intervention on the Rectus Femoris Between Lengthened and Slack Positions.

ABSTRACT: Kasahara, K, Konrad, A, Murakami, Y, Thomas, E, and Nakamura, M. Comparison of the effects of a roller massager intervention on the rectus femoris between lengthened and slack positions. J Strength Cond Res XX(X): 000-000, 2024-A roller massager (RM) is a type of foam rolling device, which previous studies have shown to be effective for acutely decreasing tissue hardness and increasing range of motion (ROM). However, these effects may differ with the RM intervention position (i.e., knee flexion or knee extension). Therefore, this study aimed to compare the acute effects of an RM intervention on the rectus femoris (RF) in the knee flexed and extended positions. The subjects were 14 healthy male college students (age, 22.6 ± 0.8 years). The RF of the dominant leg was tested. Three conditions were compared: a control condition with no intervention (CON), an RM intervention in knee extension (i.e., RM_extension), and a RM intervention in knee flexion (i.e., RM_flexion). The measurements were tissue hardness in the proximal (TH_pro), middle (TH_mid), and distal (TH_dis) portions of the RF, knee flexion ROM, pain pressure threshold (PPT), maximal voluntary isometric contraction (MVC-ISO) torque, and maximal voluntary concentric contraction (MVC-CON) torque in the RF before and immediately after the intervention. There were significant interaction effects of TH_mid and knee flexion ROM. Both RM_extension and RM_flexion conditions showed a significant (p < 0.01) decrease in TH_mid and an increase in knee flexion ROM, but there were no significant differences between conditions. There was a main effect for TH_pro and PPT (p < 0.05) but no significant interaction effect or main effect for TH_dis, MVC-ISO torque, and MVC-CON torque. The results showed that the RM intervention can effectively decrease tissue hardness and increase ROM, regardless of limb position (i.e., knee extension or flexion).

Systematic Review and Meta-Analysis of Particle Beam Therapy versus Photon Radiotherapy for Skull Base Chordoma: TRP-Chordoma 2024.

[Objective] The aim of this study was to compare the efficacy of particle beam therapy (PT) with photon radiotherapy (RT) for treatment of skull base chordoma. [Methods] A systematic review was conducted for skull base chordoma treated with PT or photon RT reported from 1990 to 2022. Data were extracted for overall survival (OS) and progression-free survival (PFS), late adverse events, age, gender, gross total resection (GTR) rates, tumor volume, total irradiation dose, and treatment modality. Random-effects meta-regression analysis with the treatment modality as an explanatory variable was performed for each outcome to compare the modalities. [Results] A meta-analysis of 30 selected articles found 3- and 5-year OS rates for PT vs. photon RT or combined photon RT/proton beam therapy (PBT) of 90.8% (95% CI: 87.4-93.3%) vs. 89.5% (95% CI: 83.0-93.6%), p = 0.6543; 80.0% (95% CI: 75.7-83.6%) vs. 89.5% (95% CI: 83.0-93.6%), p = 0.6787. The 5-year PFS rates for PT vs. photon RT or photon RT/PBT were 67.8% (95% CI: 56.5-76.7%) vs. 40.2% (95% CI: 31.6-48.7%), p = 0.0004. A random-effects model revealed that the treatment modality (PT vs. photon RT or photon RT/PBT) was not a significant factor for 3-year OS (p = 0.42) and 5-year OS (p = 0.11), but was a significant factor for 5-year PFS (p < 0.0001). The rates of brain necrosis were 8-50% after PT and 0-4% after photon RT or photon RT/PBT. [Conclusion] This study shows that PT results in higher PFS compared to photon RT for skull base chordoma, but that there is a tendency for a higher incidence of brain necrosis with PT. Publication and analysis of further studies is needed to validate these findings.

[Pedunculated Giant Condyloma Acuminatum of the Scrotum].

The patient was a 71-year-old male whose chief complaint was a scrotum mass. The mass had gradually increased in size without any associated symptoms. The physical examination revealed a pedunculated, radish brown, and elastic soft tumor (4. 5×3. 5×3. 0 cm) in the right scrotum. Blood chemical analysis of HbA1c and squamous carcinoma antigen were 8. 3% and 38. 4 ng/ml (≦1. 5), respectively. This tumor was successfully treated with surgical resection. Histopathological examination showed condyloma acuminatum without malignant findings. Giant condyloma acuminatum commonly affects the genital and perianal areas. An immunocompromised state generally exists in the background of the patients.

Proton and carbon ion radiotherapy for operable early-stage lung cancer; a prospective nationwide registry.

BACKGROUND AND PURPOSE: To investigate the toxicity and survival outcomes of proton and carbon ion radiotherapy for patients with operable early-stage lung cancer who are eligible for lobectomy. MATERIALS AND METHODS: This multicenter nationwide prospective cohort study included patients with operable early-stage lung cancer. Proton and carbon ion radiotherapy was performed according to the schedule stipulated in the unified treatment policy. Progression-free survival (PFS), overall survival (OS) and treatment-related toxicities were evaluated. RESULTS: A total of 274 patients were enrolled and included in efficacy and safety analyses. The most common tumor type was adenocarcinoma (44 %), while 105 cases (38 %) were not histologically confirmed or diagnosed clinically. Overall, 250 (91 %) of the 274 patients had tumors that were peripherally situated, while 138 (50 %) and 136 (50 %) patients were treated by proton and carbon ion radiotherapy, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7-49.0). Grade 3 or severe treatment-related toxicity was observed in 4 cases (1.5 %). Three-year PFS was 80.5 % (95 % CI: 75.7 %-85.5 %) and OS was 92.5 % (95 % CI: 89.3 %-95.8 %). Pathological confirmation and clinical stage were factors significantly associated with PFS, while tumor location and particle-ion type were not. Meanwhile, clinical stage was significantly associated with OS, but pathological confirmation, tumor location, and particle-ion type were not. CONCLUSIONS: Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS in each subset. In this disease context, proton and carbon ion beam therapies are feasible alternatives to curative surgery.

Differences in Electroencephalography Power Levels between Poor and Good Performance in Attentional Tasks.

Decreased attentional function causes problems in daily life. However, a quick and easy evaluation method of attentional function has not yet been developed. Therefore, we are searching for a method to evaluate attentional function easily and quickly. This study aimed to collect basic data on the features of electroencephalography (EEG) during attention tasks to develop a new method for evaluating attentional function using EEG. Twenty healthy young adults participated; we examined cerebral activity during a Clinical Assessment for Attention using portable EEG devices. The Mann-Whitney U test was performed to assess differences in power levels of EEG during tasks between the low- and high-attention groups. The findings revealed that the high-attention group showed significantly higher EEG power levels in the δ wave of L-temporal and bilateral parietal lobes, as well as in the ß and γ waves of the R-occipital lobe, than did the low-attention group during digit-forward, whereas the high-attention group showed significantly higher EEG power levels in the θ wave of R-frontal and the α wave of bilateral frontal lobes during digit-backward. Notably, lower θ, α, and ß bands of the right hemisphere found in the low-attention group may be key elements to detect attentional deficit.

Minimum Intensity of Daily Six Eccentric Contractions to Increase Muscle Strength and Size.

Our previous study showed that daily six maximal eccentric contractions that were performed 5 days a week for 4 weeks increased maximal voluntary isometric (MVC-ISO), concentric (MVC-CON), and eccentric contraction (MVC-ECC) strength of the elbow flexors and muscle thickness of biceps brachii and brachialis (MT) by 8.3 ± 4.9%, 11.1 ± 7.4%, 13.5 ± 11.5%, and 10.6 ± 5.1%, respectively. In the present study, we tested the hypothesis that the muscle strength and MT would still increase when the training intensity was reduced to 2/3 or 1/3 of the peak MVC-ECC torque. Thirty-six healthy young (19-24 years) adults who had not performed resistance training were placed to three groups (n = 12/group): 2/3MVC or 1/3MVC that performed six eccentric contractions with 2/3 or 1/3 MVC-ECC load using a dumbbell 5 days a week for 4 weeks or control group that did not perform any training. Changes in the MVC-ISO, MVC-CON, MVC-ECC torque, and MT before and after the 4-week period were compared among the groups and with the group of the previous study in which six maximal eccentric contractions were performed 5 days a week for 4 weeks (MVC group; n = 12). The control and 1/3MVC groups showed no significant changes in any measures. Significant (p < 0.05) increases in MVC-ISO (10.3 ± 11.4%), MVC-CON (10.9 ± 9.5%), and MVC-ECC (9.3 ± 8.8%) torque and MT (10.1 ± 9.2%) were observed for the 2/3MVC group. These changes were not significantly different from those of the MVC group. These results suggest that the 2/3-intensity eccentric contractions with a dumbbell are as effective as maximal-intensity isokinetic eccentric contractions to induce muscle adaptations.

Proton Beam Therapy for Treating Patients with Hepatocellular Carcinoma with Major Portal Vein Tumor Invasion: A Single Center Retrospective Study.

Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) has a poor prognosis and is generally not indicated for surgery. Proton beam therapy (PBT) may offer an alternative treatment. In this study, long-term outcomes were examined in 116 patients (median age 66 years, 100 males) with HCC with advanced PVTT (Vp3 or Vp4) who received PBT from April 2008 to March 2018. Of these patients, 63 received PBT as definitive treatment and 53 as palliative treatment. The representative dose was 72.6 Gy (RBE) in 22 fractions. Eight patients died in follow-up, including 72 due to tumor progression. The 5-year overall survival (OS) rate was 18.0% (95% CI 9.8-26.2%) and the 5-year local control (LC) rate was 86.1% (74.9-97.3%). In multivariate analyses, performance status and treatment strategy were significantly associated with OS. The median follow-up period for survivors with definitive treatment was 33.5 (2-129) months, and the 5-year OS rate was 25.1% (12.9-37.3%) in these cases. The median survival time after definitive irradiation was >20 months. The 5-year OS rate was 9.1% (0-19.7%) for palliative irradiation. These results compare favorably with those of other therapies and suggest that PBT is a useful option for cases of HCC with advanced PVTT that cannot undergo surgery, with an expected survival benefit and good local control. Determining the optimal indication for this treatment is a future challenge.

Elranatamab in Japanese patients with relapsed/refractory multiple myeloma: results from MagnetisMM-2 and MagnetisMM-3.

BACKGROUND: Despite advances, most patients with multiple myeloma (MM) experience relapse and repeat multiple treatment lines, highlighting an unmet need for patients with relapsed or refractory MM (RRMM). Bispecific antibodies are a new option, but their efficacy and safety in Japanese patients are unknown. METHODS: This was an analysis of Japanese patients receiving elranatamab monotherapy in MagnetisMM-2 (NCT04798586) and MagnetisMM-3 (NCT04649359). Both studies evaluated a priming dose regimen of elranatamab followed by weekly subcutaneous doses, in patients with disease progression while receiving or who were intolerant to ≥3 prior therapies (≥1 proteasome inhibitor, ≥1 immunomodulatory drug and ≥1 anti-CD38 monoclonal antibody). The primary endpoints were dose limiting toxicities (DLTs) in MagnetisMM-2 and confirmed objective response rate (ORR) in MagnetisMM-3. In both, key secondary endpoints included safety, tolerability, duration of response, time to response, progression-free survival and overall survival. RESULTS: In MagnetisMM-2 (N = 4) and MagnetisMM-3 (n = 12), median ages were 68.5 and 66.5 years, respectively. No DLTs were observed in MagnetisMM-2. ORRs were 50.0% (95% CI, 6.8-93.2) and 58.3% (95% CI, 27.7-84.8) in MagnetisMM-2 and MagnetisMM-3, respectively. All patients experienced treatment-emergent adverse events in MagnetisMM-2 (grade 3/4: 75.0%) and MagnetisMM-3 (grade 3/4: 100%); cytokine release syndrome occurred in 100% (grade 3/4: 25.0%) and 58.3% (no grade 3/4) of patients, respectively. Neither study reported immune effector cell-associated neurotoxicity syndrome. CONCLUSIONS: No new safety signals were observed, and ORRs were similar to that of the overall MagnetisMM-3 trial population, supporting further studies of elranatamab in Japanese patients with RRMM. ClinicalTrials.gov identifier: NCT04798586 (MagnetisMM-2), NCT04649359 (MagnetisMM-3).

Late Changes in Renal Volume and Function after Proton Beam Therapy in Pediatric and Adult Patients: Children Show Significant Renal Atrophy but Deterioration of Renal Function Is Minimal in the Long-Term in Both Groups.

To compare late renal effects in pediatric and adult patients with malignancies after PBT involving part of the kidney. A retrospective study was conducted to assess changes in renal volume and function in 24 patients, including 12 children (1-14 years old) and 12 adults (51-80 years old). Kidney volumes were measured from CT or MRI images during follow-up. Dose-volume histograms were calculated using a treatment planning system. In children, the median volume changes for the irradiated and control kidneys were -5.58 (-94.95 to +4.79) and +14.92 (-19.45 to +53.89) mL, respectively, with a relative volume change of -28.38 (-119.45 to -3.87) mL for the irradiated kidneys. For adults, these volume changes were -22.43 (-68.7 to -3.48) and -21.56 (-57.26 to -0.16) mL, respectively, with a relative volume change of -5.83 (-28.85 to +30.92) mL. Control kidneys in children exhibited a marked increase in size, while those in adults showed slight volumetric loss. The percentage of irradiated volume receiving 10 Gy (RBE) (V10) and 20 Gy (RBE) (V20) were significantly negatively associated with the relative volume change per year, especially in children. The CKD stage based on eGFR for all patients ranged from 1 to 3 and no cases with severe renal dysfunction were found before or after PBT. Late effects on the kidneys after PBT vary among age groups. Children are more susceptible than adults to significant renal atrophy after PBT. V10 and V20 might serve as predictors of the degree of renal atrophy after PBT, especially in children. PBT has a minimal impact on deterioration of renal function in both children and adults.

A systematic review and meta-analysis of radiotherapy and particle beam therapy for skull base chondrosarcoma: TRP-chondrosarcoma 2024.

Introduction: Chondrosarcoma is a rare malignant bone tumor. Particle beam therapy (PT) can concentrate doses to targets while reducing adverse events. A meta-analysis based on a literature review was performed to examine the efficacy of PT and photon radiotherapy for skull base chondrosarcoma. Methods: The meta-analysis was conducted using 21 articles published from 1990 to 2022. Results: After PT, the 3- and 5-year overall survival (OS) rates were 94.1% (95% confidence interval [CI]: 91.0-96.2%) and 93.9% (95% CI: 90.6-96.1%), respectively, and the 3- and 5-year local control rates were 95.4% (95% CI: 92.0-97.4%) and 90.1% (95% CI: 76.8-96.0%), respectively. Meta-regression analysis revealed a significant association of PT with a superior 5-year OS rate compared to three-dimensional conformal radiotherapy (p < 0.001). In the studies used in the meta-analysis, the major adverse event of grade 2 or higher was temporal lobe necrosis (incidence 1-18%, median 7%). Conclusion: PT for skull base chondrosarcoma had a good outcome and may be a valuable option among radiotherapy modalities. However, high-dose postoperative irradiation of skull base chondrosarcoma can cause adverse events such as temporal lobe necrosis.

The Acute Effect of Percussive Massage Intervention with and without Heat Application on Plantar Flexor Muscles' Passive and Active Properties.

Recently, percussive massage (PM) intervention using a handheld percussive massage device, namely a massage gun, has been used as an easy way to perform vibration functions. Additionally, a product has been developed that allows PM intervention and heat application to be performed simultaneously. Thus, this study aimed to compare the acute effects of PM intervention with and without heat application on dorsiflexion (DF) range of motion (ROM), passive stiffness, and muscle strength in the gastrocnemius muscle. Fifteen healthy young men (20.9 ± 0.2 years) participated in this study. We measured the DF ROM, passive torque at DF ROM (an indicator of stretch tolerance), passive stiffness, and maximum voluntary isometric contraction (MVIC) torque of the plantar flexor muscles before and immediately after 120 seconds PM intervention with and without heat application. The results showed that PM intervention with and without heat application significantly increased DF ROM and passive torque at DF ROM and decreased passive stiffness, not MVIC torque. These results suggest that PM intervention increased ROM and decreased passive stiffness regardless of the presence or absence of the heat application.

Relationship between pectoralis major stiffness and shoulder extension range of motion.

This study aimed to investigate the correlation between the passive muscle stiffness of the pectoralis major muscle pars clavicularis (PMc) and shoulder extension range of motion (ROM) in both male and female participants. Thirty-nine (23 male/16 female) physically active and healthy participants volunteered in this study. After a standardized warm-up, the PMc stiffness was tested via shear wave elastography at a slightly stretched position (long muscle length) and in a non-stretched position (short muscle length). Additionally, a custom-made device and 3D motion capture assessed the active shoulder extension ROM. We found a significant moderate and negative relationship between shoulder extension ROM and PMc stiffness at long muscle length (rs = -0.33; p = 0.04) but not at short muscle length (r = -0.23; p = 0.17). Additionally, there was no significant difference between male and female participants in the correlation analyses at both elbow angles. The moderate correlation between PMc stiffness at a slightly stretched position and shoulder extension ROM suggests that additionally, other structures such as nerves/fascia stiffness or even stretch tolerance might be factors that can be related to shoulder extension ROM.

Combined Effects of Static and Dynamic Stretching on the Muscle-Tendon Unit Stiffness and Strength of the Hamstrings.

ABSTRACT: Takeuchi, K, Nakamura, M, Matsuo, S, Samukawa, M, Yamaguchi, T, and Mizuno, T. Combined effects of static and dynamic stretching on the muscle-tendon unit stiffness and strength of the hamstrings. J Strength Cond Res 38(4): 681-686, 2024-Combined static and dynamic stretching for 30 seconds is frequently used as a part of a warm-up program. However, a stretching method that can both decrease muscle-tendon unit (MTU) stiffness and increase muscle strength has not been developed. The purpose of this study was to examine the combined effects of 30 seconds of static stretching at different intensities (normal-intensity static stretching [NS] and high-intensity static [HS]) and dynamic stretching at different speeds (low-speed dynamic [LD] and high-speed dynamic stretching [HD]) on the MTU stiffness and muscle strength of the hamstrings. Thirteen healthy subjects (9 men and 4 women, 20.9 ± 0.8 years, 169.3 ± 7.2 cm, 61.1 ± 8.2 kg) performed 4 types of interventions (HS-HD, HS-LD, NS-HD, and NS-LD). Range of motion (ROM), passive torque, MTU stiffness, and muscle strength were measured before and immediately after interventions by using an isokinetic dynamometer machine. In all interventions, the ROM and passive torque significantly increased (p < 0.01). Muscle-tendon unit stiffness significantly decreased in HS-HD and HS-LD (both p < 0.01), but there was no significant change in NS-HD (p = 0.30) or NS-LD (p = 0.42). Muscle strength significantly increased after HS-HD (p = 0.02) and NS-LD (p = 0.03), but there was no significant change in HS-LD (p = 0.23) or NS-LD (p = 0.26). The results indicated that using a combination of 30 seconds of high-intensity static stretching and high-speed dynamic stretching can be beneficial for the MTU stiffness and muscle strength of the hamstrings.

Determining Changes in Muscle Size and Architecture After Exercise Training: One Site Does Not Fit all.

ABSTRACT: Nunes, JP, Blazevich, AJ, Schoenfeld, BJ, Kassiano, W, Costa, BDV, Ribeiro, AS, Nakamura, M, Nosaka, K, and Cyrino, ES. Determining changes in muscle size and architecture after exercise training: One site does not fit all. J Strength Cond Res 38(4): 787-790, 2024-Different methods can be used to assess muscle hypertrophy, but the effects of training on regional changes in muscle size can be detected only using direct muscle measurements such as muscle thickness, cross-sectional area, or volume. Importantly, muscle size increases vary across regions within and between muscles after resistance training programs (i.e., heterogeneous, or nonuniform, muscle hypertrophy). Muscle architectural changes, including fascicle length and pennation angle, after resistance and stretch training programs are also region-specific. In this paper, we show that the literature indicates that a single-site measure of muscle shape does not properly capture the effects achieved after exercise training interventions and that conclusions concerning the magnitude of muscle adaptations can vary substantially depending on the muscle site to be examined. Thus, we propose that measurements of muscle size and architecture should be completed at multiple sites across regions between the agonist muscles within a muscle group and along the length of the muscles to provide an adequate picture of training effects.

Effects of lunges inserted in walking (eccentric walking) on lower limb muscle strength, physical and cognitive function of regular walkers.

INTRODUCTION: Walking is a popular exercise but does not increase lower limb muscle strength and balance. We hypothesized that muscle strength, physical and cognitive function would be improved by inserting lunges in conventional walking. METHODS: Eleven regular walkers (54-88 years) who had more than 5000 steps in exercise walking a day at least 5 days a week participated in this study. They walked as usual for the first 4 weeks and included lunges and descending stairs or slope walking (i.e., eccentric walking) for the next 8 weeks. The steps of eccentric walking were gradually increased from 100 to 1000 steps per week over 8 weeks. RESULTS: The average steps per day were 10,535 ± 3516 in the first 4 weeks, and 10,118 ± 3199 in the eccentric walking period without a significant difference. No significant changes in maximal voluntary isometric contraction torque of the knee extensors (MVC), 30-s chair stand (CS), 2-min step, balance assessed by center of pressure movement area with eyes close, sit and reach, a digit symbol substitution test (DSST) for cognitive function were observed in the first 4 weeks. However, significant (P < 0.05) improvements were evident in MVC (18.6 ± 15.7%), CS (24.2 ± 17.3%), balance ( - 45.3 ± 34.5%), and DSST (20.8 ± 16.7%) from weeks 4 to 12. Serum complement component 1q concentration decreased (P < 0.05) from weeks 4 to 12, although no changes in serum glucose, triglyceride, and cholesterol concentrations were observed. CONCLUSION: These results supported the hypothesis, and suggest that eccentric walking provides effects that are not achieved by conventional walking.

The effect of massage on the plantar flexor muscles during the fixation period in postoperative patients with an ankle fracture.

INTRODUCTION: Ankle fractures are one of the most common lower extremity fractures. After surgery, the ankle joint is often immobilized in a plantar flexion position, and there have been many reported cases of limited ankle joint range of motion. Therefore, the purpose of the present study was to investigate the effect of regular massage interventions on ankle joint range of motion after removal of fixation. METHODS: The massage group comprised 30 patients who had sustained an ankle fracture and had undergone surgical fixation, physical therapy, and massage between November 2020 and March 2022. These subjects received a 3-min massage twice daily, five times a week. The control group consisted of 38 patients who had sustained an ankle fracture between January 2015 and September 2020 and had undergone surgical fixation as well as regular physical therapy. RESULTS: The respective ankle dorsiflexion and plantarflexion ranges of motion after cast removal were 2.50 ± 7.2° and 42.3 ± 7.2° in the massage group and -8.62 ± 2.9° and 34.8 ± 8.3° in the control group. An unpaired t-test showed that the ankle dorsiflexion and plantarflexion ranges of motion in the massage group were significantly greater than those in the control group (p = 0.036 and p < 0.01). CONCLUSIONS: Our results indicate that regular 3-min massage interventions of the plantar flexors could prevent the progression of a range of motion limitations in postoperative patients with an ankle fracture more effectively than regular physical therapy alone.