Common carotid artery responses to the cold-pressor test are impaired in individuals with cervical spinal cord injury.

Cervical spinal cord injury (SCI) leads to autonomic cardiovascular dysfunction that underlies the three- to fourfold elevated risk of cardiovascular disease in this population. Reduced common carotid artery (CCA) dilatory responsiveness during the cold-pressor test (CPT) is associated with greater cardiovascular disease risk and progression. The cardiovascular and CCA responses to the CPT may provide insight into cardiovascular autonomic dysfunction and cardiovascular disease risk in individuals with cervical SCI. Here, we used CPT to perturb the autonomic nervous system in 14 individuals with cervical SCI and 12 uninjured controls, while measuring cardiovascular responses and CCA diameter. The CCA diameter responses were 55% impaired in those with SCI compared with uninjured controls (P = 0.019). The CCA flow, velocity, and shear response to CPT were reduced in SCI by 100% (P < 0.001), 113% (P = 0.001), and 125% (P = 0.002), respectively. The association between mean arterial pressure and CCA dilation observed in uninjured individuals (r = 0.54, P = 0.004) was absent in the SCI group (r = 0.22, P = 0.217). Steady-state systolic blood pressure (P = 0.020), heart rate (P = 0.003), and cardiac contractility (P < 0.001) were reduced in those with cervical SCI, whereas total peripheral resistance was increased compared with uninjured controls (P = 0.042). Relative cerebral blood velocity responses to CPT were increased in the SCI group and reduced in controls (middle cerebral artery, P = 0.010; posterior cerebral artery, P = 0.026). The CCA and cardiovascular responsiveness to CPT are impaired in those with cervical SCI.NEW & NOTEWORTHY This is the first study demonstrating that CCA responses during CPT are suppressed in SCI. Specifically, CCA diameter, flow, velocity, and shear rate were reduced. The relationship between changes in MAP and CCA dilatation in response to CPT was absent in individuals with SCI, despite similar cardiovascular activation between SCI and uninjured controls. These findings support the notion of elevated cardiovascular disease risk in SCI and that the cardiovascular responses to environmental stimuli are impaired.

National survey of mental health and suicidal thoughts in people with spinal cord injury.

STUDY DESIGN: Retrospective cross-sectional epidemiological study. OBJECTIVES: Previous studies have quantified longitudinal psychological morbidity in individuals with spinal cord injury (SCI) relative to uninjured individuals. However, there is limited information regarding how lifestyle and socioeconomic factors are associated with mental health conditions in individuals with SCI. This study aims to quantify and compare mental health and suicidal thoughts in people with and without SCI, and examine the associations between mental health, suicidal thoughts, sex, age, lifestyle, and socioeconomic factors. SETTING: Canada. METHODS: The 2010 Canadian Community Health Survey (n > 40,000) was used, which includes several measures assessing mental health and suicidal thoughts. Bivariate and multivariate logistic regressions were performed and odds ratios with corresponding 95% confidence intervals were estimated. Sensitivity analyses were performed to evaluate the effect of covariates on reported effect sizes. RESULTS: People with SCI had higher odds of having mood (3.6) and anxiety disorders (2.5), suicidal thoughts (2.3), self-perceived stress (1.9), and depression (4.4); in addition to lower odds of having good self-perceived mental health (0.24) and satisfaction with life (0.25). These differences persisted after adjusting for age, sex, lifestyle, and socioeconomic factors. Lower household income, fruit and vegetable consumption, and physical activity levels, and increased smoking use were associated with poorer mental health in individuals with SCI. CONCLUSIONS: Mental health is poorer in those with SCI when compared with the general population. Those with SCI exhibit a unique profile of lifestyle and socioeconomic factors that are associated with poorer mental health and increased suicidal thoughts.

Indirect analysis of first-line therapy for advanced non-small-cell lung cancer with activating mutations in a Japanese population.

Background: Five EGFR-tyrosine kinase inhibitors (EGFR TKIs) are currently available in the first-line setting for non-small-cell lung cancer (NSCLC) in Japan. The aim here was to compare the relative efficacy of EGFR TKIs in the Japanese population. Materials & methods: A systematic review identified randomized controlled trials examining the efficacy of first-line EGFR TKIs. A Bayesian network meta-analysis was used to assess these EGFR TKI comparisons for progression-free survival (PFS). Results: A total of seven randomized controlled trials were identified and considered for network meta-analysis. Dacomitinib showed a trend toward improved PFS versus all comparators. Conclusion: Dacomitinib demonstrated a trend toward improved PFS and therefore, should be considered one of the standard first-line therapies for Japanese patients diagnosed with EGFR+ non-small-cell lung cancer.

Network meta analysis of first-line therapy for advanced EGFR mutation positive non-small-cell lung cancer: updated overall survival.

Aim: To update overall survival (OS) results from a previous network meta analysis comparing the relative clinical efficacy of epidermal growth factor receptor-targeted tyrosine kinase inhibitors (EGFR TKIs) for EGFR mutation positive (EGFR+) advanced non-small-cell lung cancer (NSCLC). Materials & methods: A Bayesian network meta analysis was conducted using updated/mature randomized controlled trial OS results in response to first-line EGFR TKI therapies. Results: Dacomitinib showed a numerical improvement of OS relative to other EGFR TKIs: afatinib (hazard ratio [HR]: 0.87; 95% credible interval [CrI]: 0.61-1.24), erlotinib (HR: 0.79; 95% CrI: 0.44-1.42), gefitinib (HR: 0.75; 95% CrI: 0.59-0.95) and osimertinib (HR: 0.94; 95% CrI: 0.68-1.29). Conclusion: Dacomitinib should be considered as a first-line treatment option for patients diagnosed with advanced EGFR+ NSCLC.

Systematic review and network meta-analysis of first-line therapy for advanced EGFR-positive non-small-cell lung cancer.

Here, we compare the relative clinical efficacy of EGFR-targeted tyrosine kinase inhibitors (EGFR TKIs) for EGFR-positive advanced non-small-cell lung cancer (NSCLC). The authors systematically searched 11 electronic databases from January 2004 to August 2018 for randomized controlled trials measuring clinical efficacy of first-line TKI therapies. Clinical efficacy outcomes included overall survival and progression-free survival. Bayesian network meta-analysis was used to assess the relative efficacy of first-line EGFR TKIs for overall survival and progression-free survival. This network meta-analysis showed that dacomitinib and osimertinib resulted in improved efficacy outcomes compared with afatinib, erlotinib and gefitinib. Both osimertinib and dacomitinib should be considered as standard first-line treatment options for patients diagnosed with advanced EGFR-positive non-small-cell lung cancer.

Photobiomodulation delays the onset of skeletal muscle fatigue in a dose-dependent manner.

Photobiomodulation (PBM) therapy has been implicated as an effective ergogenic aid to delay the onset of muscle fatigue. The purpose of this study was to examine the dose-response ergogenic properties of PBM therapy and its ability to prolong time to task failure by enhancing muscle activity and delaying the onset of muscle fatigue using a static positioning task. Nine participants (24.3 ± 4.9 years) received three doses of near-infrared (NIR) light therapy randomly on three separate sessions (sham, 240, and 480 J). For the positioning task, participants held a 30 % one-repetition maximum (1-RM) load using the index finger until volitional fatigue. Surface electromyography (sEMG) of the first dorsal interosseous muscle was recorded for the length of the positioning task. Outcomes included time to task failure (TTF), muscle fatigue, movement accuracy, motor output variability, and muscle activity (sEMG). The 240-J dose significantly extended TTF by 26 % (p = 0.032) compared with the sham dose. TTF for the 240-J dose was strongly associated with a decrease in muscle fatigue (R (2) = 0.54, p = 0.024). Our findings show that a 240-J dose of NIR light therapy is efficacious in delaying the onset and extent of muscle fatigue during submaximal isometric positioning tasks. Our findings suggest that NIR light therapy may be used as an ergogenic aid during functional tasks or post-injury rehabilitation.

Technological Advances in Stroke Rehabilitation: Robotics and Virtual Reality.

Robotic technology and virtual reality (VR) have been widely studied technologies in stroke rehabilitation over the last few decades. Both technologies have typically been considered as ways to enhance recovery through promoting intensive, repetitive, and engaging therapies. In this review, we present the current evidence from interventional clinical trials that employ either robotics, VR, or a combination of both modalities to facilitate post-stroke recovery. Broadly speaking, both technologies have demonstrated some success in improving post-stroke outcomes and complementing conventional therapy. However, more high-quality, randomized, multicenter trials are required to confirm our current understanding of their role in precision stroke recovery.

Knowledge and awareness assessment of bone loss and fracture risk after spinal cord injury.

METHODS: A cross-sectional analysis was conducted on a convenience sample of 138 adults with SCI, who completed a survey regarding knowledge and awareness of post-SCI bone health as part of a larger study. Self-reported demographic information and assessments of bone health knowledge were analyzed. RESULTS: Approximately 20% (n = 28) of participants had never heard of bone mineral density (BMD), 25% (n = 34) only vaguely remembered that BMD was mentioned during their hospitalization/rehabilitation after SCI, 36% (n = 50) clearly remembered that BMD was mentioned during their hospitalization/rehabilitation, and 17% (n = 24) reported having an individual or group education session on causes and management of low BMD during rehabilitation. Only 30% (n = 42) of participants believed they had adequate knowledge on the subject, while 70% (n = 96) believed their knowledge was inadequate or were unsure. Most participants (73%, n = 101) reported being concerned about the risks of low BMD after SCI and were interested in learning more about prevention (76%, n = 105) and treatment options (78%, n = 108). CONCLUSIONS: While results suggest that most participants received some information regarding bone health in post-SCI care, over 70% of participants reported wanting more information about bone loss prevention and treatment, indicating bone health education is a patient priority in this population.

Robot-Assisted Gait Training with Trexo Home: Users, Usage and Initial Impacts.

Robotic gait training has the potential to improve secondary health conditions for people with severe neurological impairment. The purpose of this study was to describe who is using the Trexo robotic gait trainer, how much training is achieved in the home and community, and what impacts are observed after the initial month of use. In this prospective observational single-cohort study, parent-reported questionnaires were collected pre- and post-training. Of the 70 participants, the median age was 7 years (range 2 to 24), 83% had CP, and 95% did not walk for mobility. Users trained 2-5 times/week. After the initial month, families reported a significant reduction in sleep disturbance (p = 0.0066). Changes in bowel function, positive affect, and physical activity were not statistically significant. These findings suggest that families with children who have significant mobility impairments can use a robotic gait trainer frequently in a community setting and that sleep significantly improves within the first month of use. This intervention holds promise as a novel strategy to impact multi-modal impairments for this population. Future work should include an experimental study design over a longer training period to begin to understand the relationship between training volume and its full potential.

Pitching shoulder passive flexibility: torque-angle analysis for external rotation and internal rotation.

In this study, a custom device was developed to analyse the pitching shoulder's external rotation (ER) and internal rotation (IR) passive flexibility. We analysed three novel measures: the resistance onset angle (ROA = angle where the shoulder begins stretching), rotational stiffness, and torque at the end range of motion (ROM). The purpose was to conduct a bilateral analysis to determine if there are significant differences between the throwing and non-throwing shoulder. Participants were 30 upper level pitchers (13 division I, 17 minor league). During testing, pitchers laid supine on a treatment table and the arm was secured to a rotational wheel with the shoulder abducted 90° and elbow flexed 90°. Dependent t-tests revealed significant (p < 0.01) and relatively extreme bilateral differences for all three variables. The throwing shoulder had: increased ER ROA (9°), decreased IR ROA (5.3°), increased ER stiffness (17%), increased IR stiffness (34%), increased ER torque (21%), and increased IR torque (30%). Secondary correlation analysis was completed to determine if the torque-angle variables were good predictors of the end ROM. Stiffness correlations were weak for ER (r = 0.35, p = 0.048) and IR (r = 0.42, p = 0.017) but ROA correlations were strong for ER (r = 0.85, p < 0.001) and IR (r = 0.86, p < 0.001).

A national survey of physical activity after spinal cord injury.

Physical activity is a powerful modifiable risk factor for disease and mortality. Physical activity levels in people with spinal cord injury (SCI) have not been quantified relative to uninjured individuals in a large population-based sample. We aimed to quantify and compare physical activity in people with and without SCI, and to examine the associations between physical activity, lifestyle, and socioeconomic factors. The 2010 Canadian Community Health Survey (n > 57,000) was used, which includes three measures that assess physical activity levels (i.e., leisure time activity frequency, leisure time activity intensity, and transportation time activity intensity). Bivariable and multivariable logistic regressions were performed and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were estimated. The odds of physical activity in people with SCI were 0.43 (95% CI 0.3-0.61), 0.53 (95% CI 0.36-0.75), and 0.42 (95% CI 0.28-0.61), across the three measures of physical activity, respectively. These differences persisted after adjustment for lifestyle, comorbidities, and socioeconomic factors. Physical activity is reduced in the SCI population compared with the general population. This knowledge is important to direct future research and guide the allocation of health care resources.

Passive leg cycling increases activity of the cardiorespiratory system in people with tetraplegia.

Individuals with cervical spinal cord injury (SCI) are at an increased risk for cardiovascular disease. Exercise is well-established for preventing cardiovascular disease; however, there are limited straightforward and safe exercise approaches for increasing the activity of the cardiorespiratory system after cervical SCI. The objective of this study was to investigate the cardiorespiratory response to passive leg cycling in people with cervical SCI. Beat-by-beat blood pressure, heart rate, and cerebral blood flow were measured before and throughout 10 minutes of cycling in 11 people with SCI. Femoral artery flow-mediated dilation was also assessed before and immediately after passive cycling. Safety was monitored throughout all study visits. Passive cycling elevated systolic blood pressure (5 ± 2 mm Hg), mean arterial pressure (5 ± 3 mm Hg), stroke volume (2.4 ± 0.8 mL), heart rate (2 ± 1 beats/min) and cardiac output (0.3 ± 0.07 L/min; all p < 0.05). Minute ventilation (0.67 ± 0.23 L/min), tidal volume (70 ± 30 mL) and end-tidal PO2 (2.6 ± 1.23 mm Hg) also increased (all p < 0.05). Endothelial function was improved immediately after exercise (1.62 ± 0.13%, p < 0.01). Passive cycling resulted in an incidence of autonomic dysreflexia. Therefore, passive leg cycling increased the activity of the cardiorespiratory system and improved endothelial function, indicating it may be a beneficial exercise intervention for the cardiovascular and respiratory systems in people with cervical SCI. Novelty: Passive leg cycling increases the activity of the cardiorespiratory system and improves markers of cardiovascular health in cervical SCI. Passive leg cycling exercise is an effective, low-cost, practical, alternative exercise modality for people with cervical SCI.

The potential predictive value of cyclooxygenase-2 expression and increased risk of gastrointestinal hemorrhage in advanced non-small cell lung cancer patients treated with erlotinib and celecoxib.

PURPOSE: Celecoxib, a cyclooxygenase-2 (COX-2) inhibitor, potentiates antitumor effects of erlotinib in preclinical studies, and COX-2 is frequently expressed in non-small cell lung cancer (NSCLC). With these observations, we designed a phase II trial to evaluate the efficacy and safety of erlotinib plus celecoxib in advanced NSCLC. EXPERIMENTAL DESIGN: Previously treated stage IIIB/IV NSCLC patients were given celecoxib at 400 mg orally twice daily and erlotinib at 150 mg orally daily until disease progression. Planned accrual was 40 patients. Tissue was collected for epidermal growth factor receptor (EGFR) analysis and COX-2 immunohistochemistry. RESULTS: Twenty-six patients were enrolled (17 men, 9 women; median age, 66 years). Eighteen and 21 patients had tissue available for EGFR analysis and COX-2 immunohistochemistry, respectively. The median progression-free survival (PFS) and overall survival were 2.0 and 9.2 months, respectively. Eleven of 21 patients tested had increased tumor COX-2 expression, which was strongly associated with prolonged PFS (P=0.048). Four patients on anticoagulation or with a history of peptic ulcer disease had grade 3/grade 4 upper gastrointestinal bleeding (GIB), prompting early study closure. Three patients with GIB had endoscopy that found peptic ulcers. CONCLUSIONS: The combination of erlotinib and celecoxib does not seem superior to erlotinib alone in unselected patients. However, longer PFS with high-tumor COX-2 expression suggests that trials of EGFR and COX-2 inhibitors may be warranted in this patient subset. GIB observed in our trial supports excluding patients with a history of peptic ulcer disease or those requiring therapeutic anticoagulation from future EGFR and COX-2 inhibitor studies.

Stiffness of hip adductor myofibrils is decreased in children with spastic cerebral palsy.

Cerebral palsy (CP) is the result of a static brain lesion which causes spasticity and muscle contracture. The source of the increased passive stiffness in patients is not understood and while whole muscle down to single muscle fibres have been investigated, the smallest functional unit of muscle (the sarcomere) has not been. Muscle biopsies (adductor longus and gracilis) from pediatric patients were obtained (CP n = 9 and control n = 2) and analyzed for mechanical stiffness, in-vivo sarcomere length and titin isoforms. Adductor longus muscle was the focus of this study and the results for sarcomere length showed a significant increase in length for CP (3.6 µm) compared to controls (2.6 µm). Passive stress at the same sarcomere length for CP compared to control was significantly lower in CP and the elastic modulus for the physiological range of muscle was lower in CP compared to control (98.2 kPa and 166.1 kPa, respectively). Our results show that CP muscle at its most reduced level (the myofibril) is more compliant compared to normal, which is completely opposite to what is observed at higher structural levels (single fibres, muscle fibre bundles and whole muscle). It is noteworthy that at the in vivo sarcomere length in CP, the passive forces are greater than normal, purely as a functional of these more compliant sarcomeres operating at long lengths. Titin isoforms were not different between CP and non-CP adductor longus but titin:nebulin was reduced in CP muscle, which may be due to titin loss or an over-expression of nebulin in CP muscles.

Relationship of muscle morphology to hip displacement in cerebral palsy: a pilot study investigating changes intrinsic to the sarcomere.

BACKGROUND: Cerebral palsy (CP) is the most common cause of childhood disability, typified by a static encephalopathy with peripheral musculoskeletal manifestations-most commonly related to spasticity-that are progressive with age. Hip displacement is one of the most common manifestations, observed to lead to painful degenerative arthritis over time. Despite the key role that spasticity-related adductor muscle contractures are thought to play in the development of hip displacement in CP, basic science research in this area to date has been limited. This study was initiated to correlate hip adductor muscle changes intrinsic to the sarcomere-specifically, titin isoforms and sarcomere length-to the severity of hip displacement in children with spastic cerebral palsy. METHODS: Single gracilis muscle biopsies were obtained from children with CP (Gross Motor Function Classification System (GMFCS) III-V; n = 10) who underwent adductor muscle release surgery for the treatment of hip displacement. Gel electrophoresis was used to estimate titin molecular weight. Sarcomere lengths were measured from muscle fascicles using laser diffraction. The severity of hip displacement was determined by measuring by Reimers migration percentage (MP) from anteroposterior pelvic x-rays. Correlation analyses between titin, sarcomere lengths, and MP were performed. RESULTS: The mean molecular weight of titin was 3588 kDa. The mean sarcomere length was 3.51 µm. Increased MP was found to be associated with heavier isoforms of titin (R2 = 0.65, p < 0.05) and with increased sarcomere lengths (R2 = 0.65, p < 0.05). Heavier isoforms of titin were also associated with increased sarcomere lengths (R2 = 0.80, p < 0.05). CONCLUSIONS: Our results suggest that both larger titin isoforms and sarcomere lengths are positively correlated with increased severity of hip displacement and may represent adaptations in response to concomitant increases in spasticity and muscle shortening. TRIAL REGISTRATION: As this study does not report the results of a health care intervention on human participants, it has not been registered.

Effects of blood-flow restriction on biomarkers of myogenesis in response to resistance exercise.

We investigated the acute myogenic response to resistance exercise with and without blood-flow restriction (BFR). Six men and women (age, 22 ± 1 years) performed unilateral knee extensions at 40% of 1-repetition maximum with or without (CNTRL) BFR applied via pressure cuff inflated to 220 mm Hg. Muscle biopsies were collected at 4 h and 24 h postexercise. Addition of BFR increased myoD and c-Met messenger RNA expression relative to CNTRL. Expression of hepatocyte growth factor protein was significantly higher following CNTRL.

Near-infrared light therapy to attenuate strength loss after strenuous resistance exercise.

CONTEXT: Near-infrared (NIR) light therapy is purported to act as an ergogenic aid by enhancing the contractile function of skeletal muscle. Improving muscle function is a new avenue for research in the area of laser therapy; however, very few researchers have examined the ergogenic effects of NIR light therapy and the influence it may have on the recovery process during rehabilitation. OBJECTIVE: To evaluate the ergogenic effect of NIR light therapy on skeletal muscle function. DESIGN: Crossover study. SETTING: Controlled laboratory. PATIENTS OR OTHER PARTICIPANTS: Thirty-nine healthy men (n = 21) and women (n = 18; age = 20.0 ± 0.2 years, height = 169 ± 2 cm, mass = 68.4 ± 1.8 kg, body mass index = 23.8 ± 0.4 kg/m(2)). INTERVENTION(S): Each participant received active and sham treatments on the biceps brachii muscle on 2 separate days. The order of treatment was randomized. A class 4 laser with a cumulative dose of 360 J was used for the active treatment. After receiving the treatment on each day, participants completed an elbow-flexion resistance-exercise protocol. MAIN OUTCOME MEASURE(S): The dependent variables were elbow range of motion, muscle point tenderness, and strength (peak torque). Analysis of variance with repeated measures was used to assess changes in these measures between treatments at baseline and at follow-up, 48 hours postexercise. Additionally, immediate strength loss postexercise was compared between treatments using a paired t test. RESULTS: Preexercise to postexercise strength loss for the active laser treatment, although small, was less than with the sham treatment (P = .05). CONCLUSIONS: Applied to skeletal muscle before resistance exercise, NIR light therapy effectively attenuated strength loss. Therefore, NIR light therapy may be a beneficial, noninvasive modality for improving muscle function during rehabilitation after musculoskeletal injury. However, future studies using higher treatment doses are warranted.

Range of motion as a predictor of clinical shoulder pain during recovery from delayed-onset muscle soreness.

CONTEXT: Athletic trainers use clinical pain and range of motion (ROM) to gauge recovery after musculoskeletal injury. Limited evidence to date suggests which shoulder ROM measures can predict symptomatic relief and functional recovery after delayed-onset muscle soreness (DOMS). OBJECTIVE: To determine whether shoulder passive internal rotation, passive external rotation, active abduction, and active flexion and evoked pain with abduction are associated with resting pain experienced after exercise-induced DOMS. DESIGN: Descriptive laboratory study. SETTING: Controlled research laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 110 healthy, right-hand-dominant participants (44 men: age = 25.39 ± 7.00 years, height = 178.93 ± 7.01 cm, weight = 78.59 ± 14.04 kg; 66 women: age = 22.98 ± 6.11 years, height = 164.64 ± 6.94 cm, weight = 61.86 ± 11.67 kg). INTERVENTION(S): Participants completed an exercise-induced DOMS protocol for the external rotators of the dominant shoulder to replicate muscle injury. MAIN OUTCOME MEASURE(S): Current resting pain was assessed daily for 96 hours using the Brief Pain Inventory. We evaluated functional recovery with measures of ROM in abduction, internal rotation, external rotation, and flexion. Evoked pain with active abduction was reported, and the pain rating served as the dependent variable in the regression model. RESULTS: Impairment measures explained resting pain at 48 (R2 = 0.392) and 96 hours (R2 = 0.164). Abduction and internal-rotation ROM and evoked pain with abduction predicted resting pain at 48 hours (P < .001). At 96 hours, evoked pain with abduction of the injured arm (P < .001) was the significant contributor to resting pain. CONCLUSIONS: These models suggest that resting pain after experimentally induced DOMS occurs at 48 hours and is associated with specific ranges of motion and evoked pain with abduction.

Effect of near-infrared light exposure on mitochondrial signaling in C2C12 muscle cells.

Near-infrared (NIR) light is a complementary therapy used to treat musculoskeletal injuries but the underlying mechanisms are unclear. Acute NIR light treatment (~800-950 nm; 22.8 J/cm(2)) induced a dose-dependent increase in mitochondrial signaling (AMPK, p38 MAPK) in differentiated muscle cells. Repeated NIR light exposure (4 days) appeared to elevate oxidative stress and increase the upstream mitochondrial regulatory proteins AMPK (3.1-fold), p38 (2.8-fold), PGC-1α (19.7%), Sirt1 (26.8%), and reduced RIP140 (23.2%), but downstream mitochondrial regulation/content (Tfam, NRF-1, Sirt3, cytochrome c, ETC subunits) was unaltered. Our data indicates that NIR light alters mitochondrial biogenesis signaling and may represent a mechanistic link to the clinical benefits.

Oral consumption of electrokinetically modified water attenuates muscle damage and improves postexercise recovery.

The purpose of this study was to assess the effects of consuming electrokinetically modified water (EMW) on attenuating muscle damage and improving functional recovery following a single bout of isokinetic resistance exercise. Subjects were randomly assigned to an EMW (n = 20) or a placebo control (n = 20) group. Subjects consumed EMW or placebo water daily for 23 days. On day 19 subjects completed an exercise protocol for the biceps brachii to induce muscle damage. The protocol consisted of three sets of 20 repetitions using concentric and eccentric contractions of the elbow flexors. Blood draw and clinical measurements were performed preexercise as well as 24, 48, and 96 h postexercise. Clinical measures included maximal isometric strength, muscle soreness, pain with elbow extension, relaxed elbow angle (RANG), and self-report arm disability. Plasma samples were analyzed to determine concentrations of creatine kinase (CK) and high-sensitivity C-reactive protein (hsCRP). Pain with elbow extension and self-report arm disability were significantly higher in the placebo group compared with the EMW group at 48 h (P < 0.01) and 96 h (P < 0.01) after exercise, while RANG was significantly higher in the EMW group compared with placebo at 48 h (P < 0.01) and 96 h (P < 0.01) after exercise. Similarly, plasma concentrations for hsCRP and CK were significantly lower in the EMW group compared with placebo at 48 h (P < 0.05) and 96 h (P < 0.01) after exercise. Oral consumption of EMW significantly reduced exercise-induced muscle damage and inflammation and improved functional recovery.