Objectives: To determine precision errors and monitoring time intervals in imaged muscle properties and neuromuscular performance, and to explore growth-related factors associated with precision errors in children. Methods: We included 35 children (mean age 10.5yrs) in the precision study cohort and 40 children (10.7yrs) in the follow-up study cohort. We assessed forearm and lower leg muscle properties (area, density) with peripheral quantitative computed tomography. We measured neuromuscular performance via maximal pushup, grip force, countermovement and standing long jump force, power, and impulse along with long jump length. We calculated precision errors (root-mean-squared coefficient of variation) from the precision cohort and monitoring time intervals using annual changes from the follow-up cohort. We explored associations between precision errors (coefficient of variation) and maturity, time interval (between repeated measures), and anthropometric changes using Spearman’s rank correlation (p<0.05). Results: Muscle measures exhibited precision errors of 1.3-14%. Monitoring time intervals were 1-2.6yrs, except muscle density (>43yrs). We identified only one association between precision errors and maturity (maximal pushup force: rho=-0.349; p=0.046). Conclusions: Imaging muscle properties and neuromuscular performance measures had precision errors of 1-14% and appeared suitable for follow-up on ~2yr scales (except muscle density). Maximal pushup force appeared more repeatable in mature children.

Objective: The aim of this study was to assess the effect of a six-month interval rehabilitation treatment on motor function of children with PMM2-CDG syndrome (#212065 Congenital disorder of glycosylation, Type Ia; CDG1A, OMIM catalogue number). Methods: The concept ‘Auf die Beine’ (Center for Prevention and Rehabilitation of the University of Cologne, Germany) combines two short inpatient stays (1 to 2 weeks) with a six-month whole-body vibration (WBV) home-training program. 13 patients with PMM2-CDG syndrome participated in this concept from 2006 until 2015. Assessments at start, six months and 12 months (follow-up): Gross Motor Function Measure (GMFM-66), One-Minute Walk Test (1MWT) and instrumented gait analyses. Results: The GMFM-66 (9 of 13 children) improved by 5.3 (mean) points (SD 3.2) at 12 months (p=0.0039). The 1MWT (6 of 13 children) improved by 19.17 meters (SD 16.51) after 12 months (p=0.0313). Gait analysis (9 of 13 children) measured by pathlength/distance ratio improved by ~0.8 (SD 1.9) at 12 months (p=0.0195). Conclusion: Patients with PMM2-CDG syndrome benefit from the interval rehabilitation program ‘Auf die Beine’ including WBV.

Objectives: This study aimed to determine whether mechanical stress via muscle contractile exercise with belt electrode-skeletal muscle electrical stimulation (B-SES) device effectively prevents immobilization-induced bone atrophy. Methods: Wistar rats were randomly divided into the control (CON) group, immobilization (IM) group (immobilized treatment only), HES and LES groups (immobilized treatment and high or low-intensity electrical muscular stimulation through B-SES device). Bilateral femurs were used for X-ray micro-CT and biomechanical tests. Results: The maximum load value was significantly lower in the IM and HES groups than in the CON group and significantly higher in the LES group than in the IM group. The maximum crushing load was significantly lower in the IM, HES, and LES groups than in the CON group, and significantly higher in the HES and LES groups than in the IM group. In micro-CT, the mechanical stress by B-SES device did not affect degenerative microstructural changes in the cortical bone, but prevented those changes in the cancellous bone. Conclusions: Applying mechanical stress via B-SES device suppressed the loss of cancellous bone density and degenerative microstructural changes caused by immobilization, which in turn suppressed the reduction of bone strength. From these findings, muscle contractile exercise may be effective in preventing immobilization-induced bone atrophy.

Objective: The aim of our study was to assess postoperative lower limbs muscle strength (MS) as a predictor of late surgical success (36 months). Methods: Body composition analyses and isokinetic dynamometry evaluation were performed before (T0: n=123), six months (T1: n=123) and 36 months (T2: n=79) after Roux-en-y gastric bypass (RYGB). Surgical success (SS) was defined as ≥ 50% excess weight loss (EWL) 36 months after surgery or ≤ 50% surgical failure (SF). Results: There was no difference between relative MS extension (Ext) and flexion (Flex) in T1 and T2. There was also no difference between relative MS Ext and Flex in T1 and T2 between patients with SS and SF. There was a difference in relative MS Ext (144.9 ± 39.8 Nm/kg x 125.5 ± 29.2 Nm/kg; p=0.04) and Flex (73.6 ± 21.8 Nm/kg x 60.4 ± 15.8 Nm/kg; p=0.02) between SS and SF patients only in T2. Patients with an increment in Ext and Flex MS ≥4 Nm/kg at T1 had approximately 76% of SS at 36 months. Conclusion: An increase of lower limbs MS ≥4 Nm/kg 6 months after RYGB predicts SS at 36 months. ClinicalTrials.gov ID:NCT04129801

Objectives: This investigation examined the effects of continuous (CBFR) and intermittent (IBFR) blood flow restriction (BFR) applied during sprint interval training (SIT) on performance and neuromuscular function. Methods: Fifteen men completed a randomized bout of SIT with CBFR, IBFR, and without BFR (No-BFR), consisting of 2, 30-s maximal sprints on a cycle ergometer with a resistance of 7.5% of body mass. Concentric peak torque (CPT), maximal voluntary isometric contraction (MVIC) torque, and muscle thickness (MT) were measured before and after SIT, including surface electromyography (sEMG) recorded during the strength assessments. Peak and mean revolutions per minute (RPM) were measured during SIT and power output was examined relative to physical working capacity at the fatigue threshold (PWC_FT). Results:CPT and MVIC torque decreased from pre-SIT (220.3±47.6 Nm and 355.1±72.5 Nm, respectively) to post-SIT (147.9±27.7 Nm and 252.2±45.5 Nm, respectively, all P<0.05), while MT increased (1.77±0.31 cm to 1.96±0.30 cm). sEMG mean power frequency decreased during CPT (-12.8±10.5%) and MVIC (-8.7±10.2%) muscle actions. %PWCFT was greater during No-BFR (414.2±121.9%) than CBFR (375.9±121.9%).Conclusion: SIT with or without BFR induced comparable alterations in neuromuscular fatigue and sprint performance across all conditions, without affecting neuromuscular function.

Objectives: Progressive proximal muscle weakening in children with Duchenne muscular dystrophy (DMD) impairs postural adjustments by impairing motor function and preventing ambulation. During daily activities, for gait and dynamic balance, certain postural modifications are required. The objective was to compare the impact of trunk-oriented exercises versus whole-body vibration on abdominal muscle thickness and balance in children with DMD. Methods: Participants in this study were 30 boys with DMD, aged 6 to 10 years old. Children were divided into two groups (A and B) randomly. Children in group (A) underwent a prescribed regimen of physical therapy along with trunk-oriented exercises, whereas group (B) received the same regimen as group (A) together with whole-body vibration three times per week for three consecutive months. Balance and the thickness of the abdominal muscles were measured using the Biodex balance system and ultrasonography, respectively, before and after therapy. Results: When compared to the pre-treatment results in both groups, the post-treatment results showed a significant difference in all measured variables (p<0.05). Post-treatment values showed that all of the measured variables significantly differed in favor of group A. Conclusion: Trunk-oriented exercises can improve abdominal thickness and balance more effectively than whole-body vibration in children with DMD. ClinicalTrials.gov ID:NCT05688072.

Objectives: This study examines the strength and functional capacity of active soccer players two years post anterior cruciate ligament reconstruction (ACLR). Methods: Sixteen players, two years post ACLR, participated. Isokinetic tests assessed Peak Torque (PT) for concentric and eccentric contractions, along with conventional (H/Qconv) and functional (H/Qfunc) H/Q ratios at various angular velocities. Functional ability was gauged through hop tests. Paired-Samples T Test compared PT and hop test values, as well as H/Qconv and H/Qfunc ratios between involved and non-involved limbs. Limb symmetry was evaluated using the Limb Symmetry Index (LSI). Results: After two years, participants exhibited significant differences in concentric PT between limbs. The non-involved limb demonstrated superior performance at isokinetic speeds. Eccentrically, PT for knee extensors and flexors showed no significant disparities between the operated and non-operated limbs across all velocities tested. Most participants did not achieve LSI 90–110% for knee extensors and flexors. No noteworthy distinctions were observed in H/Qconv, H/Qfunc, and hop tests between limbs. The majority met LSI 90–110% in hop tests, except in the 30-second side hop (37%). Conclusions: Two years post ACLR, soccer players still manifest strength and functional deficits, heightening the risk of injury.

Objectives: Children with cerebral palsy have weak muscles, which may impair postural adjustments. These postural adjustments are required for gait and dynamic balance during the daily living activities. The aim of this study was to investigate the association between Cobb’s angle and Formetric 4D surface topography system in evaluating spinal and pelvic deformity in children with cerebral palsy. Methods: One hundred children with spastic diplegia (6 to 8 years old) diagnosed as cerebral palsy participated in this study and selected from the Outpatient Clinic of Faculty of Physical Therapy. Digital x-ray and formetric analysis were used to measure spinal deformities and pelvic deviation in children with cerebral palsy. Results: There were positive correlations between Cobb’s angle and formetric parameters, including trunk imbalance, lateral deviation, and pelvic tilt. Also, Formetric parameters were significant predictors of Cobb’s angle, including trunk imbalance (for a one-degree increase, Cobb’s angle increases by 0.227), lateral deviation (for a one-degree increase, Cobb’s angle increases by 0.665), and pelvic tilt (for a one-degree increase, Cobb’s angle increases by 0.252). Conclusion: Formetric 4D surface topography system was effective in evaluating spinal and pelvic deformity in children with cerebral palsy when compared with Digital x-ray.

Objectives: To investigate changes in the H-reflex in patients with monoradiculopathies involving L5 or S1 levels by stimulating the sciatic nerve and recording simultaneously from the tibialis anterior (TA), peroneus longus (PL), and soleus (S) muscles. Methods: Patients with unilateral radicular back pain with L5 or S1 root compression on MRI, participated in this cross-sectional study. The H-reflex over the TA, PL, and S muscles was simultaneously recorded by sciatic nerve stimulation. The H-reflex latency was compared with that of the contralateral extremity. Results: Fifty-eight patients (29 patients L5; 29 patients S1 radiculopathy) were included in the study. There were significant delays in the latency of the H-reflex over TA (30.95±2.31-29.21±1.4) and PL (3.1±0.85-29.02±1.99) muscles on the affected side in patients with L5 radiculopathy. However, the latency of the S H-reflex was similar on both sides. In contrast, in patients with S1 radiculopathy, there was a significant delay in the latency of soleus H reflex (32.76±3.45-29.9±3.19), while the significant delay was not detected in the TA and PL muscles. However, the cutoff values for the H-reflex latency of all muscles were not found to have clinical significance. Conclusions: The study presents that the H-reflex study, recorded from the TA, PL, and S muscles by sciatic nerve stimulation, is of interest but has minimal contribution to radiculopathy diagnosis in conventional electrodiagnostic tests.

Objective: To investigate the therapeutic effects of autologous platelet-rich plasma (PRP) combined with sodium hyaluronate on tendon healing following rotator cuff injury repair in rabbits. Methods: New Zealand white rabbits were randomly assigned to five groups: sham operation group, control group, PRP group, sodium hyaluronate group, and combined group, each comprising 12 rabbits. A rotator cuff injury model was established in all groups except the sham operation group. At 8 weeks post-surgery, 12 lateral rotator cuff specimens were taken from each group. Four specimens were randomly selected from each group for biomechanical testing, and analyses were conducted on the expression of vascular endothelial growth factor (VEGF), the fiber area ratio of COL-I and COL-III, and tissue morphology. Results: The combined group exhibited the highest biomechanical strength in the cuff tissue of white rabbits (P < 0.05). There was no significant difference in VEGF levels among the five groups (F = 0.814, P = 0.523). However, a significant difference was observed in the ratio of fiber area between COL-I and COL-III groups (F = 11.600, P < 0.001), with the combined group scoring the highest (3.82 ± 0.47 minutes). The inflammatory infiltration in tendon-bone tissue was minimal, and histological morphology was optimal. Conclusion: The combination of PRP and sodium hyaluronate effectively promotes the repair of rotator cuff injuries and accelerates tendon-bone healing.

Objective: To investigate the application of digital artery transposition in replanting severed fingers with vascular defects and its impact on nerve and joint function recovery. Methods: 200 patients who received replantation of severed fingers were randomly divided into artery transposition group (n = 100) and vein transplantation group (n = 100). The digital artery transposition technique was used in the artery transposition group, and the autologous vein bridging technique was used in the vein transplantation group. The clinical efficacy and survival rate of severed fingers were compared between the two groups. Results: The clinical excellent and good rate in artery transposition group was significantly higher than that in vein transplantation group (P < 0.05). Conclusion: The transposition of digital artery is effective and safe in replantation of severed fingers with vascular defects.