Journal of musculoskeletal & neuronal interactions最新文献

Objectives: Vosoritide, a C-type natriuretic peptide analog, is the first approved pharmacological treatment for achondroplasia that targets the overactive FGFR3 pathway and promotes longitudinal bone growth. As increased body height may improve biomechanical leverage and influence muscle function, this retrospective, monocentric, observational study aimed to evaluate changes in muscle performance parameters during long-term vosoritide treatment.

Methods: Nineteen (19) children with achondroplasia treated with vosoritide for at least 12 months were included. Muscle function was assessed via two-legged jump tests on a ground reaction force plate at baseline, month 12, 24 and 36. Jumping parameters, 6-minute walking distances and auxological measurements were converted to z-scores. Longitudinal changes were detected using a linear mixed-effects model.

Results: Vosoritide treatment resulted in significant gains in height z-scores over 36 months (p < 0.001). Raw values of jumping parameters increased numerically over time for all parameters except relative force; however, no significant changes were observed in z-scores. Similarly, no significant changes were detected in 6-minute walking distances.

Conclusions: While vosoritide produced significant height gains, no significant changes in muscle function z-scores were observed in this cohort. These findings are exploratory and suggest that muscle function may develop in parallel with that of unaffected children.

Objectives: This prospective pilot study in healthy children aimed to evaluate the effect of whole-body vibration therapy (WBVT) on hip girdle muscle activation and identify the optimal amplitude and frequency settings that replicate the effects of walking or running without causing discomfort.

Methods: A prospective pilot study involving 20 healthy children was conducted to evaluate muscle activation during WBVT at amplitudes of 1, 2, and 3 mm and frequencies of 5-20 Hz. Surface electromyography of the gluteus medius, tensor fascia lata, iliopsoas, and rectus femoris was recorded during walking, running, and WBVT trials, and steady-state 10-s epochs were extracted for analysis.

Results: Although dose-response analyses showed no statistically significant increases beyond 10 Hz within WBVT conditions, the reported thresholds specify the vibration settings at which WBVT-induced activation exceeded the RMS values observed during walking or running, rather than indicating significant within-WBVT frequency differences. When "optimal setting" was defined as the highest activation within tolerable ranges, the 3 mm/ 10 Hz setting met these criteria.

Conclusions: WBVT produced short-term increases in hip-girdle muscle activation under tolerable conditions. While not indicative of therapeutic benefit, these data provide hypothesis-generating insights for future clinical studies involving children with movement limitations.

Objectives: The reliability of handgrip strength measurements and their relationship with muscle power in older adults is not well understood. This study aimed to determine the reliability and correlations between handgrip strength measurements and muscle power in older women.

Methods: Twenty older healthy women (67.8±5.8 years) participated in two separate testing sessions. During each session, handgrip contractions were performed to evaluate strength, specifically measuring peak force and rate of force development (RFD) across various time intervals. Muscle power was assessed by measuring sit-to-stand peak power and seated medicine ball throw distance.

Results: Handgrip strength measurements, sit-to-stand peak power, and seated medicine ball throw distance demonstrated good test-retest reliability. The intraclass correlation coefficients were between 0.930 and 0.978. The coefficients of variation were between 2.7 and 8.0%. There were significant correlations between handgrip strength measurements and both sit-to-stand peak power (r = 0.485-0.533, P = 0.015-0.030) and seated medicine ball throw distance (r = 0.457-0.634, P = 0.003-0.043).

Conclusions: Our study showed good reliability for handgrip strength measurements, sit-to-stand peak power, and seated medicine ball throw distance in older women. The significant correlations we observed suggest that handgrip peak force and RFD may be important variables associated with one's muscle power.

Objectives: To investigate the relationship between core stability and neuromuscular performance (i.e., sprint velocity and change-of-direction speed) among adolescent male football players.

Methods: In this cross-sectional study, sixteen high-level male football players were divided into higher and lower core stability groups based on their performance in a partial range single-leg deadlift (SLD) test, assessed using a smartphone application (OCTOcore© app). Neuromuscular performance was assessed with a 30-m maximal sprint test (with 5-m split intervals) and a V-cut test, and these outcomes were correlated with SLD test results.

Results: Statistically significant differences were observed between higher and lower core performance groups in the SLD test (p = 0.001) and between SLD non-dominant and 30-m maximal sprint test (p = 0.001-0.005), while no differences were founded between SLD performance and V-cut test (p>0.05). A large correlation was found between non-dominant SLD and 10-m sprint performance (r = 0.765, p = 0.001), while moderate correlations were observed for the 15-, 20-, 25-, and 30-m sprints (r = 0.508-0.562, p = 0.023-0.044). No significant correlations between SLD performance and the V-cut test (p>0.05).

Conclusion: Core stability appears to be positively associated with sprint performance (0-30 m) but not with change-of-direction speed, suggesting that it plays a greater role in linear acceleration than in multidirectional tasks.

Objectives: Persistent toe walking (TW) in children is often idiopathic but may conceal subtle neuromuscular or metabolic causes. This cross-sectional, retrospective study investigated clinical and genetic characteristics of children carrying PYGM variants to explore potential subclinical phenotypes among heterozygous carriers.

Methods: Seventy-two (72) children meeting criteria for idiopathic TW were evaluated using a standardized clinical protocol and a validated 49-gene next-generation sequencing neuromuscular panel. Variants were classified as pathogenic, likely pathogenic, or of uncertain significance according to ACMG/AMP guidelines. Analyses were descriptive.

Results: Among 1,300 screened patients, 72 were identified as PYGM variant carriers. Toe walking was bilateral in all cases, with severe dorsiflexion restriction (≤ 5°) in 80.5%. Pes cavus was observed in 93% of patients, and muscle symptoms-pain, fatigue, or cramps-occurred in approximately one-third. VUS carriers displayed comparable, slightly milder muscle symptom frequencies than P/LP carriers. 12.5% could perform heel walking. Speech difficulties were reported in 56.9% of cases.

Conclusions: While causality cannot be inferred, these findings suggest that heterozygous PYGM variants may contribute to subtle neuromuscular phenotypes. Genetic testing can be considered in persistent TW when clinical findings raise suspicion for an underlying neuromuscular/metabolic condition.

Primary Hyperparathyroidism (PHPT) is a common endocrine disorder characterized by autonomous secretion of parathyroid hormone (PTH) leading to hypercalcemia. Whereas bone mineral density (BMD) is generally preserved at skeletal sites rich in trabecular bone, such as the lumbar spine (LS), studies, using peripheral quantitative computed tomography (pQCΤ) and high-resolution peripheral quantitative computed tomography (HR-pQCΤ), have revealed disruption of both cortical and trabecular bone microarchitecture, even in the contemporary 'asymptomatic' form of the disease, highlighting the catabolic effect of PHPT on bone. Moreover, epidemiological studies reported increased fracture risk in patients with PHPT, even in those with BMD T-score within normal or osteopenic range, suggesting that there is a discrepancy between BMD and fracture risk in patients with PHPT and that new diagnostic methods are needed for assessing bone fragility in this population. Surgery is the only definitive treatment for PHPT. Non-surgical treatment is recommended in patients who do not meet the criteria for surgical management, in patients who deny surgical treatment or are high-risk surgical patients. The most frequently used agents are bisphosphonates, denosumab, cinacalcet and vitamin D supplementation.

Objectives: Reduced weight-loading on the lower extremities during growth induces abnormal bone morphology and malalignment, but the effects of reloading on these abnormalities remain unknown. We aimed to determine the specific timeframes in which hindlimb suspension (HS) during growth induces abnormal femoral morphologies and knee malalignments present at skeletal maturity in rats.

Methods: Four-week-old female rats were subjected to HS for one, two, or four weeks using the tail suspension method, followed by reloading. Age-matched rats were used as controls. At 12 weeks of age, femoral morphology and knee joint alignment were assessed using X-ray computed tomography.

Results: Femoral anteversion angle, medial/lateral condylar height ratio (MC/LC), and patellar tilt angle were significantly larger, while trochlear angle, lateral condylar height (LC), and lateral trochlear inclination (LTI) were smaller in the groups that underwent HS for two or four weeks prior to reloading, compared with the control group. There were significant correlations between LTI and LC (r = 0.57), MC/LC (r = -0.42), and patellar tilt angle (r = -0.49). In the 4-week HS group, lateral patellar dislocation was observed in 3 of 8 animals.

Conclusion: Insufficient weight-loading more than two weeks during growth may induce knee joint instability even after reloading.

Objective: This study presents a method to determine the volumetric density of pelvic bone and cortical bone thickness along critical regions of the S2 alar-iliac (S2AI) screw trajectory using bi-planar multi-energy X-ray (BMEX).

Methods: Simulated BMEXs were generated from CT data from eight patients, with coordinate matching linking pixels to voxel density values. This dataset included pixel attenuation values, coordinates as independent variables, and voxel attenuation values (Hounsfield Units, HU) as the dependent variable for training a random forest regressor model.

Results: The trained model revealed adequate trabecular bone density prediction (root mean square error: 32.8 mg/cm³) and cortical thickness accuracy (error ≤1.2 mm). Trabecular bone showed a minor tendency for density overestimation with a maximum difference of 83 HU, while cortical bone exhibited an underestimation of up to 118 HU.

Conclusions: The improved prediction of bone density and the capability to estimate cortical bone thickness signify a significant advancement towards a comprehensive modality for predicting bone quality in implant placement planning.

Objective: To analyze the effectiveness of a modified knee joint functional exercise method combined with a goniometer in patients after joint replacement.

Methods: Sixty patients who underwent orthopedic knee replacement were divided into two groups: a control group (n = 30, conventional intervention) and an intervention group (n = 30, modified knee functional exercise method combined with a goniometer). Postoperative knee function (Knee Society Score, KSS), compliance with functional exercises, and quality of life were evaluated and compared between the two groups.

Results: Before the intervention, as well as two days post-operation and on the day of discharge, there were no significant differences in KSS scores between the two groups. However, at 2 weeks, 3 weeks, 1 month, 3 months, and 6 months post-operation, the intervention group showed significantly higher KSS scores compared to the control group (P < 0.05). The compliance rate of knee joint function exercise in the intervention group was significantly higher (P<0.05). After intervention, the PF, GH, VT, and MH dimensions of quality-of-life scores in the intervention group were higher than those before intervention and higher than those in the control group (P<0.05).

Conclusion: The modified knee functional exercise method combined with an goniometer effectively improves knee function, enhances training compliance, and improves the quality of life in patients following joint replacement.