M. C. Trillos-Almanza, Magnolia Martinez-Aguilar, J. C. Arroyave-Ospina, F. V. van Vilsteren, H. Blokzijl, Han Moshage
This comprehensive review focuses on the dynamics of branched-chain amino acids (BCAAs) metabolism and its clinical implications in chronic liver disease, with emphasis on the emerging concept of muscle–liver crosstalk. BCAAs, indispensable for protein synthesis and metabolic pathways, undergo unique tissue-specific processing in skeletal muscle and liver. The liver, responsible for amino acid metabolism, plays a distinctive role in sensing BCAAs catabolism, influencing glucose regulation and contributing to the systemic metabolism of BCAAs. Within the context of chronic liver disease, compromised liver metabolism becomes evident through amino acid abnormalities, particularly in the decrease of the Fischer ratio (BCAAs/aromatic amino acids concentrations in plasma). This reduction becomes important in assessing the severity of liver dysfunction due to its associations with adverse outcomes, including increased mortality and complications related to the liver disease. BCAAs supplementation, as explored in this review, emerges as a promising avenue, displaying positive effects on skeletal muscle mass, strength, and overall nutritional status in cirrhosis management. Understanding this interplay offers insights into therapeutic strategies for chronic liver diseases, exploring the way for precision interventions in clinical practice.
{"title":"Clinical and Therapeutic Implications of BCAAs Metabolism during Chronic Liver Disease in Humans: Crosstalk between Skeletal Muscle and Liver","authors":"M. C. Trillos-Almanza, Magnolia Martinez-Aguilar, J. C. Arroyave-Ospina, F. V. van Vilsteren, H. Blokzijl, Han Moshage","doi":"10.3390/muscles3010008","DOIUrl":"https://doi.org/10.3390/muscles3010008","url":null,"abstract":"This comprehensive review focuses on the dynamics of branched-chain amino acids (BCAAs) metabolism and its clinical implications in chronic liver disease, with emphasis on the emerging concept of muscle–liver crosstalk. BCAAs, indispensable for protein synthesis and metabolic pathways, undergo unique tissue-specific processing in skeletal muscle and liver. The liver, responsible for amino acid metabolism, plays a distinctive role in sensing BCAAs catabolism, influencing glucose regulation and contributing to the systemic metabolism of BCAAs. Within the context of chronic liver disease, compromised liver metabolism becomes evident through amino acid abnormalities, particularly in the decrease of the Fischer ratio (BCAAs/aromatic amino acids concentrations in plasma). This reduction becomes important in assessing the severity of liver dysfunction due to its associations with adverse outcomes, including increased mortality and complications related to the liver disease. BCAAs supplementation, as explored in this review, emerges as a promising avenue, displaying positive effects on skeletal muscle mass, strength, and overall nutritional status in cirrhosis management. Understanding this interplay offers insights into therapeutic strategies for chronic liver diseases, exploring the way for precision interventions in clinical practice.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140266606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikolaos D. Karakousis, Konstantinos I. Gourgoulianis, N. Papanas, O. Kotsiou
Pleural mesothelioma (PM) is a tumor related to adverse prognosis. The PM WHO classification has mainly identified three major subtypes of PM which are epithelioid, biphasic, and sarcomatoid. Sarcopenia is a medical issue related to a reduction in muscle mass and strength. It represents a major health issue globally because it is related to adverse effects such as hospitalization, increased length of stay, disability, increased morbidity and mortality and augmented health care expenditures. In this literature review, we attempted to examine the upcoming association between sarcopenia and PM. As recorded by the current literature, muscle loss in PM subjects was related to poorer survival and lower levels of activity. Subjects with PM had increased rates of pre-sarcopenia and malnutrition, while pre-sarcopenia was related to worse activity levels, and malnutrition was related to worse quality of life (QoL). Both tumor volume and sarcopenia were related to long-term mortality in surgically treated PM subjects, while sarcopenia was present both pre-operatively and post-operatively in these subjects. In addition, post-operative sarcopenic subjects showed a decreased 3-year overall survival (OS) in comparison with those who did not have sarcopenia, while pre-operative sarcopenia was importantly related to an increased rate of post-operative adverse outcomes. More studies are needed to validate these claims.
{"title":"Sarcopenia and Pleural Mesothelioma: The Current Knowledge","authors":"Nikolaos D. Karakousis, Konstantinos I. Gourgoulianis, N. Papanas, O. Kotsiou","doi":"10.3390/muscles3010006","DOIUrl":"https://doi.org/10.3390/muscles3010006","url":null,"abstract":"Pleural mesothelioma (PM) is a tumor related to adverse prognosis. The PM WHO classification has mainly identified three major subtypes of PM which are epithelioid, biphasic, and sarcomatoid. Sarcopenia is a medical issue related to a reduction in muscle mass and strength. It represents a major health issue globally because it is related to adverse effects such as hospitalization, increased length of stay, disability, increased morbidity and mortality and augmented health care expenditures. In this literature review, we attempted to examine the upcoming association between sarcopenia and PM. As recorded by the current literature, muscle loss in PM subjects was related to poorer survival and lower levels of activity. Subjects with PM had increased rates of pre-sarcopenia and malnutrition, while pre-sarcopenia was related to worse activity levels, and malnutrition was related to worse quality of life (QoL). Both tumor volume and sarcopenia were related to long-term mortality in surgically treated PM subjects, while sarcopenia was present both pre-operatively and post-operatively in these subjects. In addition, post-operative sarcopenic subjects showed a decreased 3-year overall survival (OS) in comparison with those who did not have sarcopenia, while pre-operative sarcopenia was importantly related to an increased rate of post-operative adverse outcomes. More studies are needed to validate these claims.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"17 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139851869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikolaos D. Karakousis, Konstantinos I. Gourgoulianis, N. Papanas, O. Kotsiou
Pleural mesothelioma (PM) is a tumor related to adverse prognosis. The PM WHO classification has mainly identified three major subtypes of PM which are epithelioid, biphasic, and sarcomatoid. Sarcopenia is a medical issue related to a reduction in muscle mass and strength. It represents a major health issue globally because it is related to adverse effects such as hospitalization, increased length of stay, disability, increased morbidity and mortality and augmented health care expenditures. In this literature review, we attempted to examine the upcoming association between sarcopenia and PM. As recorded by the current literature, muscle loss in PM subjects was related to poorer survival and lower levels of activity. Subjects with PM had increased rates of pre-sarcopenia and malnutrition, while pre-sarcopenia was related to worse activity levels, and malnutrition was related to worse quality of life (QoL). Both tumor volume and sarcopenia were related to long-term mortality in surgically treated PM subjects, while sarcopenia was present both pre-operatively and post-operatively in these subjects. In addition, post-operative sarcopenic subjects showed a decreased 3-year overall survival (OS) in comparison with those who did not have sarcopenia, while pre-operative sarcopenia was importantly related to an increased rate of post-operative adverse outcomes. More studies are needed to validate these claims.
{"title":"Sarcopenia and Pleural Mesothelioma: The Current Knowledge","authors":"Nikolaos D. Karakousis, Konstantinos I. Gourgoulianis, N. Papanas, O. Kotsiou","doi":"10.3390/muscles3010006","DOIUrl":"https://doi.org/10.3390/muscles3010006","url":null,"abstract":"Pleural mesothelioma (PM) is a tumor related to adverse prognosis. The PM WHO classification has mainly identified three major subtypes of PM which are epithelioid, biphasic, and sarcomatoid. Sarcopenia is a medical issue related to a reduction in muscle mass and strength. It represents a major health issue globally because it is related to adverse effects such as hospitalization, increased length of stay, disability, increased morbidity and mortality and augmented health care expenditures. In this literature review, we attempted to examine the upcoming association between sarcopenia and PM. As recorded by the current literature, muscle loss in PM subjects was related to poorer survival and lower levels of activity. Subjects with PM had increased rates of pre-sarcopenia and malnutrition, while pre-sarcopenia was related to worse activity levels, and malnutrition was related to worse quality of life (QoL). Both tumor volume and sarcopenia were related to long-term mortality in surgically treated PM subjects, while sarcopenia was present both pre-operatively and post-operatively in these subjects. In addition, post-operative sarcopenic subjects showed a decreased 3-year overall survival (OS) in comparison with those who did not have sarcopenia, while pre-operative sarcopenia was importantly related to an increased rate of post-operative adverse outcomes. More studies are needed to validate these claims.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Crescenzo, Mattia Zanoni, Laura Ferigo, Francesca Rossi, Matteo Grecò, Angelica Lupato, Alessandra Danese, Domenico Ajena, Michelangelo Turazzini
Eculizumab is a monoclonal antibody blocking the terminal complement protein C5. As demonstrated in the phase III randomized, placebo-controlled, REGAIN clinical trial, eculizumab is efficacious in acetylcholine receptor antibody (AChR-Ab)-positive refractory generalized myasthenia gravis (gMG) (Myasthenia Gravis Foundation of America—MGFA class II–IV). It has not been studied in severe myasthenic exacerbation or myasthenic crisis (MGFA V). A 73-year-old man diagnosed with myasthenia gravis AChR-Ab positivity came to our observation for symptoms of bulbar and ocular weakness and unresponsiveness or intolerability to conventional immunosuppressive therapies (prednisone and azathioprine). Due to the recurrent clinical worsening with intubation over a short-term period, the patient was treated with eculizumab. After 15 days of eculizumab treatment, we observed a significant recovery of clinical condition. We discharged the patient to an outpatient regimen, where he is continuing with maintenance doses of eculizumab and slowly tapering steroid intake. The use of eculizumab in myasthenic crises is still anecdotal. Our case aims to provide eculizumab benefit for refractory severe gMG in a practical, real-world setting beyond the criteria of the REGAIN study. Further studies are needed to evaluate the efficacy and safety of eculizumab in myasthenic crises.
Eculizumab 是一种阻断末端补体蛋白 C5 的单克隆抗体。REGAIN III 期随机安慰剂对照临床试验表明，依库珠单抗对乙酰胆碱受体抗体（AChR-Ab）阳性的难治性全身性重症肌无力（gMG）（美国重症肌无力基金会-MGFA II-IV 级）有效。目前尚未对重症肌无力加重或肌无力危象（MGFA V 级）进行研究。一名被诊断为肌无力 AChR-Ab 阳性的 73 岁男子因出现球部和眼部无力症状，以及对常规免疫抑制疗法（强的松和硫唑嘌呤）无反应或无法耐受而前来就诊。由于患者的临床症状在短期内反复恶化，需要插管治疗，因此我们使用了依库珠单抗。在接受 15 天的依库珠单抗治疗后，我们观察到患者的临床状况明显好转。患者出院后，我们对其进行了门诊治疗，继续使用维持剂量的依库珠单抗，并缓慢减少类固醇的摄入量。在肌无力危象中使用依库珠单抗仍是传闻。我们的病例旨在超越 REGAIN 研究的标准，在实际的现实环境中为难治性重症肌无力患者提供依库珠单抗的益处。还需要进一步研究来评估依库珠单抗在肌无力危象中的疗效和安全性。
{"title":"Eculizumab as Additional Rescue Therapy in Myasthenic Crisis","authors":"F. Crescenzo, Mattia Zanoni, Laura Ferigo, Francesca Rossi, Matteo Grecò, Angelica Lupato, Alessandra Danese, Domenico Ajena, Michelangelo Turazzini","doi":"10.3390/muscles3010005","DOIUrl":"https://doi.org/10.3390/muscles3010005","url":null,"abstract":"Eculizumab is a monoclonal antibody blocking the terminal complement protein C5. As demonstrated in the phase III randomized, placebo-controlled, REGAIN clinical trial, eculizumab is efficacious in acetylcholine receptor antibody (AChR-Ab)-positive refractory generalized myasthenia gravis (gMG) (Myasthenia Gravis Foundation of America—MGFA class II–IV). It has not been studied in severe myasthenic exacerbation or myasthenic crisis (MGFA V). A 73-year-old man diagnosed with myasthenia gravis AChR-Ab positivity came to our observation for symptoms of bulbar and ocular weakness and unresponsiveness or intolerability to conventional immunosuppressive therapies (prednisone and azathioprine). Due to the recurrent clinical worsening with intubation over a short-term period, the patient was treated with eculizumab. After 15 days of eculizumab treatment, we observed a significant recovery of clinical condition. We discharged the patient to an outpatient regimen, where he is continuing with maintenance doses of eculizumab and slowly tapering steroid intake. The use of eculizumab in myasthenic crises is still anecdotal. Our case aims to provide eculizumab benefit for refractory severe gMG in a practical, real-world setting beyond the criteria of the REGAIN study. Further studies are needed to evaluate the efficacy and safety of eculizumab in myasthenic crises.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"66 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139796742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Crescenzo, Mattia Zanoni, Laura Ferigo, Francesca Rossi, Matteo Grecò, Angelica Lupato, Alessandra Danese, Domenico Ajena, Michelangelo Turazzini
Eculizumab is a monoclonal antibody blocking the terminal complement protein C5. As demonstrated in the phase III randomized, placebo-controlled, REGAIN clinical trial, eculizumab is efficacious in acetylcholine receptor antibody (AChR-Ab)-positive refractory generalized myasthenia gravis (gMG) (Myasthenia Gravis Foundation of America—MGFA class II–IV). It has not been studied in severe myasthenic exacerbation or myasthenic crisis (MGFA V). A 73-year-old man diagnosed with myasthenia gravis AChR-Ab positivity came to our observation for symptoms of bulbar and ocular weakness and unresponsiveness or intolerability to conventional immunosuppressive therapies (prednisone and azathioprine). Due to the recurrent clinical worsening with intubation over a short-term period, the patient was treated with eculizumab. After 15 days of eculizumab treatment, we observed a significant recovery of clinical condition. We discharged the patient to an outpatient regimen, where he is continuing with maintenance doses of eculizumab and slowly tapering steroid intake. The use of eculizumab in myasthenic crises is still anecdotal. Our case aims to provide eculizumab benefit for refractory severe gMG in a practical, real-world setting beyond the criteria of the REGAIN study. Further studies are needed to evaluate the efficacy and safety of eculizumab in myasthenic crises.
Eculizumab 是一种阻断末端补体蛋白 C5 的单克隆抗体。REGAIN III 期随机安慰剂对照临床试验表明，依库珠单抗对乙酰胆碱受体抗体（AChR-Ab）阳性的难治性全身性重症肌无力（gMG）（美国重症肌无力基金会-MGFA II-IV 级）有效。目前尚未对重症肌无力加重或肌无力危象（MGFA V 级）进行研究。一名被诊断为肌无力 AChR-Ab 阳性的 73 岁男子因出现球部和眼部无力症状，以及对常规免疫抑制疗法（强的松和硫唑嘌呤）无反应或无法耐受而前来就诊。由于患者的临床症状在短期内反复恶化，需要插管治疗，因此我们使用了依库珠单抗。在接受 15 天的依库珠单抗治疗后，我们观察到患者的临床状况明显好转。患者出院后，我们对其进行了门诊治疗，继续使用维持剂量的依库珠单抗，并缓慢减少类固醇的摄入量。在肌无力危象中使用依库珠单抗仍是传闻。我们的病例旨在超越 REGAIN 研究的标准，在实际的现实环境中为难治性重症肌无力患者提供依库珠单抗的益处。还需要进一步研究来评估依库珠单抗在肌无力危象中的疗效和安全性。
{"title":"Eculizumab as Additional Rescue Therapy in Myasthenic Crisis","authors":"F. Crescenzo, Mattia Zanoni, Laura Ferigo, Francesca Rossi, Matteo Grecò, Angelica Lupato, Alessandra Danese, Domenico Ajena, Michelangelo Turazzini","doi":"10.3390/muscles3010005","DOIUrl":"https://doi.org/10.3390/muscles3010005","url":null,"abstract":"Eculizumab is a monoclonal antibody blocking the terminal complement protein C5. As demonstrated in the phase III randomized, placebo-controlled, REGAIN clinical trial, eculizumab is efficacious in acetylcholine receptor antibody (AChR-Ab)-positive refractory generalized myasthenia gravis (gMG) (Myasthenia Gravis Foundation of America—MGFA class II–IV). It has not been studied in severe myasthenic exacerbation or myasthenic crisis (MGFA V). A 73-year-old man diagnosed with myasthenia gravis AChR-Ab positivity came to our observation for symptoms of bulbar and ocular weakness and unresponsiveness or intolerability to conventional immunosuppressive therapies (prednisone and azathioprine). Due to the recurrent clinical worsening with intubation over a short-term period, the patient was treated with eculizumab. After 15 days of eculizumab treatment, we observed a significant recovery of clinical condition. We discharged the patient to an outpatient regimen, where he is continuing with maintenance doses of eculizumab and slowly tapering steroid intake. The use of eculizumab in myasthenic crises is still anecdotal. Our case aims to provide eculizumab benefit for refractory severe gMG in a practical, real-world setting beyond the criteria of the REGAIN study. Further studies are needed to evaluate the efficacy and safety of eculizumab in myasthenic crises.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139856702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Approximately 90% of scoliosis cases are adolescent-idiopathic (AIS). From the first appearance of scoliosis at 10–14 years of age until the age of 18, the spine is most vulnerable to deterioration; young, growing people are most susceptible to the worsening of one or more scoliotic curves. An effective non-surgical means of remediation would be welcome. Design: This was a randomized, controlled, two-arm study assessing the safety and efficacy of combining incobotulinum injections with yoga to reverse lumbar and thoracolumbar AIS. Methods: In a private clinic setting, non-pregnant, healthy 12–18 year-olds were either taught a symmetrical “placebo” yoga pose (control sub-group 1), performed the side plank (Vasisthasana) three times daily with a placebo injection (control sub-group 2) or performed the three-times-daily side plank with a botulinum injection (intervention group 3). Injection: For the injection, 33 IU of incobotulinumtoxin type A (Xeomin) was injected into the concave-side lumbar paraspinals and quadratus lumborum at L2–3 and the psoas muscle at L3–4, or participants were injected similarly with a placebo. Randomization was achieved using random.org. Objective: The objective was to determine whether the treatment of muscular asymmetry with botulinum toxin injections and side planks is safe and effective in AIS. Results/Outcome: Eleven intervention and thirteen placebo patients (Groups 1 + 2), who were 12–18 years old, completed the three-month study. Mean daily side plank time = 165 s. The mean initial lumbar curvature was 36.9 degrees (SD 14.36), (p < 0.0001); the mean Group 3 curvature at 3 weeks was 29.5 degrees (SD 14.23) (p < 0.0001); and the mean Group 3 curvature at 3 months was 26.0 degrees (SD 12.81). Onset vs. 3-month value: p < 0.0001. Harms were limited to one patient in Group 2 and one in Group 3, who complained of transient shoulder pain and supported themselves temporarily on their forearm instead of the palm of the extended hand. Conclusion: Muscle strength asymmetry appears to be relevant to AIS treatment. Incobotulinum injections combined with side planks performed with the convex side downward may be more effective in reversing lumbar AIS than placebo exercises or side planks and placebo injections.
{"title":"Incobotulinumtoxin A and Yoga-like Isometric Exercise in Adolescent Idiopathic Lumbar Scoliosis—A Randomized Pilot Study","authors":"Loren Fishman","doi":"10.3390/muscles3010004","DOIUrl":"https://doi.org/10.3390/muscles3010004","url":null,"abstract":"Background: Approximately 90% of scoliosis cases are adolescent-idiopathic (AIS). From the first appearance of scoliosis at 10–14 years of age until the age of 18, the spine is most vulnerable to deterioration; young, growing people are most susceptible to the worsening of one or more scoliotic curves. An effective non-surgical means of remediation would be welcome. Design: This was a randomized, controlled, two-arm study assessing the safety and efficacy of combining incobotulinum injections with yoga to reverse lumbar and thoracolumbar AIS. Methods: In a private clinic setting, non-pregnant, healthy 12–18 year-olds were either taught a symmetrical “placebo” yoga pose (control sub-group 1), performed the side plank (Vasisthasana) three times daily with a placebo injection (control sub-group 2) or performed the three-times-daily side plank with a botulinum injection (intervention group 3). Injection: For the injection, 33 IU of incobotulinumtoxin type A (Xeomin) was injected into the concave-side lumbar paraspinals and quadratus lumborum at L2–3 and the psoas muscle at L3–4, or participants were injected similarly with a placebo. Randomization was achieved using random.org. Objective: The objective was to determine whether the treatment of muscular asymmetry with botulinum toxin injections and side planks is safe and effective in AIS. Results/Outcome: Eleven intervention and thirteen placebo patients (Groups 1 + 2), who were 12–18 years old, completed the three-month study. Mean daily side plank time = 165 s. The mean initial lumbar curvature was 36.9 degrees (SD 14.36), (p < 0.0001); the mean Group 3 curvature at 3 weeks was 29.5 degrees (SD 14.23) (p < 0.0001); and the mean Group 3 curvature at 3 months was 26.0 degrees (SD 12.81). Onset vs. 3-month value: p < 0.0001. Harms were limited to one patient in Group 2 and one in Group 3, who complained of transient shoulder pain and supported themselves temporarily on their forearm instead of the palm of the extended hand. Conclusion: Muscle strength asymmetry appears to be relevant to AIS treatment. Incobotulinum injections combined with side planks performed with the convex side downward may be more effective in reversing lumbar AIS than placebo exercises or side planks and placebo injections.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"14 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139883514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Approximately 90% of scoliosis cases are adolescent-idiopathic (AIS). From the first appearance of scoliosis at 10–14 years of age until the age of 18, the spine is most vulnerable to deterioration; young, growing people are most susceptible to the worsening of one or more scoliotic curves. An effective non-surgical means of remediation would be welcome. Design: This was a randomized, controlled, two-arm study assessing the safety and efficacy of combining incobotulinum injections with yoga to reverse lumbar and thoracolumbar AIS. Methods: In a private clinic setting, non-pregnant, healthy 12–18 year-olds were either taught a symmetrical “placebo” yoga pose (control sub-group 1), performed the side plank (Vasisthasana) three times daily with a placebo injection (control sub-group 2) or performed the three-times-daily side plank with a botulinum injection (intervention group 3). Injection: For the injection, 33 IU of incobotulinumtoxin type A (Xeomin) was injected into the concave-side lumbar paraspinals and quadratus lumborum at L2–3 and the psoas muscle at L3–4, or participants were injected similarly with a placebo. Randomization was achieved using random.org. Objective: The objective was to determine whether the treatment of muscular asymmetry with botulinum toxin injections and side planks is safe and effective in AIS. Results/Outcome: Eleven intervention and thirteen placebo patients (Groups 1 + 2), who were 12–18 years old, completed the three-month study. Mean daily side plank time = 165 s. The mean initial lumbar curvature was 36.9 degrees (SD 14.36), (p < 0.0001); the mean Group 3 curvature at 3 weeks was 29.5 degrees (SD 14.23) (p < 0.0001); and the mean Group 3 curvature at 3 months was 26.0 degrees (SD 12.81). Onset vs. 3-month value: p < 0.0001. Harms were limited to one patient in Group 2 and one in Group 3, who complained of transient shoulder pain and supported themselves temporarily on their forearm instead of the palm of the extended hand. Conclusion: Muscle strength asymmetry appears to be relevant to AIS treatment. Incobotulinum injections combined with side planks performed with the convex side downward may be more effective in reversing lumbar AIS than placebo exercises or side planks and placebo injections.
{"title":"Incobotulinumtoxin A and Yoga-like Isometric Exercise in Adolescent Idiopathic Lumbar Scoliosis—A Randomized Pilot Study","authors":"Loren Fishman","doi":"10.3390/muscles3010004","DOIUrl":"https://doi.org/10.3390/muscles3010004","url":null,"abstract":"Background: Approximately 90% of scoliosis cases are adolescent-idiopathic (AIS). From the first appearance of scoliosis at 10–14 years of age until the age of 18, the spine is most vulnerable to deterioration; young, growing people are most susceptible to the worsening of one or more scoliotic curves. An effective non-surgical means of remediation would be welcome. Design: This was a randomized, controlled, two-arm study assessing the safety and efficacy of combining incobotulinum injections with yoga to reverse lumbar and thoracolumbar AIS. Methods: In a private clinic setting, non-pregnant, healthy 12–18 year-olds were either taught a symmetrical “placebo” yoga pose (control sub-group 1), performed the side plank (Vasisthasana) three times daily with a placebo injection (control sub-group 2) or performed the three-times-daily side plank with a botulinum injection (intervention group 3). Injection: For the injection, 33 IU of incobotulinumtoxin type A (Xeomin) was injected into the concave-side lumbar paraspinals and quadratus lumborum at L2–3 and the psoas muscle at L3–4, or participants were injected similarly with a placebo. Randomization was achieved using random.org. Objective: The objective was to determine whether the treatment of muscular asymmetry with botulinum toxin injections and side planks is safe and effective in AIS. Results/Outcome: Eleven intervention and thirteen placebo patients (Groups 1 + 2), who were 12–18 years old, completed the three-month study. Mean daily side plank time = 165 s. The mean initial lumbar curvature was 36.9 degrees (SD 14.36), (p < 0.0001); the mean Group 3 curvature at 3 weeks was 29.5 degrees (SD 14.23) (p < 0.0001); and the mean Group 3 curvature at 3 months was 26.0 degrees (SD 12.81). Onset vs. 3-month value: p < 0.0001. Harms were limited to one patient in Group 2 and one in Group 3, who complained of transient shoulder pain and supported themselves temporarily on their forearm instead of the palm of the extended hand. Conclusion: Muscle strength asymmetry appears to be relevant to AIS treatment. Incobotulinum injections combined with side planks performed with the convex side downward may be more effective in reversing lumbar AIS than placebo exercises or side planks and placebo injections.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"240 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139823322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Verónica Morales-Sánchez, R. Reigal, Verónica García-Morales, Antonio Hernández-Mendo, Coral Falcó
The use of electromyographic biofeedback (EMG-BF) in the rehabilitation of injuries has been widely referenced in the psychological literature. However, despite some pioneering work in the field of sports, its use in the rehabilitation of sports injuries has hardly been explored. A case of two professional soccer players who each suffered a distal radius fracture is presented here. Parallel to the rehabilitation plan established by medical services, an intervention strategy using EMG-BF was established. An EMG-BF intervention was performed on the brachioradialis muscle with the aim of improving the voluntary control of its electromyographic activity. The study protocol was registered with the identifier NCT05376072. An ABA design was used. In each session, a pre- and postline was recorded to determine the EMG gain acquired at each point of the session. After six sessions, the intervention was terminated. One more follow-up session was performed. The results obtained indicated the efficacy of the intervention; a statistically significant increase in muscle activity in the brachioradialis muscle was observed.
在心理学文献中，肌电生物反馈（EMG-BF）在损伤康复中的应用已被广泛引用。然而，尽管在体育领域有一些开创性的工作，但在运动损伤的康复中使用这一方法的研究还很少。这里介绍的是两个职业足球运动员的病例，他们都遭受了桡骨远端骨折。在医疗服务部门制定康复计划的同时，还制定了使用 EMG-BF 的干预策略。对肱二头肌进行了 EMG-BF 干预，目的是改善其肌电活动的自主控制。该研究方案的注册标识符为 NCT05376072。采用的是 ABA 设计。在每个疗程中，记录前线和后线，以确定疗程各点获得的肌电图增益。六个疗程后，干预结束。之后又进行了一次随访。结果表明，干预效果显著；从统计学角度看，肱二头肌的肌肉活动明显增加。
{"title":"Neuromuscular Rehabilitation of the Brachioradialis Muscle after Distal Radius Fracture in Two Professional Soccer Players Using Electromyographic Biofeedback","authors":"Verónica Morales-Sánchez, R. Reigal, Verónica García-Morales, Antonio Hernández-Mendo, Coral Falcó","doi":"10.3390/muscles3010003","DOIUrl":"https://doi.org/10.3390/muscles3010003","url":null,"abstract":"The use of electromyographic biofeedback (EMG-BF) in the rehabilitation of injuries has been widely referenced in the psychological literature. However, despite some pioneering work in the field of sports, its use in the rehabilitation of sports injuries has hardly been explored. A case of two professional soccer players who each suffered a distal radius fracture is presented here. Parallel to the rehabilitation plan established by medical services, an intervention strategy using EMG-BF was established. An EMG-BF intervention was performed on the brachioradialis muscle with the aim of improving the voluntary control of its electromyographic activity. The study protocol was registered with the identifier NCT05376072. An ABA design was used. In each session, a pre- and postline was recorded to determine the EMG gain acquired at each point of the session. After six sessions, the intervention was terminated. One more follow-up session was performed. The results obtained indicated the efficacy of the intervention; a statistically significant increase in muscle activity in the brachioradialis muscle was observed.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"127 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139605214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paulo Sgobbi, I. B. Farias, P. Serrano, Bruno Mattos Lombardi Badia, Hélvia Bertoldo de Oliveira, A. S. Barbosa, C. A. Pereira, Vanessa de Freitas Moreira, M. Chieia, A. Barbosa, P. Fraiman, Vinícius Lopes Braga, R. I. L. Machado, Sophia Luiz Calegaretti, Isabela Danziato Fernandes, Roberta Correa Ribeiro, Marco Antonio Orsini Neves, W. Pinto, A. Oliveira
An 18-year-old man presented with slowly progressive infancy-onset spasticity of the lower limbs and cerebellar ataxia, associated with painless strabismus, intellectual disability, urinary incontinence, bilateral progressive visual loss, and cognitive decline since early adolescence. A neurological examination disclosed spastic dysarthria, left eye divergent strabismus, bilateral ophthalmoparesis, impaired smooth pursuit, severe spastic paraparesis of the lower limbs with global brisk tendon reflexes, bilateral extensor plantar responses, and bilateral ankle clonus reflex. Bilateral dysdiadochokinesia of the upper limbs, Stewart-Holmes rebound phenomenon, bilateral dysmetria, and a bilateral abnormal finger-to-nose test were observed. Markedly reduced bilateral visual acuity (right side 20/150, left side 20/400) and moderate to severe optic atrophy were detected. Neuroimaging studies showed cerebellar atrophy and bilateral optic nerves and optic tract atrophy as the main findings. As a complicated Hereditary Spastic Paraplegia, autosomal dominant Spinocerebellar Ataxia, or inherited neurometabolic disorders were suspected, a large next-generation sequencing-based gene panel testing disclosed the heterozygous pathogenic variant c.162-1G>A in intron 1 of the PNPT1 gene. A diagnosis of PNPT1-related spastic ataxia was established. Clinicians must be aware of the possibility of PNPT1 pathogenic variants in cases of spastic ataxia and spastic paraplegias that are associated with optic atrophy and marked cognitive decline, regardless of the established family history of neurological compromise.
{"title":"PNPT1 Spectrum Disorders: An Underrecognized and Complex Group of Neurometabolic Disorders","authors":"Paulo Sgobbi, I. B. Farias, P. Serrano, Bruno Mattos Lombardi Badia, Hélvia Bertoldo de Oliveira, A. S. Barbosa, C. A. Pereira, Vanessa de Freitas Moreira, M. Chieia, A. Barbosa, P. Fraiman, Vinícius Lopes Braga, R. I. L. Machado, Sophia Luiz Calegaretti, Isabela Danziato Fernandes, Roberta Correa Ribeiro, Marco Antonio Orsini Neves, W. Pinto, A. Oliveira","doi":"10.3390/muscles3010002","DOIUrl":"https://doi.org/10.3390/muscles3010002","url":null,"abstract":"An 18-year-old man presented with slowly progressive infancy-onset spasticity of the lower limbs and cerebellar ataxia, associated with painless strabismus, intellectual disability, urinary incontinence, bilateral progressive visual loss, and cognitive decline since early adolescence. A neurological examination disclosed spastic dysarthria, left eye divergent strabismus, bilateral ophthalmoparesis, impaired smooth pursuit, severe spastic paraparesis of the lower limbs with global brisk tendon reflexes, bilateral extensor plantar responses, and bilateral ankle clonus reflex. Bilateral dysdiadochokinesia of the upper limbs, Stewart-Holmes rebound phenomenon, bilateral dysmetria, and a bilateral abnormal finger-to-nose test were observed. Markedly reduced bilateral visual acuity (right side 20/150, left side 20/400) and moderate to severe optic atrophy were detected. Neuroimaging studies showed cerebellar atrophy and bilateral optic nerves and optic tract atrophy as the main findings. As a complicated Hereditary Spastic Paraplegia, autosomal dominant Spinocerebellar Ataxia, or inherited neurometabolic disorders were suspected, a large next-generation sequencing-based gene panel testing disclosed the heterozygous pathogenic variant c.162-1G>A in intron 1 of the PNPT1 gene. A diagnosis of PNPT1-related spastic ataxia was established. Clinicians must be aware of the possibility of PNPT1 pathogenic variants in cases of spastic ataxia and spastic paraplegias that are associated with optic atrophy and marked cognitive decline, regardless of the established family history of neurological compromise.","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139525047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ending the year is an opportunity to reflect on the past twelve months [...]
年终是反思过去 12 个月的机会 [...]
{"title":"Muscles: An Overview of 2023 and Future Perspective","authors":"Corrado Angelini","doi":"10.3390/muscles3010001","DOIUrl":"https://doi.org/10.3390/muscles3010001","url":null,"abstract":"Ending the year is an opportunity to reflect on the past twelve months [...]","PeriodicalId":502800,"journal":{"name":"Muscles","volume":"70 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139390545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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