BACKGROUND: Spasticity is a common feature in patients with disruptions in corticospinal pathways. However, the term is used ambiguously. Here, spasticity is defined as enhanced velocity-dependent stretch reflexes and placed within the context of deforming spastic paresis encompassing other forms of muscle overactivity. OBJECTIVE: This scoping review aims at evaluating the clinimetric quality of clinical outcome assessments (COAs) for spasticity across different pathologies and to make recommendations for their use. METHODS: A literature search was conducted to identify COAs used to assess spasticity. An international expert panel evaluated the measurement properties in the included COAs. Recommendations were based on the MDS-COA program methodology based on three criteria: if the COA was (1) applied to patients with spastic paresis, (2) used by others beyond the developers, and (3) determined to be reliable, valid, and sensitive to change in patients with spasticity. RESULTS: We identified 72 COAs of which 17 clinician-reported outcomes (ClinROs) and 6 patient-reported outcomes (PROs) were reviewed. The Tardieu Scale was the only ClinRO recommended for assessing spasticity. One ClinRO-Composite Spasticity Index-and two PROs-Spasticity 0-10 Numeric Rating Scale and 88-Item Multiple Sclerosis Spasticity Scale-were recommended with caveats. The Ashworth-derived COAs were excluded after evaluation due to their focus on muscle tone rather than spasticity, as defined in this review. CONCLUSIONS: The Tardieu Scale is recommended for assessing spasticity, and two PROs are recommended with caveats. Consistent terminology about the various types of muscle overactivity is necessary to facilitate their assessment and treatment. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

• MeSH
• hodnocení výsledků zdravotní péče * normy   MeSH
• lidé MeSH
• svalová spasticita * patofyziologie   diagnóza   etiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The aim of this study was to compare the effects of 3 sets of isometric conditioning activity (ICA), each with an equal total duration (9 s per set) but with different distributions contractions, on force production during ICA and subsequent countermovement jump (CMJ) performance. Fifteen resistance-trained males participated in this study (age: 22.1 ± 2.4 years; body mass: 85.1 ± 9.7 kg; height: 181.3 ± 6.5 cm; relative one-repetition maximum (1RM) in back squat: 1.59 ± 0.32 kg/kg of body mass). Participants completed 3 conditions, each consisting of ICA in the half-back squat with a pushing isometric muscle action (PIMA) position at a 120-degree knee angle against an immovable barbell, differing in repetition distribution: 3 sets of 9 repetitions lasting 1 s each (SUST-1), 3 sets of 3 repetitions lasting 3 s each (SUST-3), 3 sets of single repetitions lasting 9 s (SUST-9), and a control condition (CTRL) without ICA. A 1-minute rest was allowed between sets. Approximately 3 min pre-ICA and at 15 s, 3-, 6-, 9-, and 12-minutes post-ICA, the CMJ performance was assessed. Moreover, peak force (PF) production, and force generated at 100 (Force100) and 200 ms (Force200) during each ICA were evaluated. A two-way repeated measures ANOVA indicated a main effect of time on CMJ height (F = 2.674; p = 0.029; ηp2=0.171) but did not show significant differences between conditions (F = 0.934; p = 0.434; ηp2=0.067) or interactions (F = 0.826; p = 0.648; ηp2=0.060). Post-hoc comparisons indicated a significant decrease in CMJ height at the 9th minute compared to the 3rd minute (35.7 ± 5.6 cm vs. 36.8 ± 5.5 cm post-CA; d = 0.161; p = 0.048). In addition, no significant interactions or main effects were found for CMJ contraction time, PF and Force100 during ICA. However, a main effect of condition was demonstrated on Force200 (F = 19.181; p < 0.001; ηp2= 0.013). Post-hoc comparisons revealed higher Force200 values in SUST-1 (mean difference [MD] = 549 ± 137 N; d = 1.049; p < 0.001) and SUST-3 (MD = 348 ± 112 N; d = 0.665; p = 0.002) compared to the SUST-9 condition. None of the ICAs used in the present study had any effect on the CMJ performance. However, the significantly higher Force200 values noted in the SUST-1, and SUST-3 conditions compared to the SUST-9 condition suggest that the specific distributions of isometric contraction influence the force generated during their execution.

• MeSH
• dospělí MeSH
• isometrická kontrakce * fyziologie   MeSH
• kosterní svaly * fyziologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• odporový trénink * metody   MeSH
• sportovní výkon * fyziologie   MeSH
• svalová síla fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION AND HYPOTHESIS: Pregnancy and delivery are commonly associated with ano-rectal dysfunction. In addition, vaginal delivery may impact both the structure and functionality of the pelvic floor. Herein, we systematically reviewed the literature for the potential association between levator ani muscle (LAM) avulsion and ano-rectal function after childbirth. METHODS: We systematically searched the PubMed, EMBASE, CINAHL, Web of Science Core Collection, CENTRAL (Cochrane), Clinicaltrials.gov, and ICTRP databases from inception. We selected studies reporting on the anatomy of the LAM and ano-rectal function within 24 months after childbirth, the former determined by imaging and the latter measured through validated questionnaires or ano-rectal manometry. Meta-analyses were used to pool data from studies reporting on the association between LAM avulsion and ano-rectal function, with subgroup analysis according to the presence or absence of anal sphincter trauma. Summary odds ratio (OR) and mean difference (MD) are reported with 95% confidence intervals. RESULTS: From the 7,621 studies identified, 11 were included, reporting on 2,146 women. Ten studies used transperineal ultrasound (TPUS) and one study used magnetic resonance imaging (MRI) for LAM assessment. Ano-rectal function was assessed through validated questionnaires in all but one study, in which ano-rectal manometry was used. There was no evidence for an association between LAM avulsion and symptoms of incontinence (OR 1.75 [0.74, 4.12]; MD 0.13 [-0.58, 0.85]), including in the subgroup of patients with concomitant anal sphincter injury (OR 1.83 [0.71, 4.71]). CONCLUSIONS: We did not identify an association between LAM avulsion and ano-rectal dysfunction following vaginal childbirth.

• MeSH
• anální kanál * patofyziologie   zranění   diagnostické zobrazování   MeSH
• fekální inkontinence etiologie   patofyziologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• manometrie MeSH
• nemoci rekta * etiologie   patofyziologie   MeSH
• pánevní dno * patofyziologie   diagnostické zobrazování   zranění   MeSH
• poporodní období MeSH
• těhotenství MeSH
• vedení porodu * škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH

PURPOSE: Exercise-based cancer rehabilitation via digital technologies can provide a promising alternative to centre-based exercise training, but data for cancer patients and survivors are limited. We conducted a meta-analysis examining the effect of telehealth exercise-based cancer rehabilitation in cancer survivors on cardiorespiratory fitness, physical activity, muscle strength, health-related quality of life, and self-reported symptoms. METHODS: PubMed, Web of Science, and reference lists of articles related to the aim were searched up to March 2023. Randomized controlled clinical trials were included comparing the effect of telehealth exercise-based cancer rehabilitation with guideline-based usual care in adult cancer survivors. The primary result was cardiorespiratory fitness expressed by peak oxygen consumption. RESULTS: A total of 1510 participants were identified, and ten randomized controlled trials (n = 855) were included in the meta-analysis. The study sample was 85% female, and the mean age was 52.7 years. Meta-analysis indicated that telehealth exercise-based cancer rehabilitation significantly improved cardiorespiratory fitness (SMD = 0.34, 95% CI 0.20, 0.49, I2 = 42%, p < 0.001) and physical activity (SMD = 0.34, 95% CI, 0.17, 0.51, I2 = 71%, p < 0.001). It was uncertain whether telehealth exercise-based cancer rehabilitation, compared with guideline-based usual care, improved the quality of life (SMD = 0.23, 95%CI, -0.07, 0.52, I2 = 67%, p = 0.14) body mass index (MD = 0.46, 95% CI, -1.19, 2.12, I2 = 60%, p = 0.58) and muscle strength (SMD = 0.07, 95% CI, -0.14, 0.28, I2 = 37%, p = 0.51). CONCLUSION: This meta-analysis showed that telehealth exercise cancer rehabilitation could significantly increase cardiorespiratory fitness and physical activity levels and decrease fatigue. It is uncertain whether these interventions improve quality of life and muscle strength. High-quality and robust studies are needed to investigate specific home-based exercise regimens in different cancer subgroups to increase the certainty of the evidence.

• MeSH
• cvičení MeSH
• kardiorespirační zdatnost * MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory * rehabilitace   MeSH
• přežívající onkologičtí pacienti MeSH
• randomizované kontrolované studie jako téma MeSH
• svalová síla * MeSH
• telemedicína MeSH
• telerehabilitace MeSH
• terapie cvičením * metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

• MeSH
• cisplatina terapeutické užití   MeSH
• gemcitabin * MeSH
• lidé MeSH
• nádory močového měchýře * farmakoterapie   MeSH
• neoadjuvantní terapie MeSH
• nivolumab terapeutické užití   MeSH
• protokoly protinádorové kombinované chemoterapie terapeutické užití   MeSH
• svaly MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze II MeSH

• MeSH
• neurologie MeSH

• Konspekt
• Patologie. Klinická medicína
• Učební osnovy. Vyučovací předměty. Učebnice
• NLK Obory
• neurologie
• NLK Publikační typ
• kolektivní monografie
• učebnice vysokých škol

Fukutinopatie patří do skupiny α-dystroglykanopatií, autosomálně recesivně dědičných myopatií kosterního svalu s variabilním postižením srdce. Onemocnění bylo objeveno v Japonsku, kde se endemicky vyskytuje ve formě Fukuyamovy vrozené svalové dystrofie. Vzácně se však vyskytuje také v jiných zemích s odlišnou genetickou architekturou. Prezentujeme případ fukutinopatie diagnostikovaný u mladého muže českého původu s dilatační kardiomyopatií, elevací kreatinkinázy a frustními známkami myopatie kosterního svalu při neurologickém vyšetření. Celoexomová sekvenace identifikovala na jedné alele patogenní variantu fukutinu (FKTN) His172Leu, která při rozsáhlé deleci exonů 1-9 na druhé alele FKTN působila jako homozygotní varianta. Kardiální i neurologický stav pacienta zůstává po čtyřech letech sledování stabilní. Recentně byla u pacienta na magnetické rezonanci (MR) mozku náhodně zjištěna rozsáhlá epidermoidní cysta čtvrté komory s útlakem mozkového kmene vyžadující neurochirurgický zákrok, která by mohla zapadat do vývojových anomálií mozku pacientů s fukutinopatiemi. V kontextu tohoto vzácného onemocnění rozebíráme diagnostiku a léčbu kardiomyopatií doprovázených onemocněním kosterního svalu.

Fukutinopathy belongs to α-dystroglykanopathies, autosomal recessive inherited skeletal muscle myopathies with a variable cardiac involvement. The disease was discovered in Japan with endemic occurrence as Fukuyama congenital skeletal dystrophy. However, it can be rarely diagnosed also in other countries with a different genetic architecture. We present a case of fukutinopathy in a young male of Czech origin with dilated cardiomyopathy and elevation of creatine phosphokinase. Neurologic assessment revealed just borderline signs of skeletal muscle myopathy. Whole-exome sequencing revealed in one allele a pathogenic missense variant of fukutin (FKTN) His172Leu, which was accompanied by a large deletion of exons 1-9 in the second allele of FKTN acting as a homozygous variant. Cardiac and neurologic status of the patient remained stable in the last four years. Recently, the patient has been diagnosed with a large epidermoid cyst of the fourth brain chamber causing a brainstem compression, which required a neurosurgical intervention. The finding could be related to congenital cerebral abnormalities seen in patients with fukutinopathies. In the context of this rare disease, we discuss diagnostics and management of cardiomyopathies associated with a skeletal muscle myopathy.

• MeSH
• dilatační kardiomyopatie etnologie   komplikace   MeSH
• komorbidita MeSH
• lidé MeSH
• mladý dospělý MeSH
• muskuloskeletální nemoci prevence a kontrola   MeSH
• svalové dystrofie etiologie   komplikace   MeSH
• syndrom Walker-Walburgové * komplikace   MeSH
• vzácné nemoci MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

This article aimed to investigate the effects of menstrual cycle phases on perceptual responses in athletes by means of systematic review and meta-analysis. The search was conducted in the PubMed, Web of Science, and Sport Discus databases considering articles with two or more menstrual phases for comparison. The PECO criteria were used for the keywords "menstrual cycle," "athletes," and "perceptual responses" with their respective entry terms. Of 1.165 records identified, 14 articles were available for the final evaluation, while eight articles were eligible for a meta-analysis. The perceptual responses evaluated in the studies were: motivation, competitiveness, sleep quality, stress, muscle soreness, fatigue, perceived effort, mood, menstrual symptoms, perceived endurance, and readiness. The meta-analysis was conducted for perceived effort only. The results showed that the level of perceived exertion does not differ two phases of the menstrual cycle (MD = 3.03, Q = 1.58, df = 1, p = 0.209), whereas RPE was 19.81 ± 0.05 and 16.27 ± 0.53 at day 1-5 and day 19-24, respectively. Two studies found statistically significant changes in motivation and competitiveness during the cycle, with better outcomes in ovulatory phase compared to follicular and luteal. One study found an increase in mood disturbance in the pre-menstrual phase (vs. mid-cycle); one decreased vigor in the menstrual phase (vs. luteal); one increased the menstrual symptoms in the follicular phase (vs. ovulation), and one study reported increased fatigue and decreased sleep quality on luteal phase (vs. follicular). The remaining studies and variables were not affected by the menstrual cycle phase. Based on the results from the studies selected, some perceptual responses are affected in different menstrual cycle phases. A "favorable" subjective response in athletes was noticed when the ovarian hormones present an increase in concentration levels compared to phases with lower concentration. Different perceptual variables and methodological approaches limit the generalization of the conclusion.

• Publikační typ
• systematický přehled MeSH

Anthocyanin-rich New Zealand blackcurrant (NZBC) may improve forearm muscle oxygenation and enhance performance in high-level rock climbers. As such, using a double-blind, randomised, cross-over design study, twelve participants performed an oxidative capacity assessment, and two successive exhaustive exercise trials (submaximal forearm muscle contractions at 60% of their maximal volitional contraction). Each visit was conducted following 7-days intake of 600 mg·day-1 NZBC extract or placebo. Oxidative capacity was estimated by calculating the oxygen half time recovery using near infrared spectroscopy. Time to exhaustion (s), impulse (kg·s), and minimum tissue saturation index (min-TSI %) were assessed during both the exercise trials. Muscle oxidative capacity was greater with NZBC (mean difference [MD] = 5.3 s, 95% confidence intervals [95% CI] = 0.4-10.2 s; p = 0.036; Cohen's d = 0.94). During the exercise trials, there was an interaction for min-TSI % (time x condition, p = 0.046; ηp2 = 0.372), which indicated a greater level of oxygen extraction during trial two with NZBC extract (MD = 9%, 95% CI = 2-15%) compared to the placebo (MD = 2%, 95% CI = 1-7%). There was a decrease in time to exhaustion (p <0.001, ηp2 = 0.693) and impulse (p = 0.001, ηp2 = 0.672) in exercise trial two, with no effect of NZBC extract. In high-level rock climbers 7-days NZBC extract improves forearm muscle oxygenation with no effect on isolated forearm muscle performance.

• MeSH
• blízká infračervená spektroskopie MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• horolezectví fyziologie   MeSH
• klinické křížové studie MeSH
• kosterní svaly fyziologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• předloktí fyziologie   MeSH
• Ribes chemie   MeSH
• rostlinné extrakty aplikace a dávkování   MeSH
• sportovní výkon fyziologie   MeSH
• spotřeba kyslíku MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH