Starting point: Cervical dystonia is a common form of focal dystonia, resulting in neck pain and the development of asymmetric neck and head postures. These abnormal postures contribute to muscular impairment, muscle imbalances, and, as a result, alteration in movement patterns. This study aimed to compare the asymmetry of cervical muscle activation pattern during cervical flexion movements between individuals with cervical dystonia and healthy young subjects. Methods: Eight individuals with cervical dystonia and eight healthy participants participated in this study. We recorded muscle activation from five pairs of cervical muscles (sternocleidomastoid, scalene, trapezius, suprahyoid, and infrahyoid) using surface electromyography. Normalized cross-correlation was used to analyze the symmetry of bilateral muscle activation. Results: The results showed significant differences in muscle activation symmetry between the cervical dystonia group and healthy subjects. Notably, patients with cervical dystonia exhibited less symmetric activation in the trapezius and sternocleidomastoid muscles compared to healthy controls (p < 0.01 and p < 0.05, respectively). Additionally, the trapezius muscle on the dystonic side lacked coordination with other cervical muscles, unlike in healthy individuals who displayed better coordination. Conclusions: These findings underline the challenges faced by individuals with cervical dystonia in achieving symmetric activation and coordination of cervical muscles. Evaluating cervical muscle activation symmetry may be a valuable approach for assessing motor impairments in these patients.
BACKGROUND: Muscle strength and postural control are essential components for performing daily living activities, particularly in older adults, and can therefore serve as screening tools for assessing fall risk in this population. METHODS: The aim of this quasi-experimental study was to evaluate the impact of a 12-week exercise intervention followed by a 2-week detraining period on lower limb strength and postural stability in older adults. The study involved 38 community-dwelling participants of Central European origin over 60 years of age. Participants underwent the measurements consisting of assessments of knee flexors and extensors strength (isokinetic dynamometer, 90° range of motion, 60°/s angular velocity, Humac Norm CSMI, Stoughton MA, USA), toe grip strength (toe grip dynamometer, Takei Scientific Instruments, Niigata, Japan), and postural stability (narrow stand, 30 s, Kistler, Switzerland). Testing was repeated three times during the study (pre-intervention, post-intervention, and post-detraining). Participants were separated into 3 groups according to the type of training: resistance training group (n = 13), proprioceptive training group (n = 14), and endurance training group (n = 11). The intervention program lasted 12 weeks, two 60-min sessions per week. A linear mixed model (LMM) predicted a change in postural stability after the resistance, proprioceptive, and endurance exercise interventions were applied. RESULTS: Results showed that knee extensor strength normalized to body mass significantly increased in the resistance training group post-intervention (p = 0.01). Toe grip strength was significantly higher after the intervention in the endurance training group (p = 0.02). A statistically significant increase in knee flexor strength was observed in the proprioceptive training group (p = 0.01). The 2-weeks detraining period revealed no statistically significant loss in training gains. The LMM found different predictions of postural stability changes related to knee extensor strength after each type of training intervention. The final LMM model explains well the variability of the dependent variable R2 = 0.866. CONCLUSIONS: These results highlight the unique characteristics of specific exercise interventions in enhancing muscular strength and postural stability, which are critical for fall prevention among older adults.
- MeSH
- Time Factors MeSH
- Exercise * physiology MeSH
- Lower Extremity * physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Linear Models MeSH
- Resistance Training * methods MeSH
- Postural Balance * physiology MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Muscle Strength * physiology MeSH
- Exercise Therapy * methods MeSH
- Accidental Falls prevention & control MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
We aimed to determine the persisting effects of various exercise modalities and intensities on functional capacity after periods of training cessation in older adults. A comprehensive search was conducted across the Cochrane Library, PubMed/MEDLINE, Scopus, and Web of Science Core Collection up to March 2024 for randomized controlled trials examining residual effects of physical exercise on functional capacity in older adults ≥ 60 years. The analysis encompassed 15 studies and 21 intervention arms, involving 787 participants. The exercise and training cessation periods ranged from 8 to 43 weeks and 4 to 36 weeks, respectively. Meta-analyses were performed using change scores from before the physical exercise to after the training cessation. The effect sizes (ES) were calculated as the standardized mean differences between the intervention and control groups' change scores. Subgroup analyses and meta-regressions explored the influence of participant characteristics, the magnitude of the effect produced by the initial training program, various exercise modalities (resistance and multicomponent training) and intensities (high and low), and subdomains of functional capacity (agility, balance, standing ability, walking ability, and stair walking). The findings revealed that exercise interventions had a significant effect on preserving functional capacity after training cessation (ES = 0.87; p < 0.01). This protective effect was consistent across various exercise modalities and intensities (ES ≥ 0.67; p ≤ 0.04). The benefits obtained during the training program were positively associated with the residual effects observed after training cessation (β = 0.73; p < 0.01), while age negatively influenced the persisting adaptations (β = -0.07; p < 0.01). Current evidence suggests that exercise-based interventions, irrespective of modality and intensity, are highly effective in preventing functional declines after training cessation among older adults.
- MeSH
- Exercise * physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Resistance Training methods MeSH
- Postural Balance physiology MeSH
- Randomized Controlled Trials as Topic MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
- Review MeSH
- Systematic Review MeSH
Spasticity often results in significant disability, which complicates rehabilitation and daily activities. This review explores the role of botulinum toxin type A (BoNT-A) in the treatment of spasticity, focusing on its effects on muscle structure and activity, function, cortical reorganization, and pain. Our findings indicate that BoNT-A injections improve motor function and gait, particularly in stroke patients, by reducing abnormal muscle activity and enhancing postural control. However, BoNT-A may also induce unwanted biomechanical changes, such as muscle atrophy and alterations in contractile elements, which could impact long-term muscle function. Regarding pain management in spasticity, BoNT-A has shown promise by reducing both peripheral and central sensitization mechanisms. Additionally, BoNT-A influences the central nervous system (CNS) by inducing cortical reorganization, which may further contribute to clinical improvements. Lastly, BoNT-A treatment requires careful consideration of individual patient characteristics to optimize outcomes and minimize side effects. A multidisciplinary approach that combines BoNT-A with physical therapy is essential to maximize functional recovery and improve the quality of life in patients with spasticity.
- MeSH
- Pain * drug therapy MeSH
- Botulinum Toxins, Type A * therapeutic use pharmacology MeSH
- Muscle, Skeletal * drug effects MeSH
- Humans MeSH
- Pain Management MeSH
- Neuromuscular Agents * therapeutic use pharmacology MeSH
- Muscle Spasticity * drug therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
BACKGROUND: Chronic low back pain (CLBP) is one of the most common musculoskeletal problems worldwide. Even though regular exercise is recommended as the primary conservative approach in treating this condition, significant part of patients lead sedentary lifestyle. Motivation to exercise is one of the variables that effects the adherence of exercise-based treatments. This study aimed to characterize the motives for exercise, as posited by self-determination theory, in persons with CLBP, and to identify subgroups (clusters) of motivational profiles in combination with socioeconomic and clinical characteristics using k-means cluster analysis. METHODS: Data were collected between September 2022 and September 2023. A total of 103 adults with CLBP completed the paper-pencil Exercise Self-Regulation Questionnaire (SRQ-E) and provided self-reported measures on anthropometric and socio-economic characteristics. Inclusion criteria were age (≥ 18 years) and non-specific CLBP (lasting longer than 12 weeks). Exclusion criteria included specific lumbar spine pathology (e.g., fracture, cancer), worsening neurological symptoms, recent injection therapy (within 3 months), and current alcohol or drug misuse. RESULTS: Three distinct motivational clusters were identified among the 103 participants: two clusters were characterized by predominantly autonomous motivation (moderately motivated cluster: 31.1%; highly motivated cluster: 54.4%), while one cluster (controlled convinced cluster: 14.6%) showed a higher level of controlled motivation. Associations were observed between the controlled cluster and factors such as higher disability scores, longer duration of pain, greater number of completed physiotherapy sessions, and elevated BMI. Notably, the controlled motivation cluster was linked with poorer clinical outcomes. CONCLUSIONS: This study provides insights into the exercise motivation of patients with CLBP, revealing that while most patients were primarily autonomously motivated, a notable subgroup exhibited lower, controlled motivation. The presence of controlled motivation was associated with worse functioning, longer pain duration, and increased utilization of physiotherapy services. Although these findings suggest a link between motivational profiles and clinical outcomes, the cross-sectional design limits causal inferences. Further research is needed to explore these relationships longitudinally. TRIAL REGISTRATION: ClinicalTrials.Gov Identifier: NCT05512338 (22.8.2022, NCT05512338).
- MeSH
- Chronic Pain * psychology therapy rehabilitation MeSH
- Exercise psychology MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Low Back Pain * psychology therapy rehabilitation MeSH
- Motivation * MeSH
- Surveys and Questionnaires MeSH
- Aged MeSH
- Exercise Therapy * methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Background and Objectives: The aim of this study was to determine the effect of immersive virtual reality used as a short-term multifaceted activity with a focus on motor and cognitive function in patients with Parkinson's Disease. The sub-objective focused on quality of life in the study group of patients. Materials and Methods: Nineteen patients (64.2 ± 12.8 years) were included in this study. Inclusion criteria for this study: adult patients in Hoehn and Yahr's stage 1-3, cooperative, with stable health status, independent and mobile. IVR therapy was performed twice a week for 20 min for one month. Input and output measurements were taken within 14 days of starting or ending therapy. The 10 Meter Walk test was used to examine and assess both comfortable and fast walking, and the Timed Up and Go (TUG) + s dual task was applied to quickly assess the highest possible level of functional mobility. The Berg Balance Scale test (BBS) was used to assess balance with a 14-item balance scale containing specific movement tasks. The standardized Parkinson's Disease Questionnaire (PDQ-39) was used to assess quality of life. Data were processed in the PAST program using a nonparametric paired Wilcoxon test. The significance level was set at α = 0.05. The value of the r score was used to evaluate the effect size. Results: A significant reduction in the time in the fast walk 10MWT (p = 0.006; r = 0.63) and TUG (p < 0.001; r = 0.80) parameter were found after therapy. Significant improvement in the BBS score was found after applied therapy (p = 0.016; r = 0.55). In the PDQ-39 questionnaire, significant improvements were found in the study group after therapy in the domains of mobility (p = 0.027; r = 0.51) and emotional well-being (p = 0.011; r = 0.58). Conclusions: The results of this study indicate a positive effect of virtual reality therapy on balance and gait, which is also good in terms of reducing the risk of falls in the study group. Therapy also promoted quality of life in the study group.
- MeSH
- Cognition physiology MeSH
- Quality of Life * psychology MeSH
- Middle Aged MeSH
- Humans MeSH
- Parkinson Disease * psychology physiopathology therapy complications MeSH
- Postural Balance physiology MeSH
- Surveys and Questionnaires MeSH
- Aged MeSH
- Virtual Reality Exposure Therapy methods MeSH
- Virtual Reality * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Background: Visceral manipulation is a soft tissue manual work technique that originates from and is classified within the Osteopathic Manipulative Technique (OMT), focusing on the fascial tissue mobilisation of the visceral system. Manual therapy on internal organs is based on anatomy, physiology and physics. Methods: Sixty women with endometriosis and pelvic organ prolapse, aged 41.5 ± 12.02, participated in the study. The women had manipulation therapy once a week for 5 weeks. The World Health Organisation Quality of Life BREF questionnaire and a postural stability assessment were administered before and after performing visceral manipulation. Results: The p-value = 0.0093 obtained in the group with prolapses and the p-value = 0.0001 in the group with endometriosis indicated that the applied visceral manipulation improved the women's quality of life. No effect of therapy was observed on postural stability. Conclusions: Visceral manipulation improved the quality of life of both study groups of women. A significant difference was also observed when comparing the two groups for area.
- Publication type
- Journal Article MeSH
INTRODUCTION: Upper limb (UL) impairment is common in people with multiple sclerosis (pwMS), and functional recovery of the UL is a key rehabilitation goal. Technology-based approaches, like virtual reality (VR), are increasingly promising. While most VR environments are task-oriented, our clinical approach integrates neuroproprioceptive 'facilitation and inhibition' (NFI) principles. To advance this, we developed immersive VR software based on NFI principles targeting UL function and sit-to-stand ability. This study aims to evaluate the effectiveness of this VR therapy compared with conventional NFI-based physical therapy in pwMS. Our study uniquely applies advanced imaging techniques, along with biological molecular assessments, to explore adaptive processes induced by VR rehabilitation. METHODS AND ANALYSIS: This double-arm, randomised, assessor-blinded, controlled trial runs over 2 months (1 hour, 2 times per week). PwMS with mild to severe disability will receive either VR therapy or real-world physical therapy. Primary outcomes include the nine-hole peg test, box and block test, handgrip strength, tremor and five times sit-to-stand test. Secondary measures include the Multiple Sclerosis Impact Scale, the 5-level EQ-5D questionnaire and kinematic analysis. Adaptive processes will be monitored using imaging techniques (functional MRI and tractography), molecular genetic methods (long non-coding RNAs) and immune system markers (leukocytes, dendritic cells). The International Classification of Functioning, Disability and Health brief set for MS will map the bio-psycho-social context of participants. ETHICS AND DISSEMINATION: This project and its amendments were approved by the Ethics Committee of the Institute for Clinical and Experimental Medicine and Thomayer Hospital (1983/21+4772/21 (G-21-02) and the Ethics Committee of Kralovske Vinohrady University Hospital (EK-VP/38/0/2021) in Prague, Czechia (with single enrolment). The findings of this project will be disseminated through scientific publications, conferences, professional networks, public engagement, educational materials and stakeholder briefings to ensure a broad impact across clinical, academic and public domains. TRIAL REGISTRATION NUMBER: clinicaltrials.gov (NCT04807738).
- MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Upper Extremity * physiopathology MeSH
- Quality of Life * MeSH
- Humans MeSH
- Magnetic Resonance Imaging * methods MeSH
- Posture MeSH
- Randomized Controlled Trials as Topic MeSH
- Multiple Sclerosis * diagnostic imaging MeSH
- Hand Strength MeSH
- Physical Therapy Modalities * MeSH
- Virtual Reality Exposure Therapy methods MeSH
- Virtual Reality MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial Protocol MeSH
Jednou z hlavních herních činností jednotlivce, na které záleží úspěch či neúspěch týmu v plážovém volejbale, je nahrávka. Nahrávka je činnost charakterizována jako odbití míče po přihrávce k vybranému smečaři. Jednou z hlavních svalových skupin, které jsou pro plážové volejbalisty důležité jsou hamstringy. Hamstringy pomáhají s flexí dolní končetiny v koleni a pomáhají s extenzí dolní končetiny v kyčelním kloubu. Studie si klade za cíl posoudit aktivitu hamstringů u vybrané herní činnosti. Studie předpokládá, že zapojení pravé a levé strany při nahrávce spodem i při nahrávce vrchem bude stejné. Zároveň je předpokládem, že u nahrávky spodem obouruč, bude aktivita hamstringů vyšší než u nahrávky vrchem obouruč. Hlavní použitou metodou pro sběr dat bylo měření pomocí povrchové elektromyografie. Pro sběr dat byl použit přístroj Ultium (Noraxon, USA), společně s kamerovým systémem Nixon. Pro zpracování dat bylo použito prostředí pro statistické výpočty R. Pro výpočet testových kritérií byl použit Mannův-Whitney U test. Z jeho výsledků vyplývá, že strany jsou do nahrávky zapojené symetricky. Nicméně statisticky významný rozdíl se projevuje mezi nahrávkou pomocí odbití vrchem a odbitím spodem u pravého bicepsu (P = 0,0337) i u pravého semitendinosus (P = 0,0097). Z výsledků můžeme konstatovat, že u nahrávky by nemělo docházet ke svalovým dysbalancím.
One of the main playing activities of an individual that depends on the success or failure of a team is setting. The setting is characterised by the action as the beating of a ball after a pass to the attacker. One of the main muscle groups that are important to beachvolleyball players is hamstrings. Hamstrings help with lower leg flexion in the knee and help with lower leg extension in the hip joint. The study aims to assess hamstring activity in selected gaming activity. We assume that the involvement of the right and left sides in the setting at the bottom and in the setting at the top will be the same.The main method used for data collection was measurement using surface electromyography. The Ultium (Noraxon, USA) instrument was used to collect the data, along with the Nixon camera system.Mann Whitney U test was used for statistical calculations The results indicate that the parties are symmetrically involved in the setting. However, a statistically significant difference occurs between the setting using the upper and lower strokes of the right bicep (P = 0,0337) and the right semitendinosus (P = 0,0097). We can conclude from the results that there should be no muscular imbalance in the setting.
- MeSH
- Data Analysis MeSH
- Biomechanical Phenomena physiology MeSH
- Electromyography methods MeSH
- Humans MeSH
- Adolescent MeSH
- Musculoskeletal System MeSH
- Postural Balance physiology MeSH
- Videotape Recording methods MeSH
- Volleyball * statistics & numerical data MeSH
- Hamstring Muscles * physiology MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Clinical Study MeSH
- Research Support, Non-U.S. Gov't MeSH
