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Introduction: Creatine (Cr) is an effective and safe ergogenic supplement that enhances post-exercise recovery, prevents injuries, supports thermoregulation, and provides benefits in rehabilitation, as well as spinal and cerebral neuroprotection for adults and older individuals. However, the evidence regarding its benefits in the pediatric population across various contexts has not been conclusive. Objective: Analyze the impact of different doses of Cr on physical performance and muscle function in children and adolescents in general through a systematic review of the literature. Materials and methods: This review followed the PRISMA reporting guidelines in the electronic databases of PubMed/Medline and Google Scholar. It included controlled clinical trials conducted between 1997 and May 2023 that assessed the effect of Cr supplementation on muscle function and physical performance in children and adolescents. A total of 20 studies were included. Results: The subjects included young high-performance athletes from different disciplines and children or adolescents diagnosed with pathologies affecting muscle function. Significant effects were found in athletes' physical performance and muscular function at various doses and periods of supplementation, unlike those involving a pathology, which mainly did not present improvements in these variables. Conclusions: Some reports suggest a positive effect on physical performance, specifically in young athletes. However, the Cr doses, posology, and administration protocols vary between studies(AU)

Introducción: La creatina (Cr) es un suplemento ergogénico eficaz y seguro que mejora la recuperación post-ejercicio, previene lesiones, favorece la termorregulación y proporciona beneficios en la rehabilitación, así como neuro protección tanto espinal como cerebral para adultos y personas mayores. No obstante, la evidencia sobre sus beneficios en la población pediátrica en diversos contextos aún no ha sido concluyente. Objetivo: Analizar el impacto de diferentes dosis de Cr sobre el rendimiento físico y la función muscular en niños y adolescentes de forma general mediante una revisión sistemática de la literatura. Materiales y métodos: Esta revisión se llevó a cabo mediante la pauta del informe PRISMA en las bases de datos electrónicas de PubMed/Medline y Google Scholar, se incluyeron ensayos clínicos controlados realizados entre 1997 y mayo de 2023 que evaluaron el efecto de la suplementación con Cr en niños y adolescentes sobre la función muscular y el rendimiento físico. Se incluyeron un total de 20 estudios. Resultados: Los sujetos incluyeron jóvenes deportistas de alto rendimiento de diferentes disciplinas y niños o adolescentes diagnosticados con algunas patologías que afectan la función muscular. Se encontraron efectos significativos en el rendimiento físico y la función muscular de los deportistas con diferentes dosis y periodos de suplementación, a diferencia de aquellos que involucran una patología que en su mayoría no presentaron mejoras en estas variables. Conclusiones: Algunos informes sugieren un efecto positivo en el rendimiento físico, especialmente en jóvenes atletas. Sin embargo, las dosis de creatina, así como los regímenes de dosificación y los protocolos de administración, varían entre los estudios(AU)

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Post-Covid-19 Syndrome (PCS) is a condition that causes persistent symptoms and impacts nutritional status such as loss of muscle mass. The objective of this study was to review and map scientific evidence on nutritional management in the loss of muscle mass in patients with PCS. The scoping review protocol was prepared following the PRISMA-ScR guidelines. Review articles not written in English or those that included only hospitalized patients and pertained to conditions other than PCS were excluded. Data extraction followed the methodology outlined by the Cochrane Review Group. Of the 81 articles initially identified, only five met the inclusion criteria. The selected studies emphasized the importance of recovering muscle mass, higher protein and caloric intake, and physical strength exercises. Consequently, nutritional interventions aimed at mitigating muscle mass loss should prioritize strategies that increase caloric and protein consumption.

A Síndrome Pós-covid-19 (SPC) é uma condição que acarreta sintomas persistentes e impactam o estado nutricional, como a perda de massa. O objetivo deste estudo foi realizar revisão para mapear evidências científicas acerca do manejo nutricional na perda de massa muscular em pacientes com SPC. O protocolo da revisão de escopo foi elaborado de acordo com o PRISMA-ScR. Foram excluídos artigos de revisão que não estivessem em inglês ou português, que incluíssem apenas pacientes hospitalizados e com outras condições que não a SPC. Os dados foram extraídos com base no Cochrane Review Group. 81 artigos foram identificados e a amostra final incluiu cinco estudos. Para a recuperação da massa muscular, maior ingestão proteica, calórica e exercícios físicos de força foram descritos nos estudos. A intervenção nutricional para recuperar a perda de massa muscular deve considerar estratégias que visam o aumento do consumo calórico e proteico.

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Objective: To analyze the muscle mass and cross-sectional area of the muscular fiber of the hemiparetic soleus in an animal model, in order to identify the muscular adaptations that occur in ischemic stroke.Method: Twelve Rattus norvegicus were divided into 2 groups: stroke group (n=6) and control group (n=6). Each group was subdivided into two subgroups, with evaluations at 7 days (CG7 and SG7) and 21 days (CG21 and SG21) after the accident. Their soleus muscles were removed for muscle mass analysis and cross-sectional area of the muscular fibers (CSAMF) measurement. The adopted statistical significance was 5%.Result: Significant differences in the muscle mass were observed between CG7 (0.120 ± 0.005 g) vs. SG7 (0.100 ± 0.004 g; p=0.035), and between CG21 (0.130 ± 0.010 g) vs. SG21 (0.078 ± 0.006; p=0.012). Significant differences in the relative muscle mass were observed between CG7 (0.044 ± 0.002 g) vs SG7 (0.039 ± 0.003; p=0.025), and CG21 (0.044 ± 0.003) vs. SG21 (0.028 ± 0.002; p=0.011). The CSAMF showed significant differences between CG7 (2,322 µm2 [2312-2453]) vs. SG7 (2,056 µm2 [2,022-2,135]; p=0.012), and CG21 (2,667 µm2 [2,692-2,845]) vs. SG21 (2,050 µm2 [2,034-2,161]; p=0.006).Conclusion: In this study in animal models of ischemic stroke, there was a significant loss of muscle mass, and this loss was accentuated in the longer term of the injury, highlighting the importance of future research on types of muscle fibers and applicability in human patients

Objetivo: Analisar a massa muscular e a área de secção transversal da fibra muscular do sóleo hemiparético em um modelo animal, a fim de identificar as adaptações musculares que ocorrem no acidente vascular cerebral isquêmico.Método: Doze Rattus norvegicus foram divididos em 2 grupos: grupo AVC (n=6) e grupo controle (n=6). Cada grupo foi subdividido em dois subgrupos, com avaliações aos 7 dias (CG7 e SG7) e 21 dias (CG21 e SG21) após o acidente. O músculo sóleo foi removido para análise de massa muscular e medição da área de secção transversal das fibras musculares (CSAMF). O nível de significância estatística adotado foi de 5%.Resultado: Diferenças significativas na massa muscular foram observadas entre CG7 (0,120 ± 0,005 g) vs. SG7 (0,100 ± 0,004 g; p=0,035), e entre CG21 (0,130 ± 0,010 g) vs. SG21 (0,078 ± 0,006; p=0,012). Diferenças significativas na massa muscular relativa foram observadas entre CG7 (0,044 ± 0,002 g) vs. SG7 (0,039 ± 0,003; p=0,025), e CG21 (0,044 ± 0,003) vs. SG21 (0,028 ± 0,002; p=0,011). A CSAMF mostrou diferenças significativas entre CG7 (2.322 µm2 [2.312-2.453]) vs. SG7 (2.056 µm2 [2.022-2.135]; p=0,012), e CG21 (2.667 µm2 [2.692-2.845]) vs. SG21 (2.050 µm2 [2.034-2.161]; p=0,006).Conclusão: Neste estudo em modelos animais de acidente vascular cerebral isquêmico, houve uma perda significativa de massa muscular, e essa perda foi acentuada no longo prazo da lesão, destacando a importância de futuras pesquisas sobre tipos de fibras musculares e aplicabilidade em pacientes humanos

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Objective: To synthesize evidence involving pathophysiological and clinical-epidemiological linking mechanisms in women with breast cancer and metabolic syndrome. Method: This is a structured scoping review according to the Joanna Briggs Institute and was conducted in the PubMed, BDENF, LILACS, IBECS, CUMED, WPRIM, BINACIS, and Embase databases. This review is registered in the Open Science Framework. Result: Regarding the level of evidence of the included studies, moderate and strong evidence levels were predominant. There were no weak evidence findings in this research. The chronic inflammatory state of breast adipose tissue in patients with obesity can worsen the negative impact on cancer cells, directly affecting survival and recurrence. Unexplained weight gain or loss is associated with shorter survival in women with breast cancer, highlighting the need for specific guidance during treatment. Conclusion: Metabolic syndrome is associated with the risk of breast cancer; however, massive weight loss during active disease can be associated with a worse prognosis and should therefore be prevented. Patients should be advised to maintain a stable weight during chemotherapy and to receive guidance on adequate nutrition and physical activity to increase muscle mass

Objetivo: Sintetizar as principais evidências envolvendo os mecanismos de ligação fisiopatológico e clínico-epidemiológico em mulheres com câncer de mama e a síndrome metabólica. Método: Trata-se de uma revisão de escopo estruturada conforme o Instituto Joanna Briggs, realizado nas bases de dados PubMed, BDENF, LILACS, IBECS, CUMED, WPRIM, BINACIS e Embase. Esta revisão encontra-se protocolada no Open Science Framework. Resultado: Com relação ao nível de evidência dos estudos inclusos, houve predominância para níveis fortes de evidência. Não houve achados de evidência fraca nesta pesquisa. O estado inflamatório crônico do tecido adiposo mamário em casos de obesidade pode agravar o impacto negativo nas células cancerígenas, afetando diretamente a sobrevida e recorrência. Ganho ou perda de peso inexplicável estão associados a uma menor sobrevida em mulheres com câncer de mama, sublinhando a necessidade de orientações específicas durante o tratamento. Conclusão: A síndrome metabólica esta associada ao risco de câncer de mama, entretanto, a perda maciça de peso durante a doença ativa pode ser um fator de pior prognóstico, devendo assim, ser realizada de forma preventiva. Os pacientes devem ser orientados a manter um peso estável durante a quimioterapia e receber orientações sobre alimentação adequada e atividade física em busca de aumento de massa muscular

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El músculo extensor digitorum brevis manus es una variante de los extensores de la mano. Se trata de un músculo supernumerario en el dorso de la muñeca ubicado en el cuarto compartimento extensor. Suele ser asintomático, pero ocasionalmente se presenta como una masa dolorosa; en estos casos, está indicado el tratamiento quirúrgico que consiste en la resección del músculo o la liberación del retináculo extensor del cuarto compartimento. Presentamos a una paciente de 30 años, con una masa dolorosa en el dorso de la mano izquierda. Según las evaluaciones clínica y ecográfica, se sospechó un ganglión y se programó la resección quirúrgica. En la cirugía, se encontró tejido muscular compatible clínicamente con el extensor digitorum brevis manus, y se liberó el retináculo extensor. Los estudios publicados sobre su incidencia y prevalencia son escasos y, en su mayoría, se trata de informes post mortem, por lo que este caso presentado reviste particular interés. Nivel de Evidencia: IV

The extensor digitorum brevis manus muscle is a variant of the hand extensors. It is a supernumerary muscle on the dorsum of the wrist, located in the fourth extensor compartment. It is usually asymptomatic, but when it causes discomfort, it manifests as a painful mass. When it is symptomatic, surgical treatment is recommended, which may include muscle excision or extensor retinaculum release. We present a 30-year-old patient with a painful mass on the dorsum of the left hand; clinically, a ganglion was suspected and scheduled for surgical resection. She underwent surgery and was diagnosed with symptomatic EDBM, which was treated with extensor retinaculum release. EDBM was found incidentally in a cadaveric dissection; therefore, its true incidence is unknown. EDBM originates in the wrist joint capsule, below the dorsal radiocarpal ligament; its distal insertion is the ulnar side of the extensor mechanism in the metacarpophalangeal joint where it is present. Innervated by the posterior interosseous, research has shown that its purpose is to extend and deviate the finger towards the side where it is inserted. This case is particularly interesting given the scarcity of information on its incidence and prevalence, with the majority of that information coming from postmortem reports. Level of Evidence: IV

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Introducción: Existen diferentes causas que impiden el movimiento muscular en una persona, para las cuales en algunos casos no existe un tratamiento médico que detenga el progreso de la enfermedad; sin embargo, existen ayudas tecnológicas que permiten a las personas con discapacidad mejorar sus habilidades para ayudarlos a vivir de forma autónoma y participar en sociedad. La tecnología asistida ha desarrollado múltiples opciones para mejorar la calidad de vida de estos pacientes. Objetivo: Evaluar el impacto de la implementación de un dispositivo en personas con discapacidad motriz en el municipio de Montería-Córdoba, Colombia. Para lo cual se establece el diseño, la construcción e implementación del dispositivo y, por último, se evalúa su impacto. Métodos: La investigación es de tipo tecnológico-descriptivo, debido a que, además del análisis de resultados, se experimentó en la población objeto de estudio. Para ello se tuvieron en cuenta criterios como tipo de discapacidad, edad promedio e influencia socioeconómica. Resultados: Se evaluó el impacto del dispositivo Helpbot, que interactúa con el usuario y facilita la realización de movimientos. Entre las características del dispositivo están ser portátil, inalámbrico e interfaz entre el humano y la máquina. Conclusiones: Los usuarios manifestaron sentirse cómodos con el artefacto; les facilitó el desarrollo de los ejercicios terapéuticos. El impacto positivo del dispositivo se refleja en la medida en que el 100 por ciento de la población recomendaría el dispositivo electrónico, por lo que la intervención fue exitosa(AU)

Introduction: There are different causes that prevent muscle movement in a person, for which in some cases there is no medical treatment that stops the progress of the disease. However, there are technological aids that allow individuals with disabilities to improve their skills to help them live autonomously and participate in society. Assisted technology has developed multiple options to improve the quality of life of these patients. Objective: To evaluate the impact of the implementation of a device in people with motor disabilities in the municipality of Montería-Córdoba, Colombia. A design, construction and implementation of the device is established and, finally, its impact is evaluated. Methods: The research is a technological-descriptive type, because, in addition to the analysis of results, it was experimented on the population under study. To this end, criteria such as type of disability, average age and socioeconomic influence were taken into account. Results: The impact of Helpbot device, which interacts with the user and facilitates the execution of movements, was evaluated. Among the features of the device are being portable, wireless and interface between human and machine. Conclusions: Users stated that they felt comfortable with the artifact. It facilitated the development of therapeutic exercises. The positive impact of the device is reflected in the extent to which 100percent of the population would recommend the electronic device, therefore the intervention was successful(AU)

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Abstract This study evaluated the effect of the volatile oil of Alpinia zerumbet (VOAz) on caveolin-1 gene expression and muscular fibrosis. The rats were immobilized to induce fibrosis of the gastrocnemius muscle, and they were treated with VOAz. Collagen quality was assessed by histology and the expression of the caveolin-1 (CAV-1) gene was evaluated using qPCR. Histomorphological analysis indicated a significant reduction in the perimeter, width, and intensity of collagen in the treated groups, thus showing that the oil was effective in regulating the quality of collagen at the three concentrations. The results of expression levels suggested a decrease in the lesioned group and in two treatment groups (0.0115 µg/g and 0.009 µg/g). However, with the lowest concentration (0.0065 µg/g), no significant difference was observed, with levels similar to those found in healthy tissue. Therefore, the results showed that VOAz has the potential to be a non-invasive and low-cost alternative to aid in the treatment of muscular fibrosis.

Resumo Este estudo avaliou o efeito do óleo volátil de Alpinia zerumbet (OVAz) na expressão do gene da caveolina-1 e na fibrose muscular. Os ratos foram imobilizados para induzir a fibrose do músculo gastrocnêmio, e foram tratados com OVAz. A qualidade do colágeno foi avaliada com histologia e à expressão do gene caveolina-1 (CAV-1) foi avaliada usando qPCR. A análise histomorfológica indicou uma redução significativa no perímetro, largura e intensidade do colágeno nos grupos tratados. Os resultados dos níveis de expressão sugeriram diminuição nos grupos de lesão e em dois grupos de tratamento (0,0115 µg/g e 0,009 µg/g). No entanto, com a menor concentração (0,0065 µg/g), não foi observada diferença significativa, apresentando níveis semelhantes aos encontrados em tecido saudável. O uso do OVAz foi eficaz para reverter as alterações do colágeno causadas pela fibrose, e sua menor concentração apresentou uma possível tendência de aumento na expressão do CAV-1. Portanto, os resultados mostraram que o OVAz tem potencial para ser uma alternativa não invasiva e de baixo custo para auxiliar no tratamento da fibrose muscular.

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El músculo esquelético (ME), debido a su significativo tamaño y función, representa el tejido que más energía demanda durante la actividad física. En respuesta a esta demanda, ha desarrollado un sistema altamente especializado para almacenar energía y satisfacer sus necesidades metabólicas. Para alcanzar esta eficacia en el almacenamiento y abastecimiento de nutrientes, en particular de glucosa, el ME depende de una incorporación nutricional eficaz. La relación entre la insulina y el ejercicio ilustra un ejemplo de equilibrio complejo y de adaptación, en el que dos fuerzas reguladoras metabólicas se contraponen en contextos cambiantes. El aumento de la insulina en la sangre comunica al ME la presencia de niveles elevados de glucosa plasmática. Aunque la insulina se secreta tras la ingesta y es la principal hormona que aumenta el almacenamiento de glucosa y ácidos grasos en forma de glucógeno y triglicéridos, respectivamente, el ejercicio es una situación fisiológica que exige la movilización y oxidación de las reservas energéticas. Por lo tanto, durante la actividad física, los efectos del almacenamiento inducidos por la insulina deben mitigarse median-te la inhibición de la liberación de insulina durante el ejercicio, y la activación de los mecanismos sistémicos y locales de movilización de energía. La interacción de la insulina con su receptor da lugar a una compleja cascada de señales que promueve la captación de glucosa y la síntesis de glucógeno. Uno de los efectos más estudiados de la señalización insulínica en él ME es el incremento en la captación de la glucosa muscular. Tanto la insulina como la actividad contráctil aumentan la entrada de glucosa en el ME, proceso que involucra la translocación y fusión de vesículas que contienen el transportador de glucosa GLUT-4 en la membrana (GSV: vesículas de almacenamiento de GLUT-4). Así, los estímulos mencionados provocan el traslado de las GSV hacia la superficie celular, donde se fusionan, lo que aumenta la presencia de GLUT-4 y favorece la captación de glucosa del entorno intersticial. Este proceso de fusión se conoce como "exocitosis de GLUT-4". Tras la actividad física, es necesario reponer las reservas de energía consumidas, en especial, el glucógeno en el músculo. El proceso se ve favorecido por un aumento de la sensibilidad a la insulina en los músculos previamente ejercitados, lo que facilita la utilización de la glucosa en la resíntesis del glucógeno. Este trabajo de revisión abarca los nuevos actores de la cascada de señalización de la insulina, el transporte de GLUT-4 y las interacciones insulina-ejercicio durante y después de la actividad física. Además, explora los efectos del entrenamiento físico regular sobre la acción de la insulina (AU)

Skeletal muscle (SM) due to its significant size and function, represents the most energetically demanding tissue during physical activity. Based on this demand, SM has developed a highly specialized system for energy storage to meet its metabolic requirements. To achieve efficiency in nutrient storage and supply, particularly glucose, SM relies on effective nutritio-nal incorporation. The relationship between insulin and exercise illustrates a complex example of balance and adaptation, wherein two regulatory metabolic forces counteract within changing contexts.The increase in blood insulin communicates the presence of elevated glucose levels in the plasma to SM. Although insulin is secreted post-intake and is the primary hormone respon-sible for increasing the storage of glucose and fatty acids in the form of glycogen and triglycerides, respectively, exercise constitutes a physiological situation that demands the mobili-zation and oxidation of energy reserves. Consequently, during physical activity, it is necessary to mitigate the storage effects promoted by insulin. This is achieved by inhibiting insulin release during exercise and activating systemic and local mecha-nisms for energy mobilization.The interaction of insulin with its receptor results in a complex cascade of signals that promote glucose uptake and glycogen synthesis. One of the most studied effects of insulin signalingin SM is the increase in muscular glucose uptake. Both insulin and contractile activity augment glucose entry into SM, a process involving the translocation and fusion of vesicles containing the glucose transporter GLUT-4 in the membrane (GSVs: GLUT-4 storage vesicles). Thus, these stimuli trigger the movement of GSVs to the cell surface, where they fuse, increasing the presence of GLUT-4 and promoting the up-take of glucose from the interstitial environment. This fusion process is known as "GLUT-4 exocytosis".Post-physical activity, replenishing the consumed energy reserves, especially muscle glycogen, becomes necessary. This process is enhanced by an increase in insulin sensitivity in pre-viously exercised muscles, facilitating the utilization of glucose in glycogen resynthesis. This review encompasses new contributors in the insulin signaling cascade, GLUT-4 transport, and insulinexercise interactions during and after physical activity. Additionally, it explores the effects of regular physical training on insulin action(AU)

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Introducción: la fusión intersomática lumbar oblicua (OLIF) es una alternativa mínimamente invasiva a la fusión intersomática abierta tradicional. Permite al cirujano acceder al espacio discal mediante un abordaje retroperitoneal anterior al músculo psoas. Tiene la ventaja teórica de preservar los ligamentos longitudinales, aumentar la altura del disco con descompresión indirecta de los elementos neurales e inserción de cajas de mayor tamaño. Objetivo: evaluar los resultados clínicos de una serie consecutiva de 32 pacientes sometidos a fusión intersomática lumbar oblicua por enfermedad degenerativa de la columna lumbar. Material y métodos: treinta y dos pacientes con hallazgos radiológicos de enfermedad degenerativa de la columna lumbar fueron tratados mediante OLIF entre enero de 2017 y junio de 2019. Los resultados clínicos se evaluaron mediante el índice de discapacidad de Oswestry (ODI), la escala analógica visual (EVA) para el dolor de espalda y EVA para el dolor de extremidades inferiores, antes de la cirugía y en el primer año de seguimiento. Además, se revisaron retrospectivamente los siguientes parámetros: edad, sexo, tipo de enfermedad degenerativa, número de niveles de fusión, tiempo operatorio, duración de la estancia hospitalaria y complicaciones quirúrgicas. Resultados: se implantaron 42 cajas intersomáticas en 32 pacientes. El 56,25% de los pacientes eran mujeres, con una edad media de 56 (30-79) años. El número de niveles fusionados fue 1 en 21 pacientes (65,6%), 2 en 7 pacientes (21,9%) y 3 en 4 pacientes (12,5%). El nivel de fusión fue L1-L2 en 2 pacientes (4,76%), L2-L3 en 7 pacientes (16,67%), L3-L4 en 12 pacientes (28,57%) y L4-L5 en 21 pacientes (50%). El tiempo operatorio medio fue de 153,13 (88-210) minutos y el tiempo medio de estancia hospitalaria fue de 2,53 días (1-5). El análisis estadístico mostró significancia para los resultados en ODI, EVA para el dolor de espalda y EVA para el dolor de extremidades inferiores. Un toral de 4 pacientes presentaron paresia transitoria del psoas por tracción del músculo. Tres pacientes presentaban entumecimiento transitorio de la ingle y el muslo, y un paciente tuvo una lesión del plexo simpático. Conclusión: la fusión intersomática lumbar oblicua ofrece a los pacientes una opción de tratamiento quirúrgico seguro y eficaz para tratar la enfermedad degenerativa de la columna lumbar(AU)

Background: oblique lumbar interbody fusion (OLIF) is a minimally invasive alternative to traditional open interbody fusion. It allows the surgeon to access the disc space via a retroperitoneal approach anterior to the psoas muscle. It has the theoretical advantage of preservation of the longitudinal ligaments, augmentation of the disc height with indirect decompression of neural elements and insertion of large footprint cages. Objective: the purpose of this study was to asses the clinical outcomes of a consecutive series of 32 patients who underwent oblique lumbar interbody fusion for degenerative lumbar spine disease. Methods: thirty-two patients with radiological findings of degenerative lumbar spine disease had undergone OLIF between January 2017 and June 2019. Clinical outcomes were assessed by means of Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for back pain and VAS for leg pain, before surgery and at first year follow-up. Furthermore, the following parameters were retrospectively reviewed: age, gender, type of degenerative disease, number of levels of fusion, operative time, length of hospital stay and surgical complications. Results: 42 interbody cages were implanted in 32 patients. 56,25% of the patients were female, with a mean age of 56 years. The number of fused levels was 1 in 21 patients (65,6%), 2 in 7 patients (21,9%) and 3 in 4 patients (12,5%). The fused level was L1-L2 in 2 patients (4,76%%), L2-L3 in 7 patients (16,67%%), L3-L4 in 12 patients (28,57%) and L4-L5 in 21 patients (50%). The mean operative time was 153,13 (88-210) minutes and the mean length of hospital stay was 2,53 days (1-5). Statistical analysis showed significance for the results in ODI, VAS for back pain and VAS for leg pain. 4 patients presented transient psoas paresis from traction of the muscle. Transient groin and thigh numbness was present on three patients and one patient had a sympathetic plexus injury. Conclusion: OLIF offers patients a safe and effective surgical treatment option to treat degenerative lumbar spine disease(AU)

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La sarcopenia asociada a la edad es una condición clínica caracterizada por una disminución en la fuerza, calidad y cantidad de masa muscular así como también en la función muscular. Un biomarcador se define como una característica que es medible objetivamente y evaluable como indicador de un proceso biológico normal, patológico o respuesta terapéutica a una intervención farmacológica. Los marcadores bioquímicos propuestos para el estudio de la sarcopenia pueden ser categorizados en dos grupos. El primero de ellos evalúa el estatus musculoesquelético; este panel de marcadores está formado por miostatina/folistatina, procolágeno aminoterminal tipo III e índice de sarcopenia. El segundo grupo de marcadores bioquímicos evalúa factores causales, para lo cual se sugiere medir el factor de crecimiento insulino-símil tipo 1 (IGF-1), dehidroepiandrosterona (DHEAS), cortisol, facto-res inflamatorios [proteína C reactiva (PCR), interleuquina 6 (IL-6) y factor de necrosis tu-moral (TNF-a)]. Las recomendaciones realiza-das están basadas en la evidencia científica disponible en la actualidad y la disponibilidad de la metodología apropiada para cada uno de los biomarcadores. (AU)

Sarcopenia is a progressive and generalized skeletal muscle disorder defined by decrease in the strength, quality and quantity of muscle mass as well as in muscle function. A biomarker is defined as a feature objectively measured and evaluated as an indicator of a normal biologic process, a pathogenic process or a pharmacologic response to therapeutic intervention. The biochemical markers proposed for the study of sarcopenia may be classified in two groups. The first group evaluates the musculoskeletal status, made up by myostatin/follistatin, N-terminal Type III Procollagen and the sarcopenia index. The second evaluates causal factors, where the measurement of the following is suggested: hormones insulin-like growth factor-1 (IGF-I), dehydroepiandrosterone sulphate (DHEAS), cortisol, inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-a (TNF-a)]. The recommendations made are based on scientific evidence currently available and the appropriate methodology availability for each biomarker. (AU)

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Introducción: el judo es un deporte de combate cuya clasificación competitiva depende del peso corporal, lo cual está destinado a promover competencias parejas y equitativas en cuanto a capacidades físicas se refiere. El avance de las ciencias del entrenamiento y de la nutrición deportiva generó una mejora de la composición corporal en los deportistas, redundando en un aumento de los valores de masa muscular y en una disminución de la masa adiposa. El objetivo del estudio fue estimar la composición corporal de las personas que practican Judo participantes del campeonato nacional argentino del año 2021. Materiales y métodos: se realizó un estudio transversal descriptivo a los/as participantes del campeonato nacional de judo del año 2021. Fueron evaluados un total de 183 judocas (51 mujeres y 132 varones), según el protocolo de medición de la ISAK. Para la determinación de la composición corporal se utilizó el método de fraccionamiento anatómico de cinco componentes de Kerry Ross. Resultados: el promedio de las judocas fue de 30,5% para la masa adiposa y de 44,5% para la masa muscular; no se encontraron diferencias estadísticamente significativas en los distintos grupos de edad. Los varones obtuvieron un valor promedio de 22,4% para la masa adiposa y 49,1%para la masa muscular; en este caso se encontraron diferencias significativas entre los distintos grupos de edad, tanto para la masa adiposa como para la muscular y la masa ósea. Discusión: se necesitan más estudios con grupos estratificados en función de la división de peso corporal para poder establecer patrones de referencia específicos para el trabajo en ciencias del ejercicio y la nutrición. Conclusión: la optimización de la composición corporal de las personas que practican Judo redunda positivamente en la mejora de las capacidades físicas específicas. Los datos presentados constituyen una referencia específica de utilidad para la evaluación y seguimiento de las personas que practican Judo. La estratificación por grupos etarios y división de peso corporal permitirá delimitar mejor aún los valores de cada categoría de edad. Se considera relevante vincular la composición corporal con las pruebas físicas y los resultados deportivos, a fin de establecer un mejor perfil del judoca argentino. (AU)

Introduction: judo is a combat sport whose competitive classification depends on body weight, intended to promote even and equitable compe-titions in terms of physical abilities. Advances in the sciences of training and sports nutrition have led to an improvement in the body composition of athletes, resulting in an increase in muscle mass and a decrease in adipose mass. This study aimed to estimate the body composition of judo fighters participating in the 2021 Argentine National Championship. Materials and methods: we conducted a descriptive cross-sectional study of participants of the 2021 national judo championship. We evaluated 183 judokas (51 women and 132 men) applying the ISAK measurement protocol. We used the Kerry Ross five-component fractional anatomic method to determine body composition. Results: the average for female judo players was 30.5% for adipose mass and 44.5% for muscle mass; we found no statistically significant diffe-rences in the different age groups. The average value for males was 22.4% for adipose mass and 49.1% for muscle mass; in this case, we found significant differences between the different age groups for adipose mass and muscle and bone mass. Discussion: there is a need for more studies with stratified groups according to body weight division to establish specific reference standards for the work in exercise science and nutrition. Conclusion: the optimization of the body composition of female and male judo players has a positive effect on the improvement of specific physical capacities. The data presented constitute a relevant reference for the evaluation and follow-up of judokas. The stratification by age groups and body weight division will allow a better delimitation of the values of each age category. Linking body composition with physical tests and results is considered relevant to obtain a better profile of the Argentinian judo player. (AU)

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INTRODUCTION: The measurement of the adductor pollicis muscle thickness (APMT) has been investigated as an index for muscle mass and undernutrition. OBJECTIVE: However, there are few studies related to community-living older adults. METHODS: Cross-sectional study carried out with community-dwelling older adults, of both sexes. The APMT, the body mass index (BMI), arm circumference (AC), arm muscle circumference (AMC), and calf circumference (CC) were evaluated. For APMT classification, the 25th percentile value (P25 ≤9 mm) of the sample was considered to identify muscle mass deficit. Chi-square test, Pearson's correlation, and Poisson regression were performed, with a significance level of p<0.05. RESULTS: Among men, APMT showed a correlation with AC (r=0.350; p<0.01), and among women it was with BMI (r=0.337; p=0.01). There was an association between the BMI classification and the APMT percentile (p=0.020). Older adults with BMI<23 kg/m² were 1.28 times more likely to have APMT≤P25 (p=0.007) and older adults with adequate BMI were 1.23 times more likely (p=0.023). Older adults with reduced CC have a 1.18 times more chance of presenting APMT≤P25 (p=0.064). CONCLUSION: APMT has been associated with BMI in older adults, proving to be a good parameter for the assessment of malnutrition.

INTRODUÇÃO: A espessura do músculo adutor do polegar (EMAP) tem sido sugerido como um índice de massa muscular e desnutrição. OBJETIVO: Verificar a associação da EMAP com indicadores antropométricos convencionais em idosos da comunidade. MÉTODOS: Estudo transversal realizado com 159 idosos da comunidade, de ambos os sexos, com média de idade de 70,9±29,4 anos. Foram avaliados a EMAP, o índice de massa corporal (IMC), as circunferências do braço (CB), muscular do braço (CMB) e da panturrilha (CP). Para classificação da EMAP se considerou o valor do percentil 25 (P25≤9 mm) da amostra para identificar déficit de massa muscular. Teste Qui-quadrado, Correlação de Pearson e Regressão de Poisson foram realizados, sendo adotado um nível de significância de p<0,05. RESULTADOS: Entre os homens, a EMAP apresentou correlação com a CB (r=0,350; p<0,01) e entre as mulheres foi com o IMC (r=0,337; p=0,01). Houve associação entre a classificação do IMC e o percentil da EMAP (p=0,020). Os idosos com IMC<23 kg/m² tinham 1,28 vezes mais chances de possuir EMAP≤P25 (p=0,007) e idosos com IMC adequado tinham 1,23 vezes mais chance (p=0,023). Idosos com CP reduzido apresentaram 1,18 vezes mais chance de apresentar EMAP≤P25 (p=0,064). Conclusão: A EMAP apresentou associação com o IMC em idosos, demostrando ser um bom parâmetro para a avaliação da desnutrição.

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The paper summarizes professor ZHANG Wei-hua's clinical experience for the treatment of chronic somatic pain with zhidong needling techniques. In terms of the characteristics of chronic somatic pain, professor ZHANG has integrated zhidong needling with acupuncture kinetic therapy. The satisfactory therapeutic effects are obtained by selecting the painful points and regions as the treatment sites and the specific techniques of zhidong needling depending on the size of affected area, the depth of illness, the size and shape of the cord-like muscle, etc. Five techniques of zhidong needling are used accordingly with twirling, pulling, lifting and thrusting, surrounding needling methods involved, as well as with the manipulation speed, direction and frequency considered.

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BACKGROUND@#Post-operative pneumonia (POP) is a common complication of lung cancer surgery, and muscular tissue oxygenation is a root cause of post-operative complications. However, the association between muscular tissue desaturation and POP in patients receiving lung cancer surgery has not been specifically studied. This study aimed to investigate the potential use of intra-operative muscular tissue desaturation as a predictor of POP in patients undergoing lung cancer surgery.@*METHODS@#This cohort study enrolled patients (≥55 years) who had undergone lobectomy with one-lung ventilation. Muscular tissue oxygen saturation (SmtO 2 ) was monitored in the forearm (over the brachioradialis muscle) and upper thigh (over the quadriceps) using a tissue oximeter. The minimum SmtO 2 was the lowest intra-operative measurement at any time point. Muscular tissue desaturation was defined as a minimum baseline SmtO 2 of <80% for >15 s. The area under or above the threshold was the product of the magnitude and time of desaturation. The primary outcome was the association between intra-operative muscular tissue desaturation and POP within seven post-operative days using multivariable logistic regression. The secondary outcome was the correlation between SmtO 2 in the forearm and that in the thigh.@*RESULTS@#We enrolled 174 patients. The overall incidence of muscular desaturation (defined as SmtO 2 < 80% in the forearm at baseline) was approximately 47.1% (82/174). The patients with muscular desaturation had a higher incidence of pneumonia than those without desaturation (28.0% [23/82] vs. 12.0% [11/92]; P  = 0.008). The multivariable analysis revealed that muscular desaturation was associated with an increased risk of pneumonia (odds ratio: 2.995, 95% confidence interval: 1.080-8.310, P  = 0.035) after adjusting for age, American Society of Anesthesiologists status, Assess Respiratory Risk in Surgical Patients in Catalonia score, smoking, use of peripheral nerve block, propofol, and study center.@*CONCLUSION@#Muscular tissue desaturation, defined as a baseline SmtO 2 < 80% in the forearm, may be associated with an increased risk of POP.@*TRIAL REGISTRATION@#No. ChiCTR-ROC-17012627.

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Iliotibial band syndrome (ITBS), as an overused injury of the lower extremities, has developed into a common cause of lateral knee pain. At present, the treatment of ITBS includes drug therapy, muscle strength training, physical therapy, and surgical treatment. Among these methods, physical therapy, drug therapy, and surgical treatment can only alleviate the symptoms of patients. As a safe and effective treatment, lower limb muscle strength training can improve patients' muscle strength, correct abnormal gait, and reduce the recurrence rate of the disease by paying attention to the dynamic changes of patients' recovery process. At present, the pathogenesis of ITBS remains unclear, and the treatment methods are not unified. It is necessary to further study the biomechanical factors related to the lower extremities and develop more scientific and comprehensive muscle strength training methods.

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Objective: To investigate the association between muscle mass and quality of life in adults in Shaanxi adults. Methods: The data in this analysis were part of the baseline survey of the Regional Ethnic Cohort Study in Northwest China from June 2018 to May 2019 in Shaanxi Province. The participants' quality of life, including physical component summary (PCS) and mental component summary (MCS), was assessed by the 12-Item Short Form Survey, and the Body Fat Determination System measured muscle mass. A logistic regression model with adjustment for confounding factors was established to analyze the association between muscle mass and quality of life in different genders. Further, sensitivity and subgroup analyses were conducted to explore its stability. Finally, a restricted cubic spline was employed to investigate the dose-response relationship between muscle mass and quality of life in different genders. Results: A total of 20 595 participants were included, with an average age of 55.0, and 33.4% were male. After controlling for potential confounders, compared with the Q1 group, the risk of low PCS was reduced by 20.6% (OR=0.794, 95%CI: 0.681-0.925) and the risk of low MCS was lower reduced by 20.1% (OR=0.799, 95%CI: 0.689-0.926) in female Q5 groups. Compared with the Q1 group, the risk of low PCS was reduced by 24.4% (OR=0.756, 95%CI: 0.644-0.888) in the male Q2 group. However, no significant association between muscle mass and MCS in males has been found. In females, restricted cubic spline analysis showed a significant linear dose-response relationship between muscle mass and PCS and MCS. Conclusions: There is a positive association between muscle mass and quality of life in Shaanxi adults, especially females. With the increase in muscle mass, the physical and mental functions of the population continue to improve.

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OBJECTIVE@#To compare the clinical efficacy on lumbar muscle strain with cold and dampness between the different operation sequences of acupuncture and cupping therapy.@*METHODS@#Seventy-six patients with lumbar muscle strain with cold and dampness were randomly divided into an acupuncture + cupping group (A + C group, 38 cases) and a cupping + acupuncture group (C + A group, 38 cases, 1 case dropped off). In the A + C group, cupping therapy was delivered 10 min after the end of treatment with acupuncture, while in the C + A group, acupuncture therapy was exerted 10 min after the end of treatment with cupping. Acupuncture was applied to Mingmen (GV 4), Yaoyangguan (GV 3), ashi point and bilateral Shenshu (BL 23), Dachangshu (BL 25), Weizhong (BL 40) and Yanglingquan (GB 34), and the needles were retained for 30 min in each intervention. Flash cupping was operated along the bilateral sides of the lumbar spine for 3 min, and the cups were retained for 10 min at bilateral Shenshu (BL 23), Dachangshu (BL 25) and ashi points. The intervention was delivered once every two days, 3 times weekly, for 3 weeks totally in each group. The scores of visual analogue scale (VAS) and Oswestry disability index (ODI), TCM syndrome score and the mean temperature of the lumbar region before and after treatment were compared between the two groups. The safety and the clinical efficacy were assessed for the interventions of the two groups.@*RESULTS@#Compared with the values before treatment, except for the sleep score of ODI, the VAS scores, ODI scores and TCM syndrome scores were decreased after treatment (P<0.01, P<0.05); while the mean temperature of the lumbar region was increased (P<0.01) in both groups. After treatment, the VAS score and the pain score of ODI in the C + A group were lower than those in the A + C group (P<0.05). The incidence rate of adverse reactions of the C + A group was lower than that of the A + C group (P<0.01). The effective rate in the A+C group was 92.1% (35/38), that in the C+A group was 94.6%(35/37), there was no statistical difference between the two groups (P>0.05).@*CONCLUSION@#Different operation sequences between acupuncture and cupping therapy obtain the similar efficacy on lumbar muscle strain with cold and dampness, but cupping therapy delivered prior to acupuncture has certain advantages in relieving pain and improving safety.

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Under the guidance of the "Sancai principle", based on the understanding of the etiology and pathogenesis of the imbalance of muscles and bones in bi syndrome of neck region, holistic treatment should be used. The needle-knife release therapy is applied at corresponding acupoints in the three parts i.e. head, neck and back including Tiancai points (Naohu [GV 17] and Naokong [GB 19]), Rencai points (neck Jiaji [EX-B 2]), and Dicai points (Dazhui [GV 14], Quyuan [SI 13] and Tianzong [SI 11]). According to the layers of the lesion's meridians and muscles, the needle-knife is inserted into skin, muscle and bone to relax the tendons and treat bone disorders, and restore the normal mechanical balance of neck.

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OBJECTIVE@#To compare the efficacy and muscle injury imaging between oblique lateral lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of single-segment degenerative lumbar spinal stenosis.@*METHODS@#The clinical data of 60 patients with single-segment degenerative lumbar spinal stenosis who underwent surgical treatment from January 2018 to October 2019 was retrospectively analyzed. The patients were divided into OLIF groups and TLIF group according to different surgical methods. The 30 patients in the OLIF group were treated with OLIF plus posterior intermuscular screw rod internal fixation. There were 13 males and 17 females, aged from 52 to 74 years old with an average of (62.6±8.3) years old. And 30 patients in the TLIF group were treated with TLIF via the left approach. There were 14 males and 16 females, aged from 50 to 81 years old with an average of (61.7±10.4) years old. General data including operative time, intraoperative blood loss, postoperative drainage volume, and complications were recorded for both groups. Radiologic data including disc height (DH), the left psoas major muscle, multifidus muscle, longissimus muscle area, T2-weighted image hyperintensity changes and interbody fusion or nonfusion were observed. Laboratory parameters including creatine kinase (CK) values on postoperative 1st and 5th days were analyzed. Visual analogue scale(VAS) and Oswestry disability index(ODI) were used to assess clinical efficacy.@*RESULTS@#There was no significant difference in the operative time between two groups(P>0.05). The OLIF group had significantly less intraoperative blood loss and postoperative drainage volume compared to the TLIF group(P<0.01). The OLIF group also had DH better recovery compared to the TLIF group (P<0.05). There were no significant differences in left psoas major muscle area and the hyperintensity degree before and after the operation in the OLIF group (P>0.05). Postoperativly, the area of the left multifidus muscle and longissimus muscle, as well as the mean of the left multifidus muscle and longissimus muscle in the OLIF group, were lower than those in the TLIF group (P<0.05) .On the 1st day and the 5th day after operation, CK level in the OLIF group was lower than that in the TLIF group(P<0.05). On the 3rd day after operation, the VAS of low back pain and leg pain in the OLIF group were lower than those in the TLIF group (P<0.05). There were no significant differences in the ODI of postoperative 12 months, low back and leg pain VAS at 3, 6, 12 months between the two groups(P>0.05). In the OLIF group, 1 case of left lower extremity skin temperature increased after the operation, and the sympathetic chain was considered to be injured during the operation, and 2 cases of left thigh anterior numbness occurred, which was considered to be related to psoas major muscle stretch, resulting in a complication rate of 10% (3/30). In the TLIF group, one patient had limited ankle dorsiflexion, which was related to nerve root traction, two patients had cerebrospinal fluid leakage, and the dural sac was torn during the operation, and one patient had incision fat liquefaction, which was related to paraspinal muscle dissection injury, resulting in a complication rate of 13% (4/30). All patients achieved interbody fusion without cage collapse during the 6- month follow-up.@*CONCLUSION@#Both OLIF and TLIF are effective in the treatment of single-segment degenerative lumbar spinal stenosis. However, OLIF surgery has obviously advantages, including less intraoperative blood loss, less postoperative pain, and good recovery of intervertebral space height. From the changes in laboratory indexes of CK and the comparison of the left psoas major muscle, multifidus muscle, longissimus muscle area, and high signal intensity of T2 image on imaging, it can be seen that the degree of muscle damage and interference of OLIF surgery is lower than that of TLIF.

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OBJECTIVE@#This study aimed to investigate the feasibility of implementing a manual therapy technique (muscle energy technique, MET) protocol in a hospital pulmonary rehabilitation (PR) program for patients with moderate to severe chronic obstructive pulmonary disease (COPD). Please cite this article as: Baxter DA, Coyle ME, Hill CJ, Worsnop C, Shergis JL. Muscle energy technique for chronic obstructive pulmonary disease: A feasibility study. J Integr Med. 2023; 21(3): 245-253.@*METHODS@#Participants aged 40 years and over, with moderate to severe COPD, were recruited into this 12-week study. The primary outcome measures were feasibility (acceptability of the intervention and attendance/adherence to the trial) and safety (adverse events, AEs). All participants received the MET and PR therapies. Participants and assessors were unblinded. Semi-standardized MET was delivered on 6 occasions (a maximum of once per week) at the hospital directly before a PR session. Participants undertook PR sessions as per the hospital program at a frequency of two days per week for 8 weeks. Participants were contacted 4 weeks after their final MET treatment via a telephone call to assess acceptability of the intervention.@*RESULTS@#Thirty-three participants were enrolled, with a median age of 74 years (range 45-89 years). The median number of MET sessions that participants attended was 5 (range 0-6) out of a possible 6 sessions (83% attendance). At follow-up, participants overwhelmingly enjoyed the MET treatment with some subjectively reporting improved breathing. There were no major AEs related to the intervention, with the majority of AEs classified as expected events related to COPD exacerbations.@*CONCLUSION@#It is feasible to implement a manual therapy protocol using MET as an adjunct to PR in a hospital setting. Recruitment rates were satisfactory and there were no AEs related to the MET component of the intervention.