Safety and effectiveness of resistance training in patients with late onset Pompe disease - a pilot study.

Pompe disease is a progressive myopathy resulting from deficiency in lysosomal enzyme acid α-glucosidase (GAA), which leads to glycogen accumulation in lysosomes primarily in skeletal and cardiac muscle. Enzyme replacement therapy (ERT) with recombinant human (rh) GAA works well in alleviating the cardiomyopathy; however, many patients continue to have progressive muscle weakness. The purpose of this study was to evaluate the effectiveness of a respiratory training combined with 24-week supervised resistance training program on muscle strength (measured by Biodex)), and respiratory function including maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) in subjects with late onset Pompe disease receiving ERT. Ten subjects participated in a 24-week resistance exercise program, three times per week, in addition to respiratory muscle exercise training six days per week. Overall, at the end of the resistance training program, as measured by Biodex dynamometry, the leg extensor strength improved by 10.5 ±â€¯3.2Nm. (

A case report comparing clinical, imaging and neuropsychological assessment findings in twins discordant for the VCP p.R155C mutation.

Inclusion body myopathy, Paget disease of bone and/or frontotemporal dementia is an autosomal dominant disease caused by mutations in the Valosin Containing Protein (VCP) gene. We compared clinical findings including MRI images and neuropsychological assessment data in affected and unaffected twin brothers aged 56 years from a family with the p.R155C VCP gene mutation. The affected twin presented with a 10 year history of progressive proximal muscle weakness, difficulty swallowing, gastroesophageal reflux, fecal incontinence, and peripheral neuropathy. Comprehensive neuropsychological testing revealed rapid cognitive decline in the absence of any behavioral changes in a span of 1 year. This case illustrates that frontotemporal dementia related cognitive impairment may precede behavioral changes in VCP disease as compared with predominance of behavioral impairment reported in previous studies. Our findings suggest that there is a need to establish VCP disease specific tools and normative rates of decline to detect pre-clinical cognitive impairment among affected individuals.

Development of fatty atrophy after neurologic and rotator cuff injuries in an animal model of rotator cuff pathology.

BACKGROUND: Detachment of a tendon from its osseous insertion, as can be the case with severe rotator cuff injuries, leads to atrophy of and increased fat in the corresponding muscle. We sought to validate a rotator cuff injury model in the rabbit and to test the hypothesis that tenotomy of a rotator cuff tendon would consistently create muscle atrophy and fatty degeneration analogous to the changes that occur after injury to a nerve innervating the same muscle. METHODS: New Zealand white rabbits were divided into three groups: (1) partial rotator cuff tear without retraction of the muscle, (2) complete rotator cuff tear with retraction of the muscle, and (3) nerve transection of the subscapular nerve. Animals were killed at two or six weeks after injury, and the muscles were analyzed for weight, cross-sectional area, myosin fiber-type composition, and fat content. In addition, the subscapular nerve was harvested at two weeks and evaluated for neuronal injury. RESULTS: At six weeks after injury, the rabbit muscles in the complete tenotomy and nerve transection groups had significant decreases in wet mass and increases in fat content relative to the control groups. Fat accumulation had a similar spatial pattern at six weeks in both the nerve transection and complete tenotomy groups. Such changes were not seen in the partial tenotomy group. No change was found in muscle myosin fiber-type composition. At two weeks after injury, subscapular nerves in the complete tenotomy group showed gross evidence of neuronal injury. CONCLUSIONS: This study establishes the rabbit subscapularis muscle as a valid model to study the muscular changes associated with rotator cuff tears. Our data suggest that the muscular changes associated with complete tenotomy are comparable with those seen with denervation of the muscle and suggest that chronic rotator cuff tears may induce a neurologic injury.

Space cycle: a human-powered centrifuge that can be used for hypergravity resistance training.

INTRODUCTION: This study represents the first step toward testing the hypothesis that hypergravity can be used as a unique resistance training modality for maintaining the health and function of skeletal muscle in microgravity. The primary objectives of this study were to use a human-powered short-arm centrifuge for the following: 1) to determine whether subjects could perform squats under hypergravity conditions without developing motion sickness or illusory motion; 2) to measure foot forces while performing squats under hypergravity conditions; and 3) to determine the mechanical power required to produce 1.5, 2.0, 2.5, and 3.0 Gz (head to foot) at the feet. METHODS: Subjects (22 males and 19 females) performed 10 squats each at 1.5, 2.0, 2.5, and 3.0 Gz on a human-powered short-arm centrifuge, the space cycle. Foot forces during each squat were monitored using insole force sensors, and normalized to foot forces measured at 1 Gz (relative foot forces). RESULTS: Illusory motion was minimized using a visual focal point, and did not affect the ability of subjects to perform squats. The mean standing relative foot forces at 3.0 Gz were 2.3 and 2.4 for the male and female subjects, respectively. The work rate required to power the space cycle was a linear function of Gz, and is well within the aerobic scope of untrained individuals. DISCUSSION: The findings of this study demonstrate that hypergravity can be used as an effective modality for loading skeletal muscle and that subjects can perform squat resistance exercise without developing motion sickness or illusory motion.