Effects of Milk Fat Globule Membrane Supplementation Following Exercise Training on Physical Performance in Healthy Young Adults: A Randomized Double-Blind, Placebo-Controlled Pilot Trial.

The purpose of this study was to examine whether 4 wk of daily ingestion of milk fat globule membrane (MFGM) combined with exercise training improves physical performance-muscle strength, agility and muscle power-in healthy young adults. The study was designed as a randomized, double-blind, and placebo-controlled trial. Twenty healthy young adults received either an MFGM powder containing 1.6 g of fat and 160 mg of sphingomyelin or an isocaloric placebo powder daily throughout 4 wk of power or agility training. Physical performance tests and body composition measurements were conducted before and after the 4-wk intervention. Ingestion of MFGM did not affect isometric or isokinetic muscle strength, but it was associated with a greater increase in vertical jump peak power compared with placebo. There were no significant changes in body weight or lean body mass during the intervention period in either group, and no significant differences between groups. We conclude that daily MFGM supplementation combined with exercise training has the potential to improve physical performance in young adults; however, further studies with larger sample sizes should be conducted to obtain more evidence supporting achievement of improved physical performance through MFGM supplementation.

Acute effects of multi-ingredient pre-workout dietary supplement on anaerobic performance in untrained men: a randomized, crossover, single blind study.

BACKGROUND: Multi-ingredient pre-workout dietary supplements (MIPS), which are combinations of different ingredients acting on different physiological mechanisms, can have a synergistic effect and improve performance. The aim of the study was to determine the acute effects of a multi-ingredient pre-workout supplement containing: beta-alanine, taurine, caffeine, L-tyrosine, and cayenne pepper (capsaicin) on anaerobic performance. METHODS: A randomized, crossover, single-blind study was designed. Twelve young, healthy, untrained men aged 22.4 ± 1.44 years participated in the study. The participants performed a supramaximal all-out test (20 s Wingate test) twice, day by day, in random order: test after placebo or MIPS consumption. In both trials, the following variables were measured in the exercise test: total work performed, peak power, mean power, time to reach peak power, and power decrease. RESULTS: MIPS was found to be effective in improving peak power (p = 0.009, ES = 0.77) and mean power (p = 0.04, ES = 0.62) in the Wingate test. However, the supplement consumption did not affect the amount of total work done (p = 0.10, ES = 0.48) in the test or power decrease (p = 0.07, ES = 0.53). The data indicate, that the improvement in anaerobic power was due to a significant improvement in pedaling speed, which was manifested in a significant improvement (i.e. shortening) in time to peak power (p = 0.003, ES = 0.88). CONCLUSION: A multi-ingredient pre-workout dietary supplement was found to be effective in improving Wingate (anaerobic) performance. TRIAL REGISTRATION: NCT06363669, retrospectively registered on 11.04.2024 (ClinicalTrials.gov).

The influence of traditional Thai massage on recovery from gastrocnemius muscle fatigue: A single-blind randomised controlled trial.

OBJECTIVE: To determine the effects of traditional Thai massage (TTM) on improving fatigue recovery and fatigue-related parameters of the gastrocnemius muscle after a heel-raise exercise. DESIGN: A single-blind randomised controlled trial. SETTING: Mae Fah Luang University Hospital, Thailand. PARTICIPANTS: Fifty-four healthy participants were randomly assigned to two groups: TTM (n = 27; 51.85 % women; mean age 23.15 ± 4.90 years; number of exercises/week: 4.78 ± 1.58) and control (n = 27; 59.26 % women; mean age 22.63 ± 4.88 years; number of exercises/week: 4.48 ± 1.25). INTERVENTIONS: After the participants performed a heel-raise exercise to induce fatigue of the gastrocnemius muscle, they received either 30 min of TTM to the gastrocnemius muscle or 30 min of control (29 min of rest and 1 min total gastrocnemius stretching). OUTCOME MEASURES: The outcome measures were the median frequency (MDF) of the electromyography signal, muscle power (MP) and feelings of muscle fatigue (FMF). All the outcome measures were evaluated before (T1) and after (T2) the fatigue-inducement protocol as well as immediately (T3), 1 h (T4) and 2 h (T5) after the interventions. RESULTS: The results show that MDF and MP were significantly increased and FMF significantly decreased in both groups immediately after the interventions and at 1 h and 2 h after the interventions (repeated measures ANOVA: p < .05). In the between-group comparisons, participants in the TTM group showed significantly greater improvement than those in the control group on all outcomes at all post-intervention assessment time points (T3, T4, T5), reflecting faster recovery from muscle fatigue (ANCOVA: p < .05). CONCLUSION: TTM proved an effective intervention for maximising recovery from fatigue of the gastrocnemius muscle.

The Impact of Range of Motion on Applied Force Characteristics and Electromyographic Activity during Repeated Sets of Bench Press Exercise.

This study examined the effects of range of motion (ROM) on applied force, power output and surface electromyographic (sEMG) responses during repeated sets of bench press exercise executed as fast as possible. Ten resistance trained men performed three sets to momentary failure with two-min rest intervals under three different ROM conditions: (a) full ROM (FULL), (b) TOP, at the top half of ROM, and (c) BOTTOM, at the bottom half of ROM. Mean and peak force were higher in TOP compared to FULL and BOTTOM (mean force: 817 ± 80 vs. 657 ± 98 vs. 623 ± 122 N, respectively, p < 0.001) with no differences between FULL and BOTTOM. During repeated sets, large decreases were found in peak (by 29.4 to 45.3%) and mean power (by 55.5 to 64.7%) from the first to the last repetitions. However, the decrease in mean force was only 2% (p < 0.01) and decreases in peak force ranged from 6.7 and 8.8% to zero, indicating the velocity loss was the main contributor to fatigue in power output. Although force and power output in set 3 were unchanged in BOTTOM, mean power output decreased significantly, suggesting that lower performance and fatigue may be related to the longer muscle length. Fatigue was accompanied by an increase in sEMG activity and a decrease in median frequency in all muscles, with triceps brachialis sEMG reflecting more the force and power differences among ROMs. In conclusion, fatigue depends on velocity rather than force loss during bench press exercise at different ROMs.

Jump Squats Performed with Both Light and Heavy Loads Have Similar Effects on the Physical Performance of Elite Rugby Players during the Initial Phase of the Competitive Period.

We examined the effectiveness of two different jump-squat (JS) loading ranges on the physical performance of rugby players. Twenty-eight elite male rugby players were divided into two JS training groups: a light-load JS group ("LJS"; JS at 40% of the one-repetition maximum [1RM] in the half-squat (HS) exercise) and a heavy-load JS group ("HJS"; JS at 80% HS-1RM). Players completed the distinct training programs over four weeks, three times per week, during the initial phase of the competitive period. Pre- and post-training tests were conducted in the following sequence: vertical jumps, a 30-m speed test, peak power in the JS and the HS, and maximum isometric force in the HS. Additionally, the rating of perceived exertion (RPE) was assessed at the end of all training sessions throughout the intervention. A two-way ANOVA with repeated measures, followed by the Tukey's post-hoc test, was employed to analyze differences between groups. The level of significance was set at p < 0.05. Effect sizes were used to assess the magnitude of differences between pre- and post-training data. Except for the RPE values (which were lower in the LJS group), no significant changes were detected for any other variable. In summary, using either a light- (40% HS-1RM) or a heavy-load (80% HS-1RM) JS during the initial phase of the competitive period is equally effective in maintaining physical performance levels attained during the preceding training period (pre-season), with the significant advantage of the light-load protocol resulting in lower levels of the RPE. This finding may have important implications for resistance training programming, especially in disciplines where acute and chronic fatigue is always a problematic issue.

Wearing a back-support exoskeleton alters lower-limb joint kinetics during single-step recovery following a forward loss of balance.

We assessed the effects of a passive, back-support exoskeleton (BSE) on lower-limb joint kinetics during the initiation and swing phases of recovery from a forward loss of balance. Sixteen (8M, 8F) young, healthy participants were released from static forward-leaning postures and attempted to recover their balance with a single-step while wearing a BSE (backXTM) with different levels of support torque and in a control condition. The BSE provided âˆ¼ 15-20 Nm of external hip extension torque on the stepping leg at the end of initiation and beginning of swing phases. Participants were unable to generate sufficient hip flexion torque, power, and work to counteract this external torque, although they sustained hip flexion torque for a more prolonged period, resulting in slightly increased hip contribution to positive leg work (compared to control). However, net positive leg work, and the net contribution of hip joint (human + BSE) to total leg work decreased with BSE use. While all participants had changes in hip joint kinetics, a significant compensatory increase in ankle contribution to positive leg work was observed only among females. Our results suggest that BSE use adversely affects reactive stepping by decreasing the stepping leg kinetic energy for forward propulsion, and that the relative contributions of lower-limb joints to total mechanical work done during balance recovery are altered by BSE use. BSEs may thus need to be implemented with caution for dynamic tasks in occupational settings, as they may impair balance recovery following a forward loss of balance.

Assessing muscular power in older adults: evaluating the predictive capacity of the 30-second chair rise test.

Background: Timed chair rise tests are frequently used as a substitute for assessing leg muscle strength or power. To determine if timed chair rise tests are an indicator of lower extremity muscle power, we examined the relationship between the repetitions completed in a 30-s chair rise test and the power generated during the test. Methods: Seventy-five individuals participated in this study (n = 30 < 65 years and 45 ≥ 65 years). Participants underwent a 30-s chair rise test while instrumented with a power analyzer. Handgrip strength was also evaluated. Results: The relationship between chair rise repetitions and average chair rise power was R 2 = 0.32 (p < 0.001). Chair rise repetitions when regressed on a total (i.e., summed) chair rise power, it yielded R 2 = 0.70 with data from all participants combined (p < 0.001). A mediation analysis indicated that anthropometrics partially mediates the relationship between chair rise repetitions and total chair rise power accounting for 2.8%-6.9% of the variance. Conclusion: Our findings indicate that in older adults, the overall performance of chair rises offers limited information about the average power per rise but is more indicative of the cumulative power exerted. Thus, the total number of chair rises in a 30-s test is likely a more comprehensive metric of overall muscular power, reflecting endurance aspects as well. Additionally, we found that personal physical attributes, such as height and weight, partially influence the link between chair rise count and total power, highlighting the importance of factoring in individual body metrics in assessments of muscular performance.

Road to Paris 2024: force-velocity profile in different speed climbers' abilities.

Speed climbing will be a new discipline in Paris 2024. The physical requirements of speed climbing are different from the other climbing modalities due to the short event time requiring higher level of strength and power. These parameters have been measured through the Force-Velocity (F-V) profile in different climbing disciplines. However, there are no known results evaluating different speed climbing abilities to establish whether F-V relationship is a determining factor between performance levels. The purpose of this study was to evaluate the upper and lower limbs F-V profile in different speed climbing abilities considering sex. Twenty-six speed climbers were divided into two groups based on their level of performance: international level (men n = 7 and women n = 2) and national level (men n = 8 and women n = 7). Participants performed pull-ups and squat incremental tests and F-V profile variables [Maximum theorical values of force (F0), velocity (V0) and power (Pmax)], one-repetition maximum value (1RM) and %1RM where peak power was expressed were collected using a linear encoder. There were significant differences in F0, relative force, %1RM where peak power was expressed, and 1RM in pull-ups (p < 0.05) between groups. However, there were not significant differences between groups in squat variables. No significant sex differences were found in any variable. There were moderate-strong correlations between running time and 1RM (pull-ups and squat), F0 and FV-slope (pull-ups) (p < 0.05) analyzed in the whole group. In conclusion, F0 and 1RM in pull-ups were significantly higher in international climbers. Therefore, national climbers should focus their training on improving force by training with heavy loads. Additionally, squat F-V profile variables do not seem to be as important as in the pull-up for performance.

Cardiorespiratory and Muscular Fitness in Children and Adolescents with Obesity.

PURPOSE OF REVIEW: Examine the current state of literature related to the impact of obesity in children and adolescents on health-related physical fitness and the resultant cardiometabolic disease risk. RECENT FINDINGS: Cardiorespiratory fitness of children and adolescents has declined over the past few decades which corresponds with an increase in obesity rates. Children with obesity are more likely to have low cardiorespiratory fitness which is associated with higher cardiometabolic disease risk and poorer mental health. The impact of obesity on muscular fitness in children and adolescents is more difficult to ascertain, but in general measures of physical function are lower in children with obesity which has also been associated with higher cardiometabolic disease risk. Components of health-related physical fitness are trending negatively in children and adolescents and appear to be related to the increase in prevalence of obesity. The resultant cardiometabolic disease risk has also risen which suggests a greater disease burden in the future. These disparaging findings highlight the need for aggressive interventions to improve physical fitness in children and adolescents.

Physical performance and negative events in very old adults: a longitudinal study examining the ilSIRENTE cohort.

BACKGROUND: Declining physical performance in old age is associated with a wide range of negative health-related outcomes. However, it is unclear which physical capabilities should be prioritized to obtain prognostic information in older adults. AIMS: To examine the associations between the performance on several physical function tests and falls, disability, and death in a well-characterized sample of very old Italian adults. METHODS: This was a prospective cohort study of older adults who lived in the mountain community of the Sirente geographic area in Central Italy. Physical performance was assessed using isometric handgrip strength (IHG), walking speed (WS) at a usual and fast pace, 5-time sit-to-stand test (5STS), and sit-to-stand power measures. Appendicular skeletal muscle mass was estimated from calf circumference using a validated equation. History of falls, incident falls, and disability status according to basic Activities of Daily Living (ADLs) were recorded over two years. Survival status was obtained from the participants' general practitioners and was confirmed by the National Death Registry over 10 years from enrolment. Linear, binary, and Cox regressions were performed to evaluate the association between physical performance measures and health outcomes. RESULTS: The mean age of the 255 participants was 84.2 ± 5.1 years, and 161 (63.1%) were women. Logistic regression indicated that IHG was significantly associated with incident ADL disability, whereas specific sit-to-stand muscle power was an independent predictor of death. No significant associations were observed between physical function and falls. CONCLUSIONS: Our findings indicate selective associations between physical function tests and the occurrence of negative events in very old adults, with poor IHG predicting disability and specific sit-to-stand muscle power being longitudinally associated with death.

Validity of a video-analysis-based app to detect prefrailty or frailty plus sarcopenia syndromes in community-dwelling older adults: Diagnostic accuracy study.

Objectives: Sarcopenia and frailty have been associated with an increased risk of suffering health-related adverse events but the combination of both conditions results in worse health-related outcomes than either condition alone. Since both syndromes are reversible states, their early detection is fundamental. This study aims to validate a video analysis-based App to detect the presence of frailty or prefrailty plus sarcopenia syndromes and to analyze its construct validity with health-related risk factors. Methods: A total of 686 community-dwelling older adults (median-age: 72, 59% female) were enrolled. Muscle power generated during a sit-to-stand test using the App and calf circumference were considered the index test. The reference standards were the EWGSOP2 criteria (five-chair stand test plus appendicular skeletal mass or skeletal muscle index) and Fried's frailty phenotype. Area under the curve (AUC), sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated. Results: The prevalence of both syndromes varied from 2.9% to 7.2% depending on the diagnostic criteria used for sarcopenia assessment. Excellent-to-outstanding AUC values were observed (range 0.80-0.92). Sensitivity and specificity ranged from 75% to 100% and 81.7% to 87.2%, respectively. PPV and NPV ranged from 12.1% to 37.5% and 97.9% to 100%, respectively. Individuals diagnosed by the App showed an increased risk of polypharmacy, depression, comorbidities, falls, hospitalization, low socioeconomical and educational levels, and smoking and poor self-perceived health compared to their healthy counterparts. Conclusions: This App seems to be reliable to detect the simultaneous presence of both syndromes in community-dwelling older adults. Individuals diagnosed by the App showed more odds to have health-related risk factors.

Why Should Athletes Brake Fast? Influence of Eccentric Velocity on Concentric Performance During Countermovement Jumps at Different Loads.

PURPOSE: The aim of the present study was to analyze the effect of different eccentric tempos on eccentric kinetics and kinematics and the subsequent concentric performance when performing countermovement jumps against different loads. METHODS: After 1-repetition-maximum assessment and 2 familiarization sessions, 13 well-trained participants performed, in randomized order, 12 sets (4 tempos × 3 loads) of 4 repetitions of the loaded countermovement-jump exercise. The eccentric tempos analyzed were 5 and 2 seconds, as fast as possible, and accelerated (ie, without pause between repetitions), while the loads used were 30%, 50%, and 70% of 1-repetition maximum. Several kinetic and kinematic variables during both phases were recorded by linking a linear position transducer to the barbell. RESULTS: The eccentric work was greater in the accelerated condition despite no changes in the eccentric depth. The peak and mean propulsive velocities were greater in the as-fast-as-possible and accelerated conditions. Correlation analysis showed that, compared with the 5-second condition, the increased concentric performance in the accelerated condition was related to the difference in eccentric work performed in the last 100 milliseconds of the eccentric phase (r > .770). CONCLUSIONS: Contrary to current practices, the current study highlights the need for performing the eccentric phase of loaded countermovement jumps, a common exercise performed by athletes for both training and evaluation purposes, as fast as possible. This allows not only a greater eccentric work but also improved concentric performance.

Validity and reliability of linear encoder muscle power testing in persons with Parkinson's disease.

OBJECTIVE: To investigate the construct validity ON medication and the reliability both ON and OFF medication of linear encoder muscle power testing in persons with Parkinson's disease (pwPD). DESIGN: A study using baseline data from one randomized controlled trial (study 1) and one cohort study (study 2). SETTING: University exercise lab. PARTICIPANTS: Study 1: 35 healthy controls and 70 pwPD. Study 2: 20 pwPD. INTERVENTION: Study 1: baseline data. Study 2: 4 chair rise tests (2 ON and 2 OFF medication), in a randomized order, separated by 4 to 16 days. MAIN MEASURES: Linear encoder data were collected from a chair rise test. Known groups validity and convergent validity (i.e., construct validity) were assessed by comparing peak power between pwPD and healthy controls and associations between peak power and functional performance (i.e., 6-Min Walk Test, Timed Up and Go Test, Six-Spot Step Test), respectively. Reliability was assessed as day-to-day variation and by intraclass correlation coefficients. RESULTS: Peak power was comparable between pwPD and healthy controls (-7.2%, p = 0.17), but lower in moderately impaired pwPD compared to mildly impaired pwPD (-27%, p < 0.01) and healthy controls (-23%, p < 0.01). Moderate to strong associations were observed between peak power and functional performance (r2 = 0.44-0.51). Day-to-day variation ON and OFF medication were 1.0 and 1.3 W/kg, respectively, while intraclass correlation coefficients were 0.95 (0.87;0.98) and 0.93 (0.82;0.97), respectively. CONCLUSION: Linear encoder muscle power testing shows inconsistent known groups validity, acceptable convergent validity ON medication, and excellent day-to-day reliability ON and OFF medication in pwPD.

Effects of Age and Playing Position on Field-Based Physical Fitness Measures in Adolescent Female Netball Players.

This cross-sectional study investigated the impact of age and playing position, controlling for maturity, on physical fitness indicators in 303 adolescent female netball players aged 12.0 to 15.9 years. Assessments included estimated maximal oxygen uptake (VO2max) via the 20 m shuttle run test, 10 m and 20 m sprints, change of direction speed (CODS) using the 505 test, and muscle power via the medicine ball chest throw (MBCT) and countermovement vertical jump (CMJ). Participants were grouped by age (12 to 15 years) and playing position (non-circle and circle players), with age at peak height velocity as a covariate for maturity. Results revealed that, at 15 years, CMJ height was greater than at 12 years and 13 years (p < 0.05, partial η2 = 0.048). MBCT distance increased across age groups (p < 0.01, partial η2 = 0.323). Age had no impact on sprints, VO2max, or CODS. Non-circle players outperformed circle players in the 10 m sprint (p = 0.042, partial η2 = 0.016) and 20 m sprints (p = 0.010, partial η2 = 0.025) and displayed higher VO2max (p < 0.001, partial η2 = 0.036). Circle players were taller (p = 0.046, partial η2 = 0.014) and heavier (p < 0.001, partial η2 = 0.040) than non-circle players. Playing positions showed no differences in CMJ and MBCT. In adolescent female netball players, only muscle power is influenced by age, while non-circle players exhibit superior aerobic fitness and speed compared to circle players. Coaches may be able to utilize the distinct age and playing position traits of adolescent netballers to inform player selection and design targeted training programs.

Post-Activation Performance Enhancement (PAPE) Increases Jumping Power in Elite Female Volleyball Athletes.

This study investigated PAPE effects of two conditioning activities (CA) and recovery times on the peak jumping power (PP) of elite female volleyball athletes. Players performed CA separately: three sets of three repetitions of back squats with 85% of 1RM (BS) or one set of five depth drops (DD). PP was measured with countermovement (CMJ) and squat jumps (SJ) before (pre-test) and two minutes (post-test 1) and six hours (post-test 2) after each CA. BS significantly reduced PP at post-test 1 (CMJ and SJ: p < 0.04, d between -0.36 and -0.28). At post-test 2, following BS, PP for both jump forms was significantly greater than at post-test 1 (p < 0.001, d between 0.54 and 0.55) and at pre-test (p < 0.048, d between 0.21 and 0.30). DD increased PP significantly (CMJ and SJ p < 0.05, d between 0.40 and 0.41) relative to pre-test at post-test 2 (there was no significant difference between pre-test and post-test 1). Comparing BS with DD, there were no significant differences (p > 0.05). The greatest PAPE effects were observed six hours after BS. CA are recommended for female athletes to improve jumping performance, but individual responses should be determined prior to use.

Power-oriented resistance training combined with high-intensity interval training in pre-frail and frail older people: comparison between traditional and cluster training set configurations on the force-velocity relationship, physical function and frailty.

OBJECTIVES: To analyse the force-velocity relationship changes in response to two different training programmes differing in the set configuration (cluster vs. traditional), and their impact on physical function and frailty in pre-frail and frail older adults. METHODS: 43 pre-frail and frail (Frailty Phenotype ≥ 1 criteria) older adults (81.4 ± 5.1 years) participated in this study. Participants were assigned to cluster (CT; n = 10; 10-s intra-set rest), traditional (TT; n = 13; no intra-set rest) or control (CON; n = 20) groups. Force-velocity relationship (F0, V0 and Pmax), physical function (Short Physical Performance Battery, SPPB) and frailty (Frailty Phenotype, FP) were assessed at baseline and after the training programme. RESULTS: Both CT and TT groups showed similar improvements in Pmax after training (CT = + 36.7 ± 34.2 W; TT = + 33.8 ± 44.6 W; both p < 0.01). V0 was improved by both CT (+ 0.08 ± 0.06 m s-1; p < 0.01), and TT (+ 0.07 ± 0.15 m s-1, p > 0.05). F0 remained unchanged in CT (+ 68.6 ± 224.2 N, p > 0.05) but increased in TT (+ 125.4 ± 226.8 N, p < 0.05). Finally, SPPB improved in both training conditions (CT = + 2.3 ± 1.3 points; TT = + 3.0 ± 1.2 points; both p < 0.05) and in the CON group (+ 0.9 ± 1.4 points, p < 0.05). CT and TT reduced their FP (CT = - 1.1 criteria; TT = - 1.6 criteria; both p < 0.01), while no changes were observed in the CON group (- 0.2 criteria, p = 0.38). CONCLUSIONS: Both training methods were equally effective for improving Pmax, physical function and reducing frailty in pre-frail and frail older people. TT may be effective for improving both force and velocity parameters, while CT may be effective for improving velocity parameters alone, although further research is required to confirm these findings.

Selective dorsal rhizotomy: Analysis of two rootlet sectioning techniques.

OBJECTIVE: To analyze and compare the efficacy of two selective dorsal rhizotomy (SDR) techniques with intraoperative neurophysiological monitoring, using instrumented three-dimensional gait analysis. INTRODUCTION: SDR is a common, irreversible surgical treatment increasingly used to address gait disturbances in children with chronic non-progressive encephalopathy by reducing spasticity. Various techniques have been used, which mainly differ in the percentage of rootlets selected for sectioning. A greater proportion of rootlets sectioned leads to a more effective reduction of spasticity; however, there is a potential risk of unwanted neurological effects resulting from excessive deafferentation. While there is evidence of the short- and long-term benefits and complications of SDR, no studies have compared the effectiveness of each technique regarding gait function and preservation of the force-generating capacity of the muscles. MATERIALS AND METHODS: Instrumented three-dimensional gait analysis was used to evaluate two groups of patients with spastic cerebral palsy treated by the same neurosurgeon in different time periods, initially using a classic technique (cutting 50% of the nerve rootlets) and subsequently a conservative technique (cutting no more than 33% the nerve rootlets). RESULTS: In addition to an increase in knee joint range of motion (ROM), in children who underwent SDR with the conservative technique, a statistically significant increase (p = 0.04) in the net joint power developed by the ankle was observed. Patients who underwent SDR with the conservative technique developed a maximum net ankle joint power of 1.37 ± 0.61 (unit: W/BW), whereas those who were operated with the classic technique developed a maximum net ankle joint power of 0.98 ± 0.18 (unit: W/BW). The conservative group not only showed greater improvement in net ankle joint power but also demonstrated more significant enhancements in minimum knee flexion during the stance phase and knee extension at initial contact. CONCLUSION: Our results show that both techniques led to a reduction in spasticity with a positive impact on the gait pattern. In addition, patients treated with the conservative technique were able to develop greater net ankle joint power, leading to a better scenario for rehabilitation and subsequent gait.

Effect of Yoga or Physical Exercise on Muscle Function in Rural Indian Children: A Randomized Controlled Trial.

BACKGROUND: Synergistic effects of yoga or physical exercise (PE) along with protein supplementation on children's muscle function in rural India have not been studied. Hence, we aimed to study the effect of yoga and PE along with protein supplementation on muscle function in healthy 6- to 11-year-old rural Indian children post 6 months of intervention. METHODS: A randomized controlled trial on 232 children, recruited into 3 groups, each receiving 1 protein-rich ladoo (148 kcal, 7 g protein/40 g ladoo-an Indian sweet snack) daily and performing (1) yoga (n = 78) for 30 minutes 5 times per week, (2) PE (n = 76) for 30 minutes 5 times per week, or (3) control group (n = 78) no additional exercise. Maximum power, maximum voluntary force (Fmax), and grip strength (GS) were measured. Data were analyzed using paired t tests and a 2-way mixed analysis of variance with post hoc Bonferroni adjustment. RESULTS: GS, maximum power, and Fmax within yoga group increased significantly (P < .05) from baseline to endline. GS and Fmax increased significantly within PE group postintervention (P < .001). In controls, GS increased (P < .05) at endline. No significant effect of the intervention was observed on the change in maximum power (P > .05) postintervention. The 2 exercise groups showed significant increase in Fmax compared with the control group (P < .05). Similarly, increase in GS was significantly higher in both the exercise groups compared with the control group (P < .05). No significant difference was observed in change in muscle function between the 2 exercise groups (P > .05). CONCLUSIONS: Structured physical activity along with protein supplementation resulted in improved muscle function in children. Yoga and PE showed a comparable impact on muscle force.

Effect of lower-extremity muscle power training on muscle strength, balance function and walking ability in older adults with heart failure: a randomized controlled trial.

PURPOSE: This study investigated the combined effect of lower-extremity muscle power training and regular cardiac rehabilitation on muscle strength, balance function, and walking ability of older adults with heart failure. METHODS: Thirty-one patients, comprising 17 males and 14 females, aged between 66 and 89 years and diagnosed with non-severe heart failure, were randomly assigned to either the intervention group (n = 15) or control group (n = 16). Both groups participated in a 12-week regular rehabilitation program, with the intervention group receiving additional lower-extremity muscle power training. Various outcome measures, including muscle strength (the five-times-sit-to-stand test and knee extensor peak torque), balance function (Berg balance scale and functional reach test), and walking ability (4-m walk and Timed Up-and-Go tests) were assessed at baseline and 12 weeks after the intervention. RESULTS: Of the 31 participants, 27 completed the study protocol. The intervention group demonstrated significantly greater improvement in the five-times-sit-to-stand test time, indicating enhanced lower-extremity muscle power compared to the control group. Both groups showed significant differences in the Berg balance scale, functional reach test, 4-m walk test, and Timed Up-and-Go test between baseline and 12 weeks. However, the effect sizes for the changes during the study period were larger in the intervention group (d = 0.74-1.19) than the control group (d = 0.57-0.96). CONCLUSION: Combining lower-extremity muscle power training with regular cardiac rehabilitation may lead to additional improvements in muscle function for older adults with heart failure, resulting in enhanced dynamic balance and walking ability. TRIAL REGISTRATION NUMBER/DATE OF REGISTRATION: UMIN000032087/April 4, 2018.

Sit-to-stand power predicts functional performance and patient-reported outcomes in patients with advanced knee osteoarthritis. A cross-sectional study.

BACKGROUND: Lower limb muscle power is positively associated with functional performance and patient-reported outcomes (PROMs) and suggested as an important variable to evaluate in patients with advanced knee osteoarthritis (OA). OBJECTIVES: To explore the association between muscle power derived from the 30-sec sit-to-stand test (STS power) with functional performance and PROMs compared to maximal isometric knee extensor strength (KE MVC) in male- and female patients with advanced OA. STUDY DESIGN: Cross-sectional design. METHODS: Eighty-six patients (66.6 [64.9-67.7]years) with advanced knee OA were included. Dependent variables were STS power and KE MVC. Independent variables were Timed Up&Go (TUG), 40-m fast-paced walk test (40mFWT), Knee injury and Osteoarthritis Outcome Score (KOOS) subscales. COVARIATE: Age. ANALYSES: Simple linear- and multiple regression analyses with and without adjusting for age. Pitman's test was used to evaluate differences in correlation strength among dependent variables. RESULTS: STS power demonstrated a statistical relationship with TUG and 40mFWT for both sexes (ß coefficients -1.11 to -4.36 (p < 0.05), r2 = 0.47-0.55 (p < 0.05)), and with KOOS Pain, ADL, and Sport for male patients (ß coefficients 6.53 to 7.17 (p < 0.05), r2 = 0.29-0.33 (p < 0.05)). Knee extensor MVC demonstrated no relationship with any outcomes for male patients or female patients. STS power displayed statistically stronger correlation to functional performance. CONCLUSION: STS power was associated with functional performance in both male patients and female patients suffering from advanced knee OA. Moreover, STS power was associated with KOOS Pain, Sport, and ADLin male patients. The assessment of STS power should be considered in the evaluation of patients with advanced knee OA. TRIAL REGISTRATION NUMBER: NCT04081493.