Safety and efficacy of abobotulinumtoxinA for hemiparesis in adults with upper limb spasticity after stroke or traumatic brain injury: a double-blind randomised controlled trial

Resistance from antagonistic muscle groups might be a crucial factor reducing function in chronic hemiparesis. The resistance due to spastic co-contraction might be reduced by botulinum toxin injections. We assessed the effects of abobotulinumtoxinA injection in the upper limb muscles on muscle tone, spasticity, active movement, and function

Physiological comparison of concentric and eccentric arm cycling in males and females

Lower body eccentric exercise is well known to elicit high levels of muscular force with relatively low cardiovascular and metabolic strain. As a result, eccentric exercise has been successfully utilised as an adaptive stressor to improve lower body muscle function in populations ranging from the frail and debilitated, to highly-trained individuals. Here we investigate the metabolic, cardiorespiratory, and energy costs of upper body eccentric exercise in a healthy population. Seven men and seven women performed 4-min efforts of eccentric (ECC) or concentric (CON) arm cycling on a novel arm ergometer at workloads corresponding to 40, 60, and 80% of their peak workload as assessed in an incremental concentric trial. The heart rate, ventilation, cardiac output, respiratory exchange ratio, and blood lactate concentrations were all clearly greater in CON condition at all of the relative workloads (all p<0.003). Effect size calculations demonstrated that the magnitude of the differences in VO2 and work economy between the ECC and CON exercise ranged from very large to extremely large; however, in no case did mechanical efficiency (ηMECH) differ between the conditions (all p>0.05). In contrast, delta efficiency (ηΔ), as previously defined by Coyle and colleagues in 1992, demonstrated a sex difference (men>women; p<0.05). Sex differences were also apparent in arteriovenous oxygen difference and heart rate during CON. Here, we reinforce the high-force, low cost attributes of eccentric exercise which can be generalised to the muscles of the upper body. Upper body eccentric exercise is likely to form a useful adjunct in debilitative, rehabilitative, and adaptive clinical exercise programs; however, reports of a shift towards an oxidative phenotype should be taken into consideration by power athletes. We suggest delta efficiency as a sensitive measure of efficiency that allowed the identification of sex differences

Acute and residual soccer match-related fatigue: A systematic review and Meta-analysis

BACKGROUND: Understanding soccer players' match-related fatigue and recovery profiles likely helps with developing conditioning programs that increase team performance and reduce injuries and illnesses. In order to improve match recovery (the return-to-play process and ergogenic interventions) it is also pivotal to determine if match simulation protocols and actual match-play lead to similar responses. OBJECTIVES: To thoroughly describe the development of fatigue during actual soccer match play and its recovery time course in terms of physiological, neuromuscular, technical, biochemical and perceptual responses, and (2) to determine similarities of recovery responses between actual competition (11 vs. 11) and match simulations. METHODS: A first screening phase consisted of a systematic search on PubMed (MEDLINE) and SportDiscus databases until March 2016. Inclusion criteria were: longitudinal study with soccer players; match or validated protocol; duration > 45 min; and published in English. RESULTS: A total of 77 eligible studies (n = 1105) were used to compute 1196 effect sizes (ES). Half-time assessments revealed small to large alterations in immunological parameters (e.g. leukocytes, ES = 1.9), a moderate decrement in insulin concentration (ES = - 0.9) and a small to moderate impairment in lower-limb muscle function (ES = - 0.5 to - 0.7) and physical performance measures (e.g. linear sprint, ES = - 0.3 to - 1.0). All the systematically analyzed fatigue-related markers were substantially altered at post-match. Hamstrings force production capacity (ES = - 0.7), physical performance (2-4%, ES = 0.3-0.5), creatine kinase (CK, ES = 0.4), well-being (ES = 0.2-0.4) and delayed onset muscle soreness (DOMS, ES = 0.6-1.3) remained substantially impaired at G + 72 h. Compared to simulation protocols, 11 vs. 11 match format (CK, ES = 1.8) induced a greater magnitude of change in muscle damage (i.e. CK, ES = 1.8 vs. 0.7), inflammatory (IL-6, ES = 2.6 vs. 1.1) and immunological markers and DOMS (ES = 1.5 vs. 0.7) than simulation protocols at post-assessments. Neuromuscular performances at post-match did not differ between protocols. CONCLUSION: While some parameters are fully recovered (e.g. hormonal and technical), our systematic review shows that a period of 72 h post-match play is not long enough to completely restore homeostatic balance (e.g. muscle damage, physical and well-being status). The extent of the recovery period post-soccer game cannot consist of a 'one size fits all approach'. Additionally, the 'real match' (11 vs. 11 format) likely induces greater magnitudes of perceptual (DOMS) and biochemical alterations (e.g. muscle damage), while neuromuscular alterations were essentially similar. Overall, coaches must adjust the structure and content of the training sessions during the 72-h post-match intervention to effectively manage the training load within this time-frame