Proposal for progressive loading of the hip abductors under mechanically unstable conditions: An electromyography study

The aim of this study was to test the effect of the stance width and asymmetry on muscle activation patterns during balancing on a tilt board. Eleven young healthy volunteers took part in the tests. After the standardized warm-up and customization protocol had been carried out, they balanced five times for 60 seconds on a tilt board, using a different foot position each time - (i) wide symmetrical, (ii) narrow symmetrical, (iii) moderate asymmetrical, (iv) extreme asymmetrical, and (v) single leg. Pair of electromyographic electrodes was glued over the gluteus medius muscle on both sides from which signals were acquired. The average values of the pre-processed signals were normalized and quantified. Repeated measures analysis of variance and t-tests revealed a systematic effect of the foot positions on the amount of the gluteus medius activation. Its activation was significantly increased in both asymmetrical stances when the foot was moved closer to the tilt board`s axis of rotation and most prominently when the single leg stance was used. These results point out the importance of the foot positioning for the actual muscle function while balancing on a tilt board. We believe that different levels of feet positioning asymmetry should be used for gradual loading of the extremity and for provoking activity in hip side stabilizers

Electrical stimulation counteracts muscle atrophy associated with aging in humans

Functional and structural muscle decline is a major problem during aging. Our goal was to improve in old subjects quadriceps m. force and mobility functional performances (stair test, chair rise test, timed up and go test) with neuromuscular electrical stimulation (9 weeks, 2-3times/week, 20-30 minutes per session). Furthermore we performed histological and biological molecular analyses of vastus lateralis m. biopsies. Our findings demonstrate that electrical stimulation significantly improved mobility functional performancies and muscle histological characteristics and molecular markers

Evidence based medicine in physical medicine and rehabilitation (English version)

In the last twenty years the term “Evidence Based Medicine (EBM)” has spread into all areas of medicine and is often used for decision-making in the medical and public health sector. It is also used to verify the significance and/or the effectiveness of different therapies. The definition of EBM is to use the physician’s individual expertise, the patient’s needs and the best external evidence for each individual patient. Today, however, the term EBM is often wrongly used as a synonym for best “external evidence”. This leads not only to a misuse of evidence based medicine but suggests a fundamental misunderstanding of the model which was created by Gordon Guyatt, David Sackett and Archibald Cochrane. This problem becomes even greater the more social insurance institutions, public healthcare providers and politicians use external evidence alone as a main guideline for financing therapies in physical medicine and general rehabilitation without taking into account the physician’s expertise and the patient’s needs.The wrong interpretation of EBM can lead to the following problems: well established clinical therapies are either questioned or not granted and are therefore withheld from patients (for example physical pain management). Absence of evidence for individual therapy methods does not prove their ineffectiveness! In this short statement the significance of EBM in physical medicine and general rehabilitation will be analysed and discussed

Long-term high-level exercise promotes muscle reinnervation with age.

The histologic features of aging muscle suggest that denervation contributes to atrophy, that immobility accelerates the process, and that routine exercise may protect against loss of motor units and muscle tissue. Here, we compared muscle biopsies from sedentary and physically active seniors and found that seniors with a long history of high-level recreational activity up to the time of muscle biopsy had 1) lower loss of muscle strength versus young men (32% loss in physically active vs 51% loss in sedentary seniors); 2) fewer small angulated (denervated) myofibers; 3) a higher percentage of fiber-type groups (reinnervated muscle fibers) that were almost exclusive of the slow type; and 4) sparse normal-size muscle fibers coexpressing fast and slow myosin heavy chains, which is not compatible with exercise-driven muscle-type transformation. The biopsies from the old physically active seniors varied from sparse fiber-type groupings to almost fully transformed muscle, suggesting that coexpressing fibers appear to fill gaps. Altogether, the data show that long-term physical activity promotes reinnervation of muscle fibers and suggest that decades of high-level exercise allow the body to adapt to age-related denervation by saving otherwise lost muscle fibers through selective recruitment to slow motor units. These effects on size and structure of myofibers may delay functional decline in late aging