Strengthening of deep muscles as the basic element of sports training- systematic review

Świadomość roli aktywności fizycznej w życiu przepełnionym stresem, nieprawidłową pozycją siedzącą, złą ergonomią pracy oraz niestosownym odżywianiem wyraża się rosnącą liczbą osób amatorsko trenujących różne dyscypliny sportowe. Najbardziej popularnym sportem jest jazda na rowerze (51%), pływanie (28%) następnie bieganie (18%), spacery (16%), piłka nożna (14%), siatkówka (14%), fitness (13%). Zwiększonej aktywności fizycznej towarzyszy jednak wzrost ryzyka wystąpienia kontuzji oraz przeciążeń. Wielu autorów zwraca uwagę na istotną rolę treningu stabilizacji mięśni głębokich jako prewencji przeciwko kontuzjom, przeciążeniom oraz powstawaniu przewlekłego bólu kręgosłupa. Najważniejszą rolą mięśni lokalnych jest ich proporcjonalna i równomierna aktywacja celem zapewnienia prawidłowych wzorców ruchowych w zakresach funkcjonalnych. Osłabienie lub niewystarczająca praca jednego z ogniw łańcucha wyzwala kompensacyjne wzorce ruchowe aktywizujące mięśnie wielostawowe. Zjawisko to doprowadza do utraty stabilności i precyzji ruchu. Konsekwencją jest również modulacja centralnego układu nerwowego, wystąpienie przewlekłego bólu, pogorszenie sprawności fizycznej, większa podatność na wystąpienie urazów. Istotą treningu mięśni lokalnych jest ich jednoczesna aktywacja, w zamkniętym łańcuchu kinematycznym, z odpowiednim ułożeniem ciała w osi z zachowaniem pozycji neutralnej oraz ich częsta impulsacja. Celem niniejszej prezentacji jest przedstawienie korzyści płynących z aktywacji mięśni głębokich i wzmocnienia „centrum” ciała w prewencji urazów sportowych.Awareness of the role of physical activity in the life full of stress, incorrect sitting position, bad work ergonomics and unhealthy eating habits are reflected in the increasing number of people who perform different amateur sport disciplines. The most popular activities are riding a bike (51%), swimming (28%), jogging (18%), walking (16%), football (14%), volleyball (14%) and fitness (13%). Unfortunately, the increased physical activity is also connected with the increased risk of contusion, injury or overload. Many authors emphasize the significant role of deep muscle stability training in injury prevention, contusion, overload and chronic back pain prevention. The most important role of local muscles is their proportional and equal activation, in order to ensure the correct movement patterns in functional ranges. Weak or insufficient work of one of the links in the chain causes compensatory movement patterns which activate polyarthritis (multijoin) muscles. This phenomenon leads to loosening of stability and movement precision. The consequences include modulation of the Central Nervous System (CNS), chronic pain, deterioration of physical activity, injuries and contusions. The aim of the local muscle training is mutual activation of these muscles in the closed kinematic chain, with the correct body position in its axis, maintaing the neutral position and frequent impulsation of muscles. The aim of this presentation is to show the benefits that can be observed in deep muscle activation and the strengthening of body center in order to prevent sport injuries

Clinical manifestations of intermediate allele carriers in Huntington disease

Objective: There is controversy about the clinical consequences of intermediate alleles (IAs) in Huntington disease (HD). The main objective of this study was to establish the clinical manifestations of IA carriers for a prospective, international, European HD registry. Methods: We assessed a cohort of participants at risk with <36 CAG repeats of the huntingtin (HTT) gene. Outcome measures were the Unified Huntington's Disease Rating Scale (UHDRS) motor, cognitive, and behavior domains, Total Functional Capacity (TFC), and quality of life (Short Form-36 [SF-36]). This cohort was subdivided into IA carriers (27-35 CAG) and controls (<27 CAG) and younger vs older participants. IA carriers and controls were compared for sociodemographic, environmental, and outcome measures. We used regression analysis to estimate the association of age and CAG repeats on the UHDRS scores. Results: Of 12,190 participants, 657 (5.38%) with <36 CAG repeats were identified: 76 IA carriers (11.56%) and 581 controls (88.44%). After correcting for multiple comparisons, at baseline, we found no significant differences between IA carriers and controls for total UHDRS motor, SF-36, behavioral, cognitive, or TFC scores. However, older participants with IAs had higher chorea scores compared to controls (p 0.001). Linear regression analysis showed that aging was the most contributing factor to increased UHDRS motor scores (p 0.002). On the other hand, 1-year follow-up data analysis showed IA carriers had greater cognitive decline compared to controls (p 0.002). Conclusions: Although aging worsened the UHDRS scores independently of the genetic status, IAs might confer a late-onset abnormal motor and cognitive phenotype. These results might have important implications for genetic counseling. ClinicalTrials.gov identifier: NCT01590589

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (&gt;59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P &lt;.001). Overall motor and cognitive performance (P &lt;.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P &lt;.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P &lt;.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P &lt;.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients