No abstract

No abstract

Disuse muscle wasting will likely affect everyone in his or her lifetime in response to pathologies such as joint immobilization, inactivity or bed rest. There are no good therapies to treat it. We previously found that allopurinol, a drug widely used to treat gout, protects muscle damage after exhaustive exercise and results in functional gains in old individuals. Thus, we decided to test its effect in the prevention of soleus muscle atrophy after two weeks of hindlimb unloading in mice, and lower leg immobilization following ankle sprain in humans (EudraCT: 2011-003541-17). Our results show that allopurinol partially protects against muscle atrophy in both mice and humans. The protective effect of allopurinol is similar to that of resistance exercise which is the best-known way to prevent muscle mass loss in disuse human models. We report that allopurinol protects against the loss of muscle mass by inhibiting the expression of ubiquitin ligases. Our results suggest that the ubiquitin-proteasome pathway is an appropriate therapeutic target to inhibit muscle wasting and emphasizes the role of allopurinol as a non-hormonal intervention to treat disuse muscle atrophy.

BackgroundAssessing the clinical effectiveness of measuring grip strength as a prognostic tool in recovering ambulation in bed-confined frail elderly patients.MethodsA prospective study was carried out with 50 elderly inpatients (mean age: 81.6 years old). Manual muscle test was used for checking strength of hip flexor muscles, hip abductor muscles and knee extensor muscles. Grip strength was assessed by hydraulic dynamometer. Walking ability was assessed by functional ambulation categories and Functional Classification of Sagunto Hospital Ambulation. Existence of cognitive impairment (Short Portable Mental Status of Pfeiffer) and comorbidity (abbreviated Charlson index) were considered to be confounding variables.Statistical analysisSimple comparisons and mixed models of multiple ordinal regression.ResultsThe sample presented generalized weakness in scapular (mean 4.22) and pelvic (mean 3.82) muscle. Mean hand grip values were similar: 11.98 kg right hand; 11.70 kg left hand. The patients had lost walking ability. After treatment, there was a statistically significant for scapular waist strength (P=0.001), pelvic waist strength (P=0.005) and walking ability (P=0.001). A statistically significant relationship in the regression analysis was found between the grip (right and left hands) and walking ability post-treatment (P=0.009; odds ratio 1.14 and P=0.0014 odds ratio 1.113 for each walking scale). The confounding variables showed no statistical significance in the results.ConclusionGrip strength is associated with walking ability in hospitalized frail elderly. Grip strength assessment by hydraulic dynamometry is useful in patients with poor collaboration. Walking ability training in frail elderly inpatients is useful.

The great diversity of prosthetic mechanisms available nowadays leads to the question of which type of artificial foot would be the most advisable for a particular person. To answer correctly, it is necessary to establish, in an objective way, the performance of each type of prosthetic mechanism. This knowledge is obtained by means of the study of the subject-prosthesis interaction, both in static and dynamic conditions. This paper, based on the analysis of 8 transtibial (TT) amputees, presents a quantitative method for the study of human gait which allows the determination of the influence of four different prosthetic ankle-foot mechanisms (SACH, Single-axis, Greissinger and Dynamic) on gait. To do this, 1341 gait trials at different cadences were analysed (383 with normal subjects and 958 with amputees, using the four prosthetic feet under study). From all the variables available for study only those which offered interpretable clinical information were chosen for analysis. A total of 18 variables (kinetic, kinematic and time-related) were selected. A covariance analysis (ANOVA) of these variables was made, which showed that the factors influencing TT amputee gait were, in order of importance, cadence and leg studied (sound or prosthetic), inter-individual variability and, finally, the prosthetic mechanism used. When looking at the performance during gait of the 4 prosthetic mechanisms studied it can be observed that there are similarities in the kinetic study between SACH and Dynamic feet on one hand and Single-axis and Greissinger feet on the other. These results seem to support the classification criteria of articulated and non-articulated prosthetic mechanisms.