<div> <div> <div> <p>Skeletal muscle occupies approximately 40 to 50 percent of body mass and is responsible for respiration, postural control, and locomotion and plays a pivotal role in regulating glucose, lipid, and protein metabolism. Acute muscle trauma and chronic disease conditions such as muscular dystrophies are associated with structural abnormalities, enhanced fatigability and impaired metabolism and consequently lead to exercise intolerance and poor quality of life. Despite the clinical importance and a number of studies on the treatment of muscle damage, few modalities have shown to elicit beneficial effects. Heat treatment has been used for a long time to treat soft tissue injuries in the field of physical therapy and sports medicine. However, the underlying mechanisms by which heat treatment accelerates muscle recovery following injury are not clear. </p> <p>The primary aim of my dissertation studies was to determine the impact of heat therapy on skeletal muscle structure and function in humans and animals. In Chapter 2, we report that a single session of local heat treatment promotes the expression of angiogenic and myogeneic mediators including vascular endothelial growth factor (VEGF) and angiopoietin 1(ANGPT1) in healthy human skeletal muscle. In Chapter 3, we report repeated exposure to heat therapy stimulates factors involved in muscle repair process and accelerates functional recovery from exercise-induced muscle damage. In Chapter 4, we show that 8 weeks of local heat therapy improves muscle strength of knee extensor and increases skeletal muscle capillarization in type II muscle fibers. In Chapter 5, we describe the effects of heat therapy in a mouse model of ischemia induced-muscle damage. Animals that were exposed to heat therapy at 39°C had improved maximal absolute force and relative muscle mass in the soleus muscle. These observations reveal that the beneficial effects of heat therapy are muscle fiber type specific and dependent on the treatment temperature. In Chapter 6, we review and summarize the outcomes described in Chapters 2-5 and provide a general conclusion as well the clinical implications of our findings. </p> </div> </div> </div>

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-06-19T15:09:33Z No. of bitstreams: 1 Henrique Dantas Pinto.pdf: 960423 bytes, checksum: 532e077b2fcb7e318a547143ea91e049 (MD5) / Made available in DSpace on 2018-06-19T15:09:33Z (GMT). No. of bitstreams: 1 Henrique Dantas Pinto.pdf: 960423 bytes, checksum: 532e077b2fcb7e318a547143ea91e049 (MD5) Previous issue date: 2015-12-15 / It has been a growth of rugby practice in country (Brazil) since its’ entrance in the Olympic Games of 2016. Consequently, it indispensable that more studies regarding training be developed in order to contribute to the improvement of that sport. Being a sport modality with intense physical contact, which the athlete must maintain high speed, strength and power throughout the game, and within several matches during the same day, muscle recovery is a crucial point to be developed for its’ athletes. Several researches have shown that the use of low-level laser therapy (LLLT) or light emitting diode therapy (LEDT) were effective in preventing muscle fatigue, delaying the effects of fatigue, aiding recovery of muscles, reducing the risk of injury, and therefore, improving the athletic performance. However, those studies have been developed in controlled environment (laboratory). Thus, the present research project aims to study the physiological response of rugby players to pre-exercise phototherapy treatment (with combination of LLLT and LEDT). A randomized, placebo-controlled, crossover, double-blind study was conducted. Therefore, this study included a field test for anaerobic capacity, a questionnaire fatigue and lactate analysis. The results showed that phototherapy previously applied to physical activity increases anaerobic endurance, delays fatigue and significantly reduces lactic acid levels in the bloodstream. Thus, the combination of LED and LLLT was efficient in improving the performance of high performance rugby players. / Com o ingresso do rugby nos jogos olímpicos de 2016 houve um crescimento da modalidade em território nacional, sendo imprescindível que mais estudos venham colaborar para a melhora dos treinamentos deste desporto. Por ser um esporte de muito contato físico no qual o atleta deve manter alta velocidade, força e potência durante todo o jogo e dentro de várias partidas durante o mesmo dia, a recuperação muscular é um ponto crucial a ser desenvolvido pelos atletas dessa modalidade. Várias pesquisas já demonstram que o uso de laserterapia de baixa potência (LBP) ou da fototerapia com diodo emissor de luz (LED) se mostraram eficientes na prevenção da fadiga muscular, sendo úteis para atenuar os efeitos da fadiga, auxiliando na recuperação da musculatura, reduzindo o risco de lesões e melhorando, portanto, o desempenho atlético. Contudo, os estudos realizados até o presente momento foram conduzidos em ambiente controlado (laboratorial). Deste modo, o presente trabalho teve como objetivo estudar a resposta fisiológica do uso da fototerapia (combinação de LBP e LED) pré-exercício em jogadores de rugby. Foi conduzido um ensaio clínico randomizado, placebo-controlado, cruzado e duplo-cego. Para tanto, este estudo contou um teste de campo para capacidade anaeróbica, um questionário de fadiga e análise de lactato. De acordo com resultados encontrados, é possível inferir que a fototerapia aplicada previamente a atividade física aumenta a resistência anaeróbica, retarda a fadiga e diminui significativamente os níveis de ácido lático na corrente sanguínea. Assim, a combinação de LBP e LED foi eficiente na melhora da performance de atletas de alto rendimento de rugby.

American maternal health is a concern and has even been described as a “crisis” (Gingrey, 2020). The US is an outlier in maternal health in comparison to other industrialized countries with more than a 50% increase in maternal death rates comparatively speaking (Taylor et al., 2022). A significant change in postpartum care must occur. Hope Health Today LLC, the proposed continuing education Limited Liability Company (LLC), will be the catalyst to this health care change. Hope Health Today LLC’s initial continuing education program will positively educate healthcare providers to better serve this at-risk population. Hope Health Today LLC will provide professional education for licensed occupational therapists, physical therapists, physicians, nurses, and midwives. The initial continuing education (CEU) course will be a holistic guide for Diastasis Recti Abdominis (DRA) recovery and postpartum care. The course will cover pelvic floor and deep core anatomy, a 20-week diastasis recti abdominis recovery program, postpartum body mechanics, breast feeding positions, roles and interpersonal relationships, signs of postpartum depression, and return to intimacy. HopeHealth Today LLC aims to make a positive impact for postpartum families. Making a change at the policy level through American College of Obstetrics and Gynecology (ACOG) to provide a 4-week pelvic floor therapy referral to all postpartum patients. Hope Health Today LLC will advance the profession of occupational therapy through advocating for a women’s health board certification through American Occupational Therapy Association (AOTA) and improving quality postpartum patient outcomes through providing research based continuing education for health care providers. HopeHealth TodayLLC will educate the public through social media. HopeHealth TodayLLC will advance the current state of postpartum care. The ambition of this company is to educate the public to know what to expect from their women’s health providers and what to ask for if care is not reaching appropriate standards.

Thesis (MSc)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Cryotherapy is one of the popular treatments used to alleviate muscle soreness, especially in the competitive sports arena. However, the therapeutic use of cryotherapy is unsubstantiated because of a lack of proper investigations in the literature, especially a hypothesised effect on muscle recovery. Thus, our aims were to characterise satellite cell (SC) activity in human subjects with delayed onset muscle soreness (DOMS) and to shed light on the effect of cryotherapy on SC activity. DOMS was induced in six male subjects (24 ± 3 years) by completion of a downhill-run (DHR) protocol (5 x 8 min bouts, 2 min rest between bouts) at 70 or 80% of their individual peak treadmill speed. Ice application was applied to only one leg per subject for 3 days: 30 min every 2 hours, 5 times per day. In total 5 muscle biopsies were obtained from each subject: 1 baseline and 4 post-DHR. Post-DHR biopsies: 1 from each leg on day 1 and 7 (1st group, n=3) and 1 from each leg on day 2 and 9 (2nd group, n=3). DOMS was successfully induced as indicated by significant increases in muscle soreness at days 1 and 2 post-DHR (P < 0.01), and creatine kinase activity at day 1 post-DHR (P < 0.01). No difference in muscle soreness was found between treated and untreated legs. SC quiescence and activation were characterised by their expression of the cell surface markers CD34 and CD56 respectively. No significant change in quiescent SC was observed in the untreated or treated legs over time. However, at day 1 post-DHR the number of quiescent SC was significantly lower in the untreated compared with the treated leg (P < 0.05). There was a significant increase in activated SC numbers at day 2 post-DHR in the untreated leg, which was sustained up to day 9 post-DHR (P < 0.01). However, no such increase was found in biopsies taken on days 1 and 7. Also, no change was found in the treated leg, however a significant difference between the number of activated SC in untreated and treated legs on days 2 and 9 post-DHR (P < 0.01) was seen. No significant effect of DOMS or ice treatment was observed for the expression of the myogenic regulatory factors, MyoD and myogenin. C2C12 cell cultures induced to differentiate, however, did stain using these antibodies. This is the first study to report an effect of cryotherapy at the tissue level. In conclusion, this study highlights many unanswered questions on the SC response to DOMS at tissue level, and lays a good foundation for future studies. / AFRIKAANSE OPSOMMING: Kreoterapie is een van die gewilde behandelings wat gebruik word om spierseerheid te verlig, veral in die kompeterende sport arena, maar die gebruik van kreoterapie is onbevestig as gevolg van ‘n gebrek aan voldoende ondersoeke in die literatuur, veral ‘n hipotese oor die effek op spier-herstel. Ons doelstellings was dus om satellietsel (SC) aktiwiteit te ondersoek in mens proefpersone met vertraagde aanvang spierseerheid (DOMS) en ook om lig te werp op die effek van kreoterapie op SC aktiwiteit. DOMS was in ses mans proefpersone (24 ± 3 jare) geїnduseer deur voltooїng van ‘n afdraend-hardloop (DHR) protokol (5 x 8 min rondtes, 2 min rus tussen rondtes) teen 70 of 80% van elkeen se individuele maksimum trapmeul-spoed. Ys was vir 3 dae op net een been per proefpersoon aangewend: 30 min elke 2 ure, 5 keer per dag. 5 spierbiopsies in totaal was van elke proefpersoon verkry: 1 basislyn en 4 post-DHR. Post-DHR biopsies: 1 van elke been op dae 1 en 7 (1ste groep, n=3) en 1 van elke been op dae 2 en 9 (2de groep, n=3). DOMS was suksesvol geїnduseer soos aangedui deur die betekenisvolle verhogings in spierseerheid op dae 1 en 2 post-HR (P < 0.01) en kreatien kinase aktiwiteit op dag 1 post-DHR (P < 0.01). Geen verskil in spierseerheid is gevind tussen die onbehandelde en behandelde bene nie. SC dormansie en aktivering was gekarakteriseer deur die onderskeidelike uitdrukking van die sel oppervlak merkers CD34 en CD56. Geen betekenisvolle verandering is in SC dormansie in die onbehandelde en behandelde bene waargeneem nie, maar op dag 1 post-DHR was die getal dormante SC betekenisvol laer in die onbehandelde been as in die behandelde been (P < 0.05). Daar was ‘n betekenisvolle verhoging in die getalle geaktiveerde SC op dag 2 post-DHR in die onbehandelde been wat volgehou was tot op dag 9 post-DHR (P < 0.01), maar so ‘n verhoging was nie in biopsies wat op dae 1 en 7 geneem is gevind nie. Daar is ook geen verandering in die behandelde been gevind nie, maar ‘n betekenisvolle verskil in die getal geaktiveerde SC is tussen die onbehandelde en behandelde bene op dae 2 en 9 post-DHR gevind(P < 0.01). Geen betekenisvolle effek van DOMS en ys-aanwending vir die uitdrukking van die miogeniese (myogenic) regulatoriese faktore, MyoD en myogenin, is waargeneem nie. C2C12 sel kulture wat geїnduseer is om te differensieer het wel gekleur vir hierdie antiliggame. Dit is die eerste studie wat ‘n effek van kreoterapie op weefselvlak rapporteer. Ten slotte, hierdie studie beklemtoon baie onbeantwoorde vrae oor die SC respons op DOMS op weefselvlak en dit lê ‘n goeie grondslag neer vir toekomstige studies.

The majority of physiological processes and various other processes taking place in the body are closely related to changes in body temperature (Shellock & Prentince, 1985; Bennett, 1990). The temperature of the human body is constant throughout one’s life. It is approximately 37ºC and it constantly adjusts itself to changes in environment, relative air humidity, the level of radiation, atmosphere pressure and thermo isolation. During long-term physical load, in case of illness or in conditions of extreme body temperature may be in the range from 32ºC to 40ºC or even more (Wilmore & Costill, 2004). It could be hypothesized therefore that the muscle warmed prior to the load to be undertaken, when the leg is extended and flexed in the knee joint at high (500, 450o / s) and average (180o / s) speed depending on gender will increase muscle force and muscle capacity to a greater extent than the cooled muscle, but after lowering the temperature muscle resistance to fatigue will increase. Though considerable research has been done already certain questions still remain to be cleared up, namely: 1. how warming affects muscle fatigue and recovery of female knee extensors and flexors when the leg is being flexed and extended in the knee joint at the fixed 500o / s speed; 2. how muscle contraction function of female and male knee extensors and flexors depends on temperature when the leg is being flexed and extended in the knee joint at the fixed 450o / s and 180o / s peed. Though there... [to full text]

Tourniquet mediated Ischemia Reperfusion (I/R) injury causes damage to skeletal muscle, often resulting in prolonged functional impairment. The current study utilizes immunohistochemistry (IHC) to determine whether the controlled release of the anabolic factor, insulin-like growth factor-I (IGF-I), from the biodegradable PEGylated fibrin gel matrix can facilitate the recovery of skeletal muscle from I/R. Treatment groups following a 2-hour tourniquet applied to the limb of 6-9 month rats, included intramuscular injections of saline, PEGylated fibrin gel (PEG-Fib) only and IGF-I conjugated to PEGylated fibrin gel (PEG-Fib-IGF). Expression of the myogenic regulatory factors MyoD and myogenin detected via IHC in the PEG-Fib-IGF group was significantly lower compared to the saline group, showing a 1.4±0.8% nuclear co-localization for MyoD and a 2.0±0.8% nuclear co-localization for myogenin at 14 days of recovery. The saline group showed higher values, 31.4±4.4% and 44.1±7.3% for MyoD and myogenin nuclear co-localization respectively. A significantly greater percentage, 88.8±3.7% of Desmin positive myofibers was seen at 14 days of recovery, while a lower percentage of fibers expressing neonatal myosin, 7.7±2.7% was seen in the PEG-Fib-IGF group compared to the saline treatment group. These results indicate that IGF-I delivered intramuscularly via PEGylated fibrin gel, functions therapeutically in skeletal muscle recovery, from I/R mediated damage. In a separate injury model that deals with volumetric muscle loss, IHC analyses were performed to test the efficacy of a novel tissue engineering strategy utilizing extracellular matrix (ECM) as a scaffold. In this model, also called the defect model, a 1.0 X 1.0 cm piece of the lateral gastrocnemius was removed and replaced with a muscle-derived ECM. The constructs were then seeded with bone marrow derived cells (BMSCs), adipose derived stem cells (ADSCs) or the peroneal nerve was relocated to the area of the ECM implant. 42 days post recovery IHC analysis was performed on the ECM implants. The quantification of desmin-positive regenerating myofibers bearing centrally located nuclei, showed significantly greater values in the top, middle and bottom region of the ECM implants that received peroneal nerve relocation, when compared to the experimental group that received the ECM implant alone. Blood vessel density increases were seen within the middle region of the ECM implant groups that received BMSC+Nerve treatment and the bottom region of the ECM implant groups that received ADSC+Nerve treatment. Thus, these results corroborate the therapeutic effect of peroneal nerve relocation, which stimulated an increase in myofiber regeneration and vascular maintenance within the construct. / text

L’exposition à une situation d’hypokinésie induit une atrophie fonctionnelle et phénotypique du musclesquelettique. Différents mécanismes sont suggérés contribuer à ce phénomène de plasticité musculaire,incluant en particulier des modifications de l’homéostasie calcique et de la production d’espèces réactivesde l’oxygène qui, en relation avec certains processus inflammatoires, activeraient des voies d’apoptose etde protéolyse musculaire. Le présent travail a porté un intérêt spécifique à ces phénomènes dans le cadrede l’atrophie musculaire induite par une hypokinésie ainsi que dans la récupération après cessation de ceprotocole. À l’aide d’approches cellulaires nous montrons que l’extrusion du calcium cytoplasmique estconsidérablement ralentie dans les fibres musculaires atrophiées. Cet effet, lié au moins en partie à unecontribution altérée des mitochondries, pourrait jouer un rôle dans l’activation de voies protéolytiquescalcium-dépendantes. Dans un deuxième temps, nous avons étudié l’évolution du niveau de stressoxydant et de l’expression de différentes cytokines ainsi que de marqueurs de la voie apoptotiquecaspase-dépendante et de la protéolyse musculaire au cours du phénomène de récupération après la fin del’hypokinésie. Les résultats montrent que le retour à la normale de la masse musculaire est facilité lors dela phase précoce (1-5 jours) de récupération via la modulation de l’apoptose mitochondriale et de laprotéolyse musculaire. Par contre le stress oxydant et la voie apoptotique impliquant TNF-a persistentjusqu’à 14 jours de récupération, alors que la masse musculaire est déjà reconstituée. / Exposure to hypokinesia induces a functional and phenotypic atrophy of skeletal muscle. Several types ofmechanisms have been suggested to contribute to this plasticity phenomenon, including changes inintracellular calcium handling and in production of reactive oxygen species which, together withinflammatory processes, would activate muscle apoptosis and proteolysis pathways. The present workspecifically focussed on these mechanisms within the framework of a model of hypokinesia-inducedatrophy and of recovery from this atrophy. Measurements on isolated muscle cells revealed that the rateof myoplasmic calcium extrusion was considerably reduced in atrophied muscle fibres. This effect whichappears to be, at least in part, related to an altered mitochondrial contribution, may play a pivotal role inthe activation of calcium-dependent proteolysis pathways. We then studied the time course of changes inoxidative stress as well as in the expression level of several cytokines and proteins specifically involvedin proteolysis and caspase-dependent apoptotic pathways, along the course of recovery from atrophy. Ourresults demonstrate that, at early stages (1-5 days) of recovery, muscle re-growth is mediated via themodulation of mitochondrial-driven apoptosis and muscle proteolysis. In contrast, oxidative stress and theTNF-a related apoptotic pathway remain activated until late stages (14 days) of recovery, at a time whenmuscle mass has already recovered.