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We examined the relationship between grip strength declines and muscle-tendon responses induced by long-term performance of a high-repetition, low-force (HRLF) reaching task in rats. We hypothesized that grip strength declines would correlate with inflammation, fibrosis and degradation in flexor digitorum muscles and tendons. Grip strength declined after training, and further in weeks 18 and 24, in reach limbs of HRLF rats. Flexor digitorum tissues of reach limbs showed low-grade increases in inflammatory cytokines: IL-1beta after training and in week 18, IL-1alpha in week 18, TNF-alpha and IL-6 after training and in week 24, and IL-10 in week 24, with greater increases in tendons than muscles. Similar cytokine increases were detected in serum with HRLF: IL-1alpha and IL-10 in week 18, and TNF-alpha and IL-6 in week 24. Grip strength correlated inversely with IL-6 in muscles, tendons and serum, and TNF-alpha in muscles and serum. Four fibrogenic proteins, TGFB1, CTGF, PDGFab and PDGFbb, and hydroxyproline, a marker of collagen synthesis, increased in serum in HRLF weeks 18 or 24, concomitant with epitendon thickening, increased muscle and tendon TGFB1 and CTGF. A collagenolytic gelatinase, MMP2, increased by week 18 in serum, tendons and muscles of HRLF rats. Grip strength correlated inversely with TGFB1 in muscles, tendons and serum; with CTGF-immunoreactive fibroblasts in tendons; and with MMP2 in tendons and serum. Thus, motor declines correlated with low-grade systemic and musculotendinous inflammation throughout task performance, and increased fibrogenic and degradative proteins with prolonged task performance. Serum TNF-alpha, IL-6, TGFB1, CTGF and MMP2 may serve as serum biomarkers of work-related musculoskeletal disorders, although further studies in humans are needed. / Biomedical Sciences

Injuries of the hands and wrist are prevalent in many occupations requiring repetitive tasks and may be further aggravated by advancing age; these injuries are termed work related musculoskeletal disorders (WMSDs). Prior studies using an innovative operant rat model of reaching and grasping as a model of WMSDs demonstrated exposure dependent changes in forelimb bones of young adult rats performing repetitive tasks ≤ 3 months. No one has yet to examine if aging enhances forelimb bone degradative changes occurring with WMSDs, or if forelimb bones adapt or degrade further in response to moderate versus high demand repetitive tasks performed for prolonged time periods (up to 24 months). Bone remodeling is a normal biological process that allows bones to adjust to strains. Unfortunately, both aging and inflammation can deregulate the balance between bone resorption and formation. Aging mammals display increased baseline inflammatory-cytokine levels, both systemically and at the tissue level. Several inflammatory cytokines have been shown to stimulate osteoclastogenesis leading to bone resorption and reduced bone formation. We have reported increased production of inflammatory cytokines in serum and musculotendinous tissues of aged animals performing a repetitive reaching and grasping tasks for up to 12 weeks, warranting further examination of whether aged rats performing these tasks have increased bone resorptive changes, compared to young adult rats. We hypothesized that aging would enhance bone degradative changes in our model as a consequence of increased bone inflammatory responses to a moderate demand repetitive task. Therefore, our first aim was to examine forearm grip strength, trabecular and cortical bone quality, and inflammatory cytokine levels in radii of mature (14-18 mo of age) and young adult (2.5-6.5 mo of age) female Sprague Dawley rats after performance of a high repetition low force (HRLF) task for 12 weeks, compared to each other and age-matched controls. We found that mature rats performing a moderate demand repetitive task for 12 weeks had decreased bone formation and quality, particularly cortical bone quality, compared to young adult rats performing the same task, with increased inflammatory and decreased anti-inflammatory responses, and perhaps lower grip strength, as likely contributors. An adaptive bone response was observed in young adult animals performing a moderate level task of high repetition low force for 12 weeks. In contrast, a previous study showed bone degradative changes in young adult rats performing a high demand task of high repetition high force task for 12 weeks. Osteocytes are the mechanosensing cells of bones, and disruption or changes to their environment can lead to apoptosis or molecular changes. In models of forced bone loading to bone fatigue, osteocyte apoptosis increases sclerostin levels and osteoclast recruitment. Increased sclerostin also leads to increased RANKL production. In contrast, low level loading for a short period reduces sclerostin levels and encourages bone formation. We hypothesized that long-term muscle loading at high repetition low force loads would induce further bone adaptation, but that long-term high repetition high force muscle loading would result in detrimental bone loss, as well as alterations in these two bone remodeling proteins, RANKL and sclerostin. Therefore, our second aim was to determine if prolonged performance of a moderate demand upper extremity reaching and grasping task by young adult rats would continue to enhance forelimb bone formation and quality. We hypothesized that continued performance of a high repetition low force (HRLF) task for 24 weeks would lead to increased bone formation. We also hypothesized that RANKL and sclerostin, two proteins that have not been investigated in our rat model of WMSDs, would be reduced in rats performing a HRLF task for 24 weeks, as the bones reach adaptation. We found that 24 week HRLF rats showed several indices of bone formation and adaptation to the task; as well as reduced sclerostin immunoexpression, compared to controls, a reduction that likely contributed to the enhanced bone formation. To expand on this investigation, in our third aim, we investigated the impact of performance of a high repetition high force (HRHF) task for 18 weeks on young adult rat forelimb bones, and on sclerostin and RANKL levels. We observed detrimental trabecular bone remodeling in the radius, including decreased trabeculae bone volume, number and thickness, increased trabecular separation and anisotropy, and a transition to rod-shaped trabeculae in 18-week HRHF task animals, compared to food restricted control rats. In the 18-week HRHF rats, osteoclast numbers increased and osteoblast numbers decreased, concomitant with increased osteocyte apoptosis and empty lacunae, compared to control rats. Also, mRNA and protein levels of RANKL increased and sclerostin decreased in the 18-week HRHF rats, compared to to control rats. Thus, prolonged performance of a high demand task of high repetition high force induced detrimental trabecular bone changes. The increased RANKL likely contributed to these changes, and although sclerostin level decreased, a change that should contribute to enhanced osteoblast activity, bone formation was not rescued. In conclusion, prolonged performance of a HRLF task by young adult rats leads to reduced sclerostin levels and increased bone formation and bone quality. Aged rats performing the same HRLF task showed increased bone degradative changes that might increase fracture risk. In contrast, prolonged performance of a HRHF task by young adult rats leads to increased bone resorption and degradation, changes associated with RANKL expression. Sclerostin levels were reduced by the HRHF task, but failed to rescue bone formation. / Cell Biology

Bakgrund: Svensk idrott med cirka tre miljoner medlemmar spelar en viktig roll i främjandet av god hälsa men medför även en risk för skador. Det kräver både preventiva och rehabiliterande åtgärder. En kartläggning av de vanligaste idrottsskadorna kan bidra till att identifiera kunskapsluckor samt underlätta implementering av förebyggande åtgärder inom fysioterapi. Syfte: Studiens syfte var att kartlägga och analysera skadepanoramat efter år 2000 inom de fem mest utövade idrotterna i Sverige, samt identifiera eventuella skillnader baserat på kön, ålder och idrott. Metod: En allmän litteraturöversikt genomfördes med fokus på epidemiologiska- och kohortstudier. 163 studier identifierades via sökningar i databaserna Pubmed (n = 78), Cinahl (n = 30) och SportDiscus (n = 55). Efter granskning av titel och abstrakt, återstod 17 studier för kvalitetsgranskning med Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Resultat: 15 studier (fotboll = 7, friidrott = 3, gymnastik = 2, innebandy = 4) inkluderades i litteraturöversikten med ett totalt deltagarantal på 3 635 628 aktiva, varav 69.7% män. Inga svenska studier om golf kunde identifieras. En hög frekvens skador i nedre extremitet noterades i alla idrotter, framförallt i fotboll och friidrott, medan skador i underarm/hand framträdde i gymnastik. Dessutom framkom en hög frekvens rygg- och huvudskador inom innebandy och gymnastik. Konklusion: Skademönstret varierar inte markant mellan könen men män uppvisar en högre skaderisk än kvinnor. Endast fotboll noterade ett varierande mönster mellan ungdomar och vuxna där ungdomar hade en lägre skadeincidens och fler frakturer. Generellt finns det ett behov av uppdaterad, könsrepresentativ forskning inom idrotterna. / Background: Swedish sports play a crucial role in promoting good health but also carry a risk of injuries. This requires both preventive and rehabilitative measures. A mapping of sports injuries can help identify knowledge gaps and facilitate the implementation of preventive measures within physiotherapy. Aim: The aim was to map and analyze the injury landscape after the year 2000 within the five most practiced sports in Sweden, and to identify any differences based on gender, age, and sport. Method: A literature review was conducted, focusing on epidemiological-, and cohort studies. 163 studies were identified through the databases Pubmed (n = 78), Cinahl (n = 30), and SportDiscus (n = 55). After reviewing title and abstract, 17 remained for quality review with the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: 15 studies (football = 7, athletics = 3, gymnastics = 2, floorball = 4) were included with a total of 3,635,628 participants, of which 69.7% were men. No studies on golf were identified. A high frequency of lower extremity injuries was noted in all sports, especially in football and athletics, while forearm/hand injuries were prominent in gymnastics. In addition, back and head injuries were noted within floorball and gymnastics. Conclusion: The injury pattern does not vary significantly between the sexes, but men show a higher risk of injury than women. Only football noted a varying pattern between youth and adults, where youth had a lower injury incidence and more fractures. There is a need for updated, gender-representative research within sports.

Thesis (MSc (Physiological Sciences))--University of Stellenbosch, 2006. / Despite a growing interest into the mechanisms of the repeated bout effect, little is known about the consequences of chronic eccentrically biased training and the possible advantageous such training may offer to athletes as well as patients with muscle-debilitating disease. This study investigated the role of satellite cells in the muscle adaptation in response to either downhill or uphill high intensity training (HIT). Welltrained endurance runners were divided into two training groups matched for training volume and 10 km running times (n = 6, uphill training, UP; n = 6, downhill training, DH) and subjects in both groups completed 10 HIT sessions over a period of 4 weeks. Running performance was tested before and after the training intervention by a 10 km road race and peak treadmill speed (PTS) in horizontal and inclined (+5%) laboratory incremental tests to exhaustion. Skeletal muscle biopsies were sampled at baseline, after 2 HIT sessions, and after 4 weeks of HIT. Muscle was analysed immunohistochemically for satellite cell frequency as identified by CD56 and M-cadherin (Mcad) expression. Myogenin protein contents of muscle homogenates were determined by western blotting. Myosin heavy chain (MyHC) isoform proportions and mean fibre crosssectional area was measured. During the HIT intervention, UP exercised at a higher percentage of their HRmax than DH (mean ± SD, 97 ± 1 vs. 92 ± 3 %HRmax, p < 0.005), but at a similar rate of perceived exertion (RPE). DH completed more intervals per session and covered greater distance per session than their UP counterparts. Both training groups increased their training intensity but decreased their training volume during the 4 weeks of HIT. The combined group of 12 athletes improved their PTSgradient (mean ± SD, 16.7 ± 0.8 vs. 17.3 ± 1.0 km/h, p < 0.05). No significant differences between groups were found for PTS, VO2max or 10 km performance. Satellite cell frequency in this cohort of trained runners (48.9 ± 10.3 km/week) at baseline was similar to healthy young males (CD56+ cells/fibre, 0.19 ± 0.10). Satellite cell frequency increased significantly in DH after 4 weeks (Mcad, 123%; CD56, 138%) and non-significantly in UP (Mcad, 45%, CD56, 39%). No significant differences were found after two training sessions or at any time between groups. Mcad and CD56 expression correlated well (r = 0.95, p < 0.0001). Muscle myogenin content increased for both groups (UP: 56%; DH: 60%) after 4 weeks. No notable changes were seen after two training sessions. However, myogenin levels 2 days after session 1 correlated well (r= 0.99, p<0.005) with muscle pain experienced on the same day, as measured by the visual analogue scale. No changes were seen in the MyHC proportions or the fibre cross-sectional area after the training intervention. It was concluded that the training intervention was too short to induce changes in MyHC distribution or fibre area. Is seems likely that satellite cell proliferation was initiated as an early response to DOMS, but the response was maintained for 4 weeks. However, due to the lack of change in fibre morphology and myonuclear number, the role of satellite cell proliferation in fibre type transformation or muscle hypertrophy could not be established. Similarly, various possible roles for increased myogenin protein are offered, but since the origin of myogenin expression (satellite cells vs. myonuclei) was not determined, no definite conclusion regarding the precise function can be made. In conclusion, this study is the first to definitively indicate satellite cell proliferation in well-trained endurance runners in response to a change in training, including specifically downhill HIT. This response was early and sustained. This study asks several questions about the role of satellite cells during muscle adaptation to repetitive downhill training, and lays a foundation for further research into this unexplored field.

Title: Algometric analysis of influence of crimp grip on soft tissues of hand and forearm. Objectives: The main aim of this thesis is comparison and evaluation of changes of nociceptors sensitivity treshold in chosen points of upper extremities area before and after defined strain using pressure algometer. Methods: Data for the experiment was obtained using pressure algometr. Pain threshold was measured in defined 42 points in the order given at each subject firstly before strain and again immediately after defined strain of upper extremities (one minute hangig by the both hands in crimp grip on a campus board in this way: 10 sec strain plus 10 sec break, all six times). Then were measured values statisticaly analysed. Sources for processing of theoretical part of this work were obtained from expert articles and literature which follow up the given task. Results: Statisticaly important results show, that decreasing of pain threshold (on average by 100 - 160 kPa) comes about in tissues of upper extremity immediately after its loading in crimp grip, which means increasing of nociceptors sensitivity. At the same time it has been proved that nociceptors sensitivity in the area of tendon pulleys correlates with frequency of their injury quoted in a literature (that is the highest sensitivity in the...

Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2018-10-10T14:22:03Z No. of bitstreams: 1 Marina Maria de Oliveira.pdf: 455355 bytes, checksum: 7c4f3bbaa59c558ac0f1baa9658f82de (MD5) / Made available in DSpace on 2018-10-10T14:22:03Z (GMT). No. of bitstreams: 1 Marina Maria de Oliveira.pdf: 455355 bytes, checksum: 7c4f3bbaa59c558ac0f1baa9658f82de (MD5) Previous issue date: 2018-08-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Os antidepressivos estão entre as classes de medicamentos mais consumidas no mundo. O alto consumo coincidiu com o aumento da prevalência de indivíduos sem diagnóstico de transtorno mental utilizando esta classe, promovendo a discussão sobre adequação do uso. O uso de antidepressivo incorre em riscos como aumento da chance de suicídio, complicações hemorrágicas, dependência e síndrome de abstinência. Além disso, a efeitos adversos como disfunção sexual que comprometem a qualidade de vida do indivíduo. Objetivo: Analisar os fatores associados ao consumo de antidepressivo por indivíduos sem diagnósticos de depressão. Métodos: Um inquérito domiciliar foi realizado com amostra probabilística (N=3744) nas cidades de São Paulo e Rio de Janeiro, entre 2007 e 2008. Os instrumentos ¿Composite International Diagnostic Interview¿ (CIDI) e questionário sobre uso de medicamentos psicotrópicos foram utilizados para obter diagnóstico de transtorno depressivo e informações sobre uso de medicamento. O modelo de regressão de poisson foi utilizado para estimar associação entre o uso de medicamento antidepressivo por indivíduos sem diagnósticos de depressão, controlado pelas variáveis sociodemográficas, outros diagnósticos de transtorno mental e histórico de doença mental na família. Resultados: Foram entrevistados 3744 indivíduos nas cidades de São Paulo e Rio de Janeiro. Destes, 4% utilizavam o medicamento antidepressivo, sendo que 59% não apresentaram diagnóstico de transtorno depressivo. Entre os indivíduos sem diagnósticos de depressão e que estavam usando medicamento antidepressivo, 60% não tinham diagnóstico de outro transtorno mental, mas 40% tinham histórico de doença mental na família. O uso de medicamento antidepressivo nestes indivíduos foi associado a ser mulher, da cor da pele branca, faixa etárias mais velhas, ter filhos, ter outros transtornos mentais e ter histórico de doença mental na família. Conclusão: na medida em que os antidepressivos estão sendo prescritos para indivíduos sem diagnóstico de transtorno depressivo, são necessários mais estudos investigativos para que o uso racional destes medicamentos seja avaliado. Os resultados deste estudo são indicativos de um uso inadequado, e, desse modo há uma necessidade de intervenções para garantir utilização adequada dos antidepressivos, seja através do fortalecimento das políticas já existentes e a elaboração de políticas especificas para a saúde mental deve ser destacada. Portanto, se faz necessária revisão de práticas e das políticas públicas dos medicamentos, buscando maneiras de coibir o uso irracional desta classe. / ABSTRACT Antidepressents are among the mostly consumed drug class in the world. The high consumption coincided with the increase in the incidence of individuals without diagnosis of mental disorder but also for other different diagnosis, promoting then the discussion about its suitability of use. The use of antidepressant medication sustains risks such as increased chance of suicide, hemorrhagic complications, dependence and withdrawal syndrome. In addition, adverse effects can also include sexual dysfunction. Objective: To analyze factors associated with antidepressant use in the general population without a diagnosis of depressive disorder. Methodology: A household survey was conducted using a probability sampling method (N=3744) in the cities of Sao Paulo and Rio de Janeiro, between 2007 and 2008. The 'Composite International Diagnostic Interview' (CIDI) and a questionnaire about the usage of psychotropic drugs were used in order to obtain diagnosis of depressive disorder and information on the use of the medication. Poisson Regression Method were performed to estimate the association between used of antidepressant medication in individuals, modeled by and sociodemographic variables, other diagnosis of mental disorder and mental history in families. Results: A total of 3744 individuals were interviewed in the cities of Sao Paulo and Rio de Janeiro. Of these, 4% used antidepressant drugs, 59% of those did not present a diagnosis of depressive disorder. Among individuals without a diagnosis of depressive disorder using the medication, 60% had no other diagnosis of mental disorder and 40% with family history of mental illness. The use of antidepressant on those individuals was associated with being female, Caucasian, between 45-59 years old, having children, diagnosed with other mental illness and having history of mental illness in the family. Conclusion: as antidepressants are being prescribed to individuals without a diagnosis of depressive disorder, further research is required for the rational use of these drugs to be evaluated. The results of this study are indicative of an inadequate use, so interventions are needed to ensure adequate use of antidepressants, either through strengthening of existing policies and the development of specific policies for mental health should be highlighted. Therefore, it is necessary to review practices and public policies of medicines, seeking ways to curb the irrational use of this class.

Background: Overuse injuries (OI) account for a substantial part of sport injury incidence among athletes of various sports and levels. They lead to serious consequences for athletes’ physical and mental health, as well as athletic performance. Despite the gradual onset of symptoms, athletes often persevere in training and competing. The present study aimed to identify psychological risk profiles suggested to explain maladaptive behaviors prior or in response to first signs of overuse injuries. Design: Prospective cohort study. Methods: 149 athletes representing 10 individual and team sports responded to a range of questionnaires regarding personal (athletic identity, perfectionistic concerns, grit and negative life stress) and interpersonal (coach-athlete relationship) psychological traits. By using the mobile application Briteback®, participants subsequently answered the OSTRC Overuse Injury Questionnaire on a weekly basis during a 10 weeks period. A latent profile analysis was used in order to identify different psychological profiles. Results: Athletes were classified into 3 latent profiles regarding their psychological characteristics: profile 1 was labelled a “perfectionistic OI risk profile”, profile 2 a “negative stress OI risk profile” whereas profile 3 was called a “low risk profile for OI”. Indeed, athletes in profile 1 and 2 were found to be significantly more often affected by overuse problems than individuals in profile 3 (71% of the time, χ² (2) = 9.62, Hedges’ g = (0.71), p &lt; .01 and 70% of the time χ² (2) = 9.13, Hedges’ g = (0.68), p &lt; .01 vs 45% of the time), with athletes in profile 1 also experiencing more substantial overuse problems than for profile 3 (35% vs 21% of the time; χ² (2) = 4.12, Hedges’ g = (0.50), p &lt; .05). Conclusions: Our findings support the existence of two “risk profiles” in which athletes are characterized either by elevated perfectionistic concerns or by high negative stress. These findings could be explained by the perseverative and rigid personality of perfectionistic concerns individuals and by the hypothesis of a synergy between psychological and physiological stress for negative stressed athletes. Coaches should pay particular attention to the psychological characteristics of their athletes in order to prevent overuse injury occurrence and worsening, especially those with high perfectionistic concerns and negative life stress. Cognitive behavioral interventions supporting at-risk athletes in reframing their rule-governed behaviors might decrease the risk of overuse problems.

Thesis (LL.M)--York University, 2003. / Includes bibliographical references. Also available on the Internet.