Neuromuscular disorders, disuse, inadequate nutrition, metabolic diseases, cancer and aging produce muscle atrophy and this implies that there are different types of molecular triggers and signaling pathways for muscle wasting. Exercise and muscle contractions may counteract muscle atrophy by releasing a group of peptides, termed myokines, to protect the functionality and to enhance the exercise capacity of skeletal muscle. In this review, we are looking at the role of myokines in the recovery of permanent denervated and elderly skeletal muscle tissue. Since sub-clinical denervation events contribute to both atrophy and the decreased contractile speed of aged muscle, we saw a parallel to spinal cord injury and decided to look at both groups together. The muscle from lifelong active seniors has more muscle bulk and more slow fiber-type groupings than those of sedentary seniors, demonstrating that physical activity maintains slow motoneurons that reinnervate the transiently denervated muscle fibers. Furthermore, we summarized the evidence that muscle degeneration occur with irreversible Conus and Cauda Equina syndrome, a spinal cord injury in which the human leg muscles may be permanently disconnected from the peripheral nervous system. In these patients, suffering with an estreme case of muscle disuse, a complete loss of muscle fibers occurs within five to ten years after injury. Their recovered tetanic contractility, induced by home-based Functional Electrical Stimulation, can restore the muscle size and function in compliant Spinal Cord Injury patients, allowing them to perform electrical stimulation-supported stand-up training. Myokines are produced and released by muscle fibers under contraction and exert both local and systemic effects. Changes in patterns of myokine secretion, particularly of IGF-1 isoforms, occur in long-term Spinal Cord Injury persons and also in very aged people. Their modulation in Spinal Cord Injury and late aging are also key factors of home-based Functional Electrical Stimulation - mediated muscle recovery. Thus, Functional Electrical Stimulation should be prescribed in critical care units and nursing facilities, if persons are unable or reluctant to exercise. This will result in less frequent hospitalizations and a reduced burden on patients’ families and public health services.
This Perspective will discuss topics recently suggested by Prof. Helmut Kern, Vienna, Austria, to advance the research activities of his team, that is: Topic A, 10 years post RISE; Topic B, New research for new solutions on old research questions; Topic C, Working groups on nerve regeneration, training-parameters of seniors in different ages, muscle adaptation; and studies of connective tissue and cartilage. This Perspective summarizes some of the basic concepts and of the evidence-based tools for developing further translational research activities. Clinically relevant results will ask for continuous interests of Basic and Applied Myologists and for the support during the next five to ten years of public and private granting agencies. All together, they will end in protocols, devices and multidisciplinary managements for persons suffering with muscle denervation, neuromuscular-related or non-related pain and for the increasing population of old, older and oldest senior citizens in Europe and beyond.
Objective: To test the cumulative effects of repeated application of Cayenne Pepper Cataplasm "Munari" alone (MUN) or in combination (COMB) with neuromuscular electrical stimulation (NMES) and massage on non-specific chronic low back pain (LBP) in terms of safety, pain relief, function and mobility.Design: Before and after intervention trial. Adults suffering from non-specific chronic LBP were treated with "Munari", ten times within 3 weeks. In COMB, following "Munari", 15 minutes of massage and 15 minutes of NMSE were performed. Blood pressure, circulating levels of acute phase proteins (ESR, CRP, CK, albumin), cortisol and inflammatory biomarkers (TNF-α, IL-6, sp-selectin) were assessed before the 1 st and after the 10 th treatment. At the same time points, measurements included VAS questionnaire, function and mobility tests (ODI, Schober), and serum levels of miRNAs involved in inflammation, pain signalling, and muscle homeostasis. Results:In MUN, blood pressure and pain were significantly reduced. In COMB, function and mobility test's scores significantly improved. In both groups, circulating levels of acute phase response or inflammatory biomarkers didn't increase, and miRNAs regulating pain signaling were significantly modulated.Conclusions: Repeated Munari applications are safe and effective for the treatment of non-specific chronic LBP, in particular when combined with NMES and massage.Zampieri S (2019) Cayenne Pepper Cataplasm "Munari" reduces pain and improves mobility in patients with non-specific chronic low back pain Volume 4: 2-7
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