Chronic muscle diseases are highly prevalent in the elderly causing severe mobility limitations, pain and frailty. The intrinsic molecular mechanisms are poorly understood due to multifactorial... Show moreChronic muscle diseases are highly prevalent in the elderly causing severe mobility limitations, pain and frailty. The intrinsic molecular mechanisms are poorly understood due to multifactorial causes, slow progression with age and variations between individuals. Understanding the underlying molecular mechanisms could lead to new treatment options which are currently limited. Shoulder complaints are highly common in the elderly, and therefore, muscles of the shoulder’s rotator cuff could be considered as a model for chronic age-associated muscle degeneration. Diseased shoulder muscles were characterized by muscle atrophy and fatty infiltration compared with unaffected shoulder muscles. We confirmed fatty infiltration using histochemical analysis. Additionally, fibrosis and loss of contractile myosin expression were found in diseased muscles. Most cellular features, including proliferation rate, apoptosis and cell senescence, remained unchanged and genome-wide molecular signatures were predominantly similar between diseased and intact muscles. However, we found down-regulation of a small subset of muscle function genes, and up-regulation of extracellular region genes. Myogenesis was defected in muscle cell culture from diseased muscles but was restored by elevating MyoD levels. We suggest that impaired muscle functionality in a specific environment of thickened extra-cellular matrix is crucial for the development of chronic age-associated muscle degeneration. Show less
Kolk, A.; Henseler, J.F.; Witte, P.B. de; Arkel, E.R.A. van; Visser, C.P.J.; Nagels, J.; ... ; Groot, J.H. de 2016
BACKGROUND: Subacromial pain syndrome (SAPS) and scapular dyskinesis are closely associated, but the role of pain is unknown. We hypothesized that pain results in asymmetrical scapular kinematics,... Show moreBACKGROUND: Subacromial pain syndrome (SAPS) and scapular dyskinesis are closely associated, but the role of pain is unknown. We hypothesized that pain results in asymmetrical scapular kinematics, and we expected more symmetrical kinematics after infiltration of subacromial anaesthetics. OBJECTIVE: To investigate the effect of subacromial anaesthetics on scapular kinematics in patients with SAPS. DESIGN: Observational cohort study. METHODS: We evaluated shoulder kinematics in 34 patients clinically and radiologically (magnetic resonance arthrography) identified with unilateral SAPS using three-dimensional electromagnetic motion analysis (Flock of Birds). Scapular internal rotation, upward rotation and posterior tilt of the affected shoulder were compared with the kinematics of the unaffected shoulder and following subacromial anaesthetics. Additionally, the association of pain (Visual Analogue Scale, VAS) and scapular rotation was analysed. RESULTS: Compared with the contralateral healthy shoulder, 5° more (95% CI 0.4-9.7, p = 0.034) scapular internal rotation was observed in the affected shoulder at 110-120° of abduction. Following subacromial anaesthetics in the affected shoulder, internal rotation increased (2°, 95% CI 0.5-3.9, p = 0.045) and posterior tilt decreased (3°, 95% CI 1.5-5.0, p = 0.001) at 110-120° of abduction. Less scapular upward rotation was significantly associated with higher pain scores before infiltration (R = 0.45, p = 0.013). CONCLUSIONS: More scapular internal rotation was observed in affected shoulders of patients with SAPS compared with unaffected shoulders. Subacromial infiltration did not restore kinematics toward symmetrical scapular motion. These findings suggest that subacromial anaesthesia is not an effective means to instantly restore symmetry of shoulder motion. Show less
Chronic muscle diseases are highly prevalent in the elderly causing severemobility limitations, pain and frailty. The intrinsic molecular mechanisms are poorlyunderstood due to multifactorial... Show moreChronic muscle diseases are highly prevalent in the elderly causing severemobility limitations, pain and frailty. The intrinsic molecular mechanisms are poorlyunderstood due to multifactorial causes, slow progression with age and variationsbetween individuals. Understanding the underlying molecular mechanisms couldlead to new treatment options which are currently limited. Shoulder complaints arehighly common in the elderly, and therefore, muscles of the shoulder’s rotator cuffcould be considered as a model for chronic age-associated muscle degeneration.Diseased shoulder muscles were characterized by muscle atrophy and fatty infiltrationcompared with unaffected shoulder muscles. We confirmed fatty infiltration usinghistochemical analysis. Additionally, fibrosis and loss of contractile myosin expressionwere found in diseased muscles. Most cellular features, including proliferation rate,apoptosis and cell senescence, remained unchanged and genome-wide molecularsignatures were predominantly similar between diseased and intact muscles.However, we found down-regulation of a small subset of muscle function genes,and up-regulation of extracellular region genes. Myogenesis was defected in musclecell culture from diseased muscles but was restored by elevating MyoD levels. Wesuggest that impaired muscle functionality in a specific environment of thickenedextra-cellular matrix is crucial for the development of chronic age-associated muscledegeneration. Show less
Purpose: Shoulder function in children with Neonatal Brachial Plexus Palsy (NBPP) can be impaired. Functional gain is possible by an internal contracture release and muscle tendon transfer (ICL+MTT... Show morePurpose: Shoulder function in children with Neonatal Brachial Plexus Palsy (NBPP) can be impaired. Functional gain is possible by an internal contracture release and muscle tendon transfer (ICL+MTT) for external rotation. This study evaluates the functional results of this intervention. Methods: Assessments were done pre-operatively and 3, 6 and 12 months thereafter and included joint-mobility (ROM), muscle strength, arm function (Assisting Hand Assessment (AHA) and Mallet-score), Quality of Life (QoL) (Pediatric Outcome Data Collecting Instrument (PODCI)) and parental satisfaction. Changes were examined using Wilcoxon’s Signed-Rank test and Cohen’s effect size. Results: Tenchildren (5 boys) aged 3-10 years who underwent a combined ICL+MTT (mm. Latissimus Dorsi/Teres Major) were included. Active and passive external rotation ROM and muscle strength improved (p<0.05). Arm function improved according to the Mallet-score (Hand-to-Head, Hand-to-Mouth, External-Rotation) (p<0.05) and the arm use and pace scales of the AHA (p<0.05). The PODCI Upper Extremity/Physical Functioning and Global Functioning subscales also showed improvements (p<0.05). Parents were highly satisfied concerning daily life activities and sports.Conclusion: ICL+MTT leads to improvement of ROM, strength, arm function, QoL and high parental satisfaction in this studies’ patients and is therefore a good intervention to consider in children with NBPP with limited shoulder function. Show less
Henseler, J.F.; Kolk, A.; Zwaal, P. van der; Nagels, J.; Vlieland, V.; Nelissen, R.G.H.H. 2015
