Search results for: muscle fatigue

Authors: Mohammad Mohammadi, Mohammad Pashmchi

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Background: Malnutrition commonly develops and worsens following gastric cancer surgery, particularly after discharge, which is associated with adverse outcomes. Former studies have primarily focused on patients during their hospital stay period, and there is limited evidence regarding the recommendation of nutritional interventions for patients after discharge from the hospital following gastric cancer surgery. This review is aimed to evaluate the efficiency of post-discharge dietary counseling with oral nutritional supplements (ONS), and dietary counseling alone on post-surgical nutritional outcomes in patients undergoing gastric cancer surgery. Methods: The four databases of Embase, PubMed, web of science, and google scholar were searched up to November 2022 for relevant randomized controlled trials. The Cochrane Collaboration’s assessment tool for randomized trials was used to evaluate the quality of studies. Results: Compared to patients who only received dietary counseling, patients who received both dietary counseling and ONS had considerably higher SMI, BMI, and less weight loss and sarcopenia occurrence rate. The patients who had received dietary counseling and ONS had significantly lower risk of chemotherapy intolerance. No differences in the readmission rate between the two groups was found. In terms of the quality of life, concomitant dietary advice and ONS significantly was associated with lower appetite loss and fatigue rate, but there was no difference in the other outcomes between the two groups. Conclusions: Post-discharge dietary advice with ONS following gastric cancer surgery may improve skeletal muscle maintenance, nutritional outcomes, quality of life variables, and chemotherapy tolerance. This evidence supports the recommendation of post-discharge dietary advice with ONS for patients who underwent gastric cancer surgery.

Keywords: gastric cancer surgery, oral nutritional supplements, malnutrition, gastric cancer

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Authors: Özge Çeliker Tosun, Melda Başer Secer, İsmail Düşmez, Sedat Çapar, İlkay Kozak, Melahat Aktaş, Furkan Can Şimşek, Gökhan Tosun

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Purpose: Portable innovative balance room system with digital game program; It was created to be able to be divided into small areas, such as inside the house, garden, balcony, to enable the person to enter and perform both evaluation and exercise safely, and to ensure that these results can be stored and sent to the therapist live or later when desired. The aim is to compare the effectiveness of the exercise program applied by the elderly within this system and the exercise program implemented under the supervision of a physiotherapist on balance and urinary incontinence symptoms. Materials and Methods: The study was conducted in a randomized controlled manner on 63 people with urinary incontinence (mean age: 75.5 years) at Narlıdere Nursing Home Elderly Care and Rehabilitation Center. Elderly people participating in the study were divided into 3 groups: 1. Group, an exercise program consisting of pelvic floor muscle training and OTOGA exercises, 2. Group, only pelvic floor muscle training, and 3. Group, pelvic floor muscle training and Otoga exercises in the form of a digital game program in a portable balance room system. (self-administered) for 12 weeks. Pelvic floor distress inventory (PTDE-20) and bladder diary were used to evaluate the incontinance symptoms of the cases. Pelvic floor muscle function was evaluated with superficial EMG. Berg, Fall Effectiveness Scale (FES) and Functional Status Evaluations (Chair Stand Test, Eight (8) Food Up and Go Test, Chair Sit and Reach Test, Two Minutes Step Test) were used to evaluate balance. The existence of differences between groups was analyzed using Krusskal Wallis analysis of variance, and the difference between before and after exercise was analyzed with Wilcoxon tests. Results: After treatment, PTDE-20, daily urinary incontinence and toilet visits values decreased significantly in all three groups (p < 0.001). While there was a statistically significant increase in pelvic floor muscle EMG values in the 2nd and third groups after treatment, there was no change in the other group (2nd Group PFM average EMG before-after: 5.5 (4.15-10.95) - 10.95 (8.68-13.68), P=0.05, 3 Group PFM average EMG before-after: 6.5 (4.28-11.55) - 11.75 (8.67-14.26), p=0.04). While BERG score, Chair Stand Test, Eight (8) Food Up and Go Test, and Two Minutes Step Test values increased in all groups (p<0.05), Fall Effectiveness Scale (FES) values did not change after treatment. Conclusion: Although pelvic floor muscle training combined with balance exercises reduces symptoms, it may not lead to a positive improvement in the functions of the pelvic floor muscles. For this reason, recovery lasts for a short time, and then symptoms may reoccur in the future. However, thanks to the new system, when balance exercises are combined with a game program for the pelvic floor muscles, a double effect can be achieved with a single application and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on this subject. However, thanks to the new system, a double effect can be achieved with a single application, and both incontinence and balance problems can be treated in a safe environment where the person can do it himself. But more work needs to be done on new system

Keywords: fall, urinary incontinance, balance, elderly

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Authors: Wei-Wen Hu, Yong-Zhi Zhong

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Depositing conductive polypyrrole (PPy) onto elastic polydimethylsiloxane (PDMS) substrate can obtain a highly stretchable conductive film, which can be used to construct a bioreactor to cyclically stretch and electrically stimulate surface cells. However, how to completely harvest these stimulated muscle tissue to repair damaged muscle is a challenge. To address this concern, N-isopropylacrylamide (NIPAAm), a monomer of temperature-sensitive polymer, was added during the polymerization of pyrrole on PDMS so that the resulting P(Py-co-NIPAAm)/PDMS should own both conductivity and thermo-sensitivity. Therefore, cells after stimulation can be completely harvested as cell sheets by reducing temperature. Mouse skeletal myoblast, C2C12 cells, were applied to examine our hypothesis. In electrical stimulation, C2C12 cells on P(Py-co-NIPAAm)/PDMS demonstrated the best myo-differentiation under the electric field of 1 V/cm. Regarding cyclic stretching, the strain equal to or higher than 9% can highly align C2C12 perpendicular to the stretching direction. The Western blotting experiments demonstrated that the cell sheets harvested by cooling reserved more extracellular matrix (ECM) than cells collected by the traditional trypsin digestion method. Immunostaining of myosin heavy chain protein (MHC) indicated that both mechanical and electrical stimuli effectively increased the number of myotubes and the differentiation ratio, and the myotubes can be aligned by cyclic stretching. Stimulated cell sheets can be harvested by cooling, and the alignment of myotubes was still maintained. These results suggested that the deposition of P(Py-co-NIPAAm) on PDMS can be applied to harvest intact cell sheets after cyclic stretching and electrical stimulation, which increased the feasibility of bioreactor for the application of tissue engineering and regenerative medicine.

Keywords: bioreactor, cell sheet, conductive polymer, cyclic stretching, electrical stimulation, muscle tissue engineering, myogenesis, thermosensitive hydrophobicity

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Authors: Mikko Salminen, Niklas Ravaja

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Previous studies have shown that emotional intelligence (EI) has an important role in leadership and social interaction. On the other hand, physiological synchronization between two interacting participants has been related to, for example, intensity of the interaction, and interestingly also to empathy. It is suggested that the amount of covariation in physiological signals between the two interacting persons would also be related to how the discussion is perceived subjectively. To study the interrelations between physiological synchronization, emotional intelligence, and subjective perception of the interaction, performance review discussions between real manager – subordinate dyads were studied using psychophysiological measurements and self-reports. The participants consisted of 40 managers, of which 24 were female, and 78 of their subordinates, of which 45 were female. The participants worked in various fields, for example banking, education, and engineering. The managers had a normal performance review discussion with two subordinates, except two managers who, due to scheduling issues, had discussion with only one subordinate. The managers were on average 44.5 years old, and the subordinates on average 45.5 years old. Written consent, in accordance with the Declaration of Helsinki, was obtained from all the participants. After the discussion, the participants filled a questionnaire assessing their emotions during the discussion. This included a self-assessment manikin (SAM) scale for the emotional valence during the discussion, with a 9-point graphical scale representing a manikin whose facial expressions ranged from smiling and happy to frowning and unhappy. In addition, the managers filled EI360, a 37-item self-report trait emotional intelligence questionnaire. The psychophysiological activity of the participants was recorded using two Varioport-B portable recording devices. Cardiac activity (ECG, electrocardiogram) was measured with two electrodes placed on the torso. Inter-beat interval (IBI, time between two successive heart beats) was calculated from the ECG signals. The facial muscle activation (EMG, electromyography) was recorded on three sites of the left side of the face: zygomaticus major (cheek muscle), orbicularis oculi (periocular muscle), and corrugator supercilii (frowning muscle). The facial-EMG signals were rectified and smoothed, and cross-coherences were calculated between members of each dyad, for all the three EMG signals, for the baseline and discussion periods. The values were natural-log transformed to normalize the distributions. Higher cross-coherence during the discussion between the manager’s and the subordinate’s zygomatic muscles was related to more positive valence self-reported emotions, F(1; 66,137) = 7,051; p=0,01. Thus, synchronized cheek muscle activation, either due to synchronous smiling or talking, was related to more positive perception of the discussion. In addition, higher IBI synchronization between the manager and the subordinate during the discussion was related to the manager’s higher self-reported emotional intelligence, F(1; 27,981)=4,58; p=0,041. That is, the EI was related to synchronous cardiac activity and possibly to similar physiological arousal levels. The results imply that the psychophysiological synchronization could be a potentially useful index in the study of social interaction and a valuable tool in the coaching of leadership skills in organizational contexts.

Keywords: emotional intelligence, leadership, psychophysiology, social interaction, synchronization

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Authors: Sangbaek Park, Seungju Lee, Soo-Won Chae

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Unstable shoes are known to strengthen lower extremity muscles and improve gait ability and to change the user’s gait pattern. The change in gait pattern affects human body enormously because the walking is repetitive and steady locomotion in daily life. It is possible to estimate the joint motion including joint moment, force and inertia effect using kinematic and kinetic analysis. However, the change of internal stress at the articular cartilage has not been possible to estimate. The purpose of this research is to evaluate the internal stress of human body during gait with unstable shoes. In this study, FE analysis was combined with motion capture experiment to obtain the boundary condition and loading condition during walking. Motion capture experiments were performed with a participant during walking with normal shoes and with unstable shoes. Inverse kinematics and inverse kinetic analysis was performed with OpenSim. The joint angle and muscle forces were estimated as results of inverse kinematics and kinetics analysis. A detailed finite element (FE) lower extremity model was constructed. The joint coordinate system was added to the FE model and the joint coordinate system was coincided with OpenSim model’s coordinate system. Finally, the joint angles at each phase of gait were used to transform the FE model’s posture according to actual posture from motion capture. The FE model was transformed into the postures of three major phases (1st peak of ground reaction force, mid stance and 2nd peak of ground reaction force). The direction and magnitude of muscle force were estimated by OpenSim and were applied to the FE model’s attachment point of each muscle. Then FE analysis was performed to compare the stress at knee cartilage during gait with normal shoes and unstable shoes.

Keywords: finite element analysis, gait analysis, human model, motion capture

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Authors: Afaque Manzoor Soomro, Faheem Ahmed, Fida Hussain Memon, Kyung Hyun Choi

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This paper proposes the bioinspired soft frog robot. All printing technology was used for the fabrication of the robot. Polyjet printing was used to print the front and back limbs, while ultrathin filament was used to print the body of the robot, which makes it a complete soft swimming robot. The dual thrust generation approach has been proposed by embedding the main muscle and antagonistic muscle in all the limbs, which enables it to attain high speed (18 mm/s), and significant control of swimming in dual modes (synchronous and asynchronous modes). To achieve the swimming motion of the frog, the design, motivated by the rigorous modelling and real frog dynamics analysis, enabled the as-developed frog robot (FROBOT) to swim at a significant level of consistency with the real frog. The FROBOT (weighing 65 g) can swim at different controllable frequencies (0.5–2Hz) and can turn in any direction by following custom-made LabVIEW software’s commands which enables it to swim at speed up to 18 mm/s on the surface of deep water (100 cm) with excellent weight balance.

Keywords: soft robotics, soft actuator, frog robot, 3D printing

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Authors: Zongping Wang, Chengjun Cui, Jiacun Wang

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The concept of intelligence has been widely used to access an individual's cognitive abilities to learn, form concepts, understand, apply logic, and reason. According to the multiple intelligence theory, there are eight distinguished types of intelligence. One of them is the bodily-kinaesthetic intelligence that links to the capacity of an individual controlling his body and working with objects. Motor intelligence, on the other hand, reflects the capacity to understand, perceive and solve functional problems by motor behavior. Both bodily-kinaesthetic intelligence and motor intelligence refer directly or indirectly to bodily capacity. Inspired by these two intelligence concepts, this paper introduces motional intelligence (MI). MI is two-fold. (1) Body strength, which is the capacity of various organ functions manifested by muscle activity under the control of the central nervous system during physical exercises. It can be measured by the magnitude of muscle contraction force, the frequency of repeating a movement, the time to finish a movement of body position, the duration to maintain muscles in a working status, etc. Body strength reflects the objective of MI. (2) Level of psychiatric willingness to physical events. It is a subjective thing and determined by an individual’s self-consciousness to physical events and resistance to fatigue. As such, we call it subjective MI. Subjective MI can be improved through education and proper social events. The improvement of subjective MI can lead to that of objective MI. A quantitative score of an individual’s MI is motional quotient (MQ). MQ is affected by several factors, including genetics, physical training, diet and lifestyle, family and social environment, and personal awareness of the importance of physical exercise. Genes determine one’s body strength potential. Physical training, in general, makes people stronger, faster and swifter. Diet and lifestyle have a direct impact on health. Family and social environment largely affect one’s passion for physical activities, so does personal awareness of the importance of physical exercise. The key to the success of the MQ study is developing an acceptable and efficient system that can be used to assess MQ objectively and quantitatively. We should apply different accessing systems to different groups of people according to their ages and genders. Field test, laboratory test and questionnaire are among essential components of MQ assessment. A scientific interpretation of MQ score is part of an MQ assessment system as it will help an individual to improve his MQ. IQ (intelligence quotient) and EQ (emotional quotient) and their test have been studied intensively. We argue that IQ and EQ study alone is not sufficient for an individual’s all round development. The significance of MQ study is that it offsets IQ and EQ study. MQ reflects an individual’s mental level as well as bodily level of intelligence in physical activities. It is well-known that the American Springfield College seal includes the Luther Gulick triangle with the words “spirit,” “mind,” and “body” written within it. MQ, together with IQ and EQ, echoes this education philosophy. Since its inception in 2012, the MQ research has spread rapidly in China. By now, six prestigious universities in China have established research centers on MQ and its assessment.

Keywords: motional Intelligence, motional quotient, multiple intelligence, motor intelligence, all round development

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Authors: Jipeng Yan, Xingchen Yang, Xiaowei Zhou, Mengxing Tang, Honghai Liu

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Shear elastic modulus of skeletal muscles can be obtained by shear wave elastography (SWE) and has been linearly related to muscle force. However, SWE is currently implemented using array probes. Price and volumes of these probes and their driving equipment prevent SWE from being used in wearable human-machine interfaces (HMI). Moreover, beamforming processing for array probes reduces the real-time performance. To achieve SWE by wearable HMIs, a customized three-element probe is adopted in this work, with one element for acoustic radiation force generation and the others for shear wave tracking. In-phase quadrature demodulation and 2D autocorrelation are adopted to estimate velocities of tissues on the sound beams of the latter two elements. Shear wave speeds are calculated by phase shift between the tissue velocities. Three agar phantoms with different elasticities were made by changing the weights of agar. Values of the shear elastic modulus of the phantoms were measured as 8.98, 23.06 and 36.74 kPa at a depth of 7.5 mm respectively. This work verifies the feasibility of measuring shear elastic modulus by wearable devices.

Keywords: shear elastic modulus, skeletal muscle, ultrasound, wearable human-machine interface

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Authors: Elizabeth A. Haruna, Bulus Kpame, Kankanala Venkateswarlu

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The interaction of health and athletic performance with biologic aging has been an interesting and intriguing area for research. There has been a general acknowledgement of its importance to major public health and elite performance outcomes. There are many questions unanswered about the mechanisms of effects and dose-response changes. An attempt has been made in this paper to highlight potentially positive effects of regular training on the aging process and its effects on health. Age associated decline in health and performance results from the combination of the aging process itself, inactive lifestyle and primary diseases. An attempt is made in this paper to critically review what is known and what is unknown about evidence based changes, common to disuse and aging. Mechanisms responsible for the slowing decline in muscle mass and muscle force (sarcopenia) down of age – associated, weakness and fatigability due to year round athletic training have been discussed. It is in this regard we have attempted to share our views on advances made so far in understanding the impact of aging on health. We also attempted to explain how the biological effects of aging are minimized during appropriate year round athletic training. On the basis of available research evidence it was concluded that exercise training significantly slow down the deleterious effects of aging on health.

Keywords: aging, atrophy, sarcopenia, plyometric training

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Authors: Martin Mensinger, Marjolaine Pfaffinger, Matthias Haslbeck

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The maintenance and expansion of the railway network represents a central task for transport planning in the future. In addition to the ultimate limit states, the aspects of resource conservation and sustainability are increasingly more necessary to include in the basic engineering. Therefore, as part of the AiF research project, ‘Integrated assessment of steel and composite railway bridges in accordance with sustainability criteria’, the entire lifecycle of engineering structures is involved in planning and evaluation, offering a way to optimize the design of steel bridges. In order to reduce the life cycle costs and increase the profitability of steel structures, it is particularly necessary to consider the demands on hanger connections resulting from fatigue. In order for accurate analysis, a number simulations were conducted as part of the research project on a finite element model of a reference bridge, which gives an indication of the internal forces of the individual structural components of a tied arch bridge, depending on the stress incurred by various types of trains. The calculations were carried out on a detailed FE-model, which allows an extraordinarily accurate modeling of the stiffness of all parts of the constructions as it is made up surface elements. The results point to a large impact of the formation of details on fatigue-related changes in stress, on the one hand, and on the other, they could depict construction-specific specifics over the course of adding stress. Comparative calculations with varied axle-stress distribution also provide information about the sensitivity of the results compared to the imposition of stress and axel distribution on the stress-resultant development. The calculated diagrams help to achieve an optimized hanger connection design through improved durability, which helps to reduce the maintenance costs of rail networks and to give practical application notes for the formation of details.

Keywords: fatigue, influence line, life cycle, tied arch bridge

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Authors: P. Y. Chiang, Y. H. Chen, Y. J. Lin, C. C. Chang, W. C. Hsu

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The number of the elderly in the world population and the rate of falls in this increasing numbers of older people are increasing. Decreasing muscle strength and an increasing risk of falling are associated with the ageing process. Because the effects of seated stepping training on the walking performance in the elderly remain unclear, the main purpose of the proposed study is to perform electromyography analysis during walking and seated stepping in the elderly. Four surface EMG electrodes were sticked on the surface of lower limbs muscles, including vastus lateralis (VL), and gastrocnemius (GT) of both sides. Before test, maximal voluntary contraction (MVC) of the respective muscle was obtained using manual muscle testing. The analog raw data of EMG signals were digitized with a sampling frequency of 2000 Hz. The signals were fully rectified and the linear envelope were calculated. Stepping motion cycle was separated into two phases by stepping timing (ST) and pedal return timing (PRT). ST refer to the time when the pedal marker reached the highest height, representing the contra-lateral leg was going to release the pedal. PRT refer to the time when the pedal marker reached the lowest height, representing the contra-lateral leg was going to step the pedal. We assumed that ST acted the same role in initial contact during walking, and PRT for toe-off. The period from ST to next PRT was called pushing phase (PP), during which the leg would start to step with resistance, and we compare this phase with the stance phase in level walking. The period from PRT to next ST was called returning phase (RP), during which leg would not have any resistance in this phase, and we compare this phase with the swing phase in level walking. VL and Gastro muscular activation had similar patterns in both side. The ability may transfer to those needed during loading response, mid-stance and terminal swing phase. User needed to make more effort in stepping compared with walking with similar timing; thus the strengthening of the VL and Gastro may be helpful to improve the walking endurance and efficiency for the elderly.

Keywords: elderly, electromyography, seated stepping, walking

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Authors: Ozcan Baris Citil

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The aim of the present study is the determination of the effects of variations in the proximate analysis, cholesterol content and fatty acid compositions of Helix aspersa. Garden snails (Helix aspersa) were picked up by hand from the Central Anatolia Region of Turkey, in autumn (November) in 2015. Fatty acid methyl esters (FAMEs) and cholesterol analysis were analyzed by gas chromatography (GC). The protein contents of snail muscle were determined with Kjeldahl distillation units. Statistical comparisons were made by using SPSS Software (version 16.0). Thirty different fatty acids of different saturation levels were detected. As the predominant fatty acids, stearic acid (C18:0), oleic acid (C18:1ω9), linoleic acid (C18:2ω6), palmitic acid (C16:0), arachidonic acid (C20:4ω6), eicosadienoic acid (C20:2) and linolenic acid (C18:3ω3) were found in Helix aspersa. Palmitic acid (C16:0) was identified as the major SFA in autumn. Linoleic acid (C18:2ω6), eicosadienoic acid (C20:2) and arachidonic acid (C20:4ω6) have the highest levels among the PUFAs. In the present study, ω3 were found 5.48% in autumn. Linolenic acid and omega-3 fatty acid amounts in the autumn decreased significantly but cholesterol content was not affected in Helix aspersa in autumn (November) in 2015.

Keywords: Helix aspersa, fatty acid, SFA, PUFA, cholesterol

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Authors: Denise Schrama, Claudia Raposo, Pedro Rodrigues

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Background: Food allergies are conducted by a hypersensitive response of the immune system. These allergies are a global concern for the public health. Consumption of fish is increasing worldwide as it is a healthy meat with high nutritional value. Unfortunately, fish can cause adverse immune-mediate reactions, affecting part of the population with higher incidence in children. β-parvalbumin, a small, highly conserved stable, calcium or magnesium binding muscle protein is the main fish allergen. In fish-allergic patients, cross-reactivity between different fish species exist due to recognition of highly identical protein regions. Enolases, aldolases, or fish gelatin are other identified fish allergens in some fish species. With no available cure for fish allergies, clinical management is only based on an avoidance diet aiming at the total exclusion of offending food. Methods: Mediterranean fish (S. aurata and D. labrax) were fed specifically designed diets, enriched in components that target the expression or inactivation of parvalbumin (creatine and EDTA, respectively). After 90 days fish were sampled and biological tissues were excised. Proteomics was used to access fish allergens characterization and expression in muscle while IgE assays to confirm the lower allergenic potential are conducted in patients with history of fish allergies. Fish welfare and quality of flesh were established with biochemical, texture and sensorial analysis. Results: Fish welfare shows no major impact between diets. In case of creatine supplementation in D. labrax proteomic analysis show a slight decrease in parvalbumin expression. No accumulation of this compound was found in muscle. For EDTA supplementation in S. aurata IgE assay show a slight decrease in allergenicity when using sera of fish allergic patients. Conclusion: Supplementation with these two compounds seems to change slightly the allergenicity of the two mean Mediterranean species.

Keywords: fish allergies, fish nutrition, proteomics, aquaculture

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Authors: Chiao-Chen Chang, Yang-Chieh Chin

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Social media has created a change in the way the network community is clustered, especially from the location of the community, from the original virtual space to the intertwined network, and thus the communication between people will change from face to face communication to social media-based communication model. However, social media users who have had a fixed engagement may have an intention to switch to another service provider because of the emergence of new forms of social media. For example, some of Facebook or Twitter users switched to Instagram in 2014 because of social media messages or image overloads, and users may seek simpler and instant social media to become their main social networking tool. This study explores the impact of system features overload, information overload, social monitoring concerns, problematic use and privacy concerns as the antecedents on social media fatigue, dissatisfaction, and alternative attractiveness; further influence social media switching. This study also uses the online questionnaire survey method to recover the sample data, and then confirm the factor analysis, path analysis, model fit analysis and mediating analysis with the structural equation model (SEM). Research findings demonstrated that there were significant effects on multiple paths. Based on the research findings, this study puts forward the implications of theory and practice.

Keywords: social media, switching, social media fatigue, alternative attractiveness

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Authors: Sohaib Raza, Parvez Mantry

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Frailty is a multi-system impairment associated with stressors such as age, disease, and invasive surgical procedures. This multi-system impairment can lead to increased post-transplant mortality and functional decline. Additionally, the prevalence and/or severity of frailty increases when patient pre-habilitation is unsatisfactory or lacking. We conducted a retrospective study to examine whether the COVID-19 Pandemic, and subsequent lack of patient access to pre-habilitation and physical therapy resources, led to an increase in the prevalence and severity of frailty, sarcopenia, and other comorbidities including diabetes, hypertension, and COPD. Secondarily, we examined the correlation between patient survival rate and liver frailty index as well as muscle wasting/sarcopenia. Data were analyzed in order to correlate variables associated with these parameters. Three hundred sixty-nine liver transplant candidates at Methodist Dallas Medical Center were administered pre-transplant frailty assessments, which consisted of chair stands, grip strength, and position balance time. A frailty score less than 3.2 indicated a robust condition, a score from 3.3 to 4.4 indicated a pre-frail condition, and a score greater than 4.5 indicated a frail condition. Greater than 50 percent of patients were found to have muscle wasting in the COVID-19 period (March 13, 2020 to February 28, 2022), an increase of 16.5 percent from the pre-COVID period (April 1st, 2018 to March 12, 2020). Additionally, sarcopenia was associated with a two-fold increase in patient mortality rate. Furthermore, high liver frailty index scores were associated with increased patient mortality. However, there was no significant difference in liver frailty index or number of comorbidities between patients in the two cohorts. Conclusion: The COVID-19 Pandemic exacerbated sarcopenia-related muscle wasting in liver transplant candidates, and patient survival rate was directly correlated with liver frailty index score and the presence of sarcopenia.

Keywords: frailty, sarcopenia, covid-19, patient mortality, pre-habilitation, liver transplant candidates

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Authors: Megumi Nishida, Naoya Motegi, Takurou Kikuchi, Tomoko Tokumura

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In recent years, power system has been changed and flexible power pricing system such as demand response has been sought in Japan. The demand response system is simple in the household sector and the owner, decision-maker, can gain the benefits of power saving. On the other hand, the execution of the demand response in the office building is more complex than household because various people such as owners, building administrators and occupants are involved in making decisions. While the owners benefit from the demand saving, the occupants are forced to be exposed to demand-saved environment certain benefits. One of the reasons is that building systems are usually centralized control and each occupant cannot choose either participate demand response event or not, and contribution of each occupant to demand response is unclear to provide incentives. However, the recent development of IT and building systems enables the personalized control of office environment where each occupant can control the lighting level or temperature around him or herself. Therefore, it can be possible to have a system which each occupant can make a decision of demand response participation in office building. This study investigates the personal behavior upon demand response requests, under the condition where each occupant can adjust their brightness individually in their workspace. Once workers participate in the demand response, their task lights are automatically turned off. The participation rates in the demand response events are compared between four groups which are divided by different motivation, the presence or absence of incentives and the way of participation. The result shows that there are the significant differences of participation rates in demand response event between four groups. The way of participation has a large effect on the participation rate. ‘Opt-out’ group, where the occupants are automatically enrolled in a demand response event if they don't express non-participation, will have the highest participation rate in the four groups. The incentive has also an effect on the participation rate. This study also reports that the impact of low illumination office environment on the occupants, such as stress or fatigue. The electrocardiogram and the questionnaire are used to investigate the autonomic nervous activity and subjective symptoms about the fatigue of the occupants. There is no big difference between dim workspace during demand response event and bright workspace in autonomic nervous activity and fatigue.

Keywords: demand response, illumination, questionnaire, electrocardiogram

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Authors: Rajwanlop Kumpoopong, Sukit Yindeesuk, Pornchai Silarom

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Modeling cracks in concrete is complicated by its strain-softening behavior which requires the use of sophisticated energy criteria of fracture mechanics to assure stable and convergent solutions in the finite-element (FE) analysis particularly for relatively large structures. However, for small-scale structures such as beams and slabs, a simpler approach relies on retaining some shear stiffness in the cracking plane has been adopted in literature to model the strain-softening behavior of concrete under monotonically increased loading. According to the shear retaining approach, each element is assumed to be an isotropic material prior to cracking of concrete. Once an element is cracked, the isotropic element is replaced with an orthotropic element in which the new orthotropic stiffness matrix is formulated with respect to the crack orientation. The shear transfer factor of 0.5 is used in parallel to the crack plane. The shear retaining approach is adopted in this research to model cracks in RC bridge deck with some modifications to take into account the effect of repetitive moving truck wheel loads as they cause fatigue cracking of concrete. First modification is the introduction of fatigue tests of concrete and reinforcing steel and the Palmgren-Miner linear criterion of cumulative damage in the conventional FE analysis. For a certain loading, the number of cycles to failure of each concrete or RC element can be calculated from the fatigue or S-N curves of concrete and reinforcing steel. The elements with the minimum number of cycles to failure are the failed elements. For the elements that do not fail, the damage is accumulated according to Palmgren-Miner linear criterion of cumulative damage. The stiffness of the failed element is modified and the procedure is repeated until the deck slab fails. The total number of load cycles to failure of the deck slab can then be obtained from which the S-N curve of the deck slab can be simulated. Second modification is the modification in shear transfer factor. Moving loading causes continuous rubbing of crack interfaces which greatly reduces shear transfer mechanism. It is therefore conservatively assumed in this study that the analysis is conducted with shear transfer factor of zero for the case of moving loading. A customized FE program has been developed using the MATLAB software to accomodate such modifications. The developed procedure has been validated with the fatigue test of the 1/6.6-scale AASHTO bridge deck under the applications of both fixed-point repetitive loading and moving loading presented in the literature. Results are in good agreement both experimental vs. simulated S-N curves and observed vs. simulated crack patterns. Significant contribution of the developed procedure is a series of S-N relations which can now be simulated at any desired levels of cracking in addition to the experimentally derived S-N relation at the failure of the deck slab. This permits the systematic investigation of crack propagation or deterioration of RC bridge deck which is appeared to be useful information for highway agencies to prolong the life of their bridge decks.

Keywords: bridge deck, cracking, deterioration, fatigue, finite-element, moving truck, reinforced concrete

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Authors: Thiago Viana

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Eventually train accidents occur on railways and for some specific cases it is necessary to use a train rescue with a crane positioned under a platform wagon. These tumbled machines are collected and sent to the machine shop or scrap yard. In one of these cranes that were being used to rescue a wagon, occurred a fall of hoist due to fracture of two large pins. The two pins were collected and sent for failure analysis. This work investigates the main cause and the secondary causes for the initiation of the fatigue crack. All standard failure analysis procedures were applied, with careful evaluation of the characteristics of the material, fractured surfaces and, mainly, metallographic tests using an optical microscope to compare the geometry of the peaks and valleys of the thread of the pins and their respective seats. By metallographic analysis, it was concluded that the fatigue cracks were started from a notch (stress concentration) in the valley of the threads of the pin applied to the right side of the crane (pin 1). In this, it was verified that the peaks of the threads of the pin seat did not have proper geometry, with sharp edges being present that caused such notches. The visual analysis showed that fracture of the pin on the left side of the crane (pin 2) was brittle type, being a consequence of the fracture of the first one. Recommendations for this and other railway cranes have been made, such as nondestructive testing, stress calculation, design review, quality control and suitability of the mechanical forming process of the seat threads and pin threads.

Keywords: crane, fracture, pin, railway

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Authors: Joseph Carl Macalintal, Erlinda Armovit

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Magnesium sulfate has been a mainstay in the management of preeclampsia and is associated with a decreased incidence of morbidity and mortality. The syndrome has an unpredictable course, sometimes rapidly evolving to full-blown disease. In patients with deteriorating status, it is indicated to terminate the pregnancy via cesarean section. The anesthesiologists would prefer to have the procedure done under regional anesthesia; however, there may be cases when neuraxial anesthesia is contraindicated, or a general anesthesia would permit prompt delivery of the fetus. A patient with severe preeclampsia was given magnesium sulfate intrapartum, wherein a primary cesarean section was indicated for arrest in cervical dilatation, and was performed under general anesthesia. The patient developed acute respiratory failure and the causes of this occurrence were investigated in this report. It was later found out that neither the hypermagnesemia nor the muscle relaxant alone caused the patient’s condition but the interaction between the two. The patient was managed expectantly at the intensive care unit (ICU) and was eventually extubated during the 1st post-operative day. Knowledge of this drug interaction would allow obstetricians to advise their patients and their family about the possibility of prolonged intubation and ICU admission. This would also bring to the anesthesiologists’ attention the need to decrease the dose of muscle relaxant and to prepare drugs for immediate decurarisation.

Keywords: eclampsia, magnesium sulfate, preeclampsia, rocuronium bromide

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Authors: Khalida S. Rijab, Mohammed E. Safi, Ayad A. Ibrahim

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When electrical electrodes are mounted on the skin surface of the muscle, a signal is detected when a skeletal muscle undergoes contraction; the signal is known as surface electromyographic signal (EMG). This signal has a noise-like interference pattern resulting from the temporal and spatial summation of action potentials (AP) of all active motor units (MU) near electrode detection. By appropriate processing (Decomposition), the surface EMG signal may be used to give an estimate of motor unit action potential. In this work, a denoising technique is applied to the MUAP signals extracted from the spatial filter (IB2). A set of signals from a non-invasive two-dimensional grid of 16 electrodes from different types of subjects, muscles, and sex are recorded. These signals will acquire noise during recording and detection. A digital fourth order band- pass Butterworth filter is used for denoising, with a tuned band-pass frequency of suitable choice of cutoff frequencies is investigated, with the aim of obtaining a suitable band pass frequency. Results show an improvement of (1-3 dB) in the signal to noise ratio (SNR) have been achieved, relative to the raw spatial filter output signals for all cases that were under investigation. Furthermore, the research’s goal included also estimation and reconstruction of the mean shape of the MUAP.

Keywords: EMG, Motor Unit, Digital Filter, Denoising

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Authors: M. Sohail Hasan, Wichuda Munbua, Chikako Fujiyama, Koichi Maekawa

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During the past few years, offshore wind energy has become the key parameter to reduce carbon emissions. In most of the previous studies, floaters in floating offshore wind turbines (FOWT) are made up of steel. However, fatigue and corrosion are always major concerns of steel marine structures. Recently, researchers are working on concrete floating substructures. In this paper, the conceptual design of pre-cast panel-based economical and durable reinforced concrete floating substructure for a 10 MW offshore wind turbine is proposed. The new geometrical shape, i.e., hexagon with inside hollow boxes, is proposed under static conditions. To design the outer panel/side walls to resist hydrostatic forces, special consideration for durability is given to limit the crack width within permissible range under service limit state. A comprehensive system is proposed for transferring the ultimate moment and shear due to strong wind at the connection between steel tower and concrete floating substructure. Moreover, a stable connection is also designed considering the fatigue of concrete and steel due to the fluctuation of stress from the mooring line. This conceptual design will be verified by subsequent dynamic analysis soon.

Keywords: cracks width control, mooring line, reinforced concrete floater, steel tower

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Authors: Anasuya Ghosh, Subhramoy Chaudhury

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During routine cadaveric dissection at gross anatomy lab of our institution, a radial artery was found with unusual origin and superficial course. Normally the radial artery takes its origin as one of the terminal branches of brachial artery at the level of the neck of radius. It usually lies along the lateral border of fore arm deep to the brachioradialis muscle. While dissecting a 72-year-old Caucasian female cadaver, it was found that the right sided radial artery originated from the upper part of brachial artery of arm, 2 cm below the lower border of teres major muscle, from the lateral aspect of brachial artery. Then the radial artery superficially crossed the brachial artery and median nerve from lateral to medial direction and rested superficially at the cubital fossa. Embryologically, it can be explained as a failure of disappearance, or abnormal persistence of some insignificant embryonic vessels may give rise to this kind of vascular anomalies. As radial artery is one of the most important upper limb arteries, its variation and related complications are clinically significant. This unusual origin and course of radial artery should be kept in mind by all healthcare providers including surgeons and radiologists during routine venipuncture, orthopedic and plastic surgeries of arm, coronary angiographic procedures in radial approach etc. to prevent unwanted complications.

Keywords: brachial artery anomalies, brachio-radial artery, high origin radial artery, superficial radial artery

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Authors: Hanaa M. M. El-Khayat, Hanan S. Gaber, Hoda Abdel-Hamid, Kadria M. A. Mahmoud, Hoda M. A. Abu Taleb

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This work aimed to examine Oreochromis niloticus fish from Lake Manzala in Port Said, Dakahlya and Damietta governorates, Egypt, as a bio-indicator for the lake water pollution through recording alterations in their hematological, physiological, and histopathological parameters. All fish samples showed a significant increase in levels of alkaline phosphatase (ALP), creatinine and glutathione-S-transferase (GST); only Dakahlya samples showed a significant increase (p<0.01) in aspartate aminotransferase (AST) level and most Dakahlya and Damietta samples showed reversed albumin and globulin ratio and a significant increase in γ-glutamyltransferase (GGT) level. Port-Said and Damietta samples showed a significant decrease of hemoglobin (Hb) while Dakahlya samples showed a significant decrease in white blood cell (WBC) count. Histopathological investigation for different fish organs showed that Port-Said and Dakahlya samples were more altered than Damietta. The muscle and gill followed by intestine were the most affected organs. The muscle sections showed severe edema, neoplasia, necrotic change, fat vacuoles and splitting of muscle fiber. The gill sections showed dilated blood vessels of the filaments, curling of gill lamellae, severe hyperplasia, edema and blood vessels congestion of filaments. The intestine sections revealed degeneration, atrophy, dilation in blood vessels and necrotic changes in sub-mucosa and mucosa with edema in between. The recorded significant alterations, in most of the physiological and histological parameters in O. niloticus samples from Lake Manzala, were alarming for water pollution impacts on lake fish community, which constitutes the main diet and the main source of income for the people inhabiting these areas, and were threatening their public health and economy. Also, results evaluate the use of O. niloticus fish as important bio-indicator for their habitat stressors.

Keywords: Lake Manzala, Oreochromis niloticus fish, water pollution, physiological, hematological and histopathological parameters

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Authors: H. Haseena Banu, D. Karthick, R. Stalin, E. Nandha Kumar, T. P. Sachidanandam, P. Shanthi

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Background of the study: Type 2 diabetes is emerging as the predominant metabolic disorder in the world among adults characterized mainly by the resistance of the insulin sensitive tissues towards insulin followed by the decrease in the insulin secretion. The treatment for this disease usually involves treatment with oral synthetic drugs which are known to cause several side effects. Therefore, identification of new biomarkers as therapeutic target is the need of the hour. miRNAs are small, non–protein-coding RNAs that negatively regulate gene expression by promoting degradation and/or inhibit the translation of target mRNAs and have emerged as biomarkers in predicting diabetes mellitus. Objective of the study: To elucidate the therapeutic role of gallic acid in modulating the alterations in glucose metabolism induced by miRNAs 194 and 135a in Type 2 diabetic rats. Materials and Methods: T2D was induced in rats by feeding them with a high fat diet for 2 weeks followed by intraperitoneal injection of 35 mg/kg/body weight (b.wt.) of streptozotocin. Microarrays were used to assess the expression of miRNAs in control, diabetic and gallic acid treated rats. Gene expression studies were carried out by RT PCR analysis. Results: Forty one miRNAs were differentially expressed in Type 2 diabetic rats. Among these, the expression of miRNA 194 was significantly decreased whereas miRNA 135a was significantly increased in Type 2 diabetic rats. The glucose metabolism was also altered significantly in skeletal muscle of Type 2 diabetic rats. Conclusion: T2D is associated with alterations in the expression of miRNAs in skeletal muscle. Both these miRNAs 194 and 135a play an important role in glucose metabolism in skeletal muscle of diabetic rats. Gallic acid effectively ameliorated the alterations in glucose metabolism. Hence, both these miRNAs can serve as biomarkers and therapeutic targets in diabetes mellitus. The study also establishes the role of gallic acid as therapeutic agent. Acknowledgment: The financial assistance provided in the form of ICMR women scientist by ICMR DHR INDIA is gratefully acknowledged here.

Keywords: gallic acid, high fat diet, type 2 diabetes mellitus, miRNAs

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Authors: Hurtado Zuñiga Yonel Marcos, Ferreira Joao Tiago

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Introduction: Leiomyoma is a benign smooth muscle tumor. It is predominantly found between 40-49 years with a small prevalence in men. It is commonly found in the uterus, stomach, and in areas with smooth muscle. It presents as nodular, solitary, variable size, slow growing, and asymptomatic. It is classified into solid, vascular, and epithelioid leiomyoma. Vascular leiomyoma is the most common in the oral cavity. Oral leiomyomas are very rare because a smooth muscle in the oral cavity isn’t common. The most frequent areas of this pathologyaretongue, lip, buccal mucosa, and palate. It may be derived from the vascular walls or excretory ducts of the salivary glands. The diagnosis is made by histologically analysis. The treatment of choice is complete excision. Recurrence is rare. Objective: To report the case of a solid leiomyoma on the dorsum of the tongue and review the literature. Case description: A 78-year-old female patient presented a nodular (ovoid) elevation of 8x6mm, brownish color, with irregular limits and firm consistency located in the dorsal part of the tongue with slight symptoms. An excisional biopsy was performed, photographic record, and 3 weeks post-surgical follow-up. Result: The surgical specimen was submitted to an anatomopathological analysis, resulting in a benign nodule with defined limits compatible with solid leiomyoma of the tongue. Discussion: It is a pathology that presents in a solitary, nodular, well-defined, asymptomatic form; in the oral cavity, leiomyomas are found in the tongue, lip, buccal mucosa, and palate; as in our patient, it was nodular and, in the tongue, with a difference only in the symptomatology. The most prevalent age is 40-49 years and with small predominance in men, unlike our female patient with 78 years. Conclusions: Oral leiomyoma is a rare benign lesion that presents as a solitary nodular nodule; for its diagnosis, an anatomopathological analysis should be performed, and the treatment of choice is total excision with little recurrence.

Keywords: tongue, bening tumor, oral leiomyoma, leiomyoma

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Authors: F. Haddadj, F. Acheuk, S. Hamdi, S. Zenia, A. Smai, H. Saadi, B. Doumandji-Mitiche

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Locust is causing significant losses in agricultural production in the countries concerned by the invasion. Up to the present control strategy has consisted only of the spreaders chemicals; they have proven harmful to the environment and. For this, a new control method appeared it comes to the biological control based mostly by using microorganism. It is in that sense is we've made our contribution by the use of a biopesticide which is entomopathogenic fungus Metarhizium anisopliae var acridium "Green Muscle" on part of the cuticule the larval of fifth instar locust Schistocerca gregaria (Forskål, 1775). Preliminary test on the study of the pathogenicity of M. anisopliae var acridium biocontrol agent, was conducted in the laboratory on L5 S. gregaria, on which we inoculated treatment in the digestive tract and it administrant 20μl of entomopathogenic solution orally at a dose DL50 = 3.25 x107 sp./ ml (median lethal dose estimated at earlier), 5 days after treatment individuals are sacrificed. After dissection cuticles are recovered and then subjected to histological sections. The histological technique followed is that of Martoja Martoja-Pierson (1967). Microscopic observation revealed alterations in the architecture of the cuticule which leads to disorganization of cell layers.

Keywords: biopesticide, cuticle, desert locust, toxicity

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Authors: Krystof Kryniski, Asa Kassman Rudolphi, Su Zhao, Per Lindholm

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ABB offers range of turbochargers from 500 kW to 80+ MW diesel and gas engines. Those operate on ships, power stations, generator-sets, diesel locomotives and large, off-highway vehicles. The units need to sustain harsh operating conditions, exposure to high speeds, temperatures and varying loads. They are expected to work at over-critical speeds damping effectively any transients and encountered resonances. Components are often connected via friction joints. Designs of those interfaces need to account for surface roughness, texture, pre-stress, etc. to sustain against fretting fatigue. The experience from field contributed with valuable input on components performance in hash sea environment and their exposure to high temperature, speed and load conditions. Study of tribological interactions of oxide formations provided an insight into dynamic activities occurring between the surfaces. Oxidation was recognized as the dominant factor of a wear. Microscopic inspections of fatigue cracks on turbine indicated insufficient damping and unrestrained structural stress leading to catastrophic failure, if not prevented in time. The contact interface exhibits strongly non-linear mechanism and to describe it the piecewise approach was used. Set of samples representing the combinations of materials, texture, surface and heat treatment were tested on a friction rig under range of loads, frequencies and excitation amplitudes. Developed numerical technique extracted the friction coefficient, tangential contact stiffness and damping. Vast amount of experimental data was processed with the multi-harmonics balance (MHB) method to categorize the components subjected to the periodic excitations. At the pre-defined excitation level both force and displacement formed semi-elliptical hysteresis curves having the same area and secant as the actual ones. By cross-correlating the terms remaining in the phase and out of the phase, respectively it was possible to separate an elastic energy from dissipation and derive the stiffness and damping characteristics.

Keywords: contact interface, fatigue, rotor-dynamics, torsional resonances

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Authors: Mustafa Gulsen, Nihan Pekyavas, Emine Atıcı

Abstract:

Purpose: The aim of this study is to investigate the effects of Kinesio taping on postural stability and in young soccer players. Subjects and Methods: 62 volunteered soccer players from Cayyolu Sports Club were included in our study. Permissions were also taken from the club directors about the inclusion of their players to our study. Soccer players between the age of 12 and 16 were included in our study. Players that had previous injury on lower extremities were excluded from the study. Players were randomly divided into two groups: Kinesio taping (KT) (n=31), and control group (n = 31). KT application including gastrocnemius and quadriceps femoris muscle facilitation techniques were applied to the first group. A rest time for 45 minutes was given in order to see the best effectiveness of the tape. The second group was set as the control group and no application was made. All participants were assessed before the application and 45 minutes later. In order to provide the double-blind design of the study, an experienced physiotherapist has done the assessments and another experienced physiotherapist has done the taping. The patients were randomly assigned to one of the two groups using an online random allocation software program. Postural stability was assessed by using Tetrax Interactive Balance System. Thermographic assessment was done by using FLIR E5 (FLIR Systems AB, Sweden) thermal camera in order to see which muscles have the most thermal activity while maintaining postural stability. Results: Statistically significant differences were found in all assessment parameters in both Kinesio Taping and control groups (all p<0.05) except thermal imaging of dominant gastrocnemius muscle results (p=0.668) (Table 1). In comparison of the two groups, statistically significant differences were found in all parameters (all p<0.05). Conclusion: In this study, we investigated the effects of Kinesio taping on postural stability in young soccer players and found that KT application on Quadriceps and Gastrocnemius muscles may have decreased the risk of falling more than the control group. According to thermal imaging assessments, both Quadriceps and Gastrocnemius muscles may be active in maintaining postural stability but in KT group, the temperature of these muscles are higher which leads us to think that they are more activated.

Keywords: Kinesio taping, fall risk, muscle temperature, postural stability

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Authors: Ali Fuad Ashour

Abstract:

Introduction: Contrary to the common belief that physical training for multiple sclerosis (MS) patients might exacerbate fatigue and provoke other symptoms of the illness, it is now widely accepted that exercise can be actually beneficial in terms of activities of daily living, reduced fatigue, and improved quality of life. The aim of this study was to assess the attitude of MS patients toward exercise. Methodology: 112 MS patients who were recruited from the local community participated in this study. We utilised a self-developed questionnaire targeting attitudes and perceptions of MS patients towards physical exercise. The questionnaire was piloted and tested for validity and reliability. Results: Before being diagnosed with MS, 49.9% of our MS patients’ respondents used to engage in different types of physical activities and sports, namely aerobics/walking (35.3%), stretching exercise (18.7%), and strengthening exercise (11.4%). After being diagnosed with MS, 40.8% of our sample showed determination to remain physically active. The interest in sports activities was consistent after the diagnoses with MS and included aerobics/walking (33.8%), stretching exercise (22.6%), and strengthening exercise (19.7%). Discussion: The Kuwaiti respondents thought that lack of encouragement was the main reason for them not exercise. Aptly put, if they try to exercise, they will be discouraged by the loved ones lest the worse happens. On the other side, British patients are generally aware of the benefits of physical and mental health-promoting activities; they can seek help from a wide range of professionals and are more actively involved in the management of their condition. It is therefore important that the benefits of physical activity are promoted among MS patients, and that attitude towards MS and MS patients is changed through education.

Keywords: perception, multiple sclerosis, exercise, physical training

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Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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