Objectives: The objective of this study was to describe the morphological changes on ultrasound scan of healing Achilles tendons that have sustained a full thickness rupture. Design: This is a case cohort study of patients referred for the conservative management of Achilles tendon ruptures. Methods: This is an observational study of 100 patients presenting with Achilles tendon ruptures who attended a consultant podiatry clinic. All patients diagnosed with an Achilles tendon rupture were conservatively managed and placed in an air shell walker boot with the patient fully weightbearing with wedges in-situ to maintain the foot in an equinus position in order to reduce the ruptured tendon gap. The wedges were removed incrementally from week 6, and the boot removed at week 10. At the initial appointment and each follow up a series of ultrasound measures were captured at the musculotendinous junction of the soleus (MTJ), gap (rupture) location (GL), corresponding gap location (CGL) of contralateral tendon and the osseo-tendinous junction at the calcaneus (OTJ). A patient reported outcome measure (ATRS) was also collected at each contact. Results: All ruptured Achilles tendons became fully united. ANOVA results of the ruptured Achilles tendon data conclude that there were statistically significant (p <0.05) differences among the means of the three anatomical locations (MTJ, GL, OTJ) for the three time points (weeks 6, 10, and 20). This suggests that the AP measure changes significantly over time across the three time points. There was no statistically significant (p <0.05) difference between measurements for each asymptomatic anatomical location over the same time period. The ruptured location of the Achilles tendon had a mean of 58.6 mm with a minimum of 14.1 mm and a maximum of 73.3 mm from the osseo-tendinous junction. 85 /100 patients ruptured between 30 mm and 60 mm proximally to the osseo-tendinous junction. The ruptured tendon gap reduced with the foot placed in 10 degrees of plantarflexed position during ultrasound. For 80 patients the gap was between 0 and 1.6 mm. Two patients presented with a gap between 8 and 9.6 mm with the foot plantarflexed. From baseline (0 weeks) to 20 weeks these data suggest a significant improvement in the ATRS scores from an average score of 3.25 at 0/52 weeks to 83.25 at 20 weeks. A Pearson’s correlation coefficient of final 20 week ATRS score suggested that age does not appear to be correlated with outcomes for ATRS (p <0.05). Conclusions: All ruptured Achilles tendons became fully united and significantly thickened by the six week time point on the pathway. By the end of the pathway significant AP thickness was observed in most cases, with significant improvements in ATRS scores. AP measure thickness at each time point was a determinant of higher ATRS scores. No significant differences in AP thicknesses were observed in the OTJ and MTJ measures of the symptomatic or tendons.
Background: Dietary supplements such as capsaicin have gained increasing attention for their potential to enhance sports performance. Brazilian Jiu-Jitsu (BJJ), a grappling-based martial art, demands high levels of muscular strength and endurance. Capsaicin (CAP), a bioactive compound found in chili peppers, has demonstrated ergogenic effects. However, its acute impact on strength and endurance in BJJ athletes remains unclear. This study aimed to evaluate the acute effects of CAP supplementation on upper-limb strength, endurance performance, and rating of perceived exertion (RPE) in BJJ athletes. Materials and methods: Eighteen athletes participated in a randomized, crossover, triple-blind clinical trial. In two separate sessions, participants ingested either 12 mg of CAP or a placebo 45 minutes before performing physical tests, including handgrip strength (HS), isometric pull-up (IP), and dynamic pull-up (DP), all conducted while wearing a gi. RPE was recorded after each test. Normally distributed variables (IP and DP) were analyzed using the paired t-test, while non-normally distributed variables (RPE and HS) were analyzed using the Wilcoxon test. A significance level of p <0.05 was adopted. Results: CAP supplementation significantly increased isometric pull-up duration (delta = +2.83 s; p = 0.040; d = 0.52). No statistical differences were found for HS, DP, or RPE; however, RPE showed a moderate effect size (r = 0.37). No significant differences in adverse events were observed between conditions. Conclusion: Acute supplementation with 12 mg of capsaicin improved isometric upper-limb endurance in BJJ athletes, as evidenced by increased isometric pull-up duration.
Introduction: Back pain is the most prominent comorbidity and a major barrier to daily functioning in patients with multiple sclerosis. Exercise programs can help reduce key disease-related symptoms like fatigue and motor impairments, promoting greater functional independence and better quality of life. Objective: To determine the impact of Pilates training versus eccentric training in patients with multiple sclerosis suffering from chronic non-specific low back pain on: pain, static, dynamic sitting balance and trunk coordination, and isometric strength of trunk flexors and extensors. Method: This randomized clinical trial involved 36 adults with multiple sclerosis, chronic non-specific low back pain, and expanded disability status scale between 2-4.5. Participants were assigned to Pilates-based core stability training or eccentric trunk training, performed for six weeks, three times a week. The study assessed trunk flexor and extensor isometric strength, pain, seated balance, and trunk coordination. Results: Both groups significantly improved in pain and trunk performance. No major differences were identified between groups for pain reduction and trunk control. The Pilates group showed greater improvements in isometric trunk flexor strength with hips extended (p = 0.03) and isometric trunk extensor strength with hips flexed 30° (p = 0.021) compared to the eccentric group. No significant differences were found between groups for trunk flexor strength with hips flexed 30° (p = 0.086) or trunk extensor strength with hip extension (p = 0.08). Conclusion: Pilates-based stability training led to greater improvements in trunk flexor and extensor strength compared to eccentric training in some testing positions; both therapies were successful in relieving pain and improving trunk performance.
Introduction: Fluoxetine hydrochloride, in addition to its antidepressant effects in the treatment of psychiatric disorders, appears to influence the process of ligament repair. This study investigated its effects on the calcaneal tendon. Aim: The aim of this study was to evaluate the influence of chronic use of fluoxetine hydrochloride on the morphology of healthy calcaneal tendons, their glycosaminoglycan distribution, and the organization of collagen fibers in rats from different groups using microscopic analysis. Methods: 25 male rats of the Wistar rats were divided into two groups, the control and fluoxetine-treated groups, and after 60 days, they were euthanized and the tendons were processed for microscopic analysis. Results: The tendons of rats treated with fluoxetine showed greater thickening and greater disorganization of fibers and cells, as well as less collagen deposition, compared to the control group. Conclusion: Chronic use of fluoxetine hydrochloride had a significant impact on tendons, weakening their structures and predisposing them to future injuries.
The aim of this study was to determine whether peripubertal exposure to glyphosate-based herbicide influences the deleterious effects of obesity induced by a high-fat diet on the diaphragm muscle of adult mice. Ten male C57BL/6 mice were randomly divided into two groups (n = 5 per group): a control group that received a high-fat diet and water by gavage, and an experimental group that received a high-fat diet and glyphosate-based herbicide (50 mg Roundup®/kg per day by gavage) from 30 to 60 days of life. From 60 to 150 days, both groups received the high-fat diet. At 150 days, the animals were euthanized and weighed. The nasoanal length was measured and fats and diaphragm were collected and weighed. The muscle was stored in specific fixatives for histological analysis of muscle fibers and neuromuscular junctions (NMJs). There was no difference in macroscopic parameters between groups. Morphological analysis of muscle fibers showed degenerative changes in the diaphragm of both groups; however, these alterations were more marked in the group exposed to the glyphosate-based herbicide. Regarding the morphometric characteristics, a significant increase in the number of degenerated fibers per mm2 was observed in the HFD-GBH group compared to the HFD-CTL group. The area and maximum diameter of NMJs were also greater in the herbicide-exposed group. In conclusion, obesity promotes degenerative changes in diaphragm muscle fibers of adult mice. Peripubertal exposure to glyphosate-based herbicide exacerbates the myotoxic effects of obesity and increases the area and maximum diameter of NMJs in obese adult mice.
