The paper deals with the torques of external muscles acting on the upper ankle joint under weight-bearing conditions and their importance in diagnosing and treating the human foot. Experimental data were collected and calculations were performed. Based on the experiments with the biomechanical model of the foot and upper ankle joint, it was shown how the changes in the force arms of the external muscles of the foot under weight-bearing conditions, change the torque. The real values of muscle forces and torques of the external muscles of the foot were calculated. Taking into account the distance of the lines of muscle action from the axis of rotation of the upper ankle joint the rotational force of the muscles was calculated. The influence of changing the force arm on the rotational efficiency of the muscle balancing the moment of gravity was shown. Knowledge of muscle torque under weight-bearing conditions is crucial for correctly assessing foot biomechanics. It has been shown that torque (gravitational and muscular), not pure force, is crucial when assessing the rotational capacity of the analyzed joint. A change in the approach to diagnostics and treating paresis or weakness of extrinsic foot muscles was proposed through the manipulation of the distance of their action line from the axis of joint rotation.

OBJECTIVE: The purpose of the present study was to determine whether there are sex differences in fatigue-induced changes in quiet standing and dynamic balance and establish whether changes in muscle torque and resting stiffness may explain the potential sex differences in balance responses.
METHODS: Sixteen recreationally active men (age; 24.8 ± 5.0 years, height; 178.2 ± 5.6 cm, mass; 77.8 ± 13.2 kg) and 10 women (age; 21.0 ± 1.6 years, height; 167 ± 5.3 cm, mass; 61.3 ± 8.9 kg) were assessed for postural sway, Y balance test performance, isokinetic and isometric knee extensor torque and resting stiffness of the vastus lateralis (VL), gastrocnemius lateralis (GL) and Achilles tendon (AT) before and immediately after fatiguing exercise. The fatigue protocol consisted of five sets of 20-drop jumps.
RESULTS: The fatiguing exercise elicited similar magnitude (effects size; ES) reductions in muscle torque (men; ES = 0.45-0.80, women; ES = 0.46-0.52), dynamic balance (men; ES = 0.45-0.74, women; ES = 0.47-0.79) and resting VL stiffness (men; ES = 0.46, women; ES = 0.36) in men and women (all p < 0.05). For quiet standing balance, fatigue induced an increase in postural sway metrics (ES = 0.64-1.28) and reduction in resting GL stiffness (ES = 0.40) in men (both p < 0.001) but not women (p > 0.05).
CONCLUSIONS: Fatiguing exercise, when producing a similar level of force reduction, induces similar magnitude reductions in dynamic postural control and resting VL stiffness in men and women. Distinct deteriorations in quiet standing balance in men but not women were accompanied by modifications in calf muscle stiffness following exercise-induced muscle fatigue.

The main objective of this study was to evaluate the level of muscle strength by using isokinetic and isometric measurements-more specifically, the force ratio between the knee flexors and extensors (values of the torques).
An experimental group of elite volleyball players (n = 14) were compared to a control group (n = 14) of healthy non-athletes of comparable ages. Torque measurements were obtained under three concentric conditions (angular velocities of 60 °/s, 180 °/s, and 300 °/s) and one static condition by utilizing the Biodex System 3.
In all trials, the volleyball players achieved significantly higher peak torque (PT) values for both the extensors and flexors (p < 0.05) than those of the control group. However, the strength ratio of the flexors and extensors (H/Q) in the experimental group was only 83% of the standard reported in the literature. The most developed and dominating muscles in the knee joints of the volleyball players were the extensors, which accounted for the low strength ratio and dynamic instability of this joint.
Based on a proper assessment of the strength ratio of the knee flexors and extensors, properly selected and implemented resistance training can improve the maximum strength and power production and reduce the incidence of injuries in volleyball.

This study explores the cardiorespiratory and muscular fatigue responses to downhill (DR) vs uphill running (UR) at similar running speed or similar oxygen uptake (⩒O2). Eight well-trained, male, trail runners completed a maximal level incremental test and three 15-min treadmill running trials at ±15% slope: i) DR at ~6 km·h-1 and ~19% ⩒O2max (LDR); ii) UR at ~6 km·h-1 and ~70% ⩒O2max (HUR); iii) DR at ~19 km·h-1 and ~70% ⩒O2max (HDR). Cardiorespiratory responses and spatiotemporal gait parameters were measured continuously. Maximal isometric torque was assessed before and after each trial for hip and knee extensors and plantar flexor muscles. At similar speed (~6 km·h-1), cardiorespiratory responses were attenuated in LDR vs HUR with altered running kinematics (all p < 0.05). At similar ⩒O2 (~3 l·min-1), heart rate, pulmonary ventilation and breathing frequency were exacerbated in HDR vs HUR (p < 0.01), with reduced torque in knee (-15%) and hip (-11%) extensors and altered spatiotemporal gait parameters (all p < 0.01). Despite submaximal metabolic intensity (70% ⩒O2max), heart rate and respiratory frequency reached maximal values in HDR. These results further our understanding of the particular cardiorespiratory and muscular fatigue responses to DR and provide the bases for future DR training programs for trail runners.

BACKGROUND: Although several studies have shown an association of muscle weakness with gait speed (GS), no study has explored the relationship of muscle strength with swing phase duration and GS after stroke among the elderly in Saudi Arabia.
OBJECTIVE: To examine the association of affected ankle dorsiflexor and hip flexor muscle strength with swing phase duration and GS in the elderly with different stroke chronicity.
METHODS: In this cross-sectional study, we included a total of 60 post-stroke patients aged ≥55 years who were admitted in neurorehabilitation units between May 2017 and August 2018. Linear regression was employed to examine the association of muscle strength (measured using a handheld dynamometer) with swing phase duration and GS (both measured using the computerized Zebris-Mat).
RESULTS: The chronicity of the stroke was negatively associated (p < 0.05) with swing phase duration. The ankle dorsiflexor muscle strength was significantly associated with GS (β= 0.656, p = 0.041). In contrast, hip flexor muscle strength was significantly associated with GS (β= 0.574, p < 0.0001) even after adjusting for stroke chronicity (β= 0.561, p < 0.0001).
CONCLUSIONS: Stroke chronicity was the predictor that reduced swing phase duration. The ankle dorsiflexor muscle strength was associated with GS. However, the hip flexor muscle strength was associated with GS even after adjusting for stroke chronicity.

Therapeutic management of the upper extremity (UE) function of people with spinal muscular atrophy (SMA) requires sensitive and objective assessment. Therefore, we aimed to measure physiologic UE function of SMA patients with different functional abilities and evaluate the relation between these physiologic measures and functional UE scales.
12 male and 5 female SMA patients (mean age 42 years; range 6-62 years) participated in this explorative study. Concerning the physiologic level, the maximal muscle torque, the maximal and normalized surface electromyography (sEMG) amplitudes, and the maximal passive and active joint angles were measured. Concerning the activity level, the Performance of the Upper Limb (PUL) scale was used, and hand function was examined using the Nine-Hole Peg Test and the Timed Test of In-Hand Manipulation (TIHM).
Outcome measures that significantly related to the functional ability were: the PUL score (all dimensions); the finger to palm task of the Timed TIHM; biceps, triceps, and forearm extensor strength; and the active range of motion of shoulder abduction, shoulder flexion, and wrist extension. In addition, the following physiologic variables were related to the activity level (PUL score): hand function (the Nine-Hole Peg Test; Rs = - 0.61), the Timed TIHM (Rs = - 0.53), the maximal muscle torque (Rs = 0.74), the maximal sEMG amplitude (Rs = 0.79), and the maximal active joint angle (Rs = 0.88).
Muscle functions in SMA patients are already affected before activity limitations are noticeable. Consequently, monitoring the maximal muscle strength and the normalized muscle activity during task performance could play a role in the early detection of UE limitations. The mechanism behind the loss of arm activities due to SMA is primarily caused by decreasing muscle capacity, which influences the ability to move an arm actively. In clinical practices, these dimensions should be considered separately when monitoring disease progression in order to better evaluate the need for interventions.

What is the central question of this study? Does fukutin deficiency in skeletal muscle cause mitochondrial dysfunction, and if so, can AMP-activated protein kinase (AMPK) stimulation via 5-aminoimidazole-4-carboxamide ribonucleotide attenuate this through regulation of mitochondrial biogenesis and autophagy? What is the main finding and its importance? Mitochondrial dysfunction is associated with fukutin deficiency and AMPK stimulation may benefit muscle contractility to a greater extent than mitochondrial function.
Disruptions in the dystrophin-glycoprotein complex (DGC) are clearly the primary basis underlying various forms of muscular dystrophies and dystroglycanopathies, but the cellular consequences of DGC disruption are still being investigated. Mitochondrial abnormalities are becoming an apparent consequence and contributor to dystrophy disease pathology. Herein, we demonstrate that muscle-specific deletion of the fukutin gene (Myf5/fktn-KO mice (Fktn KO)), a model of secondary dystroglycanopathy, results in ∼30% lower muscle strength (P < 0.001) and 16% lower mitochondrial respiratory function (P = 0.002) compared to healthy littermate controls (LM). We also observed ∼80% lower expression of the gene for peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α) (P = 0.004), a primary transcription factor for mitochondrial biogenesis, in Fktn KO mice that likely contributes to the mitochondrial defects. PGC-1α is post-translationally regulated via phosphorylation by AMP-activated protein kinase (AMPK). Treatment with the AMPK agonist 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) failed to rescue mitochondrial deficits in Fktn KO mice (P = 0.458) but did have beneficial (∼30% greater) effects on recovery of muscle contractility following injury in both LM and Fktn KO mice compared to saline treatment (P = 0.006). The beneficial effects of AMPK stimulation via AICAR on muscle contractile function may be partially explained by AMPK\'s other role of regulating skeletal muscle autophagy, a cellular process critical for clearance of damaged and/or dysfunctional organelles. Two primary conclusions can be drawn from this data: (1) fukutin deletion produces intrinsic muscular metabolic defects that likely contribute to dystroglycanopathy disease pathology, and (2) AICAR treatment accelerates recovery of muscle contractile function following injury suggesting AMPK signalling as a possible target for therapeutic strategies.

The study aimed to analyse the effectiveness of two variants of 8-week strength training (hypertrophy, strength) with different modes of resistance. Healthy male subjects (n=75) were allocated to five groups of equal size: hypertrophy training with a variable cam (Hyp-Cam), hypertrophy training with disc plates (Hyp-Disc), maximal strength training with a variable cam (Str-Cam), maximal strength training with disc plates (Str-Disc), and a control group (CG). The Hyp-Cam and Str-Cam groups trained with a machine where the load was adjusted to the strength capabilities of the elbow flexors. The Hyp-Disc and Str-Disc groups trained on a separate machine in which a load was applied with disc plates. The CG did not train. All groups were assessed for changes and differences in one-repetition (1RM) lifts, isokinetic muscle torque, arm circumference and arm skinfold thickness, and plasma creatine kinase (CK) activity. Within the 8-week training period the 1RM increased (p<.001) in all groups by over 20%, without significant between-group differences. Muscle torque increased significantly (p<.001) only in the Hyp-Cam group (by 13.7%). Arm circumference at rest increased by 1.7 cm (p<.001) and 1.1 cm (p<.001) in the Hyp-Cam and Hyp-Disc groups, respectively, but not in the Str-Cam (0.3 cm; p>.05) or Str-Disc (0.2 cm; p>.05) group. Skinfold thickness of the biceps and triceps decreased more within the 8-week period in Str-Cam (by 1.1 and 2.1 cm; p<.001 and p<.001 respectively) and Str-Disc (0.7 and 1.5 cm; p<.001 and p<.01 respectively) than in Hyp-Cam (by 0.4 and 1.8 cm; p>.05 and p<.01 respectively) and Hyp-Disc groups (by 0.2 and 1.4 cm; p>.05 and p<.05 respectively). CK activity was significantly (p<.05) elevated in each training group except Hyp-Cam (p>.05). The 8-week hypertrophy training with a variable cam results in greater peak muscle torque improvement than in the other examined protocols, with an insignificant increase in training-induced muscle damage indices.

Prolonged low-frequency force depression (PLFFD) induced by fatiguing exercise is characterized by a persistent depression in submaximal contractile force during the recovery period. Muscle glycogen depletion is known to limit physical performance during prolonged low- and moderate-intensity exercise, and accelerating glycogen resynthesis with post-exercise carbohydrate intake can facilitate recovery and improve repeated bout exercise performance. Short-term, high-intensity exercise, however, can cause PLFFD without any marked decrease in glycogen. Here, we studied whether recovery from PLFFD was accelerated by carbohydrate ingestion after 60 minutes of moderate-intensity glycogen-depleting cycling exercise followed by six 30-seconds all-out cycling sprints. We used a randomized crossover study design where nine recreationally active males drank a beverage containing either carbohydrate or placebo after exercise. Blood glucose and muscle glycogen concentrations were determined at baseline, immediately post-exercise, and during the 3-hours recovery period. Transcutaneous electrical stimulation of the quadriceps muscle was performed to determine the extent of PLFFD by eliciting low-frequency (20 Hz) and high-frequency (100 Hz) stimulations. Muscle glycogen was severely depleted after exercise, with a significantly higher rate of muscle glycogen resynthesis during the 3-hours recovery period in the carbohydrate than in the placebo trials (13.7 and 5.4 mmol glucosyl units/kg wet weight/h, respectively). Torque at 20 Hz was significantly more depressed than 100 Hz torque during the recovery period in both conditions, and the extent of PLFFD (20/100 Hz ratio) was not different between the two trials. In conclusion, carbohydrate supplementation enhances glycogen resynthesis after glycogen-depleting exercise but does not improve force recovery when the exercise also involves all-out cycling sprints.

Femoral offset (FO) and limb length discrepancy (LLD) are important perioperative considerations when performing THA. Decreased FO prevents improvement of gait and muscle recovery and residual LLD has a prominent influence on patient satisfaction with THA, while few studies have investigated the relationship between FO and/or LLD and gait disturbances. We investigated the association between these two factors and hip muscle strength and the results of 3-D gait analysis after THA.
We evaluated 92 patients (including 20 patients who underwent gait analysis) in whom total hip arthroplasty was performed for unilateral evere osteoarthritis of the hip joint. FO and LLD were measured on a standard anteroposterior radiograph of the pelvis. Hip muscle strength was evaluated by isometric hip flexion (in the manner of straight leg raising test: SLR) and hip abduction strength. To evaluate 3-D walking trajectory, we used a portable gait analyzer.
Reduction of global FO by > 5 mm after THA compared to the contralateral hip was associated with hip abductor muscle weakness. On the other hand, LLD ≤ 20 mm had no influence on hip abductor muscle strength and SLR strength. In gait analysis, SLR strength showed a significant difference between the sagittal plane symmetrical and asymmetrical groups.
Postoperative global FO > 5 mm less than that of the contralateral hip was associated with hip abductor muscle weakness. And, from the results of 3-D gait analysis, SLR weakness may increase gait asymmetry in the sagittal plane.