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Periostin: A candidate mediator of muscle–tendon ECM remodeling in obesity :
No full textObesity is associated with chronic inflammation, metabolic dysregulation, and significant remodeling of particularly muscle and tendon. Emerging evidence implicates periostin (POSTN), a non-structural matricellular protein, as a key mediator of extracellular matrix (ECM) remodeling in response to metabolic and mechanical stressors. POSTN's modular structure enables it to orchestrate ECM architecture by binding collagen, fibronectin, and matrix-modifying enzymes, positioning it as a central modulator of mechanochemical tissue properties. Normally POSTN is expressed at a low level but becomes upregulated during injury and inflammation that are associated with fibrotic responses. In obesity POSTN expression is elevated systemically and locally in adipose, muscle, and tendon tissues, where it may contribute to the maladaptive remodeling through integrin-mediated activation of signaling pathways such as PI3K/Akt and TGF-β/Smad. This promotes collagen deposition, matrix cross-linking, and fibrosis, impairing tissue function and regenerative capacity. Evidence from obesity and muscle injury models suggests that POSTN may act as both a biomarker of, and a therapeutic target for mitigating, fibrotic changes in musculoskeletal tissues. This review highlights POSTN's context-dependent roles and its potential as a mechanistic link between metabolic dysfunction and musculotendinous tissue degeneration in obesity
Sustainability of positive body image changes one year after exercise interventions in young women: a quasi-experimental study /
No full textAlthough some exercise interventions have demonstrated short-term benefits for women’s positive body image, evidence regarding their longer-term effects—particularly under real-world conditions—remains limited. Understanding the sustainability of post-intervention outcomes is important for assessing the practical relevance of exercise programmes and their potential to improve positive body image. The aim of this study was to examine the sustainability of post-intervention outcomes related to positive body image one year after participation in non-randomised 8-week Nirvana Fitness (NF) and Functional Training (FT) interventions among young women under real-world conditions. Young women (mean age 22.79 ± 6.14) were self-selected into either the NF group (n = 16) or the FT (n = 15) group and participated in an eight-week exercise intervention. A control group (n = 17) of women did not participate in the intervention. Participants completed online questionnaires assessing body appreciation, body surveillance, functionality appreciation, body–mind connection, intrinsic exercise motivation, physical activity at baseline, immediately after the intervention, and 12 months later. Changes in outcomes over time were analysed using linear mixed-effects models with fixed effects for group, time, and their interaction, random intercepts for participants, and adjustment for age and body mass index. Analysis revealed significant group × time interactions for body appreciation, functionality appreciation, body–mind connection, and intrinsic exercise regulation, indicating differential changes over time between interventions and control groups. Body surveillance showed a significant effect of time only, whereas leisure-time exercise differed between groups but did not change over time. Overall, intervention groups demonstrated more favourable change patterns across positive body image-related outcomes compared with the control group. Conclusion: Participation in intervention programmes was associated with sustained improvements in positive body image and exercise motivation, but not with changes in body surveillance or leisure-time physical activity. Given the self-selected group allocation and small sample size, these findings should be considered exploratory. Larger randomised studies are needed to confirm the sustainability and generalisability of these findings
Post-exercise controlled breathing enhances cardiovascular recovery and autonomic balance: a randomised crossover study /
No full textBackground and Objectives: Controlled breathing can influence autonomic regulation and haemodynamics; however, the role of its timing relative to exercise remains unclear. Materials and Methods: Fourteen healthy, physically active men (mean age 21.8 ± 0.7 years; body mass index within the normal range) participated in this randomised crossover study. Each session consisted of five 5 min cycling bouts at 50% of heart-rate reserve, interspersed with 3 min passive recovery periods. The three conditions were: control (no structured breathing), 30 s hyperventilation (approximately 30 breaths·min−1) performed before each bout, and the same hyperventilation performed after each bout. Resting heart rate variability spectra (low-frequency [LF], high-frequency [HF]) were assessed pre- and post-session; arterial blood pressure was measured stage-wise; quadriceps muscle oxygen saturation (StO2) was monitored using near-infrared spectroscopy; and a discriminant co-integration index (Dsk) was calculated to integrate multisystem responses. Results: Compared with baseline, LF power increased and HF power decreased after exercise in the control and post-exercise hyperventilation conditions (p < 0.05), whereas pre-exercise hyperventilation attenuated these shifts. Post-exercise hyperventilation blunted the rise in systolic blood pressure and reduced diastolic blood pressure compared with control (p < 0.05). Both breathing interventions accelerated StO2 recovery, with higher early recovery StO2 following pre-exercise hyperventilation and sustained advantages after post-exercise hyperventilation (moderate-to-extensive effects). Dsk values were consistently highest after exercise, indicating stronger and more coherent multisystem coupling. Conclusions: In this acute crossover study of healthy young men, hyperventilation performed before or after exercise induced distinct short-term cardiovascular and muscular responses, reflecting respiratory-driven modulation of haemodynamic and autonomic processes. The timing of hyperventilation influenced these responses, suggesting that deliberate hyperventilation may acutely modify exercise-related regulatory mechanisms
Diffusion and physical constraints limit oxidative capacity, capillary supply and size of muscle fibres in mice and humans /
No full textIt has been suggested that angiogenesis during skeletal muscle fibre hypertrophy allows escape from the 'size constraint', which is the inverse relationship between oxidative capacity and muscle fibre cross-sectional area (FCSA). It is, however, not known whether there are any limitations to the combinations of FCSA, oxidative capacity and capillary supply to an individual fibre. We determined the FCSA, oxidative capacity and capillary supply to fibres from highly resistance-trained men before and after superimposed endurance training, recreationally active men and women, and different mouse muscles. Both the oxidative capacity and the number of capillaries around a fibre (CAF) per FCSA (CAF/FCSA) showed an upper limit at each FCSA, irrespective of species, muscle origin or training status. The upper limit of fibre oxidative capacity was likely determined by diffusion constraints. The upper limit of CAF/FCSA was determined by physical constraints where (i) there is no further reduction in maximal diffusion distance to the core of a fibre beyond a CAF of 2, and (ii) the reduction in fibre area supplied by a capillary diminishes exponentially with an increase in CAF. The calculated upper limits of oxidative capacity and CAF/FCSA of a fibre of a given FCSA were linearly related. Irrespective of species, sex, muscle of origin and training status, our data indicate that diffusion limitations and physical limitations to capillary placement around a fibre place an upper limit on the oxidative capacity and capillary supply to a fibre of a given size, respectively
Co-designing the Join4Joy approach to boost enjoyment and social inclusion for the increase of physical activity among older people in nursing homes and community settings: a qualitative study in Spain, Denmark, Germany, Italy and France /
No full textThe global ageing population faces significant health challenges linked to insufficient physical activity (PA). Although PA offers emotional, cognitive, and physical benefits, long-term participation among older adults remains low. Enhancing enjoyment may boost their motivation and sustain engagement, while improving inclusivity is essential to reach underserved groups. This study describes the process of co-designing strategies to enhance enjoyment and social inclusion in PA interventions for community-dwelling and nursing home residents, guided by the Octalysis gamification framework. Using a qualitative phenomenological approach, we conducted 13 focus groups and 3 online individual interviews with 98 participants, including 51 older adults, 29 formal caregivers, 5 family members, 10 policymakers, and 3 students from Spain, Denmark, France, Germany, and Italy. Analysis revealed barriers such as fatigue, fear of injury, and social isolation, and facilitators including enjoyment, adaptability, and community support. Participants emphasized tailoring interventions to individual abilities and cultural contexts, integrating social connection, and fostering supportive environments. Stakeholders proposed innovative strategies to improve accessibility and enjoyment of PA. The findings underscore the value of co-design in meeting the needs of older adults and fostering a sense of ownership and commitment to PA programmes. Group-based interventions can benefit from the Join4Joy approach, which promotes enjoyment, improves movement behaviour, and mitigates social isolation. Following the co-design process, practical strategies are presented to increase PA and reduce sedentary behaviour, offering a pathway to more impactful, inclusive, and sustainable interventions for older adults
The effect of different physiotherapy programs on low back pain and function in 15-16 year old adolescents.
No full textResearch problem: One of the most common musculoskeletal disorders among modern adolescents is low back pain, which can be reduced using various physiotherapy methods depending on the cause of the pain. Research aim: To determine the effect of different physiotherapy programs on low back pain and function in 15–16-year-old adolescents. Research objectives: 1) To evaluate the lumbar pain, mobility, and static trunk muscle endurance of subjects who underwent conventional physiotherapy before and after a 3-week intervention. 2) To evaluate the lumbar pain, mobility, and static trunk muscle endurance of subjects who underwent extended physiotherapy (based on J. Cyriax’s biocybernetic concept) before and after a 3-week intervention. 3) To compare the effectiveness of both applied interventions. Research hypothesis: Based on previous studies (Trager et al., 2023; Hayden et al., 2021), it is assumed that for 15–16-year-old patients experiencing low back pain, the extended physiotherapy program (based on J. Cyriax’s biocybernetic concept) will have a more beneficial effect. Research methods: Low back pain was assessed using the Visual Analogue Scale (VAS). Lumbar mobility was evaluated using inclinometers (two inclinometers were used). The static trunk muscle endurance test was performed according to the McGill (2002) method. Research results: Analysis of low back pain results showed that pain significantly decreased in both groups (p0.05). Evaluation of lumbar mobility results revealed a statistically significant improvement in both groups (p<0.05), and when comparing results between groups, a significant improvement was observed in the experimental group (p<0.05) in both extension and flexion. Evaluation of static trunk muscle endurance (according to McGill, 2002) showed significant improvement in both groups (p<0.05), but the difference between the groups was not statistically significant. Analysis of correlations between pain and lumbar mobility, as well as pain and static trunk muscle endurance, revealed weak to moderate relationships between low back pain and lumbar mobility in both groups (p<0.05). In the control group, weak to moderate correlations were also found between low back pain and static trunk muscle endurance. Conclusions: 1) Subjects who underwent conventional physiotherapy showed a statistically significant reduction in low back pain and an increase in lumbar mobility and static trunk muscle endurance. 2) Subjects who underwent extended physiotherapy showed a statistically significant reduction in low back pain and an increase in lumbar mobility and static trunk muscle endurance. 3) Lumbar mobility was statistically better in subjects who underwent extended physiotherapy compared to those who received conventional physiotherapy, although other indicators did not differ significantly
Relationship between perceived stress and anxiety in high school senior students: the mediating role of social support and the moderating influence of lifestyle /
No full text(1) Background: The purpose of this study was to investigate the associations between perceived stress and anxiety in high school senior students, taking into account the possible influence from lifestyle (physical activity, nicotine dependence, and alcohol use) and social support. (2) Methods: A representative sample of high school senior students (N = 405; mean age: 18.2 ± 0.4), reflecting the overall geographic distribution of Lithuania’s student population, was investigated using anonymous questionnaires on perceived stress (Perceived Stress Scale, PSS-10), anxiety (Generalized Anxiety Disorder Scale, GAD-7), perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS), lifestyle (Fagerström Test for Nicotine Dependence), alcohol use (Alcohol Use Disorders Identification Test, AUDIT), and physical activity (International Physical Activity Questionnaire, IPAQ). Hierarchical multiple regression analysis was employed, investigating mediating and moderating effects. (3) Results: The direct effect of perceived stress on anxiety was significant (B = 0.364; SE = 0.0486; 95% CI [0.268, 0.459]; p < 0.001). Furthermore, the analysis revealed a significant indirect effect via social support (B = 0.387; SE = 0.0525; 95% CI [0.284, 0.490]), indicating that a portion of the relationship between perceived stress and anxiety was mediated by social support. Physical inactivity, alcohol use, and nicotine dependence served as moderators. Our findings confirmed that all three moderators showed significant interaction effects, with standardized β = −0.124, p = 0.002, for physical inactivity, β = 0.073, p = 0.016, for alcohol dependence, and β = 0.119, p = 0.001, for nicotine dependence, in the relationship between perceived stress and anxiety among high school senior students. (4) Conclusions: These findings have practical insights for educators who implement physical activity and alcohol and nicotine usage programs for high school senior students to help reduce their stress and anxiety
Measurements and digital technology solutions to monitor physical activity in patients with pediatric cancer: scoping review /
No full textBackground: Patients with pediatric cancer often experience reduced physical activity (PA) due to treatment-related fatigue, functional limitations, and lack of structured exercise programs. Digital health solutions, including wearable sensors and augmented reality (AR)-based interventions, may offer new possibilities for monitoring and improving PA in this population. Objective: This scoping review aims to address existing research gaps by identifying the instruments-both conventional and digital-used to monitor PA in patients with pediatric cancer during treatment. In addition, this study examines PA monitoring methods, identifies the variables collected, and explores the applicability of digital health solutions in facilitating PA engagement among patients with pediatric cancer. Methods: In accordance with the Joanna Briggs Institute methodology, a systematic search was conducted across 8 scientific databases-ProQuest, Web of Science, EBSCO Complete, Google Scholar, ScienceDirect, Scopus, MEDLINE (PubMed), and Cochrane-on April 18 and 19, 2024. Studies were screened using the Rayyan AI-assisted review tool based on predefined inclusion criteria targeting children aged 7-19 years who were undergoing cancer treatment or were within 2 years posttreatment. Eligible studies included clinical trials and observational studies that examined objective (eg, wearable sensors) and subjective (eg, questionnaires and self-reports) approaches to PA monitoring. Keywords and controlled vocabulary (eg, MeSH [Medical Subject Headings] terms) were identified through a review of relevant literature. Data were extracted systematically to capture study characteristics, intervention types, and outcome measures. Extracted data were charted and synthesized narratively to identify patterns, technological applications, and research gaps in PA monitoring among patients with pediatric cancer. Results: Twelve studies met the inclusion criteria and employed a range of PA monitoring tools. Digital health solutions, including Actical and Garmin VivoFit 3 devices, were used in 5 studies to assess step counts, gait cycles, and movement intensity. Self-reported measures were identified in 11 studies, most commonly the Activities Scale for Kids and the Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale, which provided insights into mobility and fatigue. Despite their feasibility, subjective assessments were limited by recall bias and motivational factors. Although digital health solutions-such as wearable sensors, gamification, and mobile applications-showed potential to improve PA adherence, their application remains underutilized, and evidence regarding their integration in pediatric oncology is limited. Conclusions: Existing objective and subjective methods for monitoring PA provide valuable insights; however, gaps remain in the use of interactive digital health solutions, such as AR-based interventions, for PA monitoring and engagement. Future research should focus on integrating digital tools that not only track PA but also actively engage patients, enhance motivation, and support rehabilitation across both clinical and home settings
Health literacy and associated factors among military personnel: a cross-sectional study in Lithuania /
No full textBackground: Health literacy is increasingly recognized as an essential determinant of health, readiness, and safety in the military, especially as health systems become more digitalized. However, evidence on general and digital health literacy in the armed forces remains limited. This study examined levels of general health literacy and digital health literacy among Lithuanian soldiers and explored their associations with sociodemographic, service-related, and health characteristics. Methods: A cross-sectional survey was conducted among 603 military personnel serving in the national armed forces. General and digital health literacy were measured with HLS19-Q12 and HLS19-DIGI. Data on sociodemographic and military characteristics, self-rated health, and self-reported long-term illnesses were collected. Descriptive statistics, correlation analyses, and multivariable regression models were used to analyze the data. Results: The sample was predominantly male (81.9%) with a mean age of 39.08 years (SD = 8.89). The mean general health literacy score was 80.1 (SD = 19.17), whereas the mean digital health literacy score was 67.81 (SD = 30.05). Overall, 45.0% of soldiers had excellent general health literacy, and 12.0% had inadequate general health literacy; 42.1% had excellent digital health literacy, and 35% had inadequate digital health literacy. Higher levels of health literacy were positively associated with better self-rated health and social status. No statistically significant associations were found between health literacy and gender, age, education, length of service, type of military service, and self-reported long-term health complaints. Conclusions: Military personnel in this study displayed relatively high general health literacy, yet digital health literacy was lower and more unevenly distributed, indicating a potential vulnerability for health outcomes as access to information, communication, and care increasingly relies on digital platforms. Given the cross-sectional design, causal inferences cannot be drawn. Military health services may build on existing health literacy strengths while considering strategies to address digital health literacy gaps (e.g., targeted training, tailored support, and user-friendly digital solutions, including service design), acknowledging that feasibility and implementation depend on organizational context and resources
Nutukimo poveikis griaučių raumenų morfologinėms, mechaninėms ir funkcinėms savybėms.
No full textObesity is a growing global epidemic associated not only with metabolic and cardiovascular disorders but also with impairments in skeletal muscle and tendon integrity. While the metabolic consequences of obesity are well described, its impact on the structural and mechanical properties of musculotendinous tissues and their functional implications has remained underexplored. This doctoral thesis investigates how obesity alters the morphology, material properties, and function of the skeletal muscle–tendon unit (MTU), aiming to clarify the mechanisms that contribute to reduced movement efficiency, tissue fragility, and impaired functional capacity. The research comprises four interrelated experimental studies using both human and animal models. The work follows a logical progression: from basic mechanical characterization of tissues to identifying the consequences of obesity-induced remodelling, and finally assessing functional implications in both locomotor and respiratory systems. The initial study focused on the passive mechanical properties of isolated skeletal muscle and adipose tissue in healthy mice, providing foundational data on the distinct mechanical behaviour of these tissues. It revealed that adipose tissue, due to its greater hysteresis and lower stiffness, may influence overall MTU mechanics when infiltrating contractile or connective tissues. Building on this, a mouse model of diet-induced obesity was used to demonstrate that obesity leads to profound structural remodelling of muscle, tendon, and the MTU junction. Histological and molecular assessments showed significant infiltration of adipose tissue, fibrosis with increased collagen cross-linking, and dysregulated expression of extra-cellular matrix remodelling markers including TGF-β1 and Periostin. These changes were associated with a reduced mechanical resilience to repetitive loading, providing mechanistic insights into tissue fragility in obesity. The human studies extended these findings to applied functional contexts. Firstly, we showed that in individuals with obesity, the triceps surae MTU exhibits increased stiffness and hysteresis, along with reduced strength relative to body mass. These mechanical alterations led to impaired calf raise efficiency, weakness and fatiguability, highlighting the direct functional cost of obesity-induced MTU remodelling on locomotor performance. Parallelly, we addressed the respiratory system, revealing that individuals with obesity display altered breathing patterns, characterized by increased respiratory rate and reduced tidal volume. These functional impairments were linked to a mechanical disadvantage of the diaphragm, suggesting that obesity may compromise not only locomotor but also ventilatory muscle performance. Taken together, these findings provide converging evidence that obesity promotes structural and biochemical remodelling of musculotendinous tissues, including adipose infiltration, fibrotic tissue accumulation with increased collagen cross-linking and disrupted extracellular matrix organization. Functionally, these alterations modify tissue passive mechanical behaviour, impair force production dynamics, increase mechanical energy dissipation, and compromise tissue resilience. Consequently, individuals with obesity may experience muscle weakness, increased energy cost of movement, reduced mobility, a less efficient breathing pattern, early fatigue, and MTU fragility, all of which contribute to a decline in physical function and quality of life. This thesis underlines the importance of recognizing obesity not only as a metabolic disease but also as a condition of musculoskeletal degradation. By clarifying the mechanical and functional consequences of obesity-induced musculotendinous remodelling, these findings provide a foundation for targeted preventive and rehabilitative strategies aimed at preserving or restoring movement efficiency and musculoskeletal health in individuals with obesity