We examined 59 patients (33 symptomatic and 26 presymptomatic) from 21 autosomal dominant families with 4q35 linked muscular dystrophy with the initial involvement of the face and shoulder girdle muscles and subsequently of the peroneal group (anterior tibial) muscles. However in most symptomatic patients the dystrophic process is not limited to these anatomical regions and is gradually extended to the thighs (posterior group of the muscles, but not quadriceps), pelvic girdle (gluteus maximus, but not gluteus medius) and not always to upper arm (biceps brachii). The dynamics of the clinical muscle pattern at different stages of the disease was confirmed by CT and MRI muscle study. Thus, our clinical study, CT and MRI studies show that in observed patients there are widespread involvements of the lower limb muscles. In this connection, the inaccuracy of the term “facio-scapulo-humeral (FSH)” or “Facio-Scapulo-Peroneal (FSP)” or “scapuloperoneal with minimal/slight affection of facial muscles [(F)SP]” muscular dystrophy becomes evident. The term “Facioscapulolimb Muscular Dystrophy, type 2 (FSLD2), descending with a “jump” with initial (F)SP or FSP phenotypes with 4q35 deletion” would be more correct. The (F)SP or the FSP phenotypes constituted merely a stage in the development of FSLD2. In many observed patients we revealed a very slight weakness (or atrophy) of individual mimic muscles or their parts, especially during the scapuloperoneal phenotype stage of the disease. A usually slight degree of weakness of the biceps brachii muscles was followed as a rule by the weakness of the peroneal group, posterior group of the thigh and gluteus maximus muscles. We suppose the FSLD2 is an independent form of the muscular dystrophy.

Many pregnant women suffer from pelvic girdle pain (PGP) during pregnancy. Etiologies are multifactorial and affect the joint stability of the sacroiliac joint. Pelvic belts could restore stability and reduce pain during gait. The Center of Pressure (COP) is a reliable parameter to assess gait and balance. The objectives of this study were to analyze the COP during gait in pregnant women with PGP, to evaluate the effect of pelvic belts and to compare two types of belts on COP parameters.

Methods:
46 pregnant women with PGP, 58 healthy pregnant women and 23 non-pregnant women were recruited. The motor task consisted of three gait trials at different velocities on an electronic walkway. Two pelvic belts for pregnant women were used. An analysis of variance was performed to determine the effects on the COP parameters of the progression of the pregnancy, gait speed, being pregnant or not and having pain or not.

Results:
Compared to the control group, pregnant women with PGP had a higher stance time, but COP displacement and velocity were lower. The COP parameters vary between pregnant women with and without pelvic girdle pain: the use of a belt during pregnancy decreases the walking velocity. No difference was found according to the type of belt.

Discussion:
Differences in COP parameters during gait between pregnant women with or without PGP were minimal. Pelvic girdle pain did not affect the center of pressure. Wearing a belt during pregnancy modified the center of pressure velocity during gait in pregnant women with PGP.

TemporoMandibular Disorders (TMDs) are comprised of varied conditions that result in Temporo Mandibular Joint (TMJ) pain, masticatory muscle pain or both.

Perceptual psychology suggested that behavior was controlled by information about the world and the self conjointly. The information has now been described. What about the control? In this article, we asserted that locomotion was controlled by rules. Surely, however, they are not rules enforced by an authority. The rules are not commands from a brain; they emerge from the human-environment system.

We found that the rule is: The line of the Ground Reaction Force (GRF) vector is very close to the Knee Instantaneous Axis (KIA). It aligns the knee joint with the GRF such that the reaction forces are torqueless. The reaction to the GRF will then be carried by the whole structures on the body instead.

Cervical Spinal Cord Injury (SCI) can result as a consequence of traumatic cervical spine fractures or dislocations. Reduction of the dislocation would help to restore the deformity and would help maintain canal diameter and may lead to an improved neurological outcome. There have been several authors who feel that traumatic disc herniation with fracture-dislocation or a facet joint dislocation increases the risk of spinal cord herniation after reduction. In 2002, the American Association of Neurological Surgeons / Congress of Neurological Surgeons published guidelines on the efficacy of closed reduction. This review looked at the efficacy of acute cervical spine fracture dislocation injuries, looking at over 1200 patients who were treated with closed reduction. They noted that roughly 80% of these reductions were successful with a low transient or permanent complication rate. Patient with cervical facture dislocations who cannot be examined because of decreased conscious levels, cannot have post reduction neurology assessed. For these set of patients, an MRI before attempted reduction would be recommended as a treatment option.

Animal laboratory tests which demonstrate that the strength of neuroprotection seems to have an inverse correlation with time to decompression. STASCIS looked at early decompressive surgery being defined at 24 hours or earlier and late surgery being classified as after this. There was a significant improvement of at least  grade 2 AIS for those who were operated on within 24 hours compared to delayed surgery. The Canadian cohort study published by Wilson et al also advocated early decompression. What is defined as early surgery is a topic of contention.

The third area of discussion is around the use of steroid in acute spinal cord injury. Many drugs have been utilized in experimental models and have been shown to improve outcome in rat models. Methyprednisolone is the most studied drug for spinal cord injury. The three prominent trials were the NASCIS (North American Spinal Cord Injury Studies). They did not demonstrate any additional benefit for the use of steroids in patients with acute spinal cord injury.

In our prior studies of distribution center workers, we found that participating companies’ injury logs contained very few reported lower extremity Musculoskeletal Disorders (MSDs), yet a significant percentage of workers reportedly had experienced knee pain. In this study, 341 workers performing material handling jobs from three distribution centers completed a questionnaire that assessed lower extremity MSD symptoms. Two-thirds of the participant’s self-reported work-related lower extremity musculoskeletal symptoms. These were most common in the ankles and feet, followed by knees and hip & thighs. Approximately half the sample experienced pain on work days and some on a daily basis. A large percentage of the respondents reported that their symptoms were exacerbated by work. Stand-up forklift drivers had the highest 12-month prevalence of knee and ankle/foot symptoms across the occupations included in this sample. Significant associations were also found between symptoms and age, gender, work experience, and smoking status.

Duchenne Muscular Dystrophy inducing fibrosis, oxidative stress and muscle necrosis. In the heart, DMD can lead to cardiac failure and death.

Objective:
This study evaluated the expression of cyclooxygenase-2 (COX-2) and ventricular histological aspects of Dystrophic mice, as well as the effects of Ascorbic acid (AA) on these parameters.

Materials and methods:
60 mice, 30 C57BL/10and 30 C57BL10-Dmdmdx, were distributed into six groups according to their age and treatment (n=10/group): control groups at 30 and 60 days (C30 and C60); Dystrophic animals at 30 and 60 days (D30 and D60); and controls and Dystrophic animals at 60days supplemented with AA (CS60 and DS60). After the trial period, the animals were euthanized and their hearts were collected. Samples were subjected to Masson’s Trichrome, Picrosirius Red under polarized light and COX-2 Immunohistochemistrytechniques.

Results:
The results showed an increase of collagen fibers in the D30 group andreduction in the area occupied by cardiomyocytes in D60. COX-2 expression washigher in the C30, D30 and D60 groups, indicating a probable cellular remodelingprocess in C30 and increased oxidative stress leading to fibrosis in dystrophic animals.

Conclusion:
AA supplementation prevented muscle loss in DS60 compared to D60, as well as a decrease of fibrosis and the expression of COX-2 in DS60, proving the protective action of AA in the hearts of these animals.

Disruption in the normal adolescent growth spurt can cause the spinal deformities that result in idiopathic scoliosis. Effects of insulin-like growth factor 1 (IGF1) and fibroblast growth factor 2 (FGF2) on the expression of genes involved in the proliferation and differentiation of myocytes in culture were analyzed. Human myocytes in in vitro culture were treated with IGF1 or FGF2 (10 ng/ml) for 24 hours. Experiments were performed during the exponential growth phase with approximately 1e7 cells per 75 cm2 flask. mRNA was reverse transcribed directly and analyzed using RT-PCR Taqman assays. Expression levels of key genes involved in cell growth and differentiation (CHD 7, HDAC 5, ACTA 1, LEF1, WNT5A, COL1A1, COL2A1, ACAN, FGF7 and VCAN) were monitored using RT-PCR with gene-specific Taqman probes. Two patterns of response to the growth factors were observed: Five genes (CHD7, HDAC5, COL1A1, ACAN, LEF1) were stimulated in their level of expression by IGF-1 with lesser or no effects of FGF2, and one gene (WNT5) was even down regulated by the addition of FGF2. Only ACTA1 showed an increased expression level that was augmented higher by FGF2 than by IGF-1.In summary, we could explicate the feasibility of our myocyte culture system to study genes with possible implication in the development of scoliosis. Growth factor addition to these cells exhibit differential effects simulating eventually the changing growth factor environment during puberty. Any disturbance of the intricate pattern of the various pathways studied might have long lasting effects on skeletal muscle development leading to human disease and might be probed in affected individuals.