Publications by authors named "Valerio Giustino"

13 Publications

  • Page 1 of 1

Changes in neural drive to calf muscles during steady submaximal contractions after repeated static stretches.

J Physiol 2021 Sep 13;599(18):4321-4336. Epub 2021 Aug 13.

Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.

Key Points: Repeated static-stretching interventions consistently increase the range of motion about a joint and decrease total joint stiffness, but findings on the changes in muscle and connective-tissue properties are mixed. The influence of these stretch-induced changes on muscle function at submaximal forces is unknown. To address this gap in knowledge, the changes in neural drive to the plantar flexor muscles after a static-stretch intervention were estimated. Neural drive to the plantar flexor muscles during a low-force contraction increased after repeated static stretches. These findings suggest that adjustments in motor unit activity are necessary at low forces to accommodate reductions in the force-generating and transmission capabilities of the muscle-tendon unit after repeated static stretches of the calf muscles.

Abstract: Static stretching decreases stiffness about a joint, but its influence on muscle-tendon unit function and muscle activation is unclear. We investigated the influence of three static stretches on changes in neural drive to the plantar flexor muscles, both after a stretch intervention and after a set of maximal voluntary contractions (MVCs). Estimates of neural drive were obtained during submaximal isometric contractions by decomposing high-density electromyographic signals into the activity of individual motor units from medial gastrocnemius, lateral gastrocnemius and soleus. Motor units were matched across contractions and an estimate of neural drive to the plantar flexors was calculated by normalizing the cumulative spike train to the number of active motor units (normalized neural drive). Mean discharge rate increased after the stretch intervention during the 10% MVC task for all recorded motor units and those matched across conditions (all, P = 0.0046; matched only, P = 0.002), recruitment threshold decreased for motor units matched across contractions (P = 0.022), and discharge rate at recruitment was elevated (P = 0.004). Similarly, the estimate of normalized neural drive was significantly greater after the stretch intervention at 10% MVC torque (P = 0.029), but not at 35% MVC torque. The adjustments in motor unit activity required to complete the 10% MVC task after stretch may have been partially attenuated by a set of plantar flexor MVCs. The increase in neural drive required to produce low plantar-flexion torques after repeated static stretches of the calf muscles suggests stretch-induced changes in muscle and connective tissue properties.
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http://dx.doi.org/10.1113/JP281875DOI Listing
September 2021

Effectiveness of Rehabilitative Intervention on Pain, Postural Balance, and Quality of Life in Women with Multiple Vertebral Fragility Fractures: A Prospective Cohort Study.

J Funct Morphol Kinesiol 2021 Mar 3;6(1). Epub 2021 Mar 3.

Department of Oncology and Stomatological Surgical Disciplines, University of Palermo, 90100 Palermo, Italy.

Patients with vertebral fragility fractures often experience chronic pain, postural and balance disorders, and poor quality of life (QoL). Although several studies have investigated the role of rehabilitation in severe osteoporosis, the effectiveness of this intervention in patients with multiple vertebral fractures is poorly known. The aim of our longitudinal cohort study is to evaluate the effectiveness of rehabilitation, including postural training, resistance exercises, and visual stabilization exercises, for a 7-week period, on the pain, postural balance, and QoL of subjects with at least two vertebral fragility fractures receiving denosumab and vitamin D. We investigated, before (T0) and after (T1, at 7 weeks) rehabilitation, the following outcome measures on 28 patients: pain (Numerical Rating Scale (NRS)), self-perceived QoL (36-Item Short Form Survey (SF-36) and Mini-Osteoporosis Quality of Life Questionnaire (Mini-OQOL)), dizziness (Dizziness Handicap Inventory (DHI-I)), mobility (Timed-Up and Go (TUG) test), and instrumental posturographic assessment (FreeMed posturography system). At the end of the treatment, improvements of pain and QoL were recorded. Pain relief was highly obtained in patients with more than two vertebral fractures. Moreover, a significant functional improvement (TUG test) was found in those with two vertebral fractures, without any statistically significant change reported for other outcomes. Our findings suggest that combined intervention, including anti-osteoporotic drugs and postural rehabilitation, should be proposed to osteoporotic patients with multiple vertebral fractures.
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http://dx.doi.org/10.3390/jfmk6010024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931028PMC
March 2021

A pilot study on non-invasive treatment of migraine: The self-myofascial release.

Eur J Transl Myol 2021 Mar 26;31(1). Epub 2021 Mar 26.

Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo.

The aims of this paper was to determine the effect of self-myofascial release (SMFR) on postural stability and to analyze if it can influence migraine condition. Twenty-five subjects (age 49.7± 12.5) affected by migraine were enrolled. Assessments included a stabilometric analysis in order to evaluate balance and plantar support, with eyes open (OE) and closed (CE); cervical ROM measurement; evaluation of upper limb strength through handgrip. All the analysis were carried out before and after the administration of a single SMFR protocol, using medium density small balls laid in the three most painful trigger points in migraine patients: trapezius, sternocleidomastoids and suboccipital muscles. Performing a T test for paired samples, there was a significant increase in two ranges of the stabilometric analysis: ellipse surface, both with open and closed eyes (p value EO = 0.05; p value EC = 0.04) and length of the sway path, but just with closed eyes (p value = 0.05). SMFR might have a positive impact on postural stability in subjects with migraine. Further investigation should be conducted to confirm the hypothesis.
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http://dx.doi.org/10.4081/ejtm.2021.9646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056163PMC
March 2021

The Effect of COVID-19 Lockdown Measures on Physical Activity Levels and Sedentary Behaviour in a Relatively Young Population Living in Kosovo.

J Clin Med 2021 Feb 14;10(4). Epub 2021 Feb 14.

Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy.

To abate the spread of the COVID-19 virus, different restriction measures were imperative, limiting the possibility to be engaged in physical activity. Therefore, this study aimed to evaluate the effect of COVID-19 lockdown on physical activity (PA) levels expressed as energy expenditure (MET-min/week) and sedentary behaviour in Kosovo. The possible association between PA levels and other factors was analyzed. 1633 participants (age range: 13 to 63 years; mean: 24.70 ± 9.33 years; body height: 172 ± 10.57 cm; body mass: 69.10 ± 13.80 kg; BMI: 23.09 ± 3.63 kg/m) participated in the study, categorized by age, gender, BMI, and living area. An online survey, including an adapted version of the IPAQ-SF, was administered once during lockdown to assess PA levels and sedentary behaviour both before and during COVID-19 lockdown. The Wilcoxon signed-rank, Mann-Whitney U and Kruskal-Wallis rank of sum tests were used for statistical analysis. COVID-19 restrictions had a negative impact on the types of and overall PA levels MET-min/week ( < 0.001). Sedentary behaviour significantly increased during COVID-19 restrictions ( < 0.001). Higher decreases in MET-min/week during lockdown were observed among males, young and young adults, overweight, and urban-living participants. Finally, COVID-19 restrictions decreased the PA levels and MET-min/week, and increased sedentary behaviour also in a relatively young cohort. Such differences were dependent on several factors.
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http://dx.doi.org/10.3390/jcm10040763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918337PMC
February 2021

Effectiveness of a Physical Education Program on the Motor and Pre-literacy Skills of Preschoolers From the Training-To-Health Project: A Focus on Weight Status.

Front Sports Act Living 2020 16;2:579421. Epub 2020 Dec 16.

Department of Psychological, Educational Science and Human Movement, University of Palermo, Palermo, Italy.

Many studies reported a positive relationship between motor skills, cognitive functions, and school performance in school-age children; however, little is known in preschool children. The aim of the present study was to demonstrate the effectiveness of a physical education program (PEP) on locomotor, object control skills, and pre-literacy cognitive functions in a wide population of preschoolers and verify whether weight status could influence these abilities. In the context of the Training-to-Health Project, a sample of 1,029 preschoolers was recruited in kindergartens from the urban area of Palermo (Italy). Their gross motor and pre-literacy skills were tested before (PRE) and after (POST) following 16 weeks (2 h/week) of a PEP, which included ludic-motor activities aimed at developing body awareness and fundamental motor and perceptual-sensory skills. Analyses of variance (ANOVA) were performed to assess the skills before and after the intervention and to evaluate the effect of different categories of weight status on the examined variables. Regression analyses were conducted to confirm the hypothesized interrelationship between motor and pre-literacy skills in the considered sample. Both locomotor/object control and pre-literacy skills were significantly higher in children after the PEP ( < 0.05). We found 23% of overweight children and no significant difference between weight status classes in both PRE and POST PEP groups. In the POST group, higher locomotor and object control skills were mostly associated with better pre-literacy skills. This study shows that PEP was effective in improving both motor and pre-literacy skills in preschoolers independently from age and gender, while weight status did not affect these skills suggesting that this program can be administrated indifferently in children with different categories of weight status. Therefore, PEP could be a decisive education strategy to enhance motor and cognitive learning in preschool children and to achieve successful academic outcomes.
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http://dx.doi.org/10.3389/fspor.2020.579421DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750875PMC
December 2020

Is bodyweight affecting plantar pressure distribution in children?: An observational study.

Medicine (Baltimore) 2020 Sep;99(36):e21968

PosturaLab Italia.

The aim of this study is twofold: firstly, to investigate the plantar pressure distribution differences in children coming from 4 different weight categories and secondly to analyze the presence of sex-related plantar pressure distribution differences.Overall, 416 children, aged 7 to 12 years old were randomly selected from 6 different local schools, and voluntarily participated in the study. Two hundred twenty six of them were men, while 190 were women (mean age: 9.93 ± 1.02 years; height: 1.39 ± 0.8 m; body mass: 37.76 ± 10.34 kg; BMI: 19.24 ± 4.02 kg/m). Based on the body mass index (BMI) the sample was grouped in the following categories: underweight (UW); normal weight (NW); overweight (OW), and obese (OB). Besides, the plantar load distribution parameters (total plantar load distribution and load distribution in forefoot and rearfoot) were assessed employing freeMed Maxi; Sensor Medica device. Shapiro-Wilk test was used to test the data distribution. Between-groups comparisons were conducted using Mann-Whitney U test, or using Kruskal-Wallis test associated with pairwise comparisons.There were significant differences in load distribution between weight categories, with (OW) and (NW) being significantly different with (O), P = .03 and P = .04, respectively. No significant differences were found on load distribution on the rearfoot and forefoot between categories. The sex effect, particularly among boys, revealed a different pattern of load distribution among (O) compared with other categories. This effect was not detected among women. Different profile of load distribution on the rearfoot and forefoot between boys and girls was found, with girls bearing significantly more weight in the right rearfoot compared with boys (P = .001).It can be concluded that the weight status of the children can affect the plantar load distribution, with obese category being different from (NW) and (OW). Additionally, the sex plays a role when it comes to the load distribution in different regions of the foot. Moreover, since the young age, due to growth and development process, is accompanied with anatomical foot changes which might be affected from numerous factors, assessing plantar pressure distribution in young children results to be a quite complicated matter.
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http://dx.doi.org/10.1097/MD.0000000000021968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478521PMC
September 2020

Physical fitness assessment in Goalball: A scoping review of the literature.

Heliyon 2020 Jul 18;6(7):e04407. Epub 2020 Jul 18.

Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy.

Background: Goalball is a Paralympic sport for visually impaired athletes. Although it is widely practiced, a great variety of tests are adopted to evaluate athletes' physical fitness. Therefore, the objective was to identify the physical fitness tests adopted in this sport to find the common aspects between them and, eventually, to propose a standard operating procedure.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were adopted. The studies were extracted from PubMed, Web of Science, and Scopus. A selection process by title, abstract, and full-text, according to the inclusion and exclusion criteria, was performed. The results were discussed with narrative synthesis.

Results: A total of 7 papers and 222 participants were included. A wide variety of tests were adopted and the Brockport Physical Fitness Test (BPFT) was the only battery included to evaluate general athletes' well-being.

Conclusions: Although few literature exists on Goalball, the BPFT could be the battery for evaluating Goalball athletes though the test battery should be standardized to the characteristics of this sport.
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http://dx.doi.org/10.1016/j.heliyon.2020.e04407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369608PMC
July 2020

Significant reduction of physical activity in patients with neuromuscular disease during COVID-19 pandemic: the long-term consequences of quarantine.

J Neurol 2021 Jan 13;268(1):20-26. Epub 2020 Jul 13.

Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, Via G. La Loggia, 1, 90129, Palermo, Italy.

Background: Quarantine was the measure taken by governments to control the rapid spread of COVID-19. This restriction resulted in a sudden change in people's lifestyle, leading to an increase in sedentary behavior and a related decrease in the practice of physical activity (PA). However, in neuromuscular diseases patients need to perform regular PA to counteract the negative consequences of the disease. Hence, the aim of this study was to estimate the levels of PA, measured as energy expenditure (MET-minute/week), among patients with neuromuscular disease (NMD) before and during the last week of quarantine.

Methods: A total of 268 Italian subjects, living in Sicily, completed an adapted version of the IPAQ-SF. Participants comprised 149 NMD, enrolled at the Neuromuscular Clinic of Palermo and 119 healthy subjects (control group). The SF-12 questionnaire was also administered to NMD. The Mann-Whitney U and the Kruskal-Wallis rank-sum tests were used for statistical analyses.

Results: We observed a significant decrease of the total weekly PA level during COVID-19 quarantine in both patients and controls. Moreover, a significant difference in the total weekly PA level was found depending on the presence of neuromuscular disease, impaired walking, gender and BMI. Finally, we found a correlation between SF-12 scores and the entity of the reduction of PA level during quarantine, thus confirming a relevant association with the quality of life in NMD.

Conclusion: Our study confirmed that COVID-19 quarantine has affected the practice of PA among both NMD and healthy controls.
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http://dx.doi.org/10.1007/s00415-020-10064-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356123PMC
January 2021

Upper and Lower Limb Strength and Body Posture in Children with Congenital Hypothyroidism: An Observational Case-Control Study.

Int J Environ Res Public Health 2020 07 4;17(13). Epub 2020 Jul 4.

Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy.

Background: Congenital hypothyroidism (CH) is an endocrine disease with a precocious significant impairment of growth and neuromotor development. Thyroid hormones are essential for central nervous system development, maturation, and myelination. Furthermore, thyroid hormone deficiency affects the function of several systems, including the musculoskeletal system. The disease has a significant incidence in the general population (1:3000-1:2000 newborns in Italy). The aim of the present study was to evaluate any differences in upper and lower limb strength, body sway, and plantar loading distribution in children with CH compared to healthy children.

Methods: In this study, the case group was composed of children with CH (CHG), while the control group included healthy children (CG). Both groups comprised 19 children (CHG: female = 12; CG: female = 9). The maximum isometric handgrip strength and explosive-elastic lower limb strength were assessed with the handgrip test and the Sargent test, respectively. The stabilometric and baropodometric analyses were used to measure the Center of Pressure displacements and the plantar loading distribution between feet, respectively. The differences between groups were analyzed by a univariate analysis of covariance using as covariates weight and height with the significant level set at < 0.05.

Results: We found that CHG children were shorter and thinner than CG ones ( < 0.05). No significant difference in the upper and lower limb strength was found between groups. CHG exhibited a significant greater Sway Path Length ( < 0.01) and Ellipse Surface ( < 0.05) than CG. Moreover, CHG displayed an asymmetric plantar loading distribution with a significant lower percentage in the right than in the left foot ( < 0.05). Moreover, a significant lower plantar loading percentage in the right foot of CHG than in the right foot of CG was observed ( < 0.05).

Conclusions: These findings seem to suggest that CH does not affect muscle strength in early treated children. However, these patients show poor postural control ability and asymmetric plantar loading distribution. Increasing the physical activity in these children could improve their body posture.
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http://dx.doi.org/10.3390/ijerph17134830DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370191PMC
July 2020

Investigating prismatic adaptation effects in handgrip strength and in plantar pressure in healthy subjects.

Gait Posture 2020 02 23;76:264-269. Epub 2019 Dec 23.

Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Italy; NeuroTeam Life and Sciences, Palermo, Italy.

Background: Prismatic Adaptation (PA) is a visuomotor procedure inducing a shift of the visual field that has been shown to modulate activation of a number of brain areas, in posterior (i.e. parietal cortex) and anterior regions (i.e. frontal cortex). This neuromodulation could be useful to study neural mechanisms associated with either postural measures such as the distribution of plantar pressure or to the generation of muscle strength. Indeed, plantar pressure distribution is associated to activation of high-level cognitive mechanisms taking place within the posterior regions of the brain dorsal stream, especially of the right hemisphere. Conversely, hand force mostly rely on sensorimotor mechanisms, fulfilled by anterior regions of the brain and involving both hemispheres.

Research Question: Since PA effects have been reported to affect both sensorimotor and higher level cognitive processes, is it possible to hypothesize a modulation of both hands strenght and plantar pressure after PA?

Methods: Forty-six healthy subjects (male = 23; mean age = 25 ± 3 years) were randomly divided into two groups: a leftward prismatic adaptation group (l-PA) and a rightward prismatic adaptation group (r-PA). Hand strength and plantar pressure were assessed, immediately before and after PA, using the handgrip task and baropodometric measurement, respectively.

Results: Both l-PA and r-PA induced a significant decrease of strength in the hand contralateral to the lenses deviation side. Only r-PA was associated with an increase of the forefoot plantar pressure in both feet. Modulation of interhemispheric inhibitory processes at sensorimotor and higher cognitive level may account for the present results.

Significance: PA exerts effects on body posture and hand strength relying on different mechanisms. The PA effects on hand strength are probably related to the modulation of interhemispheric inhibition of sensorimotor processes, involving both hemispheres. The PA effects on body posture are probably related to modulation of body representation, involving mainly the right hemisphere.
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http://dx.doi.org/10.1016/j.gaitpost.2019.12.022DOI Listing
February 2020

Orofacial muscles activity in children with swallowing dysfunction and removable functional appliances.

Eur J Transl Myol 2019 Aug 27;29(3):8267. Epub 2019 Aug 27.

Faculty of Medicine and Dental Surgery, Sapienza University of Rome, Rome, Italy.

Swallowing dysfunction is a frequent disorder among children and refers to an altered tongue posture and abnormal tongue movement during swallowing. Removable functional appliance is one of the treatments applied by dentistry to correct this disorder. The aim of this study was to evaluate any differences on orofacial muscles activity in children with swallowing dysfunction with and without removable functional appliances. 68 children were eligible for the study and divided into the orthodontic group (OG) and the no-orthodontic group (NO-OG). Both groups performed a dental occlusion-class evaluation, a swallowing function test and a myoscan analysis in order to measure perioral forces (i.e. tongue extension force, lip pressure, masseter contraction force). Our results showed a significant difference (P=0.02) between OG and NO-OG for the tongue extension force, whereas no significant differences (P>0.05) were found for the other parameters. Our findings suggest that children with swallowing dysfunction and removable functional appliance show orofacial muscles activity within the range of reference values (except for the lip pressure). However, we hypothesize that orthodontic treatment can achieve more effective results with integration of myofunctional therapy.
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http://dx.doi.org/10.4081/ejtm.2019.8267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767995PMC
August 2019

The "" Journal Club Series: Highlights on Recent Papers in Overtraining and Exercise Addiction.

J Funct Morphol Kinesiol 2019 Sep 30;4(4). Epub 2019 Sep 30.

Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy.

We are glad to introduce the seventeenth Journal Club. This edition is focused on several relevant studies published in the last years in the field of Overtraining and Exercise Addiction, chosen by our Editorial Board members and their colleagues. We hope to stimulate your curiosity in this field and to share with you the passion for the sport seen also from the scientific point of view. The Editorial Board members wish you an inspiring lecture.
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http://dx.doi.org/10.3390/jfmk4040068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739227PMC
September 2019

Decreased postural control in people with moderate hearing loss.

Medicine (Baltimore) 2018 Apr;97(14):e0244

Sport and Exercise Sciences Research Unit Bio.Ne.C. Department, ENT Section, University of Palermo PosturaLab Center, Palermo, Italy.

Balance is a complex process that involves multiple sensory integrations. The auditory, visual, and vestibular systems are the main contributors. Hearing loss or hearing impairment may induce inappropriate postural strategies that could affect balance and therefore increase the risk of falling.The aim of this study was to understand whether hearing loss could influence balance, cervical posture, and muscle activation in the cervical region.Thirteen patients (61 ± 13 years; 161.8 ± 11.0 cm; 70.5 ± 15.9 kg) with moderate hearing loss (Right ear -60 ± 21 dB; Left ear -61 ± 24 dB) underwent: an audiometric examination, a postural examination (with open and closed eyes) through a stabilometric platform, a cervical ROM examination through a head accelerometer, and a sternocleidomastoid electromyography (EMG) examination.A linear regression analysis has shown a regression coefficient (R) 0.76 and 0.69 between hearing loss and the posturographic parameters, on the sagittal sway, with open and closed eyes, respectively. The combination of frontal and sagittal sway is able to explain up to 84% of the variance of the audiometric assessment. No differences were found between right and left hemibody between the audiometric, posturographic, cervical ROM parameters, and in EMG amplitude. ROM and EMG parameters have not shown any significant associations with hearing loss, for both right and left head rotation.Hearing loss is associated to increased posturographic measures, especially the sagittal sway, underlining a reduced postural control in people with hearing impairments. No association was found between the heads posture and neck activation with hearing loss. Hearing loss may be associated with an increased risk of falls.
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http://dx.doi.org/10.1097/MD.0000000000010244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902301PMC
April 2018
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