Pfeiffer University

Limb immobilization causes rapid declines in muscle strength and mass. Given the role of the nervous system in immobilization‐induced weakness, targeted interventions may be able to preserve muscle strength, but not mass, and vice versa. The purpose of this study was to assess the effects of two distinct interventions during 1 week of knee joint immobilization on muscle strength (isometric and concentric isokinetic peak torque), mass (bioimpedance spectroscopy and ultrasonography), and neuromuscular function (transcranial magnetic stimulation and interpolated twitch technique). Thirty‐nine healthy, college‐aged adults (21 males, 18 females) were randomized into one of four groups: immobilization only (n = 9), immobilization + action observation/mental imagery (AOMI) (n = 10), immobilization + neuromuscular electrical stimulation (NMES) (n = 12), or control group (n = 8). The AOMI group performed daily video observation and mental imagery of knee extensions. The NMES group performed twice daily stimulation of the quadriceps femoris. Based on observed effect sizes, it appears that AOMI shows promise as a means of preserving voluntary strength, which may be modulated by neural adaptations. Strength increased from PRE to POST in the AOMI group, with +7.2% (Cohen's d = 1.018) increase in concentric isokinetic peak torque at 30°/s. However, NMES did not preserve muscle mass. Though preliminary, our findings highlight the specific nature of clinical interventions and suggest that muscle strength can be independently targeted during rehabilitation. This study was prospectively registered: ClinicalTrials.gov NCT05072652.

Abstract Severe COVID-19 is characterised by an overactive pro-inflammatory response of the immune system which is associated with new persistent symptoms. Differences in the persistence of symptoms, plasma inflammatory proteins and antibodies between hospitalised and non-hospitalised cases were investigated in the current study. n=120 participants were recruited with informed consent, of whom n=60 were hospitalised with severe disease. Blood samples and detailed symptom data were collected 3 months after a positive PCR test for SARS-CoV-2. Plasma samples were analysed by OLINK Explore 384 inflammation panel and ACE2 neutralisation and IgG assays. R software was used to identify statistically significant differences in protein concentration in hospitalised cases, relative to non-hospitalised cases. Differences in anti-SARS-CoV-2 IgG antibody concentration, ACE2 neutralisation and symptoms were also analysed between hospitalisation subgroups. 14 proteins including angiopoietin-like protein 2 and C-X-C motif chemokine 17 were significantly elevated (by greater than +/− 0.20 log2 fold change; p < 0.05) at 3 months in the hospitalised study group, relative to non-hospitalised cases. The concentrations of BA.2 and BA.3 specific anti-SARS-CoV-2 IgG and spike receptor binding domain neutralising antibodies were more frequently detected in non-hospitalised cases. The hospitalised cohort more frequently reported persistence of muscle pain, headache, fatigue and shortness of breath. Characteristic changes in the plasma proteome and symptom clusters that persist 3 months after infection have been observed in hospitalised COVID-19 cases. This data could help inform clinical care requirements for longer term COVID-19 recovery. Supported by grants from UKRI, SFI and HSC R&D Office

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings on social participation interventions and participation outcomes for autistic1 adults.

Low back pain (LBP) is a leading cause of disability. The use of deadlift-based assessments in assessing LBP is becoming common in clinical settings, but these concepts have not been well studied. We sought to compare force and muscle excitation during isometric deadlifts in participants suffering from LBP versus asymptomatic controls. We also compared these outcomes for conventional versus hexagonal barbells. Sixteen adults with mild-to-moderate, acute, non-specific LBP and 19 controls performed maximal, isometric deadlifts while standing on a force plate using conventional and hexagonal barbells. Surface electromyographic signals were recorded from the upper trapezius, external oblique, erector spinae, vastus lateralis, and biceps femoris. Normalized peak force and peak rate of force development were similar for those with acute, non-specific LBP and controls. Surface electromyographic excitation was not different between groups, but was higher with the hexagonal barbell for the vastus lateralis and upper trapezius. Both groups felt equally safe and confident. In summary, the presence of acute, non-specific LBP did not impair peak and rapid force or muscle excitation. Hexagonal barbells may optimize knee extensor and trapezius activation. Deadlift-based force assessments appear safe and may be useful in the assessment of functional strength in patients with acute, non-specific LBP.

Cardiac microthrombi are postulated to underlie cardiac injury in critical COVID-19. To determine pathogenic mechanism(s) of cardiac injury in fatal COVID-19, we conducted a single-center prospective cohort study of 69 consecutive COVID-19 decedents. Microthrombi was the most commonly detected acute cardiac histopathologic feature (n=48, 70%). We tested associations of cardiac microthrombi with biomarkers of inflammation, cardiac injury, and fibrinolysis and with in-hospital antiplatelet therapy, therapeutic anticoagulation, and corticosteroid treatment, while adjusting for multiple clinical factors, including COVID-19 therapies. Higher peak ESR and CRP during hospitalization were independently associated with higher odds of microthrombi (ESR, P non-linearity 0.015, P association =0.008; CRP per 20mg/L increase, OR 1.17, 95%CI 1.00-1.36). Using single nuclei RNA-sequence analysis, we discovered an enrichment of prothrombotic, anti-fibrinolytic, and extracellular matrix signaling amongst cardiac fibroblasts in microthrombi-positive COVID-19 hearts, compared with microthrombi-negative COVID-19 hearts and non-COVID-19 donor hearts. Our cumulative findings identify these specific transcriptomic changes in cardiac fibroblasts as salient features of COVID-19-associated cardiac microthrombi.