Background
It has been suggested that overweight and obese individuals have an increased risk to develop vitamin D deficiency, commonly associated with poor muscle performance. The relationship among ...fat mass, vitamin D status, and skeletal muscle is still debated.
Aims
To evaluate the effects of the combination of hypovitaminosis D and overweight on muscle mass and strength, and physical performance in post-menopausal women.
Methods
In this cross-sectional study, we recruited post-menopausal women referring to a physiatric outpatient service for the management of osteoporosis over a 36-month period. We compared four groups: (1) normal weight with hypovitaminosis D; (2) overweight with normal serum 25(OH)D
3
; (3) overweight with hypovitaminosis D; and (4) normal weight with normal serum 25(OH)D
3
(control group). Outcome measures were: appendicular lean mass-to-BMI ratio; hand grip strength; and short physical performance battery.
Results
We analysed 368 women (mean aged 67.2 ± 7.8 years): 95 normal weight with hypovitaminosis D, 90 overweight with normal levels of 25(OH)D
3
, 96 overweight with hypovitaminosis D, and 87 normal weight with normal levels of 25(OH)D
3
. Overweight women with hypovitaminosis D had a significant risk of reduced muscle mass (OR 5.70;
p
< 0.001), strength (OR 12.05;
p
< 0.001), and performance (OR 5.84;
p
< 0.001) compared to controls. Normal weight women with hypovitaminosis D had only a greater risk of an impairment of muscle strength (OR 7.30;
p
< 0.001) and performance (OR 3.16;
p
< 0.001).
Discussion
According to our findings, both hypovitaminosis D and overweight should be investigated in post-menopausal women because of their negative effects on skeletal muscle mass and function.
Conclusions
This study demonstrated that hypovitaminosis D is associated to impaired muscle function and its combination with overweight might lead also to muscle wasting in a cohort of post-menopausal women.
Background
The Italian Society for Orthopaedics and Traumatology conceived this guidance—which is primarily addressed to Italian orthopedic surgeons, but should also prove useful to other bone ...specialists and to general practitioners—in order to improve the diagnosis, prevention, and treatment of osteoporosis and its consequences.
Materials and methods
Literature reviews by a multidisciplinary team.
Results
The following topics are covered: the role of instrumental, metabolic, and genetic evaluations in the diagnosis of osteoporosis; appraisal of the risk of fracture and thresholds for intervention; general strategies for the prevention and treatment of osteoporosis (primary and secondary prevention); the pharmacologic treatment of osteoporosis; the setting and implementation of fracture liaison services for tertiary prevention. Grade A, B, and C recommendations are provided based on the main levels of evidence (1–3). Toolboxes for everyday clinical practice are provided.
Conclusions
The first up-to-date Italian guidelines for the primary, secondary, and tertiary prevention of osteoporosis and osteoporotic fractures are presented.
Background
Elderly people experience a gradual loss of muscle strength and a reduction of serum levels of vitamin D and of vitamin D receptor expression in skeletal muscle cells.
Aims
The aim of our ...study was to evaluate the association among serum levels of 25-hydroxy-vitamin D 25(OH)D
3
, muscle strength, and physical performance in post-menopausal women.
Methods
In our retrospective case–control study, we analyzed data from medical records of post-menopausal women aged ≥50 years. We compared subjects with hypovitaminosis D 25(OH)D
3
<30 ng/ml vs. those with normal levels 25(OH)D
3
≥30 ng/ml. Outcome measures were: Hand Grip Strength Test (HGS) and Knee Extension Strength Test (KES) to evaluate upper and lower limb muscle strength, respectively; Short Physical Performance Battery (SPPB) and usual 4-m gait speed (4MGS) to evaluate physical performance.
Results
We examined 80 patients (mean aged 65.92 ± 7.69 years): forty-six subjects with hypovitaminosis D (mean aged 66.09 ± 7.71 years) and 34 with normal levels of vitamin D (mean aged 65.71 ± 7.78 years). There was a statistically significant difference between hypovitaminosis D group and subjects with normal levels of vitamin D in HGS (12.13 ± 4.34 vs. 19.14 ± 5.59;
p
< 0.001), KES (11.99 ± 4.04 vs. 16.98 ± 8.43;
p
= 0.003), SPPB score 8 (5.75-10.25) vs. 12 (10-12);
p
< 0.001, and proportion of patients with usual 4MGS ≤ 0.8 m/s 29 (63.0 %) vs. 9 (26.5 %);
p
= 0.002.
Discussion
In literature, there is no agreement on the association among serum vitamin D levels and muscle function. Our data showed that post-menopausal women with hypovitaminosis D had worse upper and lower limb muscle strength and physical performance than subjects with normal levels of 25(OH)D
3
.
Conclusions
Our results support the hypothesis that there is a significant positive association among serum 25(OH)D
3
levels and upper and lower limb muscle functioning.
There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed ...to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web of Science, and Scopus were systematically searched from inception until 5 January 2022 to identify observational studies with a longitudinal study design presenting: patients with diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); occlusal splint therapy as intervention; postural assessment as outcome. Out of 133 records identified, 104 were suitable for data screening, and only 7 articles were included satisfying the eligibility criteria. We found that occlusal splints might have a positive effect on posture in TMD patients, albeit there is little evidence of appropriate investigation for postural assessment. This systematic review suggested that the occlusal splint might be considered a non-invasive therapeutic approach for patients with TMD. However, the low number of studies with high-quality methodology in these patients showed an urgent need for further research using combined force platform stabilometry and kinematic evaluation of the spine to investigate the impact of occlusal splints on posture.
Periodontal diseases are oral inflammatory diseases affecting the tissues supporting and surrounding the teeth and include gingivitis and periodontitis. Oral pathogens may lead to microbial products ...spreading into the systemic circulation and reaching distant organs, while periodontal diseases have been related to low-grade systemic inflammation. Gut and oral microbiota alterations might play a role in the pathogenesis of several autoimmune and inflammatory diseases including arthritis, considering the role of the gut-joint axis in the regulation of molecular pathways involved in the pathogenesis of these conditions. In this scenario, it is hypothesized that probiotics might contribute to the oral and intestinal micro-ecological balance and could reduce low-grade inflammation typical of periodontal diseases and arthritis. This literature overview aims to summarize state-of-the-art ideas about linkages among oral-gut microbiota, periodontal diseases, and arthritis, while investigating the role of probiotics as a potential therapeutic intervention for the management of both oral diseases and musculoskeletal disorders.
Introduction
The role of vitamin D supplementation on muscle function and physical performance is still debated. Calcifediol is an available treatment for hypovitaminosis D, particularly for ...extra-skeletal effects. Aim of this prospective cohort study was to evaluate the effectiveness of calcifediol on serum levels of 25(OH)D
3
, appendicular muscle strength, physical performance, and prevention of falls in post-menopausal women.
Methods
We recruited post-menopausal women aged ≥50 years, referring to an outpatient service for the management of osteoporosis over a 18-month period. We included women with a diagnosis of osteoporosis and/or vitamin D deficiency serum levels of 25(OH)D
3
<30 ng/ml. All the participants received calcifediol (20 μg, 4 oral drops/day) for a 6-month period. We evaluated at the baseline and after 6 months the following outcomes: serum levels of 25(OH)D
3
, appendicular muscle strength, using the Isometric Hand Grip Strength Test and the Knee Isometric Extension Strength Test, physical performance, using the Short Physical Performance Battery (SPPB) and the 4-m gait speed (4MGS), and the risk of falls (percentage of fallers and recurrent fallers and mean number of falls). A sub-analysis was performed in patients with vitamin D deficiency.
Results
We enrolled 113 post-menopausal women, mean aged 68.01 ± 9.13 years. After 6 months of treatment, there was a significant increase in serum levels of 25(OH)D
3
(
p
< 0.001), appendicular muscle strength (
p
< 0.001), and physical performance (
p
= 0.002 at SPPB and
p
= 0.010 at 4MGS, respectively). At 6 months, the percentage of fallers was lower, although not significantly (
p
= 0.078), whereas there was a significant reduction both in percentage of recurrent fallers and in the mean number of falls (
p
< 0.001 and
p
= 0.020, respectively).
Conclusion
Calcifediol was significantly effective in improving serum levels of 25(OH)D
3
and muscle function and in reducing the percentage of recurrent fallers and the mean number of falls in a cohort of post-menopausal women.
Rehabilitation might improve bone health in breast cancer (BC) patients, but the effects on bone biomarkers are still debated. Thus, this meta-analysis of randomized controlled trials (RCTs) aims at ...characterizing the impact of rehabilitation on bone health biomarkers in BC survivors. On 2 May 2022, PubMed, Scopus, Web of Science, Cochrane, and PEDro were systematically searched for RCTs assessing bone biomarker modifications induced by physical exercise in BC survivors. The quality assessment was performed with the Jadad scale and the Cochrane risk-of-bias tool for randomized trials (RoBv.2). Trial registration number: CRD42022329766. Ten studies were included for a total of 873 patients. The meta-analysis showed overall significant mean difference percentage decrease in collagen type 1 cross-linked N-telopeptide (NTX) serum level ES: -11.65 (-21.13, -2.17),
= 0.02) and an increase in bone-specific alkaline phosphatase (BSAP) levels ES: +6.09 (1.56, 10.62). According to the Jadad scale, eight RCTs were considered high-quality studies. Four studies showed a low overall risk of bias, according to RoBv.2. The significant effects of rehabilitation on bone biomarkers suggested a possible implication for a precision medicine approach targeting bone remodeling. Future research might clarify the role of bone biomarkers monitoring in rehabilitation management of cancer treatment induced bone-loss.
Volleyball players are often subject to micro-traumatisms of the heel fat pad and ankle injuries. Recently, mat-based proprioceptive training has assumed a key role in recovery from these disorders. ...Therefore, this proof-of-principle study aimed to assess the efficacy of proprioceptive mat training on plantar pressures and athletic performance in volleyball players. The participants included adult semi-professional volleyball players allocated into two groups: an experimental group, with mat-based proprioceptive and balance training, and a control group, with a sham protocol. For the outcome, we evaluated the barefoot plantar pressure, performing an analysis on a baropodometric resistive platform. The countermovement jump and squat jump were measured using an inertial measurement unit. Nineteen subjects were included in the two groups: the active proprioceptive group (
= 10) or the control group (
= 9). The results show a more uniform redistribution of loads with pressure hindfoot relief in the experimental group compared to the control group (
= 0.021, RBC = 0.67). Moreover, we observed a significant increase in peak landing force and high concentric power development in the experimental group compared to the controls. Focused proprioceptive management provided hindfoot load attenuation by stimulating higher peaks of concentric force in the experimental group compared to the sham group. Even though the study included a small sample, the results obtained in this proof-of-principle study suggest a positive role of proprioceptive stimulation in the inter-seasonal scenario for volleyball players to improve their jump performance and reduce the micro-traumatisms of the heel fat pad and the ankle injury rate. However, further studies performed on larger samples are needed to confirm these preliminary results.
Breast cancer (BC) is the most frequent malignant tumor in women in Europe and North America, and the use of aromatase inhibitors (AIs) is recommended in women affected by estrogen receptor-positive ...BCs. AIs, by inhibiting the enzyme that converts androgens into estrogen, cause a decrement in bone mineral density (BMD), with a consequent increased risk of fragility fractures. This study aimed to evaluate the role of vitamin D3 deficiency in women with breast cancer and its correlation with osteoporosis and BMD modifications. This observational cross-sectional study collected the following data regarding bone health: osteoporosis and osteopenia diagnosis, lumbar spine (LS) and femoral neck bone mineral density (BMD), serum levels of 25-hydroxyvitamin D3 (25(OH)D3), calcium and parathyroid hormone. The study included 54 women with BC, mean age 67.3 ± 8.16 years. Given a significantly low correlation with the LS BMD value (r
= 0.30,
= 0.025), we assessed the role of vitamin D3 via multiple factor analysis and found that BMD and vitamin D3 contributed to the arrangement of clusters, reported as vectors, providing similar trajectories of influence to the construction of the machine learning model. Thus, in a cohort of women with BC undergoing Ais, we identified a very low prevalence (5.6%) of patients with adequate bone health and a normal vitamin D3 status. According to our cluster model, we may conclude that the assessment and management of bone health and vitamin D3 status are crucial in BC survivors.
Vitamin D deficiency is a global health problem occurring in all age groups and in countries with both high and low levels of sunlight, and improving its role in nutrition could be considered as a ...public health priority ....
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