Miloš Kalc

In this work, we compare the supportive care models for cancer patients and survivors in two European Union countries, Germany and Slovenia. In summary, we highlight the following recommendations: integrating structured exercise facilities and clinical nutrition departments into hospital settings should become the standard of supportive care to address the projected rise in cancer incidence over the next 15 years. Current university curricula do not adequately prepare professionals to address the specific needs of cancer patients. This necessitates interdisciplinary, hospital-based exercise and nutrition programmes, supported by advanced diagnostics and delivered in accessible multilingual formats, to improve patient outcomes, enhance return-to-work rates, and justify dedicated health insurance funding through their demonstrated high economic and clinical value. These recommendations call for action to standardize supportive care protocols throughout partner countries and institutions. The success of this initiative depends on establishing sustainable funding streams from government resources, health insurance providers, and third-party funders, justified by the clear economic and clinical benefits of early occupational reintegration.

This study provides evidence that postactivation potentiation is accompanied by a reduction in soleus H-reflex amplitude and a concurrent facilitation of presynaptic spinal mechanisms. By combining global EMG and single motor unit analyses extracted from high-density surface EMG, we reveal a dissociation between spinal disinhibition and reflex depression. These findings suggest that acute postcontraction reflex suppression might be mediated by mechanisms other than presynaptic inhibition, potentially involving postactivation depression or changes in muscle spindle sensitivity.

Muscle fat fraction (MFF) obtained through magnetic resonance imaging (MRI) is the gold standard for assessing muscle quality, but it is expensive and time

This study investigated the spinal neural mechanisms underlying post-activation potentiation in ten healthy young males (21.9 ± 4.8 years). Participants performed a 10-second maximal isometric plantarflexion, after which we measured twitch torque and assessed spinal excitability using the soleus H-reflex, D1 presynaptic inhibition and heteronymous Ia facilitation (HF). High-density surface EMG was decomposed to track single motor unit responses. The conditioning contraction increased twitch torque by 12.2 Nm (p < 0.001) immediately and returning to baseline within nine minutes. This mechanical potentiation was accompanied by a 29% reduction in H-reflex amplitude (p < 0.001), which recovered within three minutes. Paradoxically, neurophysiological indices of presynaptic inhibition, D1 and HF were significantly increased (D1: p<0.017; HF: p<0.001), resulting in spinal facilitation. Single MU analysis revealed increased discharge probability, particularly in higher-threshold units indicating overall spinal facilitation. These results demonstrate that post-activation potentiation involves a complex dissociation: H-reflex pathway inhibition along with facilitation of presynaptic spinal mechanisms. This paradox can be explained by either post-activation depression (caused by depletion of neurotransmitter at the Ia–motoneuron synapse) or muscle thixotropy, a contraction history-dependent decrease in muscle spindle sensitivity, which reduces the efficacy of the Ia afferent volley independently of spinal inhibitory mechanisms. Our findings highlight a dissociation between spinal presynaptic facilitation and the decreased H-reflex, underscoring the need for future studies to explicitly test the roles of post-activation depression and muscle thixotropy during post-activation potentiation. New & Noteworthy: This study provides evidence that post-activation potentiation reduces the soleus H-reflex amplitude while concurrently facilitating presynaptic spinal mechanisms. By combining global EMG and single motor unit analyses extracted from high-density surface EMG, we reveal a dissociation between spinal disinhibition and reflex depression. These findings suggest that acute post-contraction reflex suppression might be mediated by mechanisms other than presynaptic inhibition, potentially involving post-activation depression spinal mechanisms or changes in muscle spindle sensitivity.

Leveraging both intramuscular and high-density surface EMG recordings in the vastus lateralis, we identified alterations in motor unit (MU) properties in young adults after 21 days of bed rest. These included reduced discharge rates and changes in MU potential size and complexity, observed at both low and moderate contraction intensities. Evidence of impaired neuromuscular junction (NMJ) function and denervation was also found. Our findings indicate that medium-term disuse elicits MU-level changes not detected in shorter-duration studies.

This study provides the first evidence that orofacial and neck mobility exercises can acutely reduce spinal excitability in remote lower-limb muscles. By combining high-density surface EMG with both global and single motor unit H-reflex analyses, we demonstrate a decrease in soleus H-reflex amplitude independent of presynaptic inhibition. These findings suggest potential nonpharmacological applications for managing motoneuron hyperexcitability and promoting whole body relaxation in individuals with cervical and orofacial constraints.

Introduction: Sarcopenia is a multifaceted condition affecting between 10 and 16% of the global population, and although multiple classification algorithms exist, no prevalence has been reported for a representative sample of the Slovenian population. Furthermore, multiple behavioural factors, such as malnutrition, physical inactivity, sedentary lifestyle and lower cognitive function, can contribute to the risk of sarcopenia. This study aims to: a) determine sarcopenia prevalence among Slovenian older adults according to different classification algorithms, b) compare the agreement among the algorithms and c) evaluate the relationship between proposed risk factors and sarcopenia. Methods: 654 participants (≥60 years, 30.4% males) have been classified into sarcopenia groups according to eight algorithms, and agreement (Fleiss K) between them was calculated. Additionally, age, sex, nutritional status, physical activity, sedentary levels and cognitive function were assessed as sarcopenia risk/protective factors. Results: The prevalence of sarcopenia according to EWGSOP2 was 4.1%, ranging from 2.1% to 15.3%, when classified by all eight algorithms. Overall agreement between algorithms was weak (K=.429; 95% CI .414 to .444) with 0.6% of participants classified as sarcopenic by all eight algorithms. Adequate nutrition and physical activity were identified as protective factors, while age, lower cognitive function and sedentary lifestyle were considered risk factors. Conclusion: Sarcopenia prevalence among the Slovenian general population was lower than in the global population. We can conclude that different sarcopenia algorithms lead to a different prevalence of sarcopenia. It is of great importance to be cautious when comparing prevalences among studies and to further validate the classification algorithms.

Introduction: Parkinson's disease (PD) is characterized by enhanced beta-band activity (13–30 Hz) in the motor control regions. Simultaneously, cortico-muscular (CM) connectivity in the beta-band during iso-metric contractions tends to decline with age, in various diseases, and under dual-task conditions. Objective: This study aimed to characterize electroencephalograph (EEG) and electromyograph (EMG) power spectra during a motor task, assess CM phase connectivity, and explore how these measures are modulated by an additional cognitive task. Specifically, we focused on the beta-band to explore the relationship between heightened beta amplitude and reduced beta CM connectivity. Methodology: Early-stage people with PD and age-matched controls performed an isometric knee extension task, a cognitive task, and a combined dual task, while EEG (128ch) and EMG (2x32ch) were recorded. CM phase connectivity was assessed through phase coherence and a phase dynamics model. Results: The EEG power spectrum revealed no cohort differences in the beta-band. EMG also showed no differences up to 80 Hz. However, the combined EEG-EMG analysis uncovered reduced beta phase coherence in people with early PD during the motor task. CM phase coherence exhibited distinct scalp topography and frequency ranges compared to the EEG power spectrum, suggesting different mechanisms for pathological beta increase and CM connectivity. Additionally, phase dynamics modelling indicated stronger directional coupling from the cortex to the active muscle and less prominent phase coupling across people with PD. Despite high inter-individual variability, these metrics may prove useful for personalized assessments, particularly in people with heightened CM connectivity.

Pathologies in neck and masticatory muscles affect muscle tone and biomechanical and viscoelastic properties, necessitating precise assessment for treatment. This study evaluated the impact of two guided interventions—relaxing exercises targeting the neck and masticatory muscles (“Exercise”) and heavy chewing using six chewing gums (“Chewing”)—on the masseter and upper trapezius muscles. Twelve participants (aged 19–40 years) underwent myotonometric assessment pre- and post-intervention, measuring tone, stiffness, decrement, relaxation time, and creep. The results showed significant changes in the masseter muscle after exercise, with increased stiffness (14.46%, p < 0.001) and tone (7.03%, p < 0.001) but decreased creep (−9.71%, p < 0.001) and relaxation time (−11.36%, p < 0.001). Conversely, chewing decreased stiffness (−8.82%, p < 0.001) and tone (−5.53%, p < 0.001), while it increased creep (9.68%, p < 0.001) and relaxation time (9.98%, p < 0.001). In the trapezius muscles, tone decreased after both interventions (Exercise: −7.65%, p < 0.001; Chewing: −1.06%, p = 0.003), while relaxation increased (Exercise: 1.78%, p < 0.001; Chewing: 2.82%, p < 0.001). These findings reveal the distinct effects of exercise and chewing on muscle properties, emphasising the complexity of their therapeutic potential and the need for further investigation.

To capture the relationship between the cortico-cortical and cortico-peripheral regions, as well as evaluate the brain functioning collectively, connectivity analysis has been progressively used. This work aims to evaluate the usability and temporal resolution of cortico-muscular connectivity methods by analyzing simultaneously recorded 128-channel electroencephalographic (EEG) and 64-channel high-density electromyographic (EMG) data from 40 participants, encompassing both healthy individuals and those with Parkinson’s disease. Participants underwent measurements during resting state (with eyes open) and while engaged in two mobile tasks – an isometric knee extension and a semi-tandem stance. EMG electrodes were placed on Vastus lateralis and Tibialis anterior, respectively. The analysis pipeline involves preprocessing steps such as filtering (0.5 Hz to 80 Hz, with additional line noise removal), manual cleaning, channel interpolation, average re-referencing, and independent component analysis decomposition. Subsequently, the EEG data is projected onto 68 cortical regions defined by the Desikan-Killiany atlas, employing the Standardized Low-Resolution Tomography (sLoreta) method. Analogously, EMG data is decomposed to extract motor unit activity using the Convolution Kernel Compensation method. Following data preparation, connectivity analysis will be conducted, with a focus on comparing standard coherence analysis to more advanced transfer entropy and hidden Markov modeling (using Gaussian observation model) methods, both on channel-level and source-projected data. Additionally, the study will explore variations in the time intervals over which the connectivity methods are calculated. The critical comparison of three distinct connectivity methods on cortico-muscular data will help in advancing further connectivity analyses.