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Role of Exercises in Musculoskeletal Disorders—4th Edition

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A special issue of Journal of Functional Morphology and Kinesiology (ISSN 2411-5142). This special issue belongs to the section "Functional Anatomy and Musculoskeletal System".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 54058

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Prof. Dr. Giuseppe Musumeci

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Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Sciences Section, School of Medicine, University of Catania, Catania, Italy
Interests: anatomy; histology; kinesiology; musculoskeletal disorders; sports medicine; cartilage; osteoarthritis; physical activity; aging; nutrition
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Dr. Silvia Ravalli

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Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy
Interests: osteoarthritis; tissue engeneering; telocytes; stem cells
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Physical activity covers not just sports but also simple everyday movements, such as housework, walking, and playing. Regular exercise has a great importance in maintaining good health: “Mens sana in corpore sano”. Indeed, inactivity is a risk factor for different chronic diseases. Physical exercise can play a crucial role in the treatment of musculoskeletal disorders, optimizing both physical and mental health, decreasing fatigue, and improving sleep. An exercise program for patients with musculoskeletal disorders aims to preserve or restore a range of motion of the affected joints, enhancing bone turnover, increase functional joint stability, increase muscle strength and endurance, improve balance, reduce pain, and decrease health risks associated with a sedentary lifestyle. Moreover, physical activity is a good way to socialize and improve mood, and it is an excellent antistress agent. The benefits of exercise on physical limitations and fatigue in musculoskeletal disorders seem to have both short- and long-term effectiveness. This Special Issue will focus on the “Role of Exercises in Musculoskeletal Disorders”. Original papers and review articles are all welcome.

Prof. Dr. Giuseppe Musumeci
Dr. Silvia Ravalli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Functional Morphology and Kinesiology is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

musculoskeletal disorders
physical activity
exercises
sport medicine
rehabilitation
osteoarthtritis
fatigue, pain, and balance
muscle strength and endurance
joint stability
rheumatic diseases

Published Papers (13 papers)

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Research

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10 pages, 293 KiB

Open AccessArticle

Can the Combination of Rehabilitation and Vitamin D Supplementation Improve Fibromyalgia Symptoms at All Ages?

by Dalila Scaturro, Fabio Vitagliani, Sofia Tomasello, Mirko Filippetti, Alessandro Picelli, Nicola Smania and Giulia Letizia Mauro

J. Funct. Morphol. Kinesiol. 2022, 7(2), 51; https://doi.org/10.3390/jfmk7020051 - 20 Jun 2022

Cited by 6 | Viewed by 1908

Abstract

Several studies have indicated a correlation between vitamin D deficiency and widespread chronic pain syndromes, such as fibromyalgia. During this study, the effect of supplementation with vitamin D in association with physical exercise in patients with fibromyalgia was evaluated, in terms of improvement of pain, functional capacity and quality of life, also evaluating the presence of any differences in age. A single-center, observational, comparative study was conducted in 80 fibromyalgia patients. They are randomized into 2 groups: Group A, consisting of patients ≤50 years; and group B, consisting of patients >50 years. Both received weekly supplementation with 50,000 IU cholecalciferol for 3 months in association with a rehabilitation protocol. Patients were assessed at enrollment (T0), 3 months (T1), and 6 months (T2) from the initial assessment with blood vitamin D dosage and administration of rating scales (NRS, FIQ, and SF-12). From the comparison between the two groups, we have seen that in young people, supplementation with high-dose vitamin D improves short-term musculoskeletal pain and long-term functional capacity. Conversely, musculoskeletal pain and long-term quality of life improve in the elderly. Supplementing with high doses of vitamin D in fibromyalgia patients improves the quality of life and pain in the elderly and also the functional capacity in the young. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

9 pages, 1652 KiB

Open AccessArticle

Positive Impulse Phase versus Propulsive Impulse Phase: Correlations between Asymmetry and Countermovement Jump Performance

by Keith B. Painter, William Guy Hornsby, Kevin Carroll, Satoshi Mizuguchi and Michael H. Stone

J. Funct. Morphol. Kinesiol. 2022, 7(2), 31; https://doi.org/10.3390/jfmk7020031 - 05 Apr 2022

Cited by 1 | Viewed by 2509

Abstract

The relationship between asymmetry and performance is still undetermined in the literature. Methods of assessing asymmetry have been inconsistent and focused on the analysis of jumping asymmetry. Dual ground reaction forces are prevalent in athlete monitoring, though underutilized in asymmetry research. The purpose of this study was to assess the relationship of countermovement jump (CMJ) impulse asymmetry to performance in collegiate soccer athletes. Male and female athletes were selected from an ongoing athlete research repository database of NCAA D-I soccer athletes. All athletes contributed two maximal effort unweighted (CMJ0) and weighted countermovement jumps (CMJ20) using the mean for calculations. Propulsive phase asymmetry scores (PrPAS) and positive impulse asymmetry scores (PIAS) were calculated to determine the magnitude of asymmetry for each prospective phase. Statistically significant correlations were found between CMJ0 jump height and unweighted PIAS (r = −0.43) in females. Males had statistically significant correlations between CMJ20 jump height and weighted PIAS (r = −0.49). Neither unweighted PrPAS nor weighted PrPAS produced statistically significant correlations (r < 0.26) to their prospective jump heights. When assessing CMJ asymmetry, it is recommended to conduct both weighted and unweighted CMJ testing, utilizing PIAS as the metric to be assessed. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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8 pages, 423 KiB

Open AccessArticle

Analgesic Effect of Extracorporeal Shock-Wave Therapy in Individuals with Lateral Epicondylitis: A Randomized Controlled Trial

by Salameh Aldajah, Anas R. Alashram, Giuseppe Annino, Cristian Romagnoli and Elvira Padua

J. Funct. Morphol. Kinesiol. 2022, 7(1), 29; https://doi.org/10.3390/jfmk7010029 - 18 Mar 2022

Cited by 7 | Viewed by 4150

Abstract

This study was conducted to investigate the effect of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in lateral epicondylitis. A sample of 40 patients with LE (21 males) was randomly allocated to either the ESWT experimental (n = 20) or the conventional-physiotherapy control group (n = 20). All patients received five sessions during the treatment program. The outcome measures used were the Visual Analog Scale (VAS), the Taiwan version of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and a dynamometer (maximal grip strength). Forty participants completed the study. Participants in both groups improved significantly after treatment in terms of VAS (pain reduced), maximal grip strength, and DASH scores. However, the pain was reduced and upper-extremity function and maximal grip strength were more significantly improved after ESWT in the experimental group. ESWT has a superior effect in reducing pain and improving upper-extremity function and grip strength in people with lateral epicondylitis. It seems that five sessions of ESWT are optimal to produce a significant difference. Further studies are strongly needed to verify our findings. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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10 pages, 283 KiB

Open AccessArticle

Hybrid Hyaluronic Acid versus High Molecular Weight Hyaluronic Acid for the Treatment of Hip Osteoarthritis in Overweight/Obese Patients

by Dalila Scaturro, Fabio Vitagliani, Pietro Terrana, Sofia Tomasello, Vincenzo Falco, Daniele Cuntrera, Italia Spoto, Massimo Midiri and Giulia Letizia Mauro

J. Funct. Morphol. Kinesiol. 2022, 7(1), 20; https://doi.org/10.3390/jfmk7010020 - 09 Feb 2022

Cited by 5 | Viewed by 2788

Abstract

Background: Obesity is the main risk factor for hip osteoarthritis, negatively affecting the outcome of the disease. We evaluated the effectiveness of viscosupplementation with hybrid hyaluronic acid compared to that with high molecular weight hyaluronic acid in overweight/obese patients with hip osteoarthritis (OA). Methods: 80 patients were divided into two groups: a treatment group received two ultrasound-guided intra-articular hip injections of hybrid HA 15 days apart; a control group received a single ultrasound-guided infiltration with medium-high molecular weight hyaluronic acid (1500–2000 kDa). We assessed the pain, functional and cardiovascular capacity of the patients at baseline, after 3 months, and after 6 months of the infiltrative sessions. Results: The treatment group showed greater improvements in the scores on the NRS scale (5.4 ± 0.8 vs. 6.3 ± 0.8; p < 0.05) and in the Lequesne index (11.4 ± 2.6 vs. 13.6 ± 2.7; p < 0.05) and in the distance traveled at 6MWT (238.1 ± 53.9 m vs. 210.7 ± 46.2 m; p = 0.02) both at 3 months (T1) and at 6 months (T2). Conclusions: This study underlines the importance of exploiting the anti-inflammatory, analgesic, and chondrogenic properties of hybrid HA for the treatment of hip OA in overweight/obese patients. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

15 pages, 1945 KiB

Open AccessArticle

Extracellular to Intracellular Body Water and Cognitive Function among Healthy Older and Younger Adults

by Jinhyun Lee and Richard K. Shields

J. Funct. Morphol. Kinesiol. 2022, 7(1), 18; https://doi.org/10.3390/jfmk7010018 - 05 Feb 2022

Cited by 6 | Viewed by 3231

Abstract

Compromised cognitive function is associated with increased mortality and increased healthcare costs. Physical characteristics including height, weight, body mass index, sex, and fat mass are often associated with cognitive function. Extracellular to intracellular body water ratio offers an additional anthropometric measurement that has received recent attention because of its association with systemic inflammation, hypertension, and blood–brain barrier permeability. The purposes of this study were to determine whether extracellular to intracellular body water ratios are different between younger and older people and whether they are associated with cognitive function, including executive function and attention, working memory, and information processing speed. A total of 118 healthy people (39 older; 79 younger) participated in this study. We discovered that extracellular to intracellular body water ratio increased with age, was predictive of an older person’s ability to inhibit information and stay attentive to a desired task (Flanker test; R² = 0.24; p < 0.001), and had strong sensitivity (83%) and specificity (91%) to detect a lower executive function score. These findings support that extracellular to intracellular body water ratio offers predictive capabilities of cognitive function, even in a healthy group of elderly people. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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8 pages, 511 KiB

Open AccessArticle

Application and Surgical Technique of ACL Reconstruction Using Worldwide Registry Datasets: What Can We Extract?

by Ulrike Wittig, Georg Hauer, Ines Vielgut, Patrick Reinbacher, Andreas Leithner and Patrick Sadoghi

J. Funct. Morphol. Kinesiol. 2022, 7(1), 2; https://doi.org/10.3390/jfmk7010002 - 27 Dec 2021

Cited by 6 | Viewed by 2770

Abstract

Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. The purpose of this study was to compare surgical reconstruction of the ACL between different countries and regions in order to describe differences regarding epidemiological data, reconstruction frequency, and graft choice. A systematic literature search was performed using the ACL study group website in order to identify the relevant knee ligament registers. Four national registries were included, comprising those from Sweden, the UK, New Zealand, and Norway. A large variation was found concerning the total number of primary ACL reconstructions with a reported range from 4.1 to 51.3 per 100,000 inhabitants. The country-specific delay between injury and reconstruction varied between an average of 6.0 months and 17.6 months. The leading sports activities resulting in ACL injury included soccer, alpine skiing, handball, rugby, and netball. Moreover, a strong variability in graft choice for primary reconstruction was found. The comparison of ACL registers revealed large differences, indicating different clinical implications regarding conservative or surgical therapy and choice of the preferable graft. ACL registers offer a real-world clinical perspective with the aim to improve quality and patient safety by investigating factors associated with subsequent surgical outcomes. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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13 pages, 1591 KiB

Open AccessArticle

Establishing Task-Relevant MVC Protocols for Modelling Sustained Isometric Force Variability: A Manual Control Study

by Thomas S. Novak, Shane M. Wilson and Karl M. Newell

J. Funct. Morphol. Kinesiol. 2021, 6(4), 94; https://doi.org/10.3390/jfmk6040094 - 05 Nov 2021

Viewed by 2032

Abstract

The present study examined how prevalent methods for determining maximal voluntary contraction (MVC) impact the experimentally derived functions of graded force-force variability. Thirty-two young healthy subjects performed continuous isometric force tracking (20 s trials) at 10 target percentages (5–95% MVC) normalized to a conventional discrete-point (n = 16), or sustained (n = 16) MVC calculation. Distinct rates and magnitudes of change were observed for absolute variability (standard deviation (SD), root mean squared error (RMSE)), tracking error (RMSE, constant error (CE)), and complexity (detrended fluctuation analysis (DFA)) (all p < 0.05) of graded force fluctuations between the MVC groups. Differential performance strategies were observed beyond ~65% MVC, with the discrete-point group minimizing their SD at force values below that of the criterion target (higher CE/RMSE). Moreover, the sustained group’s capacity to minimize SD/RMSE/CE corresponded to a more complex structure in their force fluctuations. These findings reveal that the time component of MVC estimation has a direct influence on the corrective strategies supporting near-maximal manual force control. While discrete MVC protocols predominate in the study of manual strength/endurance/precision, a 1:1 MVC-task mapping appears more to be ecologically valid if visuo-motor precision outcomes are of central importance. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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14 pages, 2004 KiB

Open AccessArticle

The Influence of Sonographer Experience on Skeletal Muscle Image Acquisition and Analysis

by Joshua C. Carr, Gena R. Gerstner, Caleb C. Voskuil, Joel E. Harden, Dustin Dunnick, Kristin M. Badillo, Jason I. Pagan, Kylie K. Harmon, Ryan M. Girts, Jonathan P. Beausejour and Matt S. Stock

J. Funct. Morphol. Kinesiol. 2021, 6(4), 91; https://doi.org/10.3390/jfmk6040091 - 29 Oct 2021

Cited by 14 | Viewed by 3196

Abstract

The amount of experience with ultrasonography may influence measurement outcomes while images are acquired or analyzed. The purpose of this study was to identify the interrater reliability of ultrasound image acquisition and image analysis between experienced and novice sonographers and image analysts, respectively. Following a brief hands-on training session (2 h), the experienced and novice sonographers and analysts independently performed image acquisition and analyses on the biceps brachii, vastus lateralis, and medial gastrocnemius in a sample of healthy participants (n = 17). Test–retest reliability statistics were computed for muscle thickness (transverse and sagittal planes), muscle cross-sectional area, echo intensity and subcutaneous adipose tissue thickness. The results show that image analysis experience generally has a greater impact on measurement outcomes than image acquisition experience. Interrater reliability for measurements of muscle size during image acquisition was generally good–excellent (ICC_2,1: 0.82–0.98), but poor–moderate for echo intensity (ICC_2,1: 0.43–0.77). For image analyses, interrater reliability for measurements of muscle size for the vastus lateralis and biceps brachii was poor–moderate (ICC_2,1: 0.48–0.70), but excellent for echo intensity (ICC_2,1: 0.90–0.98). Our findings have important implications for laboratories and clinics where members possess varying levels of ultrasound experience. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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11 pages, 488 KiB

Open AccessArticle

Exploring the Enjoyment of the Intergenerational Physical Activity

by Andrea Buonsenso, Giovanni Fiorilli, Cristiana Mosca, Marco Centorbi, Concetta C. Notarstefano, Giulia Di Martino, Giuseppe Calcagno, Mariano Intrieri and Alessandra di Cagno

J. Funct. Morphol. Kinesiol. 2021, 6(2), 51; https://doi.org/10.3390/jfmk6020051 - 14 Jun 2021

Cited by 10 | Viewed by 2883

Abstract

Intergenerational physical activity could be a pleasant method to prevent elderly sedentary behaviors. The aim of this study is to provide a basis to develop an intergenerational physical activity between preschool children and elderly people. An assessing enjoyment three questionnaire survey was administered to 140 participants (aged 67.8 ± 9.1): the global physical activity questionnaire (GPAQ) assessing the sedentariness degree; the physical activity enjoyment scale (PACES-Q) assessing enjoyment for the physical activity usually practiced; the physical activity enjoyment scale (PACES-INT) assessing the enjoyment for a hypothetical intergenerational program. Successively, the sample was divided into subgroups based on age, gender, marital status, education, employment, sports background, sedentariness level and residential location. Four multichoice questions, aiming to have guidelines in organizing an intergenerational program, were used. A total of 44.3% of the sample found the physical activity practiced pleasant, whereas 81.5% enjoyed the intergenerational program (only 7.1% expressed a negative judgment). A separated one-way ANOVA showed significant differences in PACES-INT for gender, (p = 0.009), residential location, (p < 0.001) and employment (p = 0.004). About 80% of the sample would adhere to the intergenerational programs, despite the fatigue fear and logistic or family relationship problems. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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Review

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11 pages, 503 KiB

Open AccessReview

Low Molecular Weight Hyaluronic Acid (500–730 Kda) Injections in Tendinopathies—A Narrative Review

by Antonio Frizziero, Filippo Vittadini, Davide Bigliardi and Cosimo Costantino

J. Funct. Morphol. Kinesiol. 2022, 7(1), 3; https://doi.org/10.3390/jfmk7010003 - 29 Dec 2021

Cited by 3 | Viewed by 2624

Abstract

Tendinopathies are common causes of pain and disability in general population and athletes. Conservative treatment is largely preferred, and eccentric exercise or other modalities of therapeutic exercises are recommended. However, this approach requests several weeks of consecutive treatment and could be discouraging. In the last years, injections of different formulations were evaluated to accelerate functional recovery in combination with usual therapy. Hyaluronic acid (HA) preparations were proposed, in particular LMW-HA (500–730 kDa) for its unique molecular characteristics in favored extracellular matrix homeostasis and tenocyte viability. The purpose of our review is to evaluate the state-of-the-art about the role of 500–730 kDa in tendinopathies considering both preclinical and clinical findings and encourage further research on this emerging topic. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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10 pages, 409 KiB

Open AccessReview

Diagnosis, Rehabilitation and Preventive Strategies for Pudendal Neuropathy in Cyclists, A Systematic Review

by Rita Chiaramonte, Piero Pavone and Michele Vecchio

J. Funct. Morphol. Kinesiol. 2021, 6(2), 42; https://doi.org/10.3390/jfmk6020042 - 10 May 2021

Cited by 4 | Viewed by 3568

Abstract

This systematic review aims to provide an overview of the diagnostic methods, preventive strategies, and therapeutic approaches for cyclists suffering from pudendal neuropathy. The study defines a guide in delineating a diagnostic and therapeutic protocol using the best current strategies. Pubmed, EMBASE, the Cochrane Library, and Scopus Web of Science were searched for the terms: “Bicycling” OR “Bike” OR “Cyclists” AND “Neuropathy” OR “Pudendal Nerve” OR “Pudendal Neuralgia” OR “Perineum”. The database search identified 14,602 articles. After the titles and abstracts were screened, two independent reviewers analyzed 41 full texts. A total of 15 articles were considered eligible for inclusion. Methodology and results of the study were critically appraised in conformity with PRISMA guidelines and PICOS criteria. Fifteen articles were included in the systematic review and were used to describe the main methods used for measuring the severity of pudendal neuropathy and the preventive and therapeutic strategies for nerve impairment. Future research should determine the validity and the effectiveness of diagnostic and therapeutic strategies, their cost-effectiveness, and the adherences of the sportsmen to the treatment. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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20 pages, 302 KiB

Open AccessReview

Efficacy of Core Stability in Non-Specific Chronic Low Back Pain

by Antonio Frizziero, Giacomo Pellizzon, Filippo Vittadini, Davide Bigliardi and Cosimo Costantino

J. Funct. Morphol. Kinesiol. 2021, 6(2), 37; https://doi.org/10.3390/jfmk6020037 - 22 Apr 2021

Cited by 30 | Viewed by 14998

Abstract

(1) Background: Management of chronic low back pain (cLBP) is often multidisciplinary, involving a combination of treatments, including therapeutic exercises. Core stability exercises aim to improve pain and disability in cLBP increasing spinal stability, neuromuscular control, and preventing shear force that causes injury to the lumbar spine. The purpose of this study was to review the available evidence about the effectiveness in reducing pain and improving disability of core stability exercises for non-specific cLBP. (2) Methods: We perform a systematic research on common Medline databases: PubMed, Pedro, and Cochrane Library. Search results were limited to articles written in English and published between January 2005 and November 2020.The search provided a total of 420 articles. Forty-nine articles met the inclusion criteria and 371 articles were excluded. (3) Results: Core stability provides great therapeutic effects in patients with non-specific chronic low back pain reducing pain intensity, functional disability, and improving quality of life, core muscle activation, and thickness. Evidences suggest that core stability is more effective than rest or no/minimal intervention and combination with other types of exercise for cLBP have shown grater efficacy. (4) Conclusion: Core stability could be proposed in a comprehensive approach in cLBP, the combination with other modalities of therapeutic exercise should be promoted. Patient compliance is crucial to determine the efficacy of the intervention. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

Other

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38 pages, 3276 KiB

Open AccessSystematic Review

Clinical Effects of L-Carnitine Supplementation on Physical Performance in Healthy Subjects, the Key to Success in Rehabilitation: A Systematic Review and Meta-Analysis from the Rehabilitation Point of View

by Michele Vecchio, Rita Chiaramonte, Gianluca Testa and Vito Pavone

J. Funct. Morphol. Kinesiol. 2021, 6(4), 93; https://doi.org/10.3390/jfmk6040093 - 04 Nov 2021

Cited by 7 | Viewed by 6095

Abstract

L-carnitine supplementation improves body strength, sports endurance and exercise capacity, as well as delaying the onset of fatigue. The aim of this study was to identify the correct dosage of supplementation to obtain improvements in physical performance and evaluate the changes related to L-carnitine supplementation in specific metabolic parameters, such as serum lactate, VO₂, serum total and free carnitine at rest and after physical activities, in healthy subjects. The search was conducted on PubMed, EMBASE, Cochrane Library, Scopus and Web of Science and identified 6404 articles with the keywords: “carnitine” AND “exercises” OR “rehabilitation” OR “physical functional performance” OR “physical activity” OR “sports” OR “health” OR “healthy”. A total of 30 publications met the inclusion criteria and were included in the systematic review. The meta-analysis did not show any significant differences in serum lactate values at rest and after exercise in healthy subjects who took L-carnitine supplementation (p > 0.05). On the contrary, L-carnitine administration significantly changed maximal oxygen consumption (VO₂) at rest (p < 0.005), serum free and total carnitine at rest and after exercise (p < 0.001). The dosage of supplementation that obtained a significant change in serum total carnitine was 2 g/dL for 4 weeks at rest, 1 g/dL for 3 weeks after exercise, and in serum free carnitine was 2 g/dL for 3 weeks and 2 g/dL for 4 weeks at rest. Based on our study, serum total and free carnitine at rest and after exercise, and VO₂ at rest could be used to clinically follow individuals during physical activity and rehabilitation programs. Moreover, the supplementation should have a correct dosage to have maximum effect. Other robust trials are needed to find the best dosage to obtain positive results in metabolic parameters and in physical performance. Full article

(This article belongs to the Special Issue Role of Exercises in Musculoskeletal Disorders—4th Edition)

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