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Haruo Tsuji - One of the best experts on this subject based on the ideXlab platform.
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back Muscle Injury after posterior lumbar spine surgery topographic evaluation of intramuscular pressure and blood flow in the porcine back Muscle during surgery
Spine, 1996Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Shoji Yabuki, Jorma Styf, Kjell Olmarker, Bjorn Rydevik, Haruo TsujiAbstract:STUDY DESIGN: Intramuscular pressure and blood flow of the back Muscles were evaluated topographically during posterior lumbar spine surgery. The topographic damage of the back Muscle after surgery was studied. OBJECTIVE: To investigate the relationship between intramuscular pressure or blood flow during posterior lumbar surgery and the back Muscle Injury after surgery. SUMMARY OF BACKGROUND DATA: Latrogenic back Muscle Injury in an animal and human model has been reported previously. Changes of intramuscular pressure and blood flow during surgery might be related to the Muscle Injury. No previous study on this issue has been published. METHODS: The contact pressure between the retractor blade and Muscle tissue was monitored in 10 pigs during posterior surgery of the lumbar spine. On one side, intramuscular pressure at 5, 10, and 20 mm lateral to the retractor and on the other side blood flow of the back Muscle at 5 and 20 mm during surgery were measured. Histologic changes of the back Muscle at 5, 10, and 20 mm to the midline were evaluated 3 hours after surgery. RESULTS: The contact pressure decreased exponentially with time. Intramuscular pressure 5 mm lateral to the retractor was 114 +/- 31 mm Hg and was significantly higher than at 10 mm and 20 mm. Blood flow markedly decreased during surgery and recovered incompletely after releasing the retractor at 5 mm and 20 mm lateral to the retractor. Blood flow at 5 mm was significantly lower than at 20 mm throughout surgery. The Muscle damage 3 hours after surgery was more severe near the retractor blade. CONCLUSIONS: The back Muscles were exposed to pathophysiologic condition by a retractor during posterior lumbar spine surgery. External compression by a retractor increases intramuscular pressure to levels that impede local Muscle blood flow. The Muscle degeneration after surgery could be explained by direct mechanical damage and by the increased intramuscular pressure of Muscle tissue by the retractor.
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back Muscle Injury after posterior lumbar spine surgery a histologic and enzymatic analysis
Spine, 1996Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:Study Design. Back Muscle Injury after posterior lumbar surgery was studied by Muscle histology and serum creatine phosphokinase MM isoenzyme activity. Objectives. To investigate intraoperative factors influencing the magnitude of back Muscle Injury after posterior lumbar surgery. Summary of Background Data. The authors previously have reported iatrogenic back Muscle Injury in an animal model and in humans. Serious Injury of the back Muscle has been shown by short-term and longterm follow-up evaluation. Methods. The retraction pressure was monitored, and the retraction pressure-time products were calculated in 24 patients. Early histologic changes of multifidus Muscle, which were taken at completion of surgery, and serum creatine phosphokinase MM isoenzyme activity changes were examined. Results. The magnitude of back Muscle Injury was significant as the pressure-time product increased. Creatine phosphokinase MM isoenzyme activity increased after surgery and reached a plateau 1 day after surgery, followed by recovery to the normal value 1 week after surgery. Creatine phosphokinase MM isoenzyme activity tended to be high in cases with multilevel exposure and with high pressure-time product. Conclusions. Back Muscle Injury occurs in all patients who underwent posterior lumbar surgery, and these injuries are related to the retraction pressure, time, and extent of exposure.
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back Muscle Injury after posterior lumbar spine surgery part 2 histologic and histochemical analyses in humans
Spine, 1994Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:STUDY DESIGN: Back Muscle Injury caused by retractor application during posterior spine surgery in rats was examined histologically and histochemically according to the postoperative time with reference to the retraction time-pressure relationship. OBJECTIVES: The results were correlated to provide the risk factors for back Muscle Injury during posterior spine surgery. SUMMARY OF BACKGROUND DATA: Back Muscles were examined histologically and histochemically after application of quantitative pressure and retraction time. No previous study has assessed this relationship. METHODS: Five groups were studied: Group 1, 1-hour low-pressure load group; Group 2, 1-hour high-pressure load group; Group 3, 3-hour low-pressure load group; Group 4, 3-hour high-pressure load group; and sham group. In each group, the multifidus Muscle was evaluated 3 hours, 48 hours, 1 week, 3 weeks, and 6 weeks after surgery. RESULTS: In all groups except the sham group, degeneration of the Muscle and neuromuscular junction was found at a very early postoperative time, but regeneration began at 1 week, and recovery was attained by 6 weeks. The extent of Muscle fiber necrosis and the severity of degeneration of the neuromuscular junctions showed a parallelism with the magnitude of the pressure load and retraction time. As the duration and pressure load increased, the time required for regeneration also increased. The fiber type grouping in group 3 and 4 was consistent with the severity of degeneration of neuromuscular junctions. CONCLUSIONS: The muscular degeneration and the regeneration was largely dependent on the retraction pressure-time product. These results suggest that denervation Muscle injuries are likely secondary responses to Muscle retraction Injury in any case of posterior spine surgery.
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back Muscle Injury after posterior lumbar spine surgery part 2
Spine, 1994Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:Study Design The histologic and histochemical changes in back Muscle were studied in virgin surgery patients with lumbar spine disorders and in patients who underwent repeat posterior lumbar surgery. Objectives The results were correlated to provide the evidences of histologic changes of back Muscle after posterior lumbar surgery. Summary of Background Data Back Muscles were examined histologically and histochemically after posterior lumbar surgery. No previous study has assessed these changes. Methods Back Muscles were obtained before and after retraction from 18 virgin surgery cases with lumbar spine disorders. In four patients, the retraction pressure was monitored and the retraction pressure-time products ([P][T]) were calculated. In 21 repeat lumbar surgery cases, Muscle samples were obtained before Muscle retraction. Samples were evaluated by histologic and histochemical methods. Results Abnormal findings were slight in virgin surgery cases. Early back Muscle Injury tended to depend on operation time and ([P][T]) products. Late back Muscle Injury in reoperated patients was marked. Various types of neurogenic changes were observed more than 10 months after the first operation. Conclusions Histologic damages of back Muscle due to previous surgical intervention were long-lasting. To avoid permanent Muscle Injury, the retraction time and pressure should be shortened or the pressure on the back Muscle should be monitored during posterior surgery.
Yoshiharu Kawaguchi - One of the best experts on this subject based on the ideXlab platform.
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back Muscle Injury after posterior lumbar spine surgery topographic evaluation of intramuscular pressure and blood flow in the porcine back Muscle during surgery
Spine, 1996Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Shoji Yabuki, Jorma Styf, Kjell Olmarker, Bjorn Rydevik, Haruo TsujiAbstract:STUDY DESIGN: Intramuscular pressure and blood flow of the back Muscles were evaluated topographically during posterior lumbar spine surgery. The topographic damage of the back Muscle after surgery was studied. OBJECTIVE: To investigate the relationship between intramuscular pressure or blood flow during posterior lumbar surgery and the back Muscle Injury after surgery. SUMMARY OF BACKGROUND DATA: Latrogenic back Muscle Injury in an animal and human model has been reported previously. Changes of intramuscular pressure and blood flow during surgery might be related to the Muscle Injury. No previous study on this issue has been published. METHODS: The contact pressure between the retractor blade and Muscle tissue was monitored in 10 pigs during posterior surgery of the lumbar spine. On one side, intramuscular pressure at 5, 10, and 20 mm lateral to the retractor and on the other side blood flow of the back Muscle at 5 and 20 mm during surgery were measured. Histologic changes of the back Muscle at 5, 10, and 20 mm to the midline were evaluated 3 hours after surgery. RESULTS: The contact pressure decreased exponentially with time. Intramuscular pressure 5 mm lateral to the retractor was 114 +/- 31 mm Hg and was significantly higher than at 10 mm and 20 mm. Blood flow markedly decreased during surgery and recovered incompletely after releasing the retractor at 5 mm and 20 mm lateral to the retractor. Blood flow at 5 mm was significantly lower than at 20 mm throughout surgery. The Muscle damage 3 hours after surgery was more severe near the retractor blade. CONCLUSIONS: The back Muscles were exposed to pathophysiologic condition by a retractor during posterior lumbar spine surgery. External compression by a retractor increases intramuscular pressure to levels that impede local Muscle blood flow. The Muscle degeneration after surgery could be explained by direct mechanical damage and by the increased intramuscular pressure of Muscle tissue by the retractor.
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back Muscle Injury after posterior lumbar spine surgery a histologic and enzymatic analysis
Spine, 1996Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:Study Design. Back Muscle Injury after posterior lumbar surgery was studied by Muscle histology and serum creatine phosphokinase MM isoenzyme activity. Objectives. To investigate intraoperative factors influencing the magnitude of back Muscle Injury after posterior lumbar surgery. Summary of Background Data. The authors previously have reported iatrogenic back Muscle Injury in an animal model and in humans. Serious Injury of the back Muscle has been shown by short-term and longterm follow-up evaluation. Methods. The retraction pressure was monitored, and the retraction pressure-time products were calculated in 24 patients. Early histologic changes of multifidus Muscle, which were taken at completion of surgery, and serum creatine phosphokinase MM isoenzyme activity changes were examined. Results. The magnitude of back Muscle Injury was significant as the pressure-time product increased. Creatine phosphokinase MM isoenzyme activity increased after surgery and reached a plateau 1 day after surgery, followed by recovery to the normal value 1 week after surgery. Creatine phosphokinase MM isoenzyme activity tended to be high in cases with multilevel exposure and with high pressure-time product. Conclusions. Back Muscle Injury occurs in all patients who underwent posterior lumbar surgery, and these injuries are related to the retraction pressure, time, and extent of exposure.
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back Muscle Injury after posterior lumbar spine surgery part 2 histologic and histochemical analyses in humans
Spine, 1994Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:STUDY DESIGN: Back Muscle Injury caused by retractor application during posterior spine surgery in rats was examined histologically and histochemically according to the postoperative time with reference to the retraction time-pressure relationship. OBJECTIVES: The results were correlated to provide the risk factors for back Muscle Injury during posterior spine surgery. SUMMARY OF BACKGROUND DATA: Back Muscles were examined histologically and histochemically after application of quantitative pressure and retraction time. No previous study has assessed this relationship. METHODS: Five groups were studied: Group 1, 1-hour low-pressure load group; Group 2, 1-hour high-pressure load group; Group 3, 3-hour low-pressure load group; Group 4, 3-hour high-pressure load group; and sham group. In each group, the multifidus Muscle was evaluated 3 hours, 48 hours, 1 week, 3 weeks, and 6 weeks after surgery. RESULTS: In all groups except the sham group, degeneration of the Muscle and neuromuscular junction was found at a very early postoperative time, but regeneration began at 1 week, and recovery was attained by 6 weeks. The extent of Muscle fiber necrosis and the severity of degeneration of the neuromuscular junctions showed a parallelism with the magnitude of the pressure load and retraction time. As the duration and pressure load increased, the time required for regeneration also increased. The fiber type grouping in group 3 and 4 was consistent with the severity of degeneration of neuromuscular junctions. CONCLUSIONS: The muscular degeneration and the regeneration was largely dependent on the retraction pressure-time product. These results suggest that denervation Muscle injuries are likely secondary responses to Muscle retraction Injury in any case of posterior spine surgery.
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back Muscle Injury after posterior lumbar spine surgery part 2
Spine, 1994Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:Study Design The histologic and histochemical changes in back Muscle were studied in virgin surgery patients with lumbar spine disorders and in patients who underwent repeat posterior lumbar surgery. Objectives The results were correlated to provide the evidences of histologic changes of back Muscle after posterior lumbar surgery. Summary of Background Data Back Muscles were examined histologically and histochemically after posterior lumbar surgery. No previous study has assessed these changes. Methods Back Muscles were obtained before and after retraction from 18 virgin surgery cases with lumbar spine disorders. In four patients, the retraction pressure was monitored and the retraction pressure-time products ([P][T]) were calculated. In 21 repeat lumbar surgery cases, Muscle samples were obtained before Muscle retraction. Samples were evaluated by histologic and histochemical methods. Results Abnormal findings were slight in virgin surgery cases. Early back Muscle Injury tended to depend on operation time and ([P][T]) products. Late back Muscle Injury in reoperated patients was marked. Various types of neurogenic changes were observed more than 10 months after the first operation. Conclusions Histologic damages of back Muscle due to previous surgical intervention were long-lasting. To avoid permanent Muscle Injury, the retraction time and pressure should be shortened or the pressure on the back Muscle should be monitored during posterior surgery.
Hisao Matsui - One of the best experts on this subject based on the ideXlab platform.
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back Muscle Injury after posterior lumbar spine surgery topographic evaluation of intramuscular pressure and blood flow in the porcine back Muscle during surgery
Spine, 1996Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Shoji Yabuki, Jorma Styf, Kjell Olmarker, Bjorn Rydevik, Haruo TsujiAbstract:STUDY DESIGN: Intramuscular pressure and blood flow of the back Muscles were evaluated topographically during posterior lumbar spine surgery. The topographic damage of the back Muscle after surgery was studied. OBJECTIVE: To investigate the relationship between intramuscular pressure or blood flow during posterior lumbar surgery and the back Muscle Injury after surgery. SUMMARY OF BACKGROUND DATA: Latrogenic back Muscle Injury in an animal and human model has been reported previously. Changes of intramuscular pressure and blood flow during surgery might be related to the Muscle Injury. No previous study on this issue has been published. METHODS: The contact pressure between the retractor blade and Muscle tissue was monitored in 10 pigs during posterior surgery of the lumbar spine. On one side, intramuscular pressure at 5, 10, and 20 mm lateral to the retractor and on the other side blood flow of the back Muscle at 5 and 20 mm during surgery were measured. Histologic changes of the back Muscle at 5, 10, and 20 mm to the midline were evaluated 3 hours after surgery. RESULTS: The contact pressure decreased exponentially with time. Intramuscular pressure 5 mm lateral to the retractor was 114 +/- 31 mm Hg and was significantly higher than at 10 mm and 20 mm. Blood flow markedly decreased during surgery and recovered incompletely after releasing the retractor at 5 mm and 20 mm lateral to the retractor. Blood flow at 5 mm was significantly lower than at 20 mm throughout surgery. The Muscle damage 3 hours after surgery was more severe near the retractor blade. CONCLUSIONS: The back Muscles were exposed to pathophysiologic condition by a retractor during posterior lumbar spine surgery. External compression by a retractor increases intramuscular pressure to levels that impede local Muscle blood flow. The Muscle degeneration after surgery could be explained by direct mechanical damage and by the increased intramuscular pressure of Muscle tissue by the retractor.
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back Muscle Injury after posterior lumbar spine surgery a histologic and enzymatic analysis
Spine, 1996Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:Study Design. Back Muscle Injury after posterior lumbar surgery was studied by Muscle histology and serum creatine phosphokinase MM isoenzyme activity. Objectives. To investigate intraoperative factors influencing the magnitude of back Muscle Injury after posterior lumbar surgery. Summary of Background Data. The authors previously have reported iatrogenic back Muscle Injury in an animal model and in humans. Serious Injury of the back Muscle has been shown by short-term and longterm follow-up evaluation. Methods. The retraction pressure was monitored, and the retraction pressure-time products were calculated in 24 patients. Early histologic changes of multifidus Muscle, which were taken at completion of surgery, and serum creatine phosphokinase MM isoenzyme activity changes were examined. Results. The magnitude of back Muscle Injury was significant as the pressure-time product increased. Creatine phosphokinase MM isoenzyme activity increased after surgery and reached a plateau 1 day after surgery, followed by recovery to the normal value 1 week after surgery. Creatine phosphokinase MM isoenzyme activity tended to be high in cases with multilevel exposure and with high pressure-time product. Conclusions. Back Muscle Injury occurs in all patients who underwent posterior lumbar surgery, and these injuries are related to the retraction pressure, time, and extent of exposure.
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back Muscle Injury after posterior lumbar spine surgery part 2 histologic and histochemical analyses in humans
Spine, 1994Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:STUDY DESIGN: Back Muscle Injury caused by retractor application during posterior spine surgery in rats was examined histologically and histochemically according to the postoperative time with reference to the retraction time-pressure relationship. OBJECTIVES: The results were correlated to provide the risk factors for back Muscle Injury during posterior spine surgery. SUMMARY OF BACKGROUND DATA: Back Muscles were examined histologically and histochemically after application of quantitative pressure and retraction time. No previous study has assessed this relationship. METHODS: Five groups were studied: Group 1, 1-hour low-pressure load group; Group 2, 1-hour high-pressure load group; Group 3, 3-hour low-pressure load group; Group 4, 3-hour high-pressure load group; and sham group. In each group, the multifidus Muscle was evaluated 3 hours, 48 hours, 1 week, 3 weeks, and 6 weeks after surgery. RESULTS: In all groups except the sham group, degeneration of the Muscle and neuromuscular junction was found at a very early postoperative time, but regeneration began at 1 week, and recovery was attained by 6 weeks. The extent of Muscle fiber necrosis and the severity of degeneration of the neuromuscular junctions showed a parallelism with the magnitude of the pressure load and retraction time. As the duration and pressure load increased, the time required for regeneration also increased. The fiber type grouping in group 3 and 4 was consistent with the severity of degeneration of neuromuscular junctions. CONCLUSIONS: The muscular degeneration and the regeneration was largely dependent on the retraction pressure-time product. These results suggest that denervation Muscle injuries are likely secondary responses to Muscle retraction Injury in any case of posterior spine surgery.
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back Muscle Injury after posterior lumbar spine surgery part 2
Spine, 1994Co-Authors: Yoshiharu Kawaguchi, Hisao Matsui, Haruo TsujiAbstract:Study Design The histologic and histochemical changes in back Muscle were studied in virgin surgery patients with lumbar spine disorders and in patients who underwent repeat posterior lumbar surgery. Objectives The results were correlated to provide the evidences of histologic changes of back Muscle after posterior lumbar surgery. Summary of Background Data Back Muscles were examined histologically and histochemically after posterior lumbar surgery. No previous study has assessed these changes. Methods Back Muscles were obtained before and after retraction from 18 virgin surgery cases with lumbar spine disorders. In four patients, the retraction pressure was monitored and the retraction pressure-time products ([P][T]) were calculated. In 21 repeat lumbar surgery cases, Muscle samples were obtained before Muscle retraction. Samples were evaluated by histologic and histochemical methods. Results Abnormal findings were slight in virgin surgery cases. Early back Muscle Injury tended to depend on operation time and ([P][T]) products. Late back Muscle Injury in reoperated patients was marked. Various types of neurogenic changes were observed more than 10 months after the first operation. Conclusions Histologic damages of back Muscle due to previous surgical intervention were long-lasting. To avoid permanent Muscle Injury, the retraction time and pressure should be shortened or the pressure on the back Muscle should be monitored during posterior surgery.
Angèle Chopard - One of the best experts on this subject based on the ideXlab platform.
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Muscle resting and TGF-β inhibitor treatment prevent fatty infiltration following skeletal Muscle Injury
Cellular Physiology and Biochemistry, 2019Co-Authors: Allan Pagano, Coralie Arc-chagnaud, Thomas Brioche, Angèle ChopardAbstract:Background/Aims: Skeletal Muscle injuries are the most common type of Injury occurring in sports, and investigating skeletal Muscle regeneration as well as understanding the related processes is an important aspect of the sports medicine field. The process of regeneration appears to be complex and precisely orchestrated, involving fibro-adipogenic progenitors (FAPs) which are a Muscle-resident stem cell population that appears to play a major role in abnormal development of fibrotic tissue or intermuscular adipose tissue (IMAT). Our present study aims to investigate whether Muscle resting or endurance exercise following Muscle Injury may change the behavior of FAPs and subsequently impact the development of fatty infiltrations and fibrosis, two hallmarks of regeneration failure. Methods:We used the validated glycerol Muscle Injury model to mimic abnormal Muscle regenerative conditions in mice. We challenged this specific regeneration model with hindlimb unloading or endurance exercise and, in a second set of experiments, we treated mice with decorin, a TGF-β inhibitor. Results:In this study, we demonstrated that: i) Muscle resting just after Injury leads to inhibition of IMAT development, ii) TNF-α mediated FAP apoptosis might be perturbed in this specific glycerol model of Muscle Injury, leading to IMAT development, and iii) treatment with the TGF-β inhibitor decorin decreases IMAT development and might restores FAP apoptosis.Conclusion:In addition to the potential clinical relevance of decorin treatment in situations involving Muscle plasticity and regeneration, this study also demonstrates that a period of Muscle resting is necessary following Muscle Injury to achieve efficient Muscle regeneration which is associated with a reduction in fatty infiltration. Unreasonably early resumption of exercise brings no gain to regeneration, further highlighting that this resting period is necessary.
Allan Pagano - One of the best experts on this subject based on the ideXlab platform.
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Muscle resting and TGF-β inhibitor treatment prevent fatty infiltration following skeletal Muscle Injury
Cellular Physiology and Biochemistry, 2019Co-Authors: Allan Pagano, Coralie Arc-chagnaud, Thomas Brioche, Angèle ChopardAbstract:Background/Aims: Skeletal Muscle injuries are the most common type of Injury occurring in sports, and investigating skeletal Muscle regeneration as well as understanding the related processes is an important aspect of the sports medicine field. The process of regeneration appears to be complex and precisely orchestrated, involving fibro-adipogenic progenitors (FAPs) which are a Muscle-resident stem cell population that appears to play a major role in abnormal development of fibrotic tissue or intermuscular adipose tissue (IMAT). Our present study aims to investigate whether Muscle resting or endurance exercise following Muscle Injury may change the behavior of FAPs and subsequently impact the development of fatty infiltrations and fibrosis, two hallmarks of regeneration failure. Methods:We used the validated glycerol Muscle Injury model to mimic abnormal Muscle regenerative conditions in mice. We challenged this specific regeneration model with hindlimb unloading or endurance exercise and, in a second set of experiments, we treated mice with decorin, a TGF-β inhibitor. Results:In this study, we demonstrated that: i) Muscle resting just after Injury leads to inhibition of IMAT development, ii) TNF-α mediated FAP apoptosis might be perturbed in this specific glycerol model of Muscle Injury, leading to IMAT development, and iii) treatment with the TGF-β inhibitor decorin decreases IMAT development and might restores FAP apoptosis.Conclusion:In addition to the potential clinical relevance of decorin treatment in situations involving Muscle plasticity and regeneration, this study also demonstrates that a period of Muscle resting is necessary following Muscle Injury to achieve efficient Muscle regeneration which is associated with a reduction in fatty infiltration. Unreasonably early resumption of exercise brings no gain to regeneration, further highlighting that this resting period is necessary.
