Manual and Skeletal Muscle Therapy Combined with Functional Exercise in the Treatment of Hip and Knee Prostheses: A Randomized Clinical Trial on a Biopsychosocial Model.

Dario Furnari1*,2,4,5,7,8,9,10Currao Giovanna1, Gaetano Bagarella1, Alessandra Passanisi1, Nihat Ayceman1,7,10, Nadya Khan3, Melissa Delaney1, Margaret Cerna1,5, Himanshu Tiwari1, V.V Manjula Kumari1 ,Khaled Hamlaoui1, Sebastien Lagree1,2, Amy Peace1,2, Megan Owens1,2, Shanee Lee Scott1,2, Tonja Latham Gustin1,2, Tanya Crowle1,2, Susana Sanchez1, Aliaksandra Eyring1, Elena Talyanova1, Monika Milczarek4, Abdulrahim Aljayar1, Juan Jose Ariet1, Vladyslav Melnyk1, Heather Perren1,2, Timothy Lee1, Sandy Wanna1, Sergey Petrov1,7, Mia M. Michel1,2, Clarice Santos1, Charlie Peebles6, Chutima Halg1, Erik Dalton1, Laura Goncalves1,8, Angela Maria Kunrath1,8, Roberto Simon Luna1,2,9, Maria Sol Rodriguez1,2,9

1 Department of The Private Hospital Argento, Rehabilitation Department

2 Department of Lagree Studio, USA, Los Angeles

3 Department of Pharmacology, College of Medicine and Health Sciences, UAEU

4 Department Monroe Medical, UK

5 Kimec Institute, USA

6 Indiana State University, USA

7 Lotus Academy, Ukraine

8 Instituto Tecnico Superior De Formarcion Integral Paraguaya

9 The Temple of Massage San Juan, Argentina

10 Ögr. Gör. presso A.Ü. Spor Bilimleri Fakültesi-Spor Sa?l?k Bilimleri ABD

*Corresponding Author:Dario Furnari, Department of The Private Hospital Argento, Rehabilitation Department, Catania,Italy.

Citation: Dario Furnari, Currao Giovanna, Gaetano Bagarella, Alessandra Passanisi, Nihat Ayceman, et al. (2023) Manual and Skeletal Muscle Therapy Combined with Functional Exercise in the Treatment of Hip and Knee Prostheses: A Randomized Clinical Trial on a Biopsychosocial Model. Medcina Intern 5: 215.

Received: November 24, 2023; Accepted: December 09, 2023; Published: December 13, 2023.

Aging (or senescence) is that period of life, characterized by a series of progressive irreversible changes affecting the cells, tissues and organs, therefore of the whole organism, which begin when this, once development is complete, has reached an adulthood, and continue to manifest themselves, culminating in death, which occurs as a consequence of them and not by the intervention of external factors.

Gerontology is the biological discipline that studies this process, which can be considered both physiological, because it is normally present in the life span, and pathological because it causes disturbances.

The senile alterations, found in many organs are quite distinct from the pathologies affecting the elderly; the branch of medicine, called Geriatrics, deals with the study of these whose appearance is certainly facilitated by the modifications caused by aging. Lifespan: The reduction in life span seems to always be due to a greater production of free radicals (defined as ROS = Reactive Oxygen Substances).

In reality, a certain amount of ROS is physiologically formed in the body's cells, hence the excessive production of these or their poor elimination, has been considered one of the most significant causes of aging due to the fact that these free radicals interact with nucleic acids, proteins and lipids, altering them structurally and functionally. the only cells that can have a maximum life span equal to that of the organism to which they belong are perennial or post mitotic cells (neurons and muscle cells), that is, those without replicative activity.

Certainly not all perennial cells live as long as the organism, as well demonstrated by the fact that the weight of the human brain, which is 1500 g at the age of 30, decreases on average to 1390 g at the age of 90 years due to the programmed death that affects a large number of neurons.

It is currently established that labile and stable cells after having performed a certain number of mitoses in the culture medium, experience aging phenomena, which prelude to death by apoptosis.

"In vivo" the most important cellular changes that occur in senescence consist in hypotrophy, which is mainly reflected in the reduction of muscle masses, and in the accumulation inside the cells and also in the intercellular spaces of harmful materials: lipofucsins, substance amyeloid and metals. Physiological functions in general improve from birth to 30 years of age, then a decline begins, variable between the various functions, which is closely linked to lifestyle.

Among these functions the most important:

Muscle strength

Nervous function

Respiratory function

Cardiovascular function

Bone mass

Normally there is a continuous remodeling of the motor units, in particular at the level of the neuromuscular plaque. The remodeling process involves atrophy and therefore effective denervation on the one hand, but at the same time, the development of new axonic terminals. With age, the denervation mechanism prevails over the regenerative one, which induces muscle atrophy with irreversible alterations, in particular for type II muscle fibers.

The reduction in muscle mass and strength therefore results from the association of two factors, on the one hand the atrophy of muscle cells and on the other the reduction of daily activity.

It is proven that in elderly subjects a regular muscle strengthening activity promotes protein anabolism and slows down the inevitable reduction in muscle mass and strength.

Results demonstrate a great ability to respond to the training stimulus also in elderly people, which involves processes of synthesis and neuromotor plasticity even in 80-year-old subjects. The cumulative effects of aging of the central nervous system are linked to a 37% reduction in the number of spinal nerve fibers and a 10% reduction in the speed of conduction of excitement along the fibers.

The execution time of relatively complex movements is greater in elderly subjects than in young people, with the same daily physical activity.

Observations suggest that maintaining a physically active lifestyle facilitates good preservation of neuromuscular function. Osteoporosis represents the main problem of aging, especially in women after menopause. The picture of osteoporosis involves the progressive demineralization of the bones which therefore become very fragile. For people over 60, the reduction in bone mass can be 30-50%.

Weightlifting can counteract this phenomenon.