2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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2023 Padua Days of Muscle and Mobility Medicine: post meeting book 
of abstracts 
Sandra Zampieri (1,2,3,4,5,6), Ines Bersch (7), Helmut Kern (5,6), Nejc Sarabon (8), 
Riccardo Rosati (9), Nathan K. LeBrasseur (10), Christiaan Leeuwenburgh (11), Ugo 
Carraro (2,3,4) 

(1) Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, 
Italy; (2) Department of Biomedical Sciences, University of Padua, Italy; (3) CIR MYO - 
Interdepartmental Research Centre of Myology, University of Padua, Italy; (4) Armando & 
Carmela Mioni-Carraro Foundation for Translational Myology, Padua, Italy; (5) Ludwig 
Boltzmann Institute for Rehabilitation Research, Wien, Austria; (6) Centre of Active Ageing, 
Sankt Poelten, Austria; (7) International FES Centre®, Swiss Paraplegic Centre, Nottwil, 
Switzerland; (8) University of Primorska, Faculty of Health Sciences, Izola, Slovenia; S2P, 
Science to Practice, Ltd., Laboratory for Motor Control and Motor Behaviour, Ljubljana, 
Slovenia; InnoRenew CoE, Izola, Slovenia; (9) Department of Biomedical Surgical and Dental 
Sciences, University of Milan, Milan, Italy; (10) Department of Physical Medicine and 
Rehabilitation, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Minnesota, USA; (11) 
Department of Aging and Geriatric Research, Institute on Aging, University of Florida, 
Gainesville, FL, USA. 
This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (CC BY-NC 4.0) which permits 
any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. 

Abstract 

The 2023 Padua Days of Muscle and Mobility Medicine (Pdm3) were held from March 29th to 
April 1st, 2023. Most of the abstracts were published electronically in the European Journal of 
Translational Myology (EJTM) 33 (1) 2023. Here we report the complete book of abstracts that 
confirms the interest of more than 150 scientists and clinicians from Austria, Bulgaria, Canada, 
Denmark, France, Georgia, Germany, Iceland, Ireland, Italy, Mongolia, Norway, Russia, 
Slovakia, Slovenia, Spain, Switzerland, The Netherlands and USA to gather to the Hotel Petrarca 
of Thermae of Euganean Hills, Padua, Italy for contributing and attending the Pdm3 
(https://www.youtube.com/watch?v=zC02D4uPWRg). The 2023 Pdm3 started March 29th in the 
historic Aula Guariento of thePadua Galilean Academy of Letters, Arts and Sciences with the 
Lecture of Prof. Carlo Reggiani and ended in the late afternoon with the Lecture of Professor 
Terje Lømo after introductory words of Professor Stefano Schiaffino. The program followed in 
the Hotel Petrarca Conferenece Halls from March 30 to April 1, 2023. The extended topic 
interests of specialists in basic myology sciences and clinicians, collected under the umbrella 
neologism of Mobility Medicine, is stressed also by expansion of Sections of the EJTM Editorial 
Board (https://www.pagepressjournals.org/index.php/bam/board). We hope that Speakers of the 
2023 Pdm3 and readers of EJTM will submit “EJTM Communications” to the European Journal 
of Translational Myology (PAGEpress, Pavia, Italy) by May 31, 2023 and/or invited review and 
original articles for the 2023 special issue: "Pdm3" of Diagnostics, MDPI, Basel, Switzerland 
due September 30, 2023. 
Key Words: Padua Days of Muscle and Mobility Medicine (Pdm3); European Journal of 
Translational Myology and Mobility Medicine, PAGEpress, Pavia, Italy. 

Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427

 The Padua Muscle Days (PMDs), i.e., meetings on 
biology, physiology, pathology, physical medicine and 
rehabilitation of skeletal muscle in health and diseases 
started in 1985 to provide advice on Translational 

Myology. Year after year interests broadened to 
complementary disciplines and neologisms were 
introduced. Finally, from 2021 the Conference was 
renamed Padua Days on Muscle and Mobility Medicine 

https://www.youtube.com/watch?v=zC02D4uPWRg
https://www.pagepressjournals.org/index.php/bam/board


2023 Pdm3 - Post meeting book of abstracts 
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(Pdm3). The program of the 2023 Pdm3 was confirmed 
in autumn 2022 with Scientific Sessions to occur over 
four full days at either the Guariento Hall of the Padua 
Galilean Academy of Arts, Letters and Sciences (March 
29, 2023) and at the Conference Halls of the Hotel 
Petrarca, Thermae of Euganean Hills (Padua), Italy.  
For a short promo of the 2023 Pdm3 link to: 
https://www.youtube.com/watch?v=zC02D4uPWRg 
Collected during autumn and winter 2022 and 2023, titles 
and abstracts of more than 90 oral presentations were 
listed in evolving preliminary schedules.1,2  
Here we add a few more last-minute abstracts, bringing 
the final Program to about 120 Presentations. 
The four days of 2023 Pdm3 included senior and junior 
speakers (basic myologists and clinicians) from Austria, 
Bulgaria, Canada, Denmark, France, Georgia, Germany, 
Iceland, Ireland, Italy, Mongolia, Norway, Russia, 
Slovakia, Slovenia, Spain, Switzerland, The Netherlands 
and USA.  
The Final Program and Book of Abstracts are here 
published in electronic format in the issue 33 (2) 2023 of 
the European Journal of Translational Myology (EJTM).  
The heterogeneity of specialists, gathered under the 
umbrella neologism of Mobility Medicine, is underlined 
by the new Sections of the 2023 Editorial Board of EJTM 
(www.pagepressjournals.org/index.php/bam/board).  
Some blank abstracts appear in the Book of 105 abstracts 
with only authors' names and affiliations, due to the 
request of Authors not to disclose their unpublished 
results. This is a pity, but at the same time it is very strong 
evidence of the actuality and originality of the 2023 
Pdm3 Program. At least 140 attendees (more than half 
were young basic scientists and clinicians) gathered in 
the rinascimental frescos-rich Aula Guariento of the 
Padua Galilean Academy of Arts, Letters and Sciences 
and in the Conference Halls of the Hotel Petrarca 
Thermae of Euganean Hills (Padua) to get a preview of 
original results of the best world laboratories performing 
translational research on muscle and mobility medicine. 
The 2023 Pdm3 started in the morning of March 29th with 
the Lecture of Prof. Carlo Reggiani of the University of 
Padua, (Italy). After introduction of Professor Stefano 
Schiaffino of the University of Padua (Italy), the Lecture 
of Professor Terje Lømo of the University of Oslo 
(Norway) closed the program of the first day.  
In the following days that we spent in the Conference 
Hall of Hotel Petrarca, the following program lists the 
Lectures of: H. Lee Sweeney of the University of Florida, 
Gainesville, FL (USA), Jonathan Jarvis of the Liverpool 
John Moores University (UK), Paolo Gargiulo of the 
University of Rejkyavik (Iceland), Feliciano Protasi of 
the University of Chieti (Italy), Helmut Kern, LBI 
Rehabilitation Research, Vienna (Austria), and long- or 
short-Oral presentations of more than 100 Speakers. 
The novelties of the 2023 Pdm3 were two Practical 
Courses: the one on the Functional analysis of the 
stomatognathic system, organized by Claudia Dellavia 
and Riccardo Rosati of the University of Milan (Italy) 

and the Practical Activities on European Medical 
Thermalism organized by Ugo Carraro of the University 
of Padua (Italy) during a working lunch at the Medical 
Hotel Ermitage in Teolo, Euganean Hills (Padua), Italy). 
Both events were appreciated by dozens of participants. 
We thank those organizers that were able to attract 
excellent young, senior and old speakers, specifically: 
Elisabeth R. Barton, Ines Bersch, Paolo Gargiulo, Elena 
P. Ivanova, Christiaan Leeuwenburgh, Marco V. Narici, 
Riccardo Rosati, Piera Smeriglio, Carla Stecco, Daniela 
Tavian and H. Lee Sweeney.  
Following Table lists the best Organizer, Conferences 
(tied), Sessions (tied), Speaker and Young Speakers 
(tied). 

In conclusion, the 2023 Pdm3 was even more interesting 
than the successful events of the last years.3-10 

List of acronyms 
EJTM - European Journal of Translational Myology  
MDPI - Molecular Diversity Preservation International  
Pdm3 - Padua Days on Muscle and Mobility Medicine 
PMD – Padua Muscle Days 

Acknowledgments 
The authors thank Organizers, Chairs, Speakers, and 
Attendees of the Pdm3. 

Funding 
The 2023 Pdm3 are supported by the University of 
Florida Myology Institute and Wellstone Center, 
Gainesville, FL, USA (H. Lee Sweeney, Gainesville, FL, 
USA) and by Physiko- & Rheuma-therapie, Institute for 
Physical Medicine and Rehabilitation, St. Pölten, 
Austria, Centre of Active Ageing - Competence Centre 
for Health, Prevention and Active Ageing, St. Pölten, 
Austria and Ludwig Boltzmann Institute for 
Rehabilitation Research, St. Pölten, Austria (Helmut 
Kern, Wien, Austria).  
Publishing is supported by PAGEpress, Pavia, Italy and 
by Armando & Carmela Mioni-Carraro Foundation for 
Translational Myology (A&C M-C Foundation), Padua, 
Italy. 

The Best of the 2023 Pdm3 
Organizer: Ugo Carraro 

Lecturers (equal in merit): Helmuth Kern; Carlo 
Reggiani 

Sessions (equal in merit): Senescence & 
Rejuvenation; FES managements of acquired 
muscle diseases 

Speaker: Nathan K. LeBrasseur 

Young Speakers (equal in merit): Agnese De Mario, 
Maria Chiara Maccarone, Maira Rossi and Ester 
Tommasini 

https://www.youtube.com/watch?v=zC02D4uPWRg
http://www.pagepressjournals.org/index.php/bam/board


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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Conflict of Interest  

The authors disclose no conflicts of research and 
publication interests or any specific endorsements of the 
products referenced in this manuscript. 

Ethical Publication Statement 
We confirm that we have read the Journal’s position on 
issues involved in ethical publication and that this report 
is consistent with those guidelines. 

Corresponding Author 
Sandra Zampieri, Department of Surgery, Oncology and 
Gastroenterology, Padua University Hospital, Padua, 
Italy. Email: sanzamp@unipd.it  
ORCID iD: 0000-0001-6070-0011 

Emails of Coauthors 
Ines Bersch: ines.bersch@paraplegie.ch 
ORCID iD: 0000-0001-5519-8593 
Helmut Kern: info@active-ageing.eu  
ORCID iD: 0000-0001-9661-8814 
Nejc Sarabon: nejc.sarabon@fvz.upr.si  
ORCID iD: 0000-0003-0747-3735 
Riccardo Rosati: riccardo@riccardorosati.eu  
ORCID iD: 0000-0001-6149-0427 
Nathan K. LeBrasseur: LeBrasseur.Nathan@mayo.edu  
ORCID iD: 0000-0002-2002-0418 
Christiaan Leeuwenburg: cleeuwen@ufl.edu  
ORCID iD: 0000-0003-0826-4257 
Ugo Carraro: ugo.carraro@unipd.it  
ORCID iD: 0000-0002-0924-4998 

References 
1. Zampieri S, Narici MV, Gargiulo P, Carraro U. 

Abstracts of the 2023 Padua Days of Muscle and 
Mobility Medicine (2023Pdm3) to be held March 29 
- April 1 at the Galileian Academy of Padua and at 
the Petrarca Hotel, Thermae of Euganean Hills, 
Padua, Italy. Eur J Transl Myol. 2023 Feb 10. doi: 
10.4081/ejtm.2023.11247. Epub ahead of print. 
PMID: 36786151. 

2. Zampieri S, Stecco C, Narici M, Masiero S, Carraro 
U. 2023 On-site Padua Days on Muscle and Mobiliy 
Medicine: Call for speakers. Eur J Transl Myol. 2022 
Dec 13. doi: 10.4081/ejtm.2022.11071. Online ahead 
of print. PMID: 36511885 Free article. 

3. Carraro U, Bittmann F, Ivanova E, Jónsson H Jr, Kern 
H, Leeuwenburgh C, Mayr W, Scalabrin M, Schaefer 
L, Smeriglio P, Zampieri S. Post-meeting report of 
the 2022 On-site Padua Days on Muscle and Mobility 
Medicine, March 30 - April 3, 2022, Padua, Italy. Eur 

J Transl Myol. 2022 Apr 13;32(2):10521. doi: 
10.4081/ejtm.2022.10521. PMID: 35421919; 
PMCID: PMC9295170. 

4. Sweeney HL, Masiero S, Carraro U. The 2022 On-
site Padua Days on Muscle and Mobility Medicine 
hosts the University of Florida Institute of Myology 
and the Wellstone Center, March 30 - April 3, 2022 
at the University of Padua and Thermae of Euganean 
Hills, Padua, Italy: The collection of abstracts. Eur J 
Transl Myol. 2022 Mar 10;32(1):10440. doi: 
10.4081/ejtm.2022.10440. PMID: 35272451; 
PMCID: PMC8992680. 

5. Carraro U, Yablonka-Reuveni Z. Translational 
research on Myology and Mobility Medicine: 2021 
semi-virtual PDM3 from Thermae of Euganean Hills, 
May 26 - 29, 2021. Eur J Transl Myol. 2021 Mar 
18;31(1):9743. doi: 10.4081/ejtm.2021.9743. PMID: 
33733717; PMCID: PMC8056169. 

7. Carraro U. Thirty years of translational research in 
Mobility Medicine: Collection of abstracts of the 
2020 Padua Muscle Days. Eur J Transl Myol. 2020 
Apr 1;30(1):8826. doi: 10.4081/ejtm.2019.8826. 
PMID: 32499887; PMCID: PMC7254447 

8. Carraro U. 2019Spring PaduaMuscleDays: 
Translational Myology and Mobility Medicine. Eur J 
Transl Myol. 2019 Feb 21;29(1):8105. doi: 
10.4081/ejtm.2019.8105. PMID: 31019665; PMCID: 
PMC6460213 

9. Carraro U. Exciting perspectives for Translational 
Myology in the Abstracts of the 2018Spring 
PaduaMuscleDays: Giovanni Salviati Memorial - 
Chapter I - Foreword. Eur J Transl Myol. 2018 Feb 
20;28(1):7363. doi: 10.4081/ejtm.2018.7363. PMID: 
29686822; PMCID: PMC5895991. 

10. Carraro U. 2017Spring PaduaMuscleDays, roots and 
byproducts. Eur J Transl Myol. 2017 Jun 
27;27(2):6810. doi: 10.4081/ejtm.2017.6810. PMID: 
28713538; PMCID: PMC5505085. 

Disclaimer 
All claims expressed in this article are solely those of the 
authors and do not necessarily represent those of their 
affiliated organizations, or those of the publisher, the 
editors and the reviewers. Any product that may be 
evaluated in this article or claim that may be made by its 
manufacturer is not guaranteed or endorsed by the 
publisher. 

Submitted: April 21, 2023 
Accepted for publication: April 21, 2023 

  

mailto:info@active-ageing.eu
mailto:nejc.sarabon@fvz.upr.si
mailto:riccardo@riccardorosati.eu
mailto:LeBrasseur.Nathan@mayo.edu
mailto:cleeuwen@ufl.edu
mailto:ugo.carraro@unipd.it


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European Journal of Translational Myology - eISSN 2037-7460 - ISSN 2037–7452 – BAM On-Line 
   

 

2023 Pdm3, March 29 - April 1, 2023 - Thermae of Euganean Hills, Padua (Italy) 
Galilean Academy of Padua &Thermae of Euganean Hills  (Padua, Italy) 

Hotel Petrarca, Piazza Roma 23, Montegrotto Terme, Euganean Hills, (Padua), 35122 Italy 
Phone +39 049 891 1744 - Email: petrarca@hotelpetrarca.it - https://www.hotelpetrarca.it/ 

 
 
 
 
 
 
 

Organizers: Elisabeth R. Barton, Ines Bersch, Ugo Carraro, Marcus Coplin, Raffaele De Caro, Paolo Gargiulo, Elena P. Ivanova, 
Helmut Kern, Nathan K. LeBrasseur, Christiaan Leeuwenburgh, Alessandro Martini, Stefano Masiero, Marco V. Narici, Rosanna 

Piccirillo, Riccardo Rosati, Marco Sandri, Piera Smeriglio, Carla Stecco, H. Lee Sweeney, Sandra Zampieri 

WEDNESDAY March 29, 2023  
08:00 AM Complimentary Bus Transfer to Padua 

Guariento Hall, Galilean Academy of Arts and Sciences of Padua, Italy 
09:00 AM Openings Raffaele De Caro, Marco V. Narici, Ugo Carraro: Greetings and thanks to 

organizers, lecturers, speakers, attendees and sponsors 
09:20 AM Lecture of Carlo Reggiani, University of Padua, Italy: Single muscle fibers as a tool in 

aging research 
10:00 AM Session I: Adaptations to Physical Exercise in Aging: from cell to functioning 
 Marco V. Narici, Roberto Bottinelli, Chairs 
10:00 AM Russell T. Hepple, University of Florida, USA: Skeletal muscle plasticity to resistance training in pre-

frail/frail elderly women  
10:20 AM Julian Alcázar Caminero, Universidad de Castilla-La Mancha, Toledo, Spain: Improving muscle power 

through exercise in old age 
10:40 AM Simone Porcelli, University of Pavia, Italy: Home-based aerobic exercise training improves skeletal 

muscle oxidative metabolism in old people 
11:00 AM Martino Franchi, University of Padua, Italy: Differential muscle adaptations to concentric and 

eccentric resistance training in older people 
11:15 AM  Marco V. Narici, University of Padua, Italy: The neuroprotective effects of exercise in older age 
11:30.AM Valli G., et al. University of Padua, Italy: Motor unit conduction velocity is reduced after 10 days of 

unilateral limb suspension 
11.45 AM Gianni Biolo, University of Trieste, Italy: Nutrient-exercise interaction on muscle mass and function in 

aging 
12:00 AM Maria Chiara Maccarone, Barbara Ravara, Walter Giuriati, Stefano Masiero, Ugo Carraro, University 

of Padua, Italy: Combating muscle weakness in bed-ridden eldery with Home-based Full-Body in-Bed 
Gym (hbFBiBG): Basics, Implementation and Preliminary Results of the Padua Initiative 

12:15 AM Ugo Carraro, University of Padua, Italy: Blood contamination a lucky chance to analyze non-invasively 
Myokines in mouth fluids 

12:30 AM Ester Tommasini, et al., Milan, Italy: Irisin and sarcopenia: salivary irisin is induced by strenuous 
exercise and correlates with circulating irisin 

 
 

12.45 AM  Lunch in Piazza Duomo, Padua, Italy  
 

  

Italian Easy Aging and    
A&C M-C Foundation for 
Translational Myology 

 CIR-MYOLOGY 
UNIVERSITY OF PADUA, ITALY  

 
 
 

    

 
 

 
  

https://www.hotelpetrarca.it/


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WEDNESDAY March 29, 2023  
Guariento Hall, Galilean Academy of Arts and Sciences of Padua, Italy 

02:00 PM    SESSION II: Skeletal Muscle Epigenetics and the dark side of the genome 
 Piera Smeriglio, Marco Sandri, Chairs 
02:00 PM  Marco Sandri, et al., University of Padua, Italy: Discovering novel longevity genes by looking at the dark 

side of the genome 
02:20 PM Chiara Lanzuolo, National Institute of Molecular Genetics, Milan, Italy: Chromatin conformation of 

muscle stem cells in physiological and pathological muscular aging  
02:40 PM Isabella Scionti, INMG, Lyon, France: Epigenetic modifiers role in modulating muscle stem cell plasticity 
03:00 PM Piera Smeriglio, Sorbonne Université, Paris, France: Understanding epigenetics in spinal muscle atrophy: 

how the yin and yang of genomic regulation contribute to the disease 
03:20 PM Giuseppina Caretti, et al., Milan University, Italy: Epigenetic targeting of BET proteins rewire 

metabolism in the aged skeletal muscle 
03:40 PM Silvere M. van der Maarel, Leiden University Medical Center, The Netherlands: Facioscapulohumeral 

Dystrophy: Incomplete Repression of the Cleavage Stage Transcription Factor DUX4 in Skeletal Muscle 
 

04:00 PM   SESSION III: Adaptations in Aging: from molecules to functioning 
 Amber L. Pond, Rosanna Piccirillo, Chairs 
04:00 PM Amber L. Pond, Southern Illinois University School of Medicine in Carbondale, IL, USA: The HERG K+ 

channel increases intracellular calcium in myotubes by modulation of Calsequestrin 
04:20 PM Hans Hoppeler, University of Bern, Switzerland: Fascia, Facts and Fantasies 
04:40 PM Rosanna Piccirillo, et al., IRCCS - "Mario Negri", Milan, Italy: MyoRep: a novel reporter system to detect 

early muscle atrophy in vivo 
05.00 PM Paolo Grumati, Telethon Institute of Genetics and Medicine, Naples, Italy: Selective autophagy and ER 

dynamics during muscle differentiation 
05:15 PM Bert Blaauw, University of Padua, Italy: The role of Akt-mTORC1 signaling in regulating muscle mass and 

function 
05:30 PM Tania Zaglia, et al., University of Padua, Italy: Circulating muscle-derived miR-206 links skeletal muscle 

dysfunction to heart sympathetic denervation 
 
05:45 PM Stefano Schiaffino, University of Padua, Italy: Who is Terje Lømo, a 88-year-YOUNG scientist still fully 

active! 
06:00 PM Lecture of Terje Lømo, University of Oslo, Norway: Body temperature regulation by muscle 

tone 
 
 
06:40 PM Complimentary Bus Transfer to Hotel Petrarca, Thermae of Euganean Hills (Padua), Italy  
 
 

08:00 PM Dinner in Hotel Petrarca 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  



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THURSDAY March 30, 2023  
Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 

09:00 AM SESSION IV: FES managements of acquired muscle diseases,  
 Ines Bersch, Helmut Kern, Chairs 
 

09:00 AM Winfried Mayr, University of Vienna, Austria: Electrical stimulation in lower motoneuron lesions, from 
scientific evidence to clinical practice: a successful transition – The Engineer perspectives 

09:20 AM  Ines Bersch, Functional Electrical Stimulation Center, Notwill, Switzerland: Electrical stimulation in 
lower motoneuron lesions, from scientific evidence to clinical practice: a successful transition - The 
Physiotherapist experience and researcher perspective 

09:40 AM Ashraf Gorgey, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA: Home-
Based Electrical stimulation training for SCI perons with lower motor neuron injury 

10:00 AM Giovanna Albertin, University of Padua, Italy: Skin improvements by home-based FES 
10:15 AM Giovanni Pegoraro, Neuromuscular Rehabilitation Center, Fondazione Borghi, Varese, Italy: 

Neuromuscular electrical stimulation of hand in post-COVID syndrome 
10:30 AM Ugo Carraro, University of Padua, Italy: 40 years of basic and applied myology for hbDDM FES in 10 

slides 
 

10:45 AM  Break 
 
 
 

THURSDAY March 30, 2023 

Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 
 

11:00 AM  Lecture of H. Lee Sweeney, University of Florida, Gainesville, FL, USA: Improving upon 
AAV.micro-dystrophin gene therapy for DMD 

 

11:40 AM SESSION Va: Genetic muscle diseases - Elisabeth R. Barton, H. Lee Sweeney, Chairs 
 

11:40 AM Kay Ohlendieck, Maynooth University, Maynooth, Co. Kildare, Ireland: Proteomic profiling of reactive 
myofibrosis in the aged and dystrophic diaphragm 

12:00 AM Philippe Perrin, et al., Development, Adaptation and Handicap, University of Lorraine, France: Postural 
control impairments in Fabry disease 

12:30 AM Lunch 
 

THURSDAY March 30, 2023  
Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy  

02:00 AM SESSION Vb: Genetic muscle diseases - Capucine Trollet, H. Lee Sweeney, Chairs 
 

02:00 AM Elisabeth R. Barton, University of Florida, Gainesville FL, USA: Novel role of store operated Ca2+ entry in 
Limb-Girdle Muscular Dystrophy 2A  

02.20 AM Capucine Trollet, Sorbonne Université, INSERM, Myology Institute, Paris, France: Cell and molecular 
actors of fibrosis in muscle diseases 

02.40 AM Massimo Ganassi, King’s College London, London, UK: Investigating pathogenic mechanisms in FSHD 
myogenesis 

 
 
 
 
 
 
 
 
 
 
 
  



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THURSDAY March 30, 2023  
Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy  

 

03:00 PM - SESSION VI: Twenty Years of AIM 
  Daniela Tavian, Corrado Angelini, Chairs 
 

03:00 PM Gabriele Siciliano et al., University of Pisa, Italy: Phenotype variabilities of laminopathies 
03:15 PM Alberto Benetollo, et al., DSB, University of Padua, Italy: Pharmacological profile of the most promising 

CFTR corrector for sarcoglycanopathy treatment 
03:30 PM  Francesco Dalla Barba, et al., DSB, University of Padua, Italy: Zebrafish and sarcoglycanopathies: 

Characterization of models suitable for phenotype-based screening of drugs 
03:45 PM Gulia Ricci,  et al., University of Pisa, Italy: New avenues for treatment of facioscapulohumeral MD 
04:00 PM Giovanna Cenacchi, et al., Alma Mater Studiorum University of Bologna, Italy: Two plasma circulating-

miRs for the diagnosis of idiopathic inflammatory myopathies 
04:15 PM Roberta Costa, et al., Alma Mater Studiorum University of Bologna, Italy: Morpho-functional 

characterization of Transportin3 in myogenic differentiation of a cell model of LGMD D2 
04:30 PM  Giosuè Annibalini, et al., University of Urbino Carlo Bo, Urbino, Italy: N-glycosylation inhibition impairs 

C2C12 and L6 myoblast differentiation and IGF-1 signalling 
04:30 PM Ester Tommasini, Daniela Tavian, et al., Milan, Italy: Irisin and sarcopenia: salivary irisin is induced by 

strenuous exercise and correlates with circulating irisin 
04:45 PM  Massimiliano Filosto, NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, 

Italy:  Clinical and genetic characterization of Neutral lipid storage disease with myopathy (NLSDM) 
 

05:00 PM  Braek 
 

05:15 PM Fabiola Moretti et al., Catholic University of Rome, Roma, Italy: Estrogens recover muscle regeneration 
impaired by the pathogenic gene, DUX4, in orthotopic human xenograft 

05:30 PM Abbass Jaber, et al., Evry University, Inserm, Evry, France: Perturbations of cholesterol metabolism in 
the dystrophic muscle in DMD 

05:45 PM Michele Guescini, et al., University of Urbino Carlo Bo, Italy: Modulation of vesicles’ secretion by EPS in 
an in vitro muscle model 

06:00 PM Alessia Geremia, et al., University of Padua, Italy: Activation of muscle-specific Akt1 reverts cancer-
dependent muscle wasting and reduces tumor mass 

 
06:15 PM Lecture of Jonathan Jarvis, Liverpool John Moores University, UK: Transcriptomic and 

growth responses to programmed resistance training in mouse, rat and human 
 

 
07.30 PM Dinner 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

  



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FRIDAY March 31, 2023 

Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 
09.00 AM SESSION VII: Senescence & Rejuvenation 
  Nathan K. LeBrasseur, Christiaan Leeuwenburgh, Chairs 
09:00 AM Nathan K. LeBrasseur, Mayo Clinic, Rochester, MN, USA: Cellular senescence as a driver of skeletal 

muscle aging 
09:30 AM David Hood, York University, Canada: Impact of age and sex on lysosomes and mitophagy during muscle 

use and disuse 

10:00 AM Christiaan Leeuwenburgh, University of Florida, Gainesville, FL, USA: Inflammation, mitochondrial 
dysfunction senescense in skeletal muscle with aging and in peripheral artery disease 

10:30 AM Agnese De Mario, et al., University of Padua, Italy: Pharmacological modulation of MCU in skeletal 
muscle 

10:40 AM Maira Rossi, et al., University of Pavia, Italy: Nitrate supplementation promotes an anabolic response 
and attenuates neuromuscular alterations in 24-months old male mice 

10:50 AM Nicola Fiotti, et al., University of Trieste, Italy: Insulin resistance modification during bed rest: 
relationship with circulating and muscular MMP and TIMPs 

FRIDAY March 31, 2023 

ROOM B, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 
09:30 AM  Practical Course on functional analysis of the stomatognathic system 
 Claudia Dellavia, Riccardo Rosati, Chairs 
09:30-11.00: Riccardo Rosati, Milan, Italy: Instrumental evaluations of the stomatognathic apparatus: static tests 
11:15-12:30: Claudia Dellavia, Milan, Italy: Instrumental evaluations of the stomatognathic apparatus: dynamic 

tests, 
For dentists who want to review/expand the functional analysis protocols of the stomatognathic system developed 
at the Laboratory of Functional Anatomy of the Stomatognathic Apparatus (LAFAS) of the University of Milan, Italy 
 

 

FRIDAY March 31, 2023 

Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 
11:00 AM SESSION VIII: Muscle Fascia, biology and pathology - Carla Stecco, Alessandro Martini, Chairs  
 
11:00 AM Carla Stecco, University of Padua, Italy: Fascia and aging 
11:15 AM Diego Cazzador, et al., Otolaryngology Unit, Department of Neurosciences University of Padua, Italy: 

Tensor Tympani: unveiling a hidden muscle  
11:30 AM Carmelo Pirri, et al., University of Padua, Italy: Ultrasound imaging and fasciae 
11:45 AM Caterina Fede, et al., University of Padua, Italy: How sex hormones can affect the fasciae: Implication 

for pain 
12:00 AM Giovanna Albertin, et al., University of Padua, Italy: Lymphatic vessels detection in subcutis and 

superficial fascia 
12:15 AM Lucia Petrelli, et al., University of Padua, Italy: Innervation and vascularization of the superficial fascia 
12:30 AM Lorenza Bonaldi, et al., University of Padua, Italy: Biomechanical properties of the fascial system 
12.45 AM Ilaria Fantoni, et al., Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and 

Gastroenterology (DiSCOG), University of Padua, Italy: Fascia Lata alterations in hip osteoarthritis: An 
observational cross-sectional study 

13:00 PM Lunch 
 
 
 

  



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FRIDAY March 31, 2023     
Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 

 

02:00 PM Lecture of Paolo Gargiulo, University of Rejkyavik, Iceland: 3D Quantitative Muscle 
Color Computed Tomography 

02:40 PM   SESSION IX: Non-invasive Assessments in Myology - Paolo Gargiulo, Ugo Carraro, Chairs 
02:40 PM Riccardo Forni, et al., University of Rejkyavik, Iceland: Virtual cardiac histology: a densitometric 

characterisation of left ventricular tissue 
02:50 PM Debora Jacob, et al., University of Rejkyavik, Iceland: Assessing early-stage Parkinson’s Disease using a 

moving platform (BioVRSea) 
03:00 PM Valentina Betti, et al., University of Rejkyavik, Iceland: An in silico 3d approach to evaluate bone 

remodelling after total hip arthroplasty: a six years longitudinal study 
03:10 PM Federica Ciliberti, et al., University of Rejkyavik, Iceland: Novel strategies for cartilage assessment, 

interplay between bone and muscles 
03:20 PM Carlo Ricciardi, Alfonso Maria Ponsiglione, University of Federico II, Naples, Italy: Interplay between the 

age and the asymmetry of NTRA in elderly people 
03:30 PM Magnus Gislason, et al., University of Rejkyavik, Iceland: Time shift of peak activation levels in 

quadriceps and hamstrings after ACL reconstruction during single leg jump 
03:40 PM Ettore Rocchi, et al., University of Urbino Carlo Bo, Urbino, Italy: Exploring myofibrillar alignement in 

muscular tissue 
03:50 PM Break 
 

FRIDAY March 31, 2023 

Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 
04:00 PM   SESSION X:  Muscle Rehabilitation in Dentistry, Riccardo Rosati, Elena P. Ivanova, 

Chairs 
04:00 PM Elena P. Ivanova, Rehabilitation and Balneology Center, Moscow, Russia: Innovative methods of full 

dental rehabilitation 
04:15 PM  Gaia Pellegrini, University of Milan, Italy: Standardised protocols for sEMG of the masticatory muscles 

in oral rehabilitation  
04:30 PM Francesca Ferrante, et al., University of Pavia, Italy: Electromyographic analysis of masticatory muscles 

before and after rapid palatal expansion 
04:45 PM Roberto Rongo, University of Naples Federico II, Italy: Masticatory muscles pain management 
05:00 PM Mauricio Gonzalez Balut, Centro Ortodoncico Especializado, Mexico City, Mexico: Definite Orthodontic 

treatment for patients with Temporomandibular Joint problems and Craniomandibular Dysfunctions 
05:15 PM Bazar Amarsaikhan, Mongolia: Chewing hard food and its importance for general health 
05:30 PM Avtandil Bakradze, Tbilisi State Medical University, Tbilisi, Georgia: Peculiarities of the chewing muscles 

electrophysiological activity in mouth breathing individuals 
05:45 PM Mariana Dimova-Gabrovska, Department of Prosthetic Dentistry, Medical University-Sofia, Bulgaria: 

Craniomandibular dysfunctions – modern diagnostic methods 
06:00 PM Giuseppe Messina, et al., University of Palermo, Italy: Intra-articular ultrasound-guided injection with 

Hyaluronic Acid and corticosteroid in retrodiscal tissue for Temporomandibular disorders 
06:15PM Marieta Karadjova, et. al., Department of Neurology, Medical University-Sofia, Bulgaria: Improvement 

of gait, balance and coordination after application of Taopatch® device 
06:30 PM Francesco Mantia, et al., University of Palermo, Italy: Effects of Platelet-Rich-Plasma injection in 

association with therapeutic exercise in the management of medial epicondylitis 
 

06:45 PM Lecture of Feliciano Protasi University of Chieti, Italy: Mechanisms underlying exercise-
dependant remodelling of the sarcotubular system: the role of temperature and pH 

 

07:30 PM Dinner 
 

 

 

  



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SATURDAY April 1, 2023 
Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 

09:00 AM Session XI: LBI workshop on muscle rehabilitation - from mouse to elderly 
 Sandra Zampieri, Feliciano Protasi, Chairs 
09:00 AM Feliciano Protasi, University of Chieti, Italy: Mimicking disuse and rehabiliation in a mouse model 
09:30 AM Antonio Musarò, University Sapienza of Rome, Italy: Molecular biological basis and effects of immobility 

and training in young and aging 
10:00 AM Sandra Zampieri, University of Padua, Italy: C-Terminal Agrin Fragment as a biomarker of muscle 

wasting and weakness in aging and disuse 

10:30 AM Jan Cvecka, University of Bratislava, Slovakia: Missing speaker 
11:00 AM Nejc Sarabon, University of Primorska, Slovenia: Relationship between 24-hour movement behaviour 

and physical performance in older adults: A cross-sectional insight  into the Centre of active ageing data 
11:30 AM Stefan Loefler, Helmut Kern, LBI Rehabilitation Research, Vienna, Austria: AMB-REMOB – results of an 

early outpatient rehabilitation program 
12:00 AM Vincent Grote, Michael Fischer, LBI Rehabilitation Research, Vienna, Austria: Outcomes of early 

rehabilitation in elderly patients 
12.30 AM Lunch 
 
 

SATURDAY April 1, 2023 
 
12:30 AM Complimentary Transfer to Medical Hotel Ermitage (restricted to 15 Attendees) 
 

Medical Hotel Ermitage, Thermae of Euganean Hills (Padua) Italy 
12:45 PM Practical Actitvities on European Medical Thermalism – Ugo Carraro, Chair 
12:45 PM Working Lunch in Medical Hotel Ermitage 
01:15 PM Marco Maggia, Director of the Medical Hotel Ermitage: Balneotherapy, Mud and Physiotherapies for 

Prevention & Rehabilitation in the Medical Hotel Ermitage, a pioneering 15-year successful example 
02:00 pM Complimentary Transfer to Hotel Petrarca Thermae of Euganean Hills (Padua) Italy 
 
 

SATURDAY April 1, 2023 
Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 

02:40 PM Lecture of Helmut Kern, LBI Rehabilitation Research, Vienna, Austria: Underwather 
physiotherapy after knee replacement 

03:20 PM SESSION XIIa: European Medical Thermalism and the World Federation Hydrotherapy 
(FEMTEC) - Umberto Solimene, Stefano Masiero, Chairs  

03:20 PM Umberto Solimene, Center Integrative Medicine, State University Milan, Italy: Missing speaker 

03:40 PM Maria Chiara Maccarone, Ugo Carraro, Stefano Masiero, University of Padua, Italy: Balneology and 
Health Resort Medicine and rehabilitation in the Euganean Hills Thermae: building the future 

04:00 PM Daniele Coraci, et al. University of Padua, Italy: Technological transition of different rehabilitation 
approaches: challenges and answers 

 

04:20 PM Break 
 
 
 
 
 
 
 
 



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SATURDAY April 1, 2023 

Conference Hall, Hotel Petrarca, Thermae of Euganean Hills (Padua) Italy 
04:30 PM SESSION XIIb: European Medical Thermalism and the World Federation Hydrotherapy (FEMTEC) 

Stefano Masiero, Elena P. Ivanova, Chairs 
04:20 PM  Anna Mihaylova, Medical University of Plovdiv, Bulgaria: Balneotherapy - prospects for the development 

of health tourism in Bulgaria  
04:40 PM  Marcus Coplin, Balneology Association of North America, Naturopathic Healthcare, Pagosa Springs, 

Colorado, USA: A case study of balneotherapy in Fibromyalgia 
 05:00 PM  Thordur Helgason, Reykjavik University, Reykjavik, Iceland: Event-related potential analysis in healthy 

and spinal cord injured individuals: some results  
05:20 PM  Andrey Rachin, Rehabilitation and Balneology Center, Moscow, Russia: Modern methods of 

neurorehabilitation  
05:35 PM  Maxim Yu. Yakovlev, et al., Rehabilitation and Balneology Center, Moscow, Russia: Correction of 

increased meteosensitivity of obese patients when using Terrainkur, taking into account the bioclimatic 
characteristics during stay in health resorts  

05:50 PM  Kirill V. Terente,v et al., Moscow regional research clinical institute named after M.F. Vladimirsky, 
Moscow, Russia: Video analysis of patients’ gait during Terrainkur in obese people 

 06:05 PM  Irina A. Grishechkina, Rehabilitation and Balneology Center, Moscow, Russia: Outcomes of rehabilitation 
programs in patients with post-COVID-19 syndrome 

 

07:00 PM Ugo Carraro: Adijo, Adiós, Arrivederci, Auf Wiedersehen, Au revoir, Goodbye to the 
2024 Padua Days on Muscle and Mobility Medicine – Padua, Italy,February 27  – 
March2, 2024 

 
07:30 PM Dinner 
 

 

SPONSORS 

***** 
A&C M-C Foundation for Translational Myology, Padua, Italy 

***** 

CIR - MYO, DEPARTMENT OF BIOMEDICAL SCIENCES, 
DEPARTMENT OF NEUROSCIENCE  

of the UNIVERSITY OF PADUA, ITALY 
***** 

E CON IL PATROCINIO DI 

 
 

  



2023 Pdm3 - Post meeting book of abstracts 
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2023 Pdm3 - BOOK of ABSTRACTS 
 

WEDNESDAY March 29, 2023 
Aula Guariento, Galilean Academy of Arts, 

Letters and Sciences, Padua, Italy 
 

 
Session I: Adaptations to Physical Exercise in 

Aging: from cell to functioning 
 Marco V. Narici, Roberto Bottinelli, Chairs 
 

***** 

2023Pdm3 March 29 - Abstract 1 
 

LECTURE 
Single fibers as a tool in aging muscle research 
 
Carlo Reggiani 
 

Department of Biomedical Sciences, 
University of Padova, Italy; ZRS, 
Koper, Slovenia. 
Email: carlo.reggiani@unipd.it 
 
Skeletal muscle is a highly 
heterogeneous tissue, composed of a 
variety of cells and different myofiber 
types, mostly classified as slow and 
fast, the latter divided in two subgroups 

fast 2A and fast 2X. The functional properties of a muscle 
are determined not only by its myofibers with their 
contractile and metabolic features but also by all cellular 
components. With aging, progressive alterations of all 
cellular and molecular components lead to skeletal 
muscle atrophy and loss of performance. Although the 
final functional output of a muscle depends on many 
factors from neural drive to metabolic support, muscle 
fibers are the only component able to generate force and 
movement. The study of the structural, molecular and 
physiological characteristics of individual single fibers 
can provide important clues to understand which changes 
are more relevant to the age-dependent impairment of 
muscle function and, to some extent, to design possible 
countermeasures aimed to slow down the aging process  

Key Words: aging; skeletal muscle; fiber types; force 
generation; fiber size regulation. 
References 
1. Murgia M, Toniolo L, Nagaraj N, Ciciliot S, Vindigni 

V, Schiaffino S, Reggiani C, Mann M. Single Muscle 
Fiber Proteomics Reveals Fiber-Type-Specific 
Features of Human Muscle Aging. Cell Rep. 2017 
Jun 13;19(11):2396-2409. doi: 
10.1016/j.celrep.2017.05.054. PMID: 28614723 

2. Aas SN, Breit M, Karsrud S, Aase OJ, Rognlien SH, 
Cumming KT, Reggiani C, Seynnes O, Rossi AP, 
Toniolo L, Raastad T. Musculoskeletal adaptations to 
strength training in frail elderly: a matter of quantity 
or quality? J Cachexia Sarcopenia Muscle. 2020 
Jun;11(3):663-677. doi: 10.1002/jcsm.12543. Epub 
2020 Feb 24. PMID: 32091670; PMCID: 
PMC7296272 

3. Venturelli M, Saggin P, Muti E, Naro F, Cancellara 
L, Toniolo L, Tarperi C, Calabria E, Richardson RS, 
Reggiani C, Schena F. In vivo and in vitro evidence 
that intrinsic upper- and lower-limb skeletal muscle 
function is unaffected by ageing and disuse in oldest-
old humans. Acta Physiol (Oxf). 2015 Sep;215(1):58-
71. doi: 10.1111/apha.12524. Epub 2015 May 28. 
PMID: 25965867; PMCID: PMC4516639. 

3. Rejc E, Floreani M, Taboga P, Botter A, Toniolo L, 
Cancellara L, Narici M, Šimunič B, Pišot R, Biolo G, 
Passaro A, Rittweger J, Reggiani C, Lazzer S. Loss of 
maximal explosive power of lower limbs after 2 
weeks of disuse and incomplete recovery after 
retraining in older adults. J Physiol. 2018 Feb 
15;596(4):647-665. doi: 10.1113/JP274772. Epub 
2018 Jan 19. PMID: 29266264; PMCID: 
PMC5813607. 

4. Marcucci L, Reggiani C. Increase of resting muscle 
stiffness, a less considered component of age-related 
skeletal muscle impairment. Eur J Transl Myol. 2020 
Jun 17;30(2):8982. doi: 10.4081/ejtm.2019.8982. 
PMID: 32782762; PMCID: PMC7385684. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 2 
 
Skeletal muscle plasticity to resistance training in pre-
frail/frail elderly women 
 
Russell T. Hepple, University of Florida, USA 
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

 

mailto:carlo.reggiani@unipd.it


2023 Pdm3 - Post meeting book of abstracts 
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2023Pdm3 March 29 - Abstract 3 
 
Improving muscle power through exercise in old age 
 
Julian Alcázar Caminero (1,2) 
 
(1) GENUD Toledo Research Group, Universidad de 
Castilla-La Mancha, Toledo, Spain; (2) CIBER of Frailty 
and Healthy Aging, Instituto de Salud Carlos III, Madrid, 
Spain. 
E-mail: julian.alcazar@uclm.es  
 
Muscle power is defined as the rate at which mechanical 
work is performed or the product of force and velocity. 
Notably, muscle power is one of the first capabilities 
declining with age, making the loss of muscle power an 
important hallmark of aging. The loss of muscle power 
with age is also one of the main determinants of impaired 
functional ability in older people. Specifically, relative 
muscle power (i.e., normalized to body mass) has been 
found to be more strongly associated to physical 
performance in older people in comparison with absolute 
muscle power, handgrip strength and sarcopenia. This 
would be due to most of the activities of daily living 
being weight bearing tasks (e.g., walking, chair rising or 
stair climbing). Nevertheless, the lack of feasible tests 
and normative data for older people has prevented the 
widespread testing of muscle power in older people in the 
past. Recently, a feasible test to evaluate relative lower-
limb muscle power in older people has been validated: 
the sit-to-stand muscle power test (1). In addition, 
normative data, cut-off points and an operational 
algorithm to diagnose low relative muscle power in older 
people has been provided (2). Importantly, older people 
having low relative muscle power presented a higher risk 
of mobility limitations, frailty, disability, hospitalization, 
and all-cause mortality. Fortunately, power-oriented 
resistance training performed throughout a relative wide 
range of loads has been provided as an effective treatment 
to revert low muscle power in older people (3). With the 
advent of increasingly aging societies, and with main 
healthy aging goal of maintaining functional ability, the 
monitoring and treatment of low relative muscle power 
through exercise in older people should be a public health 
priority. Finally, and with this purpose, a free-cost 

smartphone app (PowerFrail App®) that integrates the 
sit-to-stand muscle power test is available. 
Key Words: Mechanical power; aging; power training; 
functional ability; sarcopenia. 
References 
1. Alcazar J, Losa-Reyna J, Rodriguez-Lopez C, Alfaro-

Acha A, Rodriguez-Mañas L, Ara I, García-García 
FJ, Alegre LM. The sit-to-stand muscle power test: 
An easy, inexpensive and portable procedure to 
assess muscle power in older people. Exp Gerontol. 
2018 Oct 2;112:38-43. doi: 
10.1016/j.exger.2018.08.006. Epub 2018 Sep 1. 
PMID: 30179662.. 

2. Alcazar J, Alegre LM, Van Roie E, Magalhães JP, 
Nielsen BR, González-Gross M, Júdice PB, Casajús 
JA, Delecluse C, Sardinha LB, Suetta C, Ara I. 
Relative sit-to-stand power: aging trajectories, 
functionally relevant cut-off points, and normative 
data in a large European cohort. J Cachexia 
Sarcopenia Muscle. 2021 Aug;12(4):921-932. doi: 
10.1002/jcsm.12737. Epub 2021 Jul 3. PMID: 
34216098; PMCID: PMC8350203. 

3. Rodriguez-Lopez C, Alcazar J, Sanchez-Martin C, 
Baltasar-Fernandez I, Ara I, Csapo R, Alegre LM. 
Neuromuscular adaptations after 12 weeks of light- 
vs. heavy-load power-oriented resistance training in 
older adults. Scand J Med Sci Sports. 2022 
Feb;32(2):324-337. doi: 10.1111/sms.14073. Epub 
2021 Oct 16. PMID: 34618979. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 4 
 
Home-based aerobic exercise training improves 
skeletal muscle oxidative metabolism in old people 
 
Simone Porcelli (1,2), Mauro Marzorati (2), Lucrezia 
Zuccarelli (3), Roberto Bottinelli (1,4), Bruno Grassi (4). 
 
(1) Department of Molecular Medicine, University of 
Pavia; (2) Institue of Biomedical Technologies, National 
Research Council; (3) Department of Medicine, 
University of Udine; (4) Interdepartmental Centre of 
Biology and Sport Medicine, IRCCS Mondino 
Foundation, Italy. 
Email: simone.porcelli@unipv.it  
 
The world population is ageing, and adults more than 65 
years old are expected to double in number to about 1.5 
billion in 2050. Although the rate of change is 
heterogeneous, the human ageing is characterized by 
inevitable and progressive reduction of physiological 
functions leading to exercise intolerance, defined as the 
incapacity to produce/maintain adequate muscle force or 
power to accomplish activities of daily living. In aged 
adults slower gait speed, lower muscle strength and 

 
Functional trajectories according to relative muscle 
power 

mailto:julian.alcazar@uclm.es
mailto:simone.porcelli@unipv.it


2023 Pdm3 - Post meeting book of abstracts 
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changes in muscle quality have been correlated to 
impaired skeletal muscle oxidative capacity. Elderly, 
compared to young, show lower O2 consumption at peak 
exercise (VO2peak) and impaired submaximal muscle 
oxidative function as well as decreases in mitochondrial 
content and reduced function in mitochondrial respiration 
and mitochondrial enzymatic activities. High-level of 
habitual physical activity and exercise training may 
slower VO2peak decline and preserve mitochondrial 
function in elderly. This presentation will focus on 
methods and tools capable to objectively identify and 
quantify, noninvasively, changes in O2 delivery and O2 
uptake within skeletal muscle in response to endurance 
training when home-based aerobic training sessions are 
prescribed to older adults and patients with metabolic 
myopathies. The importance of exercise intensity for 
individualized training prescription will be also 
highlighted together with potential pitfalls of prescribing 
exercise at home based on specific heart rate (HR) values 
as textbook and guidelines suggest. 
Key Words: Activities of daily living; metabolic 
myopathies; chronic heart failure; NIRS; high-resolution 
respirometry. 
References 
1. Harridge SD, Lazarus NR. Physical Activity, 

Aging, and Physiological Function. Physiology 
(Bethesda). 2017 Mar;32(2):152-161. doi: 
10.1152/physiol.00029.2016. 

2. Gonzalez-Freire M, Scalzo P, D'Agostino J, Moore 
ZA, Diaz-Ruiz A, Fabbri E, Zane A, Chen B, 
Becker KG, Lehrmann E, Zukley L, Chia CW, 
Tanaka T, Coen PM, Bernier M, de Cabo R, 
Ferrucci L. Skeletal muscle ex vivo mitochondrial 
respiration parallels decline in vivo oxidative 
capacity, cardiorespiratory fitness, and muscle 
strength: The Baltimore Longitudinal Study of 
Aging. Aging Cell. 2018 Apr;17(2):e12725. doi: 
10.1111/acel.12725. 

3. Cartee GD, Hepple RT, Bamman MM, Zierath JR. 
Exercise Promotes Healthy Aging of Skeletal 
Muscle. Cell Metab. 2016 Jun 14;23(6):1034-1047. 
doi: 10.1016/j.cmet.2016.05.007. PMID: 
27304505; PMCID: PMC5045036. 

4. Porcelli S, Marzorati M, Morandi L, Grassi B. 
Home-based aerobic exercise training improves 
skeletal muscle oxidative metabolism in patients 
with metabolic myopathies. J Appl Physiol (1985). 

2016 Sep 1;121(3):699-708. doi: 
10.1152/japplphysiol.00885.2015. Epub 2016 Jul 
21. PMID: 27445303. 

5. Zuccarelli L, Porcelli S, Rasica L, Marzorati M, 
Grassi B. Comparison between Slow Components 
of HR and V˙O2 Kinetics: Functional Significance. 
Med Sci Sports Exerc. 2018 Aug;50(8):1649-1657. 
doi: 10.1249/MSS.0000000000001612. PMID: 
29570539. 

Pdm3 March 29 - April 1, 2023 
***** 

2023Pdm3 March 29 Abstract 5 
 
Differential muscle adaptations to concentric and 
eccentric resistance training in older people 
 
Martino Franchi 
University of Padua, Italy  
Email: martino.franchi@unipd.it 
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 Abstract 6 
 
The neuroprotective effects of exercise in older age 
 
Marco V. Narici 
University of Padua, Italy 
Email: marco.narici@unipd.it  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 Abstract 7 
 
Nutrient-exercise interaction on muscle mass and 
function in aging 
 
Gianni Biolo 
University of Trieste, Italy:  
Email: biolo@units.it  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

 
Schematic representation about how endurance exercise 
can prevent skeletal muscle impariments by improving 
microvascular O2 delivery and mitochondrial respiratory 
function. 

mailto:martino.franchi@unipd.it
mailto:marco.narici@unipd.it
mailto:biolo@units.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 15 - 
 

 

2023Pdm3 March 29 Abstract 8 
 
Nutrient-exercise interaction on muscle mass and 
function in aging 
 
Valli G, Sarto F, Negro F, Monti E, Sirago G, Zampieri 
S, Narici M, De Vito G  
University of Padua, Italy  
Email: giacomo.valli@phd.unipd.it  
 
Motor Unit conduction velocity (MUCV) relates to 
muscle fiber diameter and is considered a size principle 
parameters.1,2 In the present study, the MUCV response 
to 10 days of unilateral limb suspension (ULLS), was 
investigated using high-density surface 
electromyography (HDsEMG). In addition, muscle 
biopsies were collected. All measures were performed at 
baseline (LS0) and after the ULLS (LS10). Ten healthy 
young male volunteers underwent, over two sessions, 
HDsEMG recording during trapezoidal isometric 
contractions at 25 and 50% of maximal voluntary 
contraction (MVC) using a 64 electrodes grid positioned 
over the vastus lateralis muscle. MUCV and action 
potential amplitude were computed at recruitment on the 
double differential derivation of MUs action potential 
waveforms along the electrode columns as previously 
described2. MUs action potential amplitude was 
calculated as the root mean square of the waveforms 
(RMS) on the same channels used for MUCV 
calculation. Muscle fibre diameter was estimated from 
serial cross-sections stained for myofibrillar ATPase. 
Correlations between MUCV and muscle fiber diameter 
were computed at LS0 and LS10 and were reported as 
coefficient of determination (R2). Preliminary results for 
a subgroup of 7 participants out of 10 showed decreased 
MUCV at LS10 from 4.40 ± 0.13 m/s to 4.07 ± 0.13 m/s 
at 25% MVC (p<0.001) and from 4.64 ± 0.13 to 4.30 ± 
0.14 m/s at 50% MVC (p<0.001). MUs RMS was not 
affected by the intervention (from 41.70 ± 7.13 to 44.70 
± 7.17 mV at 25% MVC (p=0.269) and from 59.10 ± 8.06 
to 66.50 ± 8.60 mV at 50% MVC(p=0.119)). MUCV 
showed a strong correlation with muscle fibers diameter 
at LS0 (R2=0.78 at 25% MVC and R2=0.64 at 50% 
MVC). However, this correlation was disrupted by the 
intervention (at LS10, R2=0.22 at 25% MVC and 
R2=0.30 at 50% MVC). This last finding suggests that 
other non-structural factors, such as ion channels 
dysregulation (e.g., calcium handling), could be 
responsible for the observed reduction in MUCV and 
lack of correlation between MUCV and estimated fiber 
diameter after 10 days of unilateral limb suspension. 
Key Words: motor unit; high density electromyography; 
muscle fiber conduction velocity, muscle fiber diameter. 
References 
1. Andreassen S, Arendt-Nielsen L. Muscle fibre 

conduction velocity in motor units of the human 
anterior tibial muscle: a new size principle parameter. 
J Physiol. 1987 Oct;391:561-71. doi: 

10.1113/jphysiol.1987.sp016756. PMID: 3443957; 
PMCID: PMC1192232. 

2. Casolo A, Maeo S, Balshaw TG, Lanza MB, Martin 
NRW, Nuccio S, Moro T, Paoli A, Felici F, Maffulli 
N, Eskofier B, Kinfe TM, Folland JP, Farina D, 
Vecchio AD. Non-invasive estimation of muscle fibre 
size from high-density electromyography. J Physiol. 
2023 Mar 16. doi: 10.1113/JP284170. Epub ahead of 
print. PMID: 36929484.  

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 9 
 
Combating muscle weakness in bed-ridden eldery 
with Home-based Full-Body in-Bed Gym (hbFBiBG): 
Basics, Implementation and Preliminary Results of 
the Padua Initiative 
 
Maria Chiara Maccarone (1), Barbara Ravara (2,3,4,5), 
Walter Giuriati (2), Stefano Masiero (1,3), Ugo Carraro 
(2,3,5) 
 
(1) Physical Medicine and Rehabilitation School, 
Department of Neuroscience, University of Padua, Italy, 
(2) Department of Biomedical Sciences, University of 
Padua; (3) CIR-Myo - University of Padua; (4) 
Department of Neuroscience, Section of Rehabilitation, 
University of Padua, Italy; (5) A-C M-C Foundation for 
Translational Myology, Padua, Italy. 
E-mail: mariachiara.maccarone@phd.unipd.it  
 
Mobility-impaired subjects, either very old or younger 
but suffering with systemic neuromuscular disorders or 
chronic organ failures, spend small amounts of time for 
daily physical activity, contributing to aggravate their 
poor mobility by resting muscle atrophy.1,2 Among these 
patients at risk of developing muscle atrophy and skeletal 
muscle weakness, also patients suffering from COVID-
19 syndrome or Long Covid outcomes can be included.3 
In addition to the management of psychological 
symptoms, it is mandatory to offer to these patients 
physical rehabilitation approaches easy to learn and to 
self-manage at home. Inspired by the proven capability 
to recover skeletal muscle contractility and strength by 
home-based volitional exercises and functional electrical 
stimulation, we suggest a 10-20 min-long daily routine of 
easy and safe physical exercises that can activate, and 
recover from weakness, skeletal muscles employed in 
every-day mobility activities. Most of these exercises can 
be performed in bed (Full-Body in-Bed Gym) and 
hospitalized patients can learn this light training before 
leaving the hospital, representing an extension of the 
traditional cardiovascular-respiratory rehabilitation 
training.1-5 We started collecting preliminary data from 
patients enrolled in the Full-Body in-Bed Gym program 

mailto:giacomo.valli@phd.unipd.it
mailto:mariachiara.maccarone@phd.unipd.it


2023 Pdm3 - Post meeting book of abstracts 
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at the Rehabilitation Section of the University of Padua, 
Italy. Blood pressure readings demonstrated a transient 
decrease in peripheral resistance due to the increased 
blood flow in the main activated muscles. Patients’ good 
compliance to the treatment and satisfaction were also 
collected. Preliminary data suggest that Full-Body in-
Bed Gym, performed regularly and continued over time, 
may help maintaining independence of frail subjects, 
including patients suffering from COVID-19 pandemic 
outcomes. We hope that our preliminary experience in 
the future will be extended with further results from an 
international clinical trial. Interested colleagues are 
invited to join our project. 
Key Words: skeletal muscle weakness; home-based Full-
Body in-Bed Gym; older olds; mobility impaired persons 
References 
1. Gava P, Kern H, Carraro U. Age-associated power 

decline from running, jumping, and throwing male 
masters world records. Exp Aging Res. 
2015;41(2):115-35. doi: 10.1080/0361073X.2015. 
1001648. 

2. Carraro U, Gava K, Musumeci A, Baba A, Piccione 
F, Marcante A. Safe Antiaging Full-Body In-Bed 
Gym and FES for Lazy Persons: Home In-Bed 
Exercises for Fighting Muscle Weakness in 
Advanced Age. In: Rehabilitation Medicine for 
Elderly Patients, Masiero S, Carraro U, Eds., pag. 
43-52. ISBN 978-3-319-57405-9 ISBN 978-3-319-
57406-6 (eBook). doi 10.1007/978-3-319-57406-6. 

3. Carraro U, Marcante A, Ravara B, Albertin G, 
Maccarone MC et al. Skeletal muscle weakness in 
older adults home-restricted due to COVID-19 
pandemic: a role for full-body in-bed gym and 
functional electrical stimulation. Aging Clin Exp 
Res. 2021;33(7):2053-2059. doi:10.1007/s40520-
021-01885-0 

4. Carraro U, Gava K, Baba A, Marcante A, Piccione 
F. To Contrast and Reverse Skeletal Muscle Atrophy 
by Full-Body In-Bed Gym, a Mandatory Lifestyle 
for Older Olds and Borderline Mobility-Impaired 
Persons. Adv Exp Med Biol. 2018;1088:549-560. 
doi: 10.1007/978-981-13-1435-3_25. 

5. Berger D, Bloechlinger S, von Haehling S, Doehner 
W, Takala J, Z'Graggen WJ, Schefold JC. 
Dysfunction of respiratory muscles in critically ill 
patients on the intensive care unit. J Cachexia 
Sarcopenia Muscle. 2016. Sep;7(4):403-12. doi: 
10.1002/jcsm.12108. Epub 2016. Mar 9. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 
 
 
 

 
 

Fig 1. The routine will sequentially contract all 
major skeletal muscles, alternating exercises 
mobilizing arms, legs, spine, neck, 
diaphragm and other ventilation muscles. 

 
 

Fig 2. The routine will sequentially activate major 
skeletal muscles, alternating exercises 
mobilizing arms, legs, spine, neck, 
diaphragm and other ventilation muscles.  



2023 Pdm3 - Post meeting book of abstracts 
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2023Pdm3 March 29 - Abstract 10 
 
Blood contamination, a lucky chance to analyze non-
invasively Myokines in mouth fluids 
 
Ugo Carraro (1,2,3) 
 
(1) Department of Biomedical Sciences, University of 
Padua; (2) CIR-Myo - University of Padua; (3) A-C M-
C Foundation for Translational Myology, Padua, Italy. 
Email: ugo.carraro@unipd.it  
 
Use of saliva in clinical studies are increasing to identify 
methods less invasive than blood sampling in search for 
systemic changes of biomarkers related to physical 
activity, aging, late aging and rehabilitation. The 
consensus is that the diagnostic value of whole saliva is 
compromised by the presence of blood, but we are 
looking at the contamination as a major opportunity for 

non-invasive analyses of serological biomarkers. The 
aim of this preliminary study was to evaluate the 
presence of serum in mouth fluids of healthy seniors and 
the eventual changes after a modest trauma, i.e., tooth 
brushing. Seven heathy persons, aged more than 65 
years, drooling saliva in a test tube provided the fluids for 
the analyses. After low speed centrifugation, small 
aliquots of supernatants were frozen in liquid nitrogen 
and stored at -80° until use. Aliquots were thawed and 
used for quantification by the Lowry method of total 
proteins and by colorimetric ELISA of serum albumin, 
fibrinogen and lysozyme. Hemoglobin content was 
quantified by Spectrophotometry. Adjustment of saliva 
dilution, after a preliminary test, increased the 
homogeneity of the analytes' content determined by 
colorimetric ELISA. The control reference to judge the 
quantity of serum in saliva was a pool of sera from age-
matched healthy persons. Saliva collected from the seven 
healthy elderly person before and after tooth-and-gum, 
brushing presented measurable amount of the analytes, 
including fibrinogen, a minor component of the pooled 
sera. Tooth brushing did not induced statistically 
significant difference in analytes' contents, suggesting 
that a measurable blood contamination is a frequent event 
in elderly persons. In conclusion, fibrinogen analysis in 
saliva is a promising approach to quantify serological 
biomarkers by a non-invasive procedure that will 
increase acceptability and frequency of analyses during 
follow-up in aging and rehabilitation 
Key Words: saliva; blood contamination; fibrinogen; 
non-invasive analyses of plasm proteins. 
References 
1. Ravara B, Zampieri S, Kern H, Carraro U. Blood 

contamination, a problem or a lucky chance to 
analyze non-invasively Myokines in mouth fluids? 
Eur J Transl Myol. 2019 Dec 10;29(4):8713. doi: 
10.4081/ejtm.2019.8713. PMID: 31908751; PMCID: 
PMC6926435. 

2. Kang JH, Kho HS. Blood contamination in salivary 
diagnostics: current methods and their limitations. 
Clin Chem Lab Med. 2019 Jul 26;57(8):1115-1124. 
doi: 10.1515/cclm-2018-0739. PMID: 30511922  

3. Parkin GM, Kim S, Mikhail A, Malhas R, McMillan 
L, Hollearn M, Granger DA, Mapstone M, Yassa 
MA, Thomas EA. Associations between saliva and 
plasma cytokines in cognitively normal, older adults. 
Aging Clin Exp Res. 2023 Jan;35(1):117-126. doi: 
10.1007/s40520-022-02292-9. Epub 2022 Nov 1. 
PMID: 36319939 

4. Forcina L, Miano C, Scicchitano BM, Musarò A. 
Signals from the Niche: Insights into the Role of IGF-
1 and IL-6 in Modulating Skeletal Muscle Fibrosis. 
Cells. 2019 Mar 11;8(3):232. doi: 
10.3390/cells8030232. PMID: 30862132; PMCID: 
PMC6468756.  

 
Pdm3 March 29 - April 1, 2023 

***** 

 
Fibrinogen contamination of saliva in aged persons 

mailto:ugo.carraro@unipd.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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2023Pdm3 March 29 Abstract 11 
 
Salivary irisin is induced by strenuous exercise 
stimulus and correlates with circulating irisin 
 
Ester Tommasini (1,2)*, Sara Missaglia (1,3), Paola 
Vago (1,3), Claudio Pecci (4), Christel Galvani (2), 
Andrea Silvestrini (5), Alvaro Mordente (5), Daniela 
Tavian (1,3) 
 
(1) Department of Psychology, Università Cattolica del 
Sacro Cuore, Milan, Italy; (2) Exercise & Sport Science 
Laboratory, Università Cattolica del Sacro Cuore, Milan, 
Italy; (3) Laboratory of Cellular Biochemistry and 
Molecular Biology, CRIBENS, Università Cattolica del 
Sacro Cuore, Milan, Italy; (4) Human Performance 
Laboratory, MAPEI Sport Research Centre, Olgiate 
Olona (VA), Italy; (5) Department of Basic 
Biotechnological Sciences, Intensivological and 
Perioperative Clinics, Università Cattolica del Sacro 
Cuore, Rome, Italy. 
*E-mail: ester.tommasini@unicatt.it  
 
Physical activity can increase the circulating level of 
irisin, fostering several beneficial effects on health.1,2 
This exercise-induced myokine is generally analyzed in 
blood, but its collection is invasive and exposes to 
potential risks. Substitution of saliva sample for blood 
would represent a less invasive method for irisin 
detection. However, a limited number of studies 
evaluated the amount of irisin in saliva samples.3,4 Our 
purpose was to verify whether saliva could represent an 
alternative sample in which detecting irisin changes 
induced by an exogenous stimulus. Five active healthy 
adults (age: 29±14yrs; mean body mass index: 
22,9±3,7kg/m2; mean peak oxygen uptake 
54,0±16,5ml/kg/min) performed an incremental exercise 
until exhaustion on a cycle ergometer and their blood and 

saliva samples were collected before the exercise, 15min, 
24h, 48h post-exhaustion. Irisin levels were determined 
using ELISA Assay Kit (#EK-067-29). Incremental 
exercise has determined consistent changes in irisin 
levels. Indeed, serum and salivary irisin levels increased 
from baseline to 24h post-exercise, and then returned to 
basal level after 48h of rest. A significant difference of 
serum irisin levels at 15min (p≤0,01) and 24h (p≤0,001) 
compared to baseline was found. Moreover, a significant 
correlation (r=0,92, P<0,05) was found between irisin 
percentage change in serum and saliva from baseline to 
24h post-exercise.5 The findings, while preliminary, 
indicate that collecting saliva samples represents a valid 
and sensitive method of detecting irisin level changes in 
response to exercise.  
Key Words: irisin; saliva sample; serum sample; physical 
exercise. 
References: 
1. Liu S, Cui F, Ning K, Wang Z, Fu P, Wang D, Xu H. 

Role of irisin in physiology and pathology. Front 
Endocrinol. 2022; 13:962968. doi: 
10.3389/fendo.2022.962968.   

2. Bao JF, She QY, Hu PP, Jia N, Li A. Irisin, a 
fascinating field in our times. Trends Endocrinol 
Metab. 2022; 33(9):601-613. doi: 
10.1016/j.tem.2022.06.003.  

3. Aydin S, Aydin S, Kobat MA, Kalayci M, Eren MN, 
Yilmaz M, Kuloglu T, Gul E, Secen O, Alatas OD, 
Baydas A. Decreased saliva/serum irisin 
concentrations in the acute myocardial infarction 
promising for being a new candidate biomarker for 
diagnosis of this pathology. Peptides. 2014; 56:141-
145.doi: 10.1016/j.peptides.2014.04.002.  

4. Khan SU, Ghafoor  S, Khaliq S, Syed AR. Salivary 
Irisin and periodontal clinical parameters in patients 
of chronic periodontitis and healthy individuals: A 
novel salivary myokine for periodontal disease. J Pak 
Med Assoc. 2022; 72(1):27-33.doi: 
10.47391/JPMA.01367. 

5. Missaglia S, Tommasini E, Vago P, Pecci C, Galvani 
C, Silvestrini A, Mordente A, Tavian D. Salivary and 
serum irisin in healthy adults before and after 
exercise. European Journal of Translational 
Myology. 2023. https://doi.org/10.4081/ejtm. 
2023.11093 

 
Pdm3 March 29 - April 1, 2023 

***** 

 

 

 

 

 

 
 

Correlation between irisin percentage change in 
saliva and serum from baseline to 24 h postexercise 
in 5 subjects. Reproduced with permissions from Reference5.  

mailto:ester.tommasini@unicatt.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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WEDNESDAY March 29, 2023  
Guariento Hall, Galilean Academy of Arts and 

Sciences of Padua, Italy 
 
SESSION II: Skeletal Muscle Epigenetics and 
the dark side of the genome 
 

Piera Smeriglio, Marco Sandri, Chairs 
 

***** 

2023Pdm3 March 29 - Abstract 12 
 
Discovering novel longevity genes by looking at the 
dark side of the genome 
 
Marco Sandri et al.,  
University of Padua, Italy 
 
On-site presentation of unpublished results. The 
authors denied Zoom recording, circulation and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 13 
 
Chromatin conformation of muscle stem cells in 
physiological and pathological muscular aging 
 
Philina Santarelli (1) , Emanuele di Patrizio Soldateschi 
(2), Federica Lucini (3), Margherita Mutarelli (4), 
Valentina Rosti (2), Cristiano Petrini (3), Elisa Salviato 
(3), Francesco Ferrari (3), Chiara Lanzuolo (1,2) 
 
(1) Istituto Nazionale Genetica Molecolare (INGM), 
Milan; (2) CNR Institute of Biomedical Technologies 
(ITB), Milan; (3) IFOM, the FIRC Institute of Molecular 
Oncology, Milan; (4) CNR Institute of Applied Sciences 
and Intelligent System, Pozzuoli (ISASI); (5) CNR 
Istituto di Genetica Molecolare 
E-mail: chiara.lanzuolo@cnr.it  
 
The correct 3D organization of the genome is known to 
influence the spatiotemporal expression of lineage-
specific genes during stem cell differentiation and aging 
processes. We introduce a novel evolution of the 
SAMMY-seq technique to precisely map genomic 
regions separated by their biochemical properties. This 
single-handedly technique enables the identification of 
heterochromatic and euchromatic domains and their 
compartmentalization in the nuclear space. Crucial 
practical advantages of this method include: its 
applicability on as little as 10K cells; reduced costs; few 

manipulation steps and short execution time. In postnatal 
Muscle Stem Cells (MuSCs) we observed a reproducible 
distribution of euchromatic and heterochromatic 
genomic domains, in line with known epigenetic 
signatures. Our findings highlight how MuSCs over life 
exhibit a global steady chromatin organization, 
accompanied by solubility changes that favour processes 
such as MuSCs activation but may become obstacles 
during aging for proper pool maintenance. Still, we 
describe environmental alterations of the muscle niche, 
emphasizing a supportive population of MuSCs, namely 
FAPs, which exhibit dramatic transcriptional alterations 
during aging. Our extensive characterization of the 
environment and chromatin organization in MuSCs 
expands our understanding of quiescence, activation and 
aging processes, laying the groundwork for the study of 
the role of the epigenome in pathological conditions. 

Key Words: Muscle stem cells; epigenetics; chromatin 
compartments; muscle aging. 
References 
1. Rosti V., Gorini F., Santarelli P., Sarnicola M. L., 

Magnani S.  and Lanzuolo C “Polycomb bodies 
detection in murine fibromuscular stroma from skin, 
skeletal muscles and aortic tissues” Methods Mol 
Biol. In press. 

2. Sebestyén E, Marullo F, Lucini F, Petrini C, Bianchi 
A, Valsoni S, Olivieri I, Antonelli L, Gregoretti F, 
Oliva G, Ferrari F, Lanzuolo C. SAMMY-seq reveals 
early alteration of heterochromatin and deregulation 
of bivalent genes in Hutchinson-Gilford Progeria 
Syndrome. Nat Commun. 2020 Dec 8;11(1):6274. 

 
Experimental Design: Mice of different ages were 
subjected to MRI/MRS and µCT (1). Limb muscles 
were excised and enzymatically digested to obtain a 
cell suspension (2). The cell suspension was then 
stained and FACS-sorted to obtain two cell 
populations, MuSCs and FAPs (3). These 
populations were further divided to perform ChlP-
seq (4). The tibialis anterior was embedded in OCT 
and flas-frozen for immunofluorescence analysis 
(5). This schematic representation was creted with 
BioRender.com 

mailto:chiara.lanzuolo@cnr.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 20 - 
 

 

doi: 10.1038/s41467-020-20048-9. PMID: 
33293552; PMCID: PMC7722762. 

3. Bianchi A, Mozzetta C, Pegoli G, Lucini F, Valsoni 
S, Rosti V, Petrini C, Cortesi A, Gregoretti F, 
Antonelli L, Oliva G, De Bardi M, Rizzi R, Bodega 
B, Pasini D, Ferrari F, Bearzi C, Lanzuolo C. 
Dysfunctional polycomb transcriptional repression 
contributes to lamin A/C-dependent muscular 
dystrophy. J Clin Invest. 2020 May 1;130(5):2408-
2421. doi: 10.1172/JCI128161. PMID: 31999646; 
PMCID: PMC7190994. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 
2023Pdm3 March 29 - Abstract 14 
 
Epigenetic modifiers role in modulating muscle stem 
cell plasticity 
 
Isabella Scionti 
Neuro Myo Gene Institute – Pathophysiology and 
Genetics of Neuron and Muscle (INMG-PGNM), Lyon, 
France 
Email: isabella.scionti@inserm.fr  
 
On-site presentation of unpublished results. The 
authors denied Zoom recording, circulation and post-
meeting dissemination by YOUTUBE  
 
Pdm3 March 29 - April 1, 2023 

***** 

 
2023Pdm3 March 29 - Abstract 15 

Understanding epigenetics in spinal muscle atrophy: 
how the yin and yang of genomic regulation 
contribute to the disease 
 
Piera Smeriglio 
Sorbonne Université, Paris, France 
Email: p.smeriglio@institut-myologie.org  

On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 29 - Abstract 16 
 
Epigenetic targeting of BET proteins rewire 
metabolism in the aged skeletal muscle 
 
Lorenzo Nevi (1), Cinzia Bottino (1), Ummu Guven (1), 
Giulio Pavesi (1), Marc Beltrà (2), Fabio Penna (2), 
Giuseppina Caretti (1) 
 
(1) Department of Biosciences, University of Milan, 
Milan, Italy; (2) Department of Clinical and Biological 
Sciences, University of Torino, Italy 
Email: giuseppina.caretti@unimi.it  
 
Aging is associated with a progressive decline of muscle 
mass and strength that is observed among healthy adults, 
with an acceleration in the rate of decline past middle age. 
The pathological loss of muscle mass associated with 
aging, known as sarcopenia, negatively affects the 
quality of life and leads to increased occurrence of falls, 
hospitalization, and to decreased independence. Previous 
reports from our group showed that the epigenetic factor 
bromodomain and extra-terminal domain (BET) protein 
BRD4 plays a role in promoting muscle wasting in 
experimental models of cancer cachexia and muscular 
dystrophy. Here, we evaluated the impact of 
pharmacological blockade of BET proteins in the skeletal 
muscle of 24-month-old mice. Mice were treated with the 
BET inhibitor JQ1+ (20mg/kg) or the inactive 
enantiomer JQ1- daily, for 24 days. During treatment, 
mice were weighed, and muscle performance was 
evaluated through the treadmill and grip tests. After 
sacrifice, different muscles and several tissues were 
isolated and collected for morphological and molecular 
analysis, including RNA-seq, Western Blot, and IHC. 
Our data show that JQ1 treatment induced weight loss in 
old mice and BET blockade also displayed a beneficial 
effect on muscle performance, and it was associated with 
a marked reduction in fibrosis. Following JQ1 treatment, 
RNA-seq assays highlighted an enrichment in the level 
of key transcripts involved in fatty acid oxidation in 
skeletal muscle. Metabolomic and immunoblot analysis 
revealed a reduced reliance on glycolysis and an increase 
in fatty acid oxidation. In conclusion, our data suggest 
that JQ1+ treatment ameliorates mitochondrial fatty acid 
metabolism in old mice, improves muscle function and it 
may be beneficial in the treatment of sarcopenia. 
Key Words: BET proteins; sarcopenia; lipid metabolism. 
References 
1. von Haehling S, Morley JE, Anker SD. An overview 

of sarcopenia: facts and numbers on prevalence and 

 

mailto:isabella.scionti@inserm.fr
mailto:p.smeriglio@institut-myologie.org
mailto:giuseppina.caretti@unimi.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 21 - 
 

 

clinical impact. J Cachexia Sarcopenia Muscle. 2010 
Dec;1(2):129-133. doi: 10.1007/s13539-010-0014-2. 
Epub 2010 Dec 17. PMID: 21475695; PMCID: 
PMC3060646. 

2. Segatto M, Fittipaldi R, Pin F, Sartori R, Dae Ko K, 
Zare H, Fenizia C, Zanchettin G, Pierobon ES, 
Hatakeyama S, Sperti C, Merigliano S, Sandri M, 
Filippakopoulos P, Costelli P, Sartorelli V, Caretti G. 
Epigenetic targeting of bromodomain protein BRD4 
counteracts cancer cachexia and prolongs survival. 
Nat Commun. 2017 Nov 22;8(1):1707. doi: 
10.1038/s41467-017-01645-7. PMID: 29167426; 
PMCID: PMC5700099. 

3. Segatto M, Szokoll R, Fittipaldi R, Bottino C, Nevi 
L, Mamchaoui K, Filippakopoulos P, Caretti G. BETs 
inhibition attenuates oxidative stress and preserves 
muscle integrity in Duchenne muscular dystrophy. 
Nat Commun. 2020 Nov 30;11(1):6108. doi: 
10.1038/s41467-020-19839-x. PMID: 33257646; 
PMCID: PMC7705749. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 17 
 
Facioscapulohumeral Dystrophy: Incomplete 
Repression of the Cleavage Stage Transcription 
Factor DUX4 in Skeletal Muscle 
 
Silvère van der Maarel 
 
Department of Human Genetics, Leiden University 
Medical Center, Leiden, Netherlands 
E-mail: maarel@lumc.nl  
 
Facioscapulohumeral dystrophy (FSHD) is characterized 
by progressive weakness and wasting of the facial, 
shoulder girdle and upper arm muscles. FSHD is caused 
by incomplete repression of the cleavage stage 
transcription factor DUX4 in skeletal muscle. A copy of 
this DUX4 gene is located in each unit of the D4Z4 
macrosatellite repeat in the subtelomere of chromosome 
4q, which adopts a repressive chromatin structure 
preventing DUX4 expression in somatic cells. In the 
population, the polymorphic D4Z4 repeat varies between 
8-100 units and most often, DUX4 expression in skeletal 
muscle of FSHD patients is caused by D4Z4 chromatin 
relaxation as a consequence of a contraction of the repeat 
to a size of 1-10 units (FSHD1). However, with the 
advances in genome technologies, new genetic causes for 
FSHD have been uncovered over the past decade. In 
addition to genomic rearrangements to D4Z4 other than 
repeat contractions such as translocations and 
duplications, also mutations in chromatin factors that are 
necessary to establish or maintain a repressive D4Z4 
chromatin structure (SMCHD1, DNMT3B and LRIF1) 
have been recognized to cause FSHD (FSHD2). 

However, rather than a dichotomy between both disease 
forms, FSHD1 and FSHD2 should rather be considered a 
continuum in which the reduced D4Z4 repeat size and a 
partial failure in establishing and maintaining a 
repressive D4Z4 chromatin structure proportionally 
contribute to the derepression of DUX4 in skeletal 
muscle. 
Key Words: Facioscapulohumeal dystrophy (FSHD); 
D4Z4; epigenetics; chromatin; DUX4. 
References 
1. Tihaya MS, Mul K, Balog J, de Greef JC, Tapscott 

SJ, Tawil R, Statland JM, van der Maarel SM. 
Facioscapulohumeral muscular dystrophy: the road to 
targeted therapies. Nat Rev Neurol. 2023 Jan 10. doi: 
10.1038/s41582-022-00762-2. Epub ahead of print. 
PMID: 36627512. 

 
Pdm3 March 29 - April 1, 2023 

***** 

WEDNESDAY March 29, 2023  
Guariento Hall, Galilean Academy of Arts and 

Sciences of Padua, Italy 
 
SESSION III: Adaptations in Aging: from 
molecules to functioning 

 
Amber L. Pond, Rosanna Piccirillo, Chairs 

 

2023Pdm3 March 29 - Abstract 18 
 
The HERG K+ Channel increases Intracellular 
Calcium in myotubes by modulation of Calsequestrin 
 
Amber Pond (1), Shalini Guha (1), Emily LaVigne (2), 
Natalie McClure (1), Jennifer Koran (3), Gregory H. 
Hockerman (2). 
 
(1) Anatomy Department, Southern Illinois University 
School of Medicine, USA; (2) Medicinal Chemistry and 
Molecular Pharmacology, Purdue University, IN, USA; 
(3) School of Education, Southern Illinois University-
Carbondale, USA. 
E-mail: apond@siumed.edu  
 
The ERG1A K+ channel upregulates protein degradation 
in skeletal muscle atrophying in response to disuse1 and 
is found upregulated in muscle atrophying in response to 
cancer1 and denervation2.  We have shown that over-
expression of the HERG channel increases basal 
intracellular calcium concentration ([Ca2+]i) and calpain 
activity in C2C12 myotubes3; however, it is not known 
how HERG modulates [Ca2+]i.  Indeed, we find that L-
type calcium current is not changed by HERG 
expression. Thus, to explore this mechanism, we 

mailto:maarel@lumc.nl
mailto:apond@siumed.edu


2023 Pdm3 - Post meeting book of abstracts 
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increased [Ca2+]i by depolarization with 100 mM KCl 
and used Fura2 dyes and immunoblot to reveal that 
HERG does not alter myotube calcium levels by affecting 
L-type calcium channels.  Instead, using the SERCA 
blocking agent thapsigargin with our Fura2 assay, we 
discovered that the HERG-mediated increase in calcium 
occurs through modulation of intracellular calcium 
stores4. Therefore, we hypothesized that HERG may be 
modulating[Ca2+]i by modulation of ryanodine receptor  
(RyR1) activity. To investigate this, we transduced 
myotubes in a 96-well plate with either a control or 
HERG-encoded adenovirus and after 48 hours loaded 
these with QBT Fura (Molecular Devices; San Jose, CA).  
At 1 hour post-loading, we treated the myotubes with 
either ryanodine (90 uM to block RyR1 receptors) or 
vehicle for 30 minutes.  We then treated the cells with 
caffeine (5 mM) to activate ryanodine receptors and 
evaluated the [Ca2+]i over time by fluorescence (340 and 
380 excitement; 508 nm emission).  The 340/380 ratios 
were determined and normalized to baseline.  The ratios 
were plotted over time, the area under the curve (AUC) 
was calculated, and these were analyzed by ANOVA 
with means separated by Tukey’s test.  Interestingly, in 
response to caffeine, the significant increase in [Ca2+]i 
was similar in control (73.3%, p<0.005) and HERG-
expressing (71.7%, p<.001) myotubes.  However, when 
the cells were treated with ryanodine to block RyR1, the 
[Ca2+]i increase was lower in the HERG-expressing 
(46.4%, p<0.02) relative to control (24.9%, p<0.8) 
myotubes.  The data suggest that the increase in [Ca2+]i 
in the HERG-expressing cells is, at  least in part, a result 
of RyR1 activation.  Because calsequestrin 1 (CaSeq1) is 
an integral part of RyR1 modulation of [Ca2+]i and was 
reported mildly downregulated in HERG-expressing 
myotubes by Next Generation Sequencing,5 we 
performed an immunoblot on control and HERG-
expressing myotubes (n=8, 4 replicates each HERG and 
control), in which we detected a full length CaSeq ~63 
kD protein along with ~50 kD and ~40 kD CaSeq 

proteins which appear to be CaSeq1 degradation 
products.  Each protein was decreased in the HERG-
expressing myotubes relative to control cells: ~63 kD 
decreased 47.2%, p<0.001; ~50 kD decreased 44.9%, 
p<0.01; and ~40 kD decreased 49.8%, p<0.01 (Student’s 
t-test).  CaSeq1 is known to function as a calcium buffer 
in skeletal muscle sarcoplasmic reticulum (SR), storing 
calcium when the concentration is high.  Thus, we 
suggest that HERG expression produces a decrease in 
CaSeq protein, which removes this calcium binding 
protein and increases free calcium in intracellular 
calcium stores (Figure).  Dysregulation of normal 
calcium buffering is known to contribute to pathologies 
in both skeletal muscle and heart. This is an exciting 
finding which merits further exploration. 
 
Key Words: HERG, calcium signaling, ryanodine 
receptors, calsequestrin, myotubes 
 
References 
1. Pond AL, Whitmore C, Thimmapuram J, Hockerman 

GH.  The ERG1A potassium channel induces 
expression of genes related to skeletal muscle atrophy 
in C2C12 myotubes. FASEBJ 2021;35(S1):1. 
https://doi.org/ 10.1096/fasebj.2021.35.S1.04316. 

2. Wang X, Hockerman GH, Green HW 3rd, Babbs CF, 
Mohammad SI, Gerrard D, Latour MA, London B, 
Hannon KM, Pond AL. Merg1a K+ channel induces 
skeletal muscle atrophy by activating the ubiquitin 
proteasome pathway. FASEB J. 2006 Jul;20(9):1531-
3. doi: 10.1096/fj.05-5350fje. Epub 2006 May 24. 
PMID: 16723379. 

3. Anderson LB, Ravara B, Hameed S, Latour CD, 
Latour SM, Graham VM, Hashmi MN, Cobb B, 
Dethrow N, Urazaev AK, Davie JK, Albertin G, 
Carraro U, Zampieri S, Pond AL. MERG1A Protein 
Abundance Increases in the Atrophied Skeletal 
Muscle of Denervated Mice, But Does Not Affect 
NFκB Activity. J Neuropathol Exp Neurol. 2021 Sep 
10;80(8):776-788. doi: 10.1093/jnen/nlab062. PMID: 
34363662. 

4. Whitmore C, Pratt EPS, Anderson L, Bradley K, 
Latour SM, Hashmi MN, Urazaev AK, Weilbaecher 
R, Davie JK, Wang WH, Hockerman GH, Pond AL. 
The ERG1a potassium channel increases basal 
intracellular calcium concentration and calpain 
activity in skeletal muscle cells. Skelet Muscle. 2020 
Jan 16;10(1):1. doi: 10.1186/s13395-019-0220-3. 
PMID: 31948476; PMCID: PMC6966811. 

5. Pond AL, Pratt E, Whitmore C, Rantz E, Salyer A, 
Carraro U, Zampieri S, Cheatwood J, Hockerman 
GH.  2018. Investigation of the mechanism by which 
the ERG1a K+ channel increases intracellular 
calcium. Presented at 2018 Spring Padua Muscle 
Days, March 15-17; University of Padua, Italy. 

5. Pond AL, Whitmore C, Thimmapuram J, Hockerman 
GH.  The ERG1A potassium channel induces 
expression of genes related to skeletal muscle atrophy 

 
HERG may increase intracellular Ca2+ 
concentration by decreasing abundance of the 
calcium binding/buffering protein CalSequestrin 1 



2023 Pdm3 - Post meeting book of abstracts 
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in C2C12 myotubes. FASEBJ 2021;35(S1):1.  
https://doi.org/10.1096/fasebj.2021.35.S1.04316. 
Presented Virtually at the 2021 Experimental Biology 
Conference on April 27, 2021. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 
2023Pdm3 March 29 - Abstract 19 
 
Fascia; facts and fantasies 
 
Hans Hoppeler 
Department of Anatomy, University of Bern, Switzerland 
E-mail: hans.hoppeler@unibe.ch  
 
Classical anatomy of academic medicine describes bones 
(osteology), joints (arthrology) and muscle (myology).  
There is no specific category which describes “fascia” as 
an independent anatomical entity. Likewise, academic 
medicine does not recognize fascia as a pathogenetic 
entity other than when considered as connective tissue 
under the broad heading of rheumatic diseases. This is 
different in osteopathic medicine. The founder of 

osteopathic medicine, Still, A.T. (1828-1917) viewed the 
human organism very much as a mechanical contraption 
that needed to be balanced to function properly. As a MD, 
trained by his father, he abhorred the drug medications of 
his time, which he (rightfully) considered dangerous. 
Instead, he corrected the mechanical causes for 
disordered bodily functions by adjusting the bony 
framework. For Still, the power to cure depended on the 
knowledge of the right or normal position and the skill to 
adjust bones, muscles and ligaments accordingly. As 
broadly speaking connective tissue (ligaments, fascia, 
tendons, connective interstitial tissue) is responsible for 
the connectivity and the positioning of the body elements 
in 3D space, it follows that these elements have become 
a major focus in osteopathic medicine today. Academic 
medicine sees connective tissue as composed of collagen, 
elastin and matrix with mechanical properties depending 
on the quantity and arrangement of these elements 
harbouring various sensory elements and important parts 
of the immune system and response. However, academic 
medicine does not see somatic dysfunctions in general 
related to myofascial function or dysfunction. 
Osteopathic medicine has a different perspective and sees 
fascia as a key mediator in somatic disease and pain 
conditions. Over the last 20 years a sizeable osteopathic 
literature has developed on these issues. This merits a 
closer look at fascia function and malleability in view of 
their potentially overlooked relevance for pathological 
processes in human disease. 
 
Key Words: Osteopatic medicine; fascia; connective 
tissue; mechanical signaling. 
References 
1. Still AT. Osteopathy, Research and Practice. 1910, 

Past Masters Press, 2020, ISBN 978-1-396-31698-2. 
2. Liem T, Tozzi P, Chila A.  Fascia in the Osteopathic 

Field. 2017, Handspring, ISBN 9781909141278. 
 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 20 
 
MyoRep: a novel reporter system to detect early 
muscle atrophy in vivo 
 
Andrea Re Cecconi, Nicoletta Rizzi, Mara Barone, Mara 
Forti, Michela Chiappa, Adriana Maggi, Paolo Ciana, 
Lorena Zentilin, Rosanna Piccirillo 
IRCCS - "Mario Negri", Milan, Italy 
Email:  rosanna.piccirillo@marionegri.it 
 
On-site presentation of unpublished results. The 
authors denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

       

 
 

      
 

 

 
 

Fibrocyte (top) and collagen, elastin and 
hyalorunides responsible for mechanical properties 
of fascia (below). 

https://doi.org/10.1096/fasebj.2021.35.S1.04316
mailto:hans.hoppeler@unibe.ch
mailto:rosanna.piccirillo@marionegri.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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2023Pdm3 March 29 - Abstract 21 
 
Selective autophagy and ER dynamics during muscle 
differentiation 
 
Paolo Grumati,  
Telethon Institute of Genetics and Medicine, Naples, 
Italy – Email: p.grumati@tigem.it  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 22 
 
The role of Akt-mTORC1 signaling in regulating 
muscle mass and function 
 
Bert Blaauw,  
Department of Biomedical Sciences, University of 
Padua, Italy. - Email: bert.blaauw@unipd.it  
 
On-site presentation of unpublished results. The author 
denied Zoom circulation, recording and post-meeting 
dissemination by YOUTUBE 

***** 

Pdm3 March 29 - April 1, 2023 
2023Pdm3 March 29 - Abstract 23 
 
Circulating muscle-derived miR-206 links skeletal 
muscle dysfunction to heart sympathetic denervation 
 
Marco Ronfini (1,2),* Di Mauro V. (3),* Prando V. 
(1,2),* Franco-Romero A. (1,2), Antonio Mazzaro (4), 
Favaro G. (2), Lo Verso F. (2), Dokshokova L. (1,2), 
Armani A. (1,2), Gianni Sorarù (5), Guescini M. (6), 
Catalucci D. (3), Marco Mongillo (1,2), Marco Sandri 
(1,2),§ Tania Zaglia (1,2)§ - *, §, equal contributions 
 
(1) Department of Biomedical Sciences, University of 
Padova, Italy; (2), Veneto Institute of Molecular 
Medicine (VIMM), Padova, Italy; (3) Humanitas 
Research Hospital, Rozzano, Milan, Italy; (4) 
Department of Cardiac, Thoracic, Vascular Sciences and 
Public Health, Padova, Italy; (5), Department of 
Neuroscience, Azienda Ospedaliera di Padova, Padua, 
Italy; (6) Department of Molecular Sciences, University 
of Urbino Carlo Bo, Urbino, Italy. 
E-mail: tania.zaglia@unipd.it  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 – Abstract 24 
 
Sympathetic neuropathology is revealed in muscles 
affected by Amyotrophic Lateral Sclerosis 
Antonio Mazzaro (1,2), Veronica Vita (1,2), Marco 
Ronfini (2,3), Irene Casola (4), Arianna Klein (2),   
Gabriella Dobrowolny (4), Gianni Sorarù (5), Antonio 
Musarò (4,6), Marco Mongillo (2,3,7),* Tania Zaglia 
(2,3)* - *, §, equal contributions 
 
(1) Department of Cardiac, Thoracic, Vascular Sciences 
and Public Health, University of Padua, Padua, Italy; (2) 
Veneto Institute of Molecular Medicine, Padua, Italy; (3) 
Department of Biomedical Sciences, University of 
Padua, Padua, Italy; (4), Laboratory Affiliated to Institute 
Pasteur Italia-Fondazione Cenci Bolognetti, DAHFMO-
Unit of Histology and Medical Embryology, Sapienza 
University of Rome, Rome, Italy; (5) Department of 
Neuroscience, Azienda Ospedaliera di Padova, Padua, 
Italy; (6) Scuola Superiore di Studi Avanzati Sapienza 
(SSAS), Sapienza University of Rome, Italy; (7) CNR 
Institute of Neuroscience, Padua, Italy. 
E-mail: tania.zaglia@unipd.it  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 25 
 

LECTURE 
Body temperature regulation by muscle tone 
 
Terje Lømo (1), Arild Njå 
 
Institute of Basic Medical Sciences, University of Oslo, 
Norway. 
E-mail: terje.lomo@medisin.uio.no 
 
Experiments were done on adult, male, Wistar rats 
chronically implanted with (i) EMG electrodes for 
recording motor unit activity, (ii) thermistors for 
recording core body and muscle temperatures, and (iii) a 
tube in the jugular vein for infusion of drugs. Each rat 
was placed in a climate chamber and video recorded at 
temperatures ranging from +4 to +34°C. Four springs 
supported the floor under which a force transducer 
recorded all movements such that each movement and the 
rest/sleep period that followed, could be monitored 
consecutively for the duration of the experiment. 

mailto:p.grumati@tigem.it
mailto:tania.zaglia@unipd.it
mailto:tania.zaglia@unipd.it
mailto:terje.lomo@medisin.uio.no


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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Previous work had shown (i) that during rest/sleep, tonic 
motor unit activity in several deep muscles increases 
linearly when the ambient temperature falls from 32°C to 
less than 7°C and (ii) that overt shivering first occurs 
when the temperature reaches about 7°C (Lømo et al., 
2020). Here we show, first, that in adductor longus, a red 
muscle that lies close to the large femoral vein, the 
amount of tonic activity increases progressively when it 
gets colder, confirming our view that such heat-
producing activity in deep muscles warms up the blood 
in nearby veins before it enters the body’s cavities. 
Second, we show that iliopsoas, a large muscle that we 
term internal because it lies inside the abdominal and 
pelvic cavities, may generate substantial amounts of tonic 
motor unit activity during rest/sleep. But, unlike all deep 
external muscles that we record from, this tonic activity 
is independent of the ambient temperature. Furthermore, 
simultaneous EMG recordings from iliopsoas and 
different deep external muscles revealed occasional brief 
peaks of tonic activity in iliopsoas that coincided with 
similarly brief periods of no activity (atonia) in the 
external muscles. The duration and spacing of these 
peaks/troughs suggested some relationship to REM 
sleep, which accompanies such muscle atonia. Third, and 
again unexpectedly, we observed massive tonic motor 
unit activity in iliopsoas when the rat recovered from 
general anaesthesia, using ZRF i.v. (14.7 mg zolazepam, 
14.7 mg tiletamine, 1.77 mg xylazine and 10 μg fentanyl 
per ml 0.9% NaCl). Following ZRF, all motor unit 
activity stopped, and the body temperature fell rapidly. 
During recovery, tonic activity started first in iliopsoas, 
then in deep external muscles, and, at about the same 
time, the body temperature began to rise. Only much later 
did the rat begin to wake up and start moving. This 
suggested that iliopsoas may generate heat-producing 
tonic activity in an emergency that threatens the body’s 
core temperature without participating in the daily 
moment to moment temperature control. The results bear 
on the relative roles of brown adipose tissue (BAT) and 
tonic motor unit activity in controlling the body 
temperature and will be discussed. The relevant literature 
is confusing. Muscle tone and burst activity (overt 
shivering) are both described as forms of shivering, the 
continuous form often presented as pre-shivering tone or 
as a pre-stage to overt shivering. In general, these forms 
are not explicitly distinguished and are often treated as 
different expressions of the same underlying 
phenomenon. Although they both produce heat to protect 
the body against hypothermia, they should not be 
conflated because they arise from entirely different 
mechanism and cover strikingly different ambient 
temperature ranges (Lømo et al., 2020). 
References 
1. Lømo T, Njå A. Body temperature control in rats by 

muscle tone during rest or sleep. Acta Physiol. 2020; 
228(2) e13348. 

 https://doi-org.ezproxy.uio.no/10.1111/apha.13348  
Pdm3 March 29 - April 1, 2023 

THURSDAY March 30, 2023  
Conference Hall, Hotel Petrarca, Thermae of 

Euganean Hills (Padua) Italy 
 
09:00 AM SESSION IV: FES managements of 
acquired muscle diseases 
 

Ines Bersch, Helmut Kern, Chairs 
 

 
2023Pdm3 March 30 - Abstract 26 
 
Electrical stimulation in lower motoneuron lesions, 
from scientific evidence to clinical practice – a 
successful transition, a Physioterapy experience and 
research perspective  
 
Ines Bersch (1), Winfried Mayr (2) 
 
(1) International FES Centre®, Swiss Paraplegic Centre, 
Nottwil, Switzerland; (2) Medical University of Vienna, 
Center for Medical Physics and Biomedical Engineering, 
Vienna, Austria; 
E-mail: ines.bersch@paraplegie.ch 
 
Long pulse stimulation and its beneficial effect on lower 
motor neuron (LMN) damage have long been 
underestimated in daily rehabilitation practice in 
Switzerland/worldwide. The underlying reason may be 
the lack of knowledge about the neurophysiological 
changes of muscle after LMN in the acute phase after 
injury, the incorrect selection of stimulation parameters, 
namely pulse width, frequencies and amplitudes, the lack 
of perseverance in the application in the chronic phase 
after injury or the unavailability of appropriate 
stimulators. In addition, the aetiology of the damage to 
the LMN may vary. The lesion might directly occur in 
the anterior horn, as it is the case in spinal cord injury 
(SCI), or it might result from peripheral nerve injuries, 
which can affect upper or lower extremities as a result of 
cuts, fractures or disc herniations. Due to the large 
heterogeneity of the aetiologies and the small population 
in the individual groups, the aim of the present 
observational study was to extract the number of patients, 
the type of LMN and form of stimulation from data 
collected in 2022 and consequently to substantiate these 
with the scientific evidence of the expected stimulation 

 
From left: Giovanna Albertin, Marie Alberty, 
Ugo Carraro, Ashraf S. Gorgey, Winfried Mayr, 
Helmut Kern, Giovanni Pegoraro  

 
 

Ines Bersch 

https://doi-org.ezproxy.uio.no/10.1111/apha.13348
mailto:ines.bersch@paraplegie.ch


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 26 - 
 

 

effect. Data collection included a pool of 128 patients 
seen in the year 2022. Only those who consulted the 
outpatient service for the first time seeking to conduct 
long pulse stimulation in the domestic setting were 
included for data analysis. The individuals were grouped 
in stimulation of the upper or lower extremities as well as 
in damage affecting the anterior horn or the peripheral 
nerve. 100 new patient cases were evaluated in 2022. 
38% showed an upper motor neuron lesion, 49% a LMN 
lesion and 13% a combined lesion (Fig.1). In 57% the 
lower limbs and in 43% the upper limbs were affected, 
respectively (Fig. 2). The heterogeneity of the various 
types of LMN is reflected in Figure 3. Six patients that 
conducted long pulse stimulation at home are presented 
as cases with the physiological background and the 
illustration of their functional improvement. FES of 
denervated muscles is an early treatment option in 
temporary and potentially chronic peripheral 
denervation. The best effects are accomplished as long as 
the muscle is intact or just slightly atrophied and not yet 
undergoes degenerative developments.1-4 In cases with 

perspective of recovery of nerve supply, the method is 
capable of preserving the reinnervation target in near-
normal state. If denervation is permanent, FES of 
denervated muscle is the only option to maintain muscle 
tissue and metabolic functioning in the anatomical 
region.5,6 This is important for prevention, e.g. pressure 
injuries, various degenerative developments, and 
eventual future novel therapy options. Long-term 
degeneration results in definitely irreversible conditions; 
nevertheless there is evidence, that even then tissue 
morphology and metabolic processes can be positively 
affected.6 The spectrum of available stimulators is still 
limited. There are several handy stimulators on the 
market, that allow shorter “long-duration” stimuli – 
shorter means duration per phase of 15 to 20ms in 
biphasic pulses, which is a precondition to accomplish 
fused contractions via pulse trains with frequencies of 20 
Hz or more, in principle. This is essential for building of 
muscle volume, force and endurance training, and 
functional use. A limitation of most available stimulators 
is in low deliverable maximum amplitude and minimum 
of inter-pulse pauses being longer than the pulse itself. 
Currently, the “Stimulette RISE”, offered by the 
Viennese family enterprise Schuhfried, is the only 
certified medical product capable of delivering stimuli 
with the necessary reduced inter-pulse pauses, down to 
10ms, which are required for eliciting fused contractions, 
and an intensity reserve sufficient for activating larger 
muscles. What remains critical, is handling and 
placement of electrodes. As excessive local current 
density can result in skin injury, care must be taken to 
assure full surface skin contact with evenly distributed 
contact pressure and so, well distributed current density. 
Longstanding denervation and in particular large muscles 
require the use of conductive polymer electrodes in wet 
foam pockets or with gel as contact medium. Biphasic 
rectangular pulses are first choice and most effective in 
eliciting muscle contractions. For cases, where intact 
sensory nerves or motor nerves are unintentionally co-
activated, ramp-shaped pulse forms can shift activation 
thresholds of neurons higher than those of muscle fibers, 
based on accommodation effects in the nerve fiber 
membrane with a higher excitability. In case of partly 
denervation of a muscle, which is seen in practice rather 
often, accommodating pulses can be useful for recruiting 
the denervated fiber population with some selectivity. 
This is useful for estimating the degree of denervation in 
single muscles as well as for focused conditioning of the 
denervated fiber population. 
 
Key words: long pulse stimulation, denervation, lower 
motoneuron damage 
 
References 
1. Alberty M, Mayr W, Bersch I. Electrical Stimulation 

for Preventing Skin Injuries in Denervated Gluteal 
Muscles-Promising Perspectives from a Case Series 
and Narrative Review. Diagnostics (Basel). 2023 Jan 

 
Fig 1: Distribution of upper and lower 

motoneuron lesions.

Fig 2: Distribution in stimulation between upper 
and  lower limbs 

   

 
Fig 3: Etiological heterogeneity of LMN lesions 



2023 Pdm3 - Post meeting book of abstracts 
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- 27 - 
 

 

6;13(2):219. doi: 10.3390/diagnostics13020219. 
PMID: 36673029; PMCID: PMC9857944. 

2. Bersch I, Fridén J. Electrical stimulation alters muscle 
morphological properties in denervated upper limb 
muscles. EBioMedicine. 2021 Dec;74:103737. doi: 
10.1016/j.ebiom.2021.103737. Epub 2021 Dec 9. 
PMID: 34896792; PMCID: PMC8671101. 

3. Bersch I, Fridén J. Upper and lower motor neuron 
lesions in tetraplegia: implications for surgical nerve 
transfer to restore hand function. J Appl Physiol 
(1985). 2020 Nov 1;129(5):1214-1219. doi: 
10.1152/japplphysiol.00529.2020. Epub 2020 Sep 
24. PMID: 32969783. 

4. Chandrasekaran S, Davis J, Bersch I, Goldberg G, 
Gorgey AS. Electrical stimulation and denervated 
muscles after spinal cord injury. Neural Regen Res. 
2020 Aug;15(8):1397-1407. doi: 10.4103/1673-
5374.274326. PMID: 31997798; PMCID: 
PMC7059583. 

5. Kern H, Salmons S, Mayr W, Rossini K, Carraro U. 
Recovery of long-term denervated human muscles 
induced by electrical stimulation. Muscle Nerve. 
2005 Jan;31(1):98-101. doi: 10.1002/mus.20149. 
PMID: 15389722. 

6. Kern H, Carraro U. Home-Based Functional 
Electrical Stimulation of Human Permanent 
Denervated Muscles: A Narrative Review on 
Diagnostics, Managements, Results and Byproducts 
Revisited 2020. Diagnostics (Basel). 2020 Jul 
29;10(8):529. doi: 10.3390/diagnostics10080529. 
PMID: 32751308; PMCID: PMC7460102. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 27 
 
Home-Based Electrical Stimulation Training for SCI 
Persons with Lower Motor Neuron Injury 
 
Ashraf S. Gorgey (1, 2), Ahmad M. Azaam (1) Refka E. 
Khalil (1) 
 
(1) Spinal Cord Injury and Disorders, Hunter Holmes 
McGuire VA Medical Center, Richmond, VA, USA; (2) 
Virginia Commonwealth University, Department of 
Physical Medicine & Rehabilitation, Richmond, VA, 
USA. - E-mail: ashraf.gorgey@va.gov  
 
Spinal cord injury (SCI) results in skeletal muscle 
atrophy and dramatic changes in body composition. 
Lower motor neuron (LMN) injury results in denervation 
of the lower extremity muscles which exacerbates muscle 
atrophy.1,2 Our recent unpublished work demonstrated 
that compared to innervated group with SCI (Figure), 
LMN resulted in remarkably lower cross-sectional area 
of the whole thigh and knee extensor muscles. This is 

accompanied with increased intramuscular fat and 
decreased leg lean mass.  
Furthermore, knee bone mineral density of the distal 
femur and proximal tibia is severely impacted following 
LMN. In the RISE project, long pulse width stimulation 
(LPWS) has shown promising outcomes in stimulation of 
the denervated muscles.1,2 However, applications of 
LPWS are clearly limited in North America. We have 
previously shown that using testosterone treatment in 
conjunction with surface neuromuscular resistance 
training augmented muscle hypertrophy and enhanced 
metabolic profile after SCI.3,4 We, hereby, present our 
preliminary evidence about conducting home-based and 
lab-based trial of combining TT + either short or LPWS 
stimulation in SCI persons with LMN. The overall goal 
is to increase skeletal muscle size, leg lean mass and to 
improve metabolic health in this sub-population with SCI 
https://clinicaltrials.gov/ct2/show/NCT03345576. The-
12 month trial demonstrated the safety and feasibility of 
using LPWS with TT in restoring muscle size after 
chronic LMN. Furthermore, home-based approach is 
likely to provide an opportunity for long-term 
commitment and adherence for this population; 
especially during the era of COVID-19 pandemic. 

Key Words: Denervation; muscle cross sectional area; 
intramuscular fat; long pulse width stimulation; 
testosterone; spinal cord injury. 
References 
1. Gorgey AS, Khalil RE, Alrubaye M, Gill R, Rivers J, 

Goetz LL, Cifu DX, Castillo T, Caruso D, Lavis TD, 

 

mailto:ashraf.gorgey@va.gov
https://clinicaltrials.gov/ct2/show/NCT03345576


2023 Pdm3 - Post meeting book of abstracts 
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Lesnefsky EJ, Cardozo CC, Adler RA. Testosterone 
and long pulse width stimulation (TLPS) for 
denervated muscles after spinal cord injury: a study 
protocol of randomised clinical trial. BMJ Open. 
2022 Oct 5;12(10):e064748. doi: 10.1136/bmjopen-
2022-064748.  

2. Chandrasekaran S, Davis J, Bersch I, Goldberg G, 
Gorgey AS. Electrical stimulation and denervated 
muscles after spinal cord injury. Neural Regen Res. 
2020 Aug;15(8):1397-1407. doi: 10.4103/1673-
5374.274326. PMID: 31997798. 

3. Gorgey AS, Khalil RE, Gill R, Gater DR, Lavis TD, 
Cardozo CP, Adler RA. Low-Dose Testosterone and 
Evoked Resistance Exercise after Spinal Cord Injury 
on Cardio-Metabolic Risk Factors: An Open-Label 
Randomized Clinical Trial. J Neurotrauma. 2019 Sep 
15;36(18):2631-2645. doi: 10.1089/neu.2018.6136. 

4. Gorgey AS, Graham ZA, Chen Q, Rivers J, Adler 
RA, Lesnefsky EJ, Cardozo CP. Sixteen weeks of 
testosterone with or without evoked resistance 
training on protein expression, fiber hypertrophy and 
mitochondrial health after spinal cord injury. J Appl 
Physiol (1985). 2020 Jun 1;128(6):1487-1496. doi: 
10.1152/japplphysiol.00865.2019. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 28 
 
Skin improvements by home-based Functional 
Electrical Stimulation (hbFES) 
 
Giovanna Albertin (1,2), Andrea Porzionato (1,2), 
Helmut Kern (3,4), Ugo Carraro (2,5,6) 
 
(1) Department of Neuroscience (DNS), Section of 
Human Anatomy, University of Padova, Italy; (2) 
Interdepartmental Research Center of Myology, (CIR-
Myo), University of Padova, Italy; (3), Ludwig 
Boltzmann Institute of Electrical Stimulation and 
Physical Rehabilitation, Vienna, Austria; (4) Ludwig 
Boltzmann Institute of Rehabilitation Research, St 
Pölten, Austria (5) Department of Biomedical Sciences 
(DSB), University of Padova, Italy; (6) A&C M-C 
Foundation for Translational Myology, Padova, Italy. 
Email: giovanna.albertin@unipd.it  
 
The epidermis represents the first line of defense of our 
body against the outside world. The skin is a complex 
sensory organ that protects the internal body from 
chemical, physical, and biological insults despite its 
apparently simple structure. Dermatological 
complications may develop after spinal cord injury (SCI) 
due to higher vulnerability to hypoxia, injury and 
infection (1). Despite the clinical relevance of 
dermatological complications, information on the 
histological changes that occur in skin of SCI persons is 

scarce, mainly because skin biopsies are usualy not 
performed except for major dermatological problems, 
such as  pressure sore complications(2). Through the EU 
Program RISE (3,4), SCI patients suffering with 
complete conus and cauda equina syndrome (Conus-
Cauda Syndrome), and thus with permanent denervation 
and degeneration of muscles (DDM), , were subjected to 
home-based functional electrical stimulation (h-bFES) of 
atrophic quadriceps muscles. It was observed impressive 

positive changes in the stimulated thigh muscles over a 
period of two years with use of very large electrodes in 
contact with the skin and a new electrical stimulator 
designed in Vienna. Because tissue biopsies harvested for 
muscle's analysis included the skin, we had extended 
quantitative histologic analyses of 52 skin biopsies of 
both legs of 13 SCI patients. We stressed that the tissue 
biopsies were collected only from SCI patients who did 
not present with any local or general dermatological 
complications. The aim of this study was to verify the 
influence of h-bFES on skin. We have proven that 2 years 
of h-bFES reversed the process of skin atrophy and the 
flattening that occurs between 1 and 8 years post-SCI, 
that were the different period from spinal cord injury of 
the subjects that we have analyzed. We provided 
evidence that h-bFES produced an increased epidermal 
thickness and dermal-epidermal complexity (5), both of 
which are important mechanisms of skin resistance to 
physical, chemical and biological insult. The skin 
epidermis has shown an increase of thickness from 46.3 
μm ± 9.6 μm before electrical stimulation to 64.3 μm ± 
12.9 μm after 2 years of daily electrical stimulation. 

 
 
H-E staining in skin specimens: skin sample from a SCI patient 
injured 5 years before (a) and after two years of h-bFES . 

mailto:giovanna.albertin@unipd.it


2023 Pdm3 - Post meeting book of abstracts 
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Times different from the spinal damage allowed us to 
highlight that it was possible to act on the process of skin 
atrophy even though several years had passed since the 
spinal damage. Our results provided the evidence to 
justify further testing of electrical stimulation as an 
important contributory mechanism to prevent or manage 
skin disorders, in particular incoming pressure sores in 
SCI, metabolic diseases and late aging. 
Key words: Epidermis thickness; electrostimulation; 
hbFES; spinal cord injury. 
References 
1. Marbourg JM, Bratasz A, Mo X, Popovich PG. Spinal 

Cord Injury Suppresses Cutaneous Inflammation: 
Implications for Peripheral Wound Healing. J 
Neurotrauma. 2017 Mar 15;34(6):1149-1155. doi: 
10.1089/neu.2016.4611. Epub 2016 Oct 17. PMID: 
27650169; PMCID: PMC5359642.  

2. Hitzig SL, Eng JJ, Miller WC, Sakakibara BM; 
SCIRE Research Team. An evidence-based review of 
aging of the body systems following spinal cord 
injury. Spinal Cord. 2011 Jun;49(6):684-701. doi: 
10.1038/sc.2010.178. Epub 2010 Dec 14. PMID: 
21151191; PMCID: PMC3181216.  

3. Kern H, Carraro U, Adami N, Biral D, Hofer C, 
Forstner C, Mödlin M, Vogelauer M, Pond A, 
Boncompagni S, Paolini C, Mayr W, Protasi F, 
Zampieri S. Home-based functional electrical 
stimulation rescues permanently denervated muscles 
in paraplegic patients with complete lower motor 
neuron lesion. Neurorehabil Neural Repair. 2010 
Oct;24(8):709-21. doi: 10.1177/1545968310366129. 
Epub 2010 May 11. PMID: 20460493. 

4. Carraro U, Kern H, Gava P, Hofer C, Loefler S, 
Gargiulo P, Mosole S, Zampieri S, Gobbo V, Ravara 
B, Piccione F, Marcante A, Baba A, Schils S, Pond 
A, Gava F. Biology of Muscle Atrophy and of its 
Recovery by FES in Aging and Mobility 
Impairments: Roots and By-Products. Eur J Transl 
Myol. 2015 Aug 25;25(4):221-30. doi: 
10.4081/ejtm.2015.5272. PMID: 26913160; PMCID: 
PMC4748978. 

5. Kern H, Hofer C, Loefler S, Zampieri S, Gargiulo P, 
Baba A, Marcante A, Piccione F, Pond A, Carraro U. 
Atrophy, ultra-structural disorders, severe atrophy 
and degeneration of denervated human muscle in SCI 
and Aging. Implications for their recovery by 
Functional Electrical Stimulation, updated 2017. 
Neurol Res. 2017 Jul;39(7):660-666. doi: 
10.1080/01616412.2017.1314906. Epub 2017 Apr 
13. PMID: 28403681. 

6. Ravara B, Hofer C, Kern H, Guidolin D, Porzionato 
A, De Caro R, Albertin G. Dermal papillae flattening 
of thigh skin in Conus Cauda Syndrome. Eur J Transl 
Myol. 2018 Dec 13;28(4):7914. doi: 
10.4081/ejtm.2018.7914. PMID: 30662702; PMCID: 
PMC6317141. 

7. Kern H, Carraro U. Home-Based Functional 
Electrical Stimulation of Human Permanent 

Denervated Muscles: A Narrative Review on 
Diagnostics, Managements, Results and Byproducts 
Revisited 2020. Diagnostics (Basel). 2020 Jul 
29;10(8):529. doi: 10.3390/diagnostics10080529. 
PMID: 32751308 Free PMC article. Review. 

 
Pdm3 March 29 - April 1, 2023 
 
2023Pdm3 March 30 - Abstract 29 
 
40 years of basic and applied myology for hbDDM 
FES in 20 slides 
 
Ugo Carraro (1,2,3) 
 
(1) Department of Biomedical Sciences of the University 
of Padua; (2) CIR-Myo - University of Padua; (3) A-C 
M-C Foundation for Translational Myology, Padua, 
Italy. E-mail: ugo.carraro@unipd.it  
 
I will begin by describing my research activities in 1979 
and the serendipitous events of my dedication to 
denervation-reinnervation of muscles and their electrical 
stimulation in animal models,1-4 and years later in 
patients.5-11 After many years of basic research, I found 
myself conducting human studies to apply our findings to 
human mobility disorders, including those of aging. My 
contributions have been light and ultrastructural 
microscopy and molecular approaches, in particular on 
isomyosins and other muscle-type markers, but above all 
I have had the good fortune to attract brilliant young 
collaborators,7 and to propose them to apply to skeletal 
muscle approaches that had proven to be effective in 
clinical cardiology.9 Along the way, a few scientists and 
clinicians (particularly physical medicine and 
rehabilitation specialists) with similar interests 
approached me.5-11 Some collaborations yielded exciting 
results,4-11 most frustrations. However, this is the normal 
ratio in translational studies from basic science to 
medicine: many exciting preliminary results end in 
failure, especially the most original and promising ones. 
Fortunately, after so many years in which we were the 
only research team to publish good results in the field of 
electrical stimulation of chronically denervated muscles, 
independent groups are following our lead, obtaining 
promising results.12,13 I have to admit that most of my 
projects have ended in disappointments, but I still think 
it's more than enough to have dreams and the great luck 
to test them with rigorous scientific approaches, sharing 
emotions and frustrations with brilliant young 
collaborators. 
Key words: Permanent muscle denervation; electrical 
stimulation; hbFES for DDM; countermeasures for aging 
and preliminary aging. 
References 
1. Carraro U. Translational mobility medicine: 

Dreams, hopes, frustrations. CLEUP, Padua, Italy. 
ISBN 978 88 5495 609 4. 

mailto:ugo.carraro@unipd.it


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2. Carraro U, Catani C, Biral D. Selective 
maintenance of neurotrophically regulated proteins 
in denervated rat diaphragm. Exp Neurol. 1979 
Mar;63(3):468-75. doi: 10.1016/0014-
4886(79)90165-1. PMID: 155010. 

3. Carraro U, Morale D, Mussini I, Lucke S, Cantini 
M, Betto R, Catani C, Dalla Libera L, Danieli Betto 
D, Noventa D. Chronic denervation of rat 
hemidiaphragm: maintenance of fiber heterogeneity 
with associated increasing uniformity of myosin 
isoforms. J Cell Biol. 1985 Jan;100(1):161-74. doi: 
10.1083/jcb.100.1.161. PMID: 3965469 Free PMC 
article. 

4. Carraro U, Catani C, Belluco S, Cantini M, 
Marchioro L. Slow-like electrostimulation switches 
on slow myosin in denervated fast muscle. Exp 
Neurol. 1986 Dec;94(3):537-53. doi: 
10.1016/0014-4886(86)90236-0. PMID: 3780906. 

5. Kern H, Boncompagni S, Rossini K, Mayr W, Fanò 
G, Zanin ME, Podhorska-Okolow M, Protasi F, 
Carraro U. Long-term denervation in humans 
causes degeneration of both contractile and 
excitation-contraction coupling apparatus, which is 
reversible by functional electrical stimulation 
(FES): a role for myofiber regeneration? J 
Neuropathol Exp Neurol. 2004 Sep;63(9):919-31. 
doi: 10.1093/jnen/63.9.919. PMID: 15453091.  

6. Boncompagni S. Severe muscle atrophy due to 
spinal cord injury can be reversed in complete 
absence of peripheral nerves. Eur J Transl Myol 
2012;22:161–200. 10.4081/bam.2012.4.161 – DOI 

7. Squecco R, Carraro U, Kern H, Pond A, Adami N, 
Biral D, Vindigni V, Boncompagni S, Pietrangelo 
T, Bosco G, Fanò G, Marini M, Abruzzo PM, 
Germinario E, Danieli-Betto D, Protasi F, Francini 
F, Zampieri S. A subpopulation of rat muscle fibers 
maintains an assessable excitation-contraction 
coupling mechanism after long-standing 
denervation despite lost contractility. J Neuropathol 
Exp Neurol. 2009 Dec;68(12):1256-68. doi: 
10.1097/NEN.0b013e3181c18416. PMID: 
19915489. 

8. Kern H, Carraro U, Adami N, Biral D, Hofer C, 
Forstner C, Mödlin M, Vogelauer M, Pond A, 
Boncompagni S, Paolini C, Mayr W, Protasi F, 
Zampieri S. Home-based functional electrical 
stimulation rescues permanently denervated 
muscles in paraplegic patients with complete lower 
motor neuron lesion. Neurorehabil Neural Repair. 
2010 Oct;24(8):709-21. doi: 
10.1177/1545968310366129. Epub 2010 May 11. 
PMID: 20460493. 

9. Gargiulo P, Reynisson PJ, Helgason B, Kern H, 
Mayr W, Ingvarsson P, Helgason T, Carraro U. 
Muscle, tendons, and bone: structural changes 
during denervation and FES treatment. Neurol Res. 
2011 Sep;33(7):750-8. doi: 10.1179/ 
1743132811Y.0000000007. PMID: 21756556. 

    

 

 

 
Forty years of research on translational myology 
for denervated degenerating muscle by hbFES: 
From rats (top black/white panels, 19792 and 
19853) to patients (bottom color panels 202011).  
Reproduced with permission.1 

 

 



2023 Pdm3 - Post meeting book of abstracts 
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10. Kern H, Carraro U. Home-Based Functional 
Electrical Stimulation of Human Permanent 
Denervated Muscles: A Narrative Review on 
Diagnostics, Managements, Results and 
Byproducts Revisited 2020. Diagnostics (Basel). 
2020 Jul 29;10(8):529. doi: 
10.3390/diagnostics10080529. PMID: 32751308 
Free PMC article. Review. 

11. Albertin G, Ravara B, Kern H, Zampieri S, Loefler 
S, Hofer C, Guidolin D, Messina F, De Caro R, 
Alaibac M, Carraro U. Trauma of Peripheral 
Innervation Impairs Content of Epidermal 
Langerhans Cells. Diagnostics (Basel). 2022 Feb 
23;12(3):567. doi: 10.3390/diagnostics12030567. 
PMID: 35328120 Free PMC article. 

12. Bersch I, Fridén J. Electrical stimulation alters 
muscle morphological properties in denervated 
upper limb muscles. EBioMedicine. 2021 
Dec;74:103737. doi: 10.1016/j.ebiom.2021. 
103737. Epub 2021 Dec 9. 

13. Gorgey AS, Khalil RE, Alrubaye M, Gill R, Rivers 
J, Goetz LL, Cifu DX, Castillo T, Caruso D, Lavis 
TD, Lesnefsky EJ, Cardozo CC, Adler RA. 
Testosterone and long pulse width stimulation 
(TLPS) for denervated muscles after spinal cord 
injury: a study protocol of randomised clinical trial. 
BMJ Open. 2022 Oct 5;12(10):e064748. doi: 
10.1136/bmjopen-2022-064748. PMID: 36198461 
Free PMC article. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 – Abstract 30 
 
Neuromuscular electrical stimulation of hand in post-
COVID syndrome 
 
Giovanni Pegoraro (1), Alessandro Ambrosi (2) 
Neuromuscular Rehabilitation Center, Fondazione 
Borghi, Varese, Italy 
E-mail: pegogio@hotmail.com  
 
The global pandemic of coronavirus disease 2019 
(COVID-19) has revealed a surprising number of extra-
pulmonary manifestations of the SARS-CoV-2 infection. 
There have been emerging reports related to COVID-19 
infection and disease course including myositis, 
neuropathy, arthropathy, and soft tissue abnormalities in 
lower and upper limb too. NMES can be used to induce 
a muscle contraction when it is difficult or impossible for 
the person to achieve this voluntarily thereby allowing 
effective exercise and the strengthening of muscles 
observed that usual programs for amyotrophy couldn’t 
provide any muscular contraction. So we propose 
specific neuro muscular electrostimulation (NMES) 
parameters at low frequency to increase upper limb 

muscles strength. We studied 10 patients who developed 
diffuse and symmetrical muscle weakness after a long 
stay in the intensive care unit (ICU). We applied 30 
minutes a day for two months three different frequency 
electrostimulation to: 
1. Arm extensor muscles because they provide help to 

the control of the trunk in sitting and standing position  
2.  Intrinsic muscles because of their severe ipotrophy. 
We applied the following parameters of frequency: 
1. Amyotrophy frequency 30-40 hz, 250 µs 
2. Study frequency 1-2 hz, 250 µs 
3. Triangular stimulation 0,2 hz, 250 µs 
Muscle contractions have been detected by visualization 
and a biofeedback EMG device. In the arm extensor at 
the beginning only low Frequency and high intensive 
stimulation could provide muscle contraction. After two 
months of high intensive stimulation, and physiotherapy, 
muscle normal excitability seemed to be restored. About 
hand intrinsic muscle, triangle impulse resulted the best 
parameters. We treated very severe weak muscle in 
patient after long covid. In conclusion, to reanimate 
muscular function of arm extensor muscles, hypotrophy 
muscle stimulation tetanic parameters have not provide 
any muscular activity. Only low frequency (1-2 hz) high 
intensity stimulation (80-120 mAmp) could achieve 
muscular contraction. 
 
Key Words: Skeletal muscle weakness; COVID-19 
pandemic syndrome; electrical stimulation parameters. 
 
References 
1. Segers J, Hermans G, Bruyninckx F, Meyfroidt G, 

Langer D, Gosselink R. Feasibility of neuromuscular 
electrical stimulation in critically ill patients. J Crit 
Care. 2014 Dec;29(6):1082-8. doi: 
10.1016/j.jcrc.2014.06.024. Epub 2014 Jun 30. 
PMID: 25108833. 

2. Routsi C, Gerovasili V, Vasileiadis I, Karatzanos E, 
Pitsolis T, Tripodaki E, Markaki V, Zervakis D, 
Nanas S. Electrical muscle stimulation prevents 
critical illness polyneuromyopathy: a randomized 
parallel intervention trial. Crit Care. 2010;14(2):R74. 
doi: 10.1186/cc8987. Epub 2010 Apr 28. PMID: 
20426834; PMCID: PMC2887197. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 

 

 

 

 

 

mailto:pegogio@hotmail.com


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THURSDAY March 30, 2023 

Conference Hall, Hotel Petrarca, Thermae of 
Euganean Hills (Padua) Italy  
 
SESSION Va: Genetic muscle diseases 
 

Elisabeth R. Barton, H. Lee Sweeney, Chairs 
 

***** 

2023Pdm3 March 30 - Abstract 31 
LECTURE 

Improving upon AAV.micro-dystrophin gene 
therapy for DMD  
 
H. Lee Sweeney 
 
Department of Pharmacology and Therapeutics and the 
Myology Institute, University of Florida, College of 
Medicine, Gainesville, FL, USA 
Email: lsweeney@ufl.edu  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 32 
 
Proteomic profiling of reactive myofibrosis in the 
aged and dystrophic diaphragm 
 
Kay Ohlendieck (1,2), Stephen Gargan (1,2), Dieter 
Swandulla (3), Paul Dowling (1,2). 
 
(1) Department of Biology, Maynooth University, 
Maynooth, Co. Kildare, Ireland; (2) Kathleen Lonsdale 
Institute for Human Health Research, Maynooth 
University, Maynooth, Co. Kildare, Ireland; (3) Institute 
of Physiology, University of Bonn, D53115 Bonn, 
Germany. 
E-mail: kay.ohlendieck@mu.ie  
 
The membrane cytoskeletal protein dystrophin and its 
associated sarcolemmal protein complex are involved in 
contractile fibre stability, lateral force transmission and 
cellular signaling mechanisms in skeletal muscle tissues. 
Primary abnormalities in the DMD gene result in the 
almost complete loss of the Dp427-M isoform of 
dystrophin and cause progressive skeletal muscle wasting 
in association with fat substitution and chronic 
inflammation. A striking pathophysiological hallmark of 

X-linked muscular dystrophy is reactive myofibrosis that 
results in fibre scarring and the loss of muscle elasticity 
during excitation-contraction relaxation cycles. In order 
to study changes in the extracellular matrix in association 
with Duchenne muscular dystrophy, our laboratories 
have carried out mass spectrometry-based proteomic 
surveys of the dystrophic and aged diaphragm muscle 
from the mdx-4cv model of dystrophinopathy. A drastic 
increase in components of the matrisome, including 
various collagens, proteoglycans, fibronectin and the 
matricellular protein periostin, were identified. Changes 
in protein abundance related to the extracellular matrix 
were confirmed by comparative immunoblotting and 
immunofluorescence microscopy. We are currently 
evaluating the suitability of fibrotic markers to 
characterize patient biopsy specimens. Novel proteomic 
markers can now be tested for their suitability to improve 
diagnostic procedures, prognosis, and therapeutic 
monitoring, as well as for being used for the 
identification of new therapeutic targets.  
 
Key Words: Duchenne muscular dystrophy; dystrophin; 
dystrophinopathy; fibrosis; matrisome.  
 
References 
1. Ohlendieck K, Swandulla D. Complexity of skeletal 

muscle degeneration: multi-systems pathophysiology 
and organ crosstalk in dystrophinopathy. Pflugers 
Arch. 2021 Dec;473(12):1813-1839. doi:  
10.1007/s00424-021-02623-1. Epub 2021 Sep 22. 
PMID: 34553265; PMCID: PMC8599371. 

2. Dowling P, Gargan S, Murphy S, Zweyer M, Sabir H, 
Swandulla D, Ohlendieck K. The Dystrophin Node as 
Integrator of Cytoskeletal Organization, Lateral 
Force Transmission, Fiber Stability and Cellular 
Signaling in Skeletal Muscle. Proteomes. 2021 Feb 
2;9(1):9. doi: 10.3390/proteomes9010009. PMID: 
33540575; PMCID: PMC7931087. 

 
Mass spectrometry-based proteomic analysis 
pipeline for the identification of dystrophinopathy-
associated changes in the matrisome. 

mailto:lsweeney@ufl.edu
mailto:kay.ohlendieck@mu.ie


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3. Zweyer M, Sabir H, Dowling P, Gargan S, Murphy S, 
Swandulla D, Ohlendieck K. Histopathology of 
Duchenne muscular dystrophy in correlation with 
changes in proteomic biomarkers. Histol Histopathol. 
2022 Feb;37(2):101-116. doi: 10.14670/HH-18-403. 
Epub 2021 Dec 7. PMID: 34873679. 

4. Dowling P, Gargan S, Swandulla D, Ohlendieck K. 
Proteomic profiling of impaired excitation-
contraction coupling and abnormal calcium handling 
in muscular dystrophy. Proteomics. 2022 Dec;22(23-
24):e2200003. doi: 10.1002/pmic.202200003. Epub 
2022 Aug 8. PMID: 35902360. 

5. Gargan S, Dowling P, Zweyer M, Henry M, Meleady 
P, Swandulla D, Ohlendieck K. Proteomic 
Identification of Markers of Membrane Repair, 
Regeneration and Fibrosis in the Aged and 
Dystrophic Diaphragm. Life (Basel). 2022 Oct 
22;12(11):1679. doi: 10.3390/life12111679. PMID: 
36362832; PMCID: PMC9696191. 

6. Dowling P, Gargan S, Zweyer M, Sabir H, Henry M, 
Meleady P, Swandulla D, Ohlendieck K. Proteomic 
profiling of the interface between the stomach wall 
and the pancreas in dystrophinopathy. Eur J Transl 
Myol. 2021 Mar 26;31(1):9627. doi: 
10.4081/ejtm.2021.9627. PMID: 33709651; PMCID: 
PMC8056161. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 33 
 
To unravel immune response in Duchenne Muscular 
Dystrophy 
 
Marina Bouchè 
 
DAHFM, Sapienza University of Rome, Italy 
Email: marina.bouche@uniroma1.it  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 34 
 
Postural control impairments in Fabry disease 
 
Philippe Perrin (1-3), Roland Jaussaud (1,4), Laetitia 
Peultier-Celli (1,2), Joëlle Deibener-Kaminsky (4), 
François Feillet (5), Pierre Kaminsky (1,4) 
 
(1) EA 3450 – Development, Adaptation and Handicap, 
University of Lorraine; (2) Laboratory for the Analysis 

of Posture, Equilibrium and Motor Function (LAPEM), 
University Hospital of Nancy; (3) Department of 
Pediatric Oto-Rhino-Laryngology, University Hospital 
of Nancy, Vandoeuvre-lès-Nancy; (4) Department of 
Internal Medicine and Clinical Immunology, University 
Hospital of Nancy; (5) Reference Centre for Inborn 
Errors of Metabolism, 
University Hospital of Nancy, Children Hospital, France 
E-mail: philippe.perrin@univ-lorraine.fr  
 
Fabry disease (FD) is a rare inherited lysosomal storage 
disorder caused by the deficiency of the enzyme alpha-
galactosidase A. This deficiency leads to an 
accumulation of glycosphingolipids leading to 
progressive and multisystemic disease, including renal, 
cardiac, and neurological damages. Neuro-otological and 
visual impairments can generate postural control 
impairments, inner ear, and vision being involved in this 
function (1-4). Fourteen adult patients (8 men/6 women, 
mean age = 37.6 ± 11.4 years) and two children (mean 
age = 11 years) with FD, and 19 healthy adults (12 men/7 
women, mean age = 36.5 ± 16.9 years) and two healthy 
children (mean age = 10.5 years) took part in this study 
to assess the impact of FD on postural control. The 
sensory organization test (SOT) (EquiTest, NeuroCom, 
Clackamas, OR, USA) was used to assess overall balance 
and the use of specific sensory inputs to maintain postural 
control. An environmental conflict (visual and/or 
somatosensory) was created combining three visual 
situations (eyes open, eyes closed, and sway referenced 
visual surround motion) with two platform situations  
(stable platform and sway referenced platform motion), 

 
Computerized Dynamic Posturography (Equitest, 
NeuroCom, Clackhamas, OR) - Sensory 
organization test. 

mailto:marina.bouche@uniroma1.it
mailto:philippe.perrin@univ-lorraine.fr


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aiming to calculate a composite equilibrium score (CES), 
a high score being representative of good postural 
control. Somatosensory (RSOM), visual (RVIS), and 
vestibular (RVEST) contributions to postural control 
were calculated, a low score reflecting a poor use of the 
indicated sensory input. The CES (p < 0.001), RVIS (p = 
0.001) and RVEST (p = 0.003) were lower in adult 
patients with FD compared with the healthy subjects, 
whereas no difference in RSOM was observed. Inner ear 
and visual pathologies associated with the central 
nervous system impairments are factors of postural 
control impairments. Understanding the specific balance 
control deficits in FD, determining the appropriate 
modalities of visuo-vestibular rehabilitation and 
quantifiably assessing its effect on improving postural 
stability and quality of life, could help to provide better 
balance-oriented programs (5). Physical activities, which 
can also be rehabilitative, by maintaining or increasing 
the weight of proprioception, may help diminish 
dependency on altered sensorial inputs, with the 
particular attempt of preventing falls. 
Key words: Fabry disease; postural control; 
posturography; rehabilitation; cochleo-vestibular 
disorders. 
References 
1. Peultier-Celli L, Jaussaud R, Kaminsky P, Deibener-

Kaminsky J, Feillet F, Perrin P. Balance control 
impairments in Fabry disease. Front Neurol. 2022 Sep 
30;13:856946. doi: 10.3389/fneur.2022.856946. 

2. Germain DP. Fabry disease. Orphanet J Rare Dis. 
2010 Nov 22;5:30. doi: 10.1186/1750-1172-5-30. 

3. Lidove O, Kaminsky P, Hachulla E, Leguy-Seguin V, 
Lavigne C, Marie I et al.; FIMeD investigators. Fabry 
disease 'The New Great Imposter': results of the 
French Observatoire in Internal Medicine 
Departments (FIMeD). Clin Genet. 2012 
Jun;81(6):571-7. doi: 10.1111/j.1399-
0004.2011.01718.x 

4. Cammarata G, Fatuzzo P, Rodolico MS, Colomba P, 
Sicurella L, Iemolo F, Zizzo C, Alessandro R, 
Bartolotta C, Duro G, Monte I. High variability of 
Fabry disease manifestations in an extended Italian 
family. Biomed Res Int. 2015;2015:504784. doi: 
10.1155/2015/504784. 

5. Buatois S, Gauchard GC, Aubry C, Benetos A, Perrin 
P. Current physical activity improves balance control 
during sensory conflicting conditions in older adults. 
Int J Sports Med. 2007 Jan;28(1):53-8. doi: 
10.1055/s-2006-924054. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 

 

 

THURSDAY March 30, 2023 

Conference Hall, Hotel Petrarca, Thermae of 
Euganean Hills (Padua) Italy  

 
SESSION Vb: Genetic muscle diseases 
 

Capucine Trollet, H. Lee Sweeney, Chairs 
 

 
2023Pdm3 March 30 - Abstract 35 
 
Novel role of store operated Ca2+ entry in Limb-
Girdle Muscular Dystrophy 2A  
 
Katelyn Villani, Renjia Zhong, Zachary Brandt, C. 
Spencer Henley-Beasley, Lan Wei-LaPierre, Elisabeth 
Barton 
 
Department of Applied Physiology and Kinesiology, 
University of Florida, Gainesville, FL, USA 
E-mail: erbarton@ufl.edu  
 
Limb-Girdle Muscular Dystrophy 2A (LGMD2A) is an 
autosomal recessive muscle disease characterized by 
progressive weakness of pelvic and scapular muscles.  
LGMD2A results from loss-of-function mutations in 
Calpain-3 (CAPN3), a calcium-dependent, non-
lysosomal protease strictly expressed in skeletal muscle 
(1). Although LGMD2A is the most prevalent of the 
LGMDs, the the exact contribution of CAPN3 loss to the 
variable pathology remains unclear.  Initially, CAPN3 

 
       

 
 

Immunostaining of ORAI1 and RYR show absence 
of Orai1 doublet in resting C3KO muscle. 

mailto:erbarton@ufl.edu


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 35 - 
 

 

was found to maintain sarcomere integrity by regulating 
sarcomere remodeling through its localization on Titin  
(2). However, recent evidence suggests CAPN3 is also 
localized at the triad and may contribute to Ca2+ 

regulation and signaling during excitation-contraction 
coupling. In particular, the main SR Ca2+ pump, 
sarco/endo-plasmic reticulum Ca2+ ATPase (SERCA) 
activity is significantly reduced in calpain-3 knockout  
(C3KO) mice, which may lead to SR store depletion and 
the activation of  store operated Ca2+ entry to replensish 
the SR Ca2+ store (3). SOCE activity was assessed at 
baseline then subsequently evoked with a treadmill 
running protocol in C57BL/6J (C57) and Calpain-3 
knockout (C3KO) mice at pre-symptomatic (8 weeks 
old) and symptomatic (6-months old) ages (4).  Muscle 
bundles from Extensor Digitorum Longus (EDL) 
muscles, selected due to their high SOCE activity, were 
analyzed using immunohistochemistry for proteins in the 
triad associated with SOCE activity. SOCE activity was 
measured in Flexor Digitorum Brevis fibers via Indo-1 
Ca2+ measurements.    Surprisingly, muscles from C3KO 
mice showed evidence of SOCE activity at rest, which 
persisted following treadmill running. This was in 
distinct contrast to muscles from C57 mice, where no 
SOCE occurred at rest, but was apparent after treadmill 
running. Thus, constitutively active SOCE in C3KO 
muscles is a newly identified mechanism underlying 
LGMD2A pathology of LGMD2A and supports a role of 
CAPN3 in Ca2+ homeostasis and handling 
Key Words: Orai1; Stim 1; SOCE. 
References: 
1. Sorimachi H, Kimura S, Kinbara K, Kazama J, 

Takahashi M, Yajima H, Ishiura S, Sasagawa N, 
Nonaka I, Sugita H, Maruyama K, Suzuki K. 
Structure and physiological functions of ubiquitous 
and tissue-specific calpain species. Muscle-specific 
calpain, p94, interacts with connectin/titin. Adv 
Biophys. 1996;33:101-22. doi: 10.1016/s0065-
227x(96)90026-x. PMID: 8922106. 

2. Kramerova I, Kudryashova E, Tidball JG, Spencer 
MJ. Null mutation of calpain 3 (p94) in mice causes 
abnormal sarcomere formation in vivo and in vitro. 
Hum Mol Genet. 2004 Jul 1;13(13):1373-88. doi: 
10.1093/hmg/ddh153. Epub 2004 May 11. PMID: 
15138196. 

3. Lyfenko AD, Dirksen RT. Differential dependence of 
store-operated and excitation-coupled Ca2+ entry in 
skeletal muscle on STIM1 and Orai1. J Physiol. 2008 
Oct 15;586(20):4815-24. doi: 
10.1113/jphysiol.2008.160481. Epub 2008 Sep 4. 
PMID: 18772199; PMCID: PMC2614059. 

4. Boncompagni S, Michelucci A, Pietrangelo L, 
Dirksen RT, Protasi F. Exercise-dependent formation 
of new junctions that promote STIM1-Orai1 
assembly in skeletal muscle. Sci Rep. 2017 Oct 
27;7(1):14286. doi: 10.1038/s41598-017-14134-0. 
Erratum in: Sci Rep. 2018 Nov 27;8(1):17463. PMID: 
29079778; PMCID: PMC5660245. 

5. Michelucci A, Boncompagni S, Pietrangelo L, 
García-Castañeda M, Takano T, Malik S, Dirksen 
RT, Protasi F. Transverse tubule remodeling 
enhances Orai1-dependent Ca2+ entry in skeletal 
muscle. Elife. 2019 Oct 28;8:e47576. doi: 
10.7554/eLife.47576. PMID: 31657717; PMCID: 
PMC6837846. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 36 
 
Cell and molecular actors of fibrosis in muscle 
diseases 
 
Capucine Trollet (1), Mona Bensalah (1), Laura 
Muraine (1), Alexis Boulinguiez (1), Paul Dowling (2), 
Jean Lacau-St Guily (1,3), Sophie Perie (4), Kay 
Ohlendieck (2), Vincent Mouly (1), Gillian Butler-
Browne (1), Anne Bigot (1), Elisa Negroni (1) 
 
(1) Center for Research in Myology UMRS974, 
Sorbonne Université, INSERM, Myology Institute, Paris, 
France, (2) Department of Biology, National University 
of Ireland, Maynooth, County Kildare, Ireland; (3) 
Department of Otolaryngology-Head and Neck surgery, 
Rothschild Foundation Hospital and Sorbonne 
University, Paris, France; (4) Department of 
Otolaryngology Head and Neck Surgery, Com Maillot-
Hartmann Clinic, Neuilly Sur Seine, France. 
E-mail: capucine.trollet@sorbonne-universite.fr  
 
Fibrosis is described in many organs as an excessive 
accumulation of extracellular matrix (ECM) proteins that 
replace tissue and alter its function. In skeletal muscle, 
fibrosis is a pathological feature common to many 
myopathies, such as Duchenne muscular dystrophy 
(DMD), oculopharyngeal muscular dystrophy (OPMD) 
or inclusion body myositis (IBM). Excessive 
accumulation of ECM alters the muscular function and 
the potential innovative therapeutic strategies. Several 
cellular actors are known to be implicated in the 
establishment and the maintenance of the fibrosis: 
macrophages, fibroadipogenic progenitors (FAPS) as 
well as satellite cells. The ECM, apart from its essential 
role as an architectural scaffold, has also a pivotal role in 
this process influencing muscle-resident cells through 
biochemical and biomechanical signals.  Combining 
mass cytometry, transcriptome profiling, secretome 
analysis, in vitro co-culture experiments and in vivo 
transplantation in immunodeficient mice, we first 
investigated the role and nature of FAPs from human 
fibrotic muscles and compared them to FAPs from 
healthy muscle. Our results show that human FAPs from 
fibrotic muscles display a strikingly different profile than 
FAPs from non fibrotic muscles; fibrotic FAPs show an 
exacerbated proliferation and ECM secretion, and when 

mailto:capucine.trollet@sorbonne-universite.fr


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 36 - 
 

 

activated, have a detrimental effect on muscle 
differentiation. In pharyngeal muscles, we also 
demonstrated the role of endothelin, a new targetable 
regulator involved in this process. Then using mass 
spectrometry, we characterized the ECM composition of 
DMD, OPMD and IBM human skeletal muscle biopsies. 
We identified a few shared ECM protein components as 
well as many specific ones for each pathology, 
highlighting differences in the amount and nature of 
ECM components. This work on human muscle biopsies 
provides a better understanding (a) of the key role of 
FAPs and their cross-talk with muscle cells through a 
paracrine signaling pathway and (b) of the ECM 
proteome of the muscle in pathological conditions. 
Altogether these data will lead the way to the 
identification of key components and targetable 
pathways for anti-fibrosis therapies. 
Key Words: Skeletal muscle; fibrosis; FAPs; cell-cell 
communication; ECM; myopathies. 
References 
1. Muscle fibro-adipogenic progenitors from a single-

cell perspective: Focus on their "virtual" secretome. 
Negroni E, Kondili M, Muraine L, Bensalah M, 
Butler-Browne GS, Mouly V, Bigot A, Trollet C. 
Front Cell Dev Biol. 2022 Sep 19;10:952041. doi: 
10.3389/fcell.2022.952041. 

2. A negative feedback loop between fibroadipogenic 
progenitors and muscle fibres involving endothelin 
promotes human muscle fibrosis. Bensalah M, 
Muraine L, Boulinguiez A, Giordani L, Albert V, 
Ythier V, Dhiab J, Oliver A, Hanique V, Gidaro T, 
Perie S, Lacau St-Guily J, Corneau A, Butler- Browne 
G, Bigot A, Mouly V, Negroni E, Trollet C. J 

Cachexia Sarcopenia Muscle. 2022 Jun;13(3):1771-
1784. doi: 10.1002/jcsm.12974. 

3. Combined methods to evaluate human cells in muscle 
xenografts. Bensalah M, Klein P, Riederer I, Chaouch 
S, Muraine L, Savino W, Butler- Browne GS, Trollet 
C, Mouly V, Bigot A, Negroni E. PLoS One. 2019 
May 2;14(5):e0211522. doi: 10.1371/journal.pone. 
0211522.  

4. Update on anti-fibrotic pharmacotherapies in skeletal 
muscle disease. Muraine L, Bensalah M, Butler-
Browne G, Bigot A, Trollet C, Mouly V, Negroni E. 
Curr Opin Pharmacol. 2022 Dec 23;68:102332. doi: 
10.1016/j.coph.2022.102332. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 37 
 
Investigating pathogenic mechanisms in FSHD 
myogenesis 
 
Massimo Ganassi, Peter S. Zammit 
 
Randall Centre for Cell and Molecular Biophysics, 
King’s College London, London, UK 
E-mail: massimo.ganassi@kcl.ac.uk  
MG is supported by Amis FSH (20210627-1) and SOLVE-FSHD. 
 
Muscle strength is essential for efficient movement and 
muscle weakness affects function to rapidly impinge on 
the quality of life. Facioscapulohumeral muscular 
dystrophy (FSHD) is usually characterized by weakness 
and wasting of specific muscle groups and disease can 
progress and compromise self-sufficiency. FSHD 
pathogenesis is associated with epigenetic derepression 
at chromosome 4q35, unleashing expression of the 
transcription factor DUX4, whose accumulation hampers 
myogenesis and induces cell-death. Why FSHD muscle 
progressively weakens is still unclear, and is likely not 
solely caused by DUX4. Efficient muscle function is 
usually maintained by a specialized group of proteins that 
remove and replace worn components of the sarcomere, 
the force-generating apparatus, to assure its working 
integrity throughout life. Little is known on muscle 
integrity in FSHD, but sarcomeric dysfunction 
contributes to muscle weakness and reduced growth (1), 
suggesting that suppression of factors involved in 
sarcomere homeostasis may participate to FSHD 
pathogenesis. Our transcriptomic analysis (2) revealed 
suppression of genes involved in sarcomere homeostasis 
in FSHD muscles. Specifically, we found severely 
reduced level of a factor involved in sarcomere 
maintenance and regulating crucial myogenic signals 
during myogenesis. Here we show how manipulation of 
this factor in muscle cells affects FSHD myogenesis and 
modulate DUX4-induced signals (3) indicating its 

       

 

 
        

                   

mailto:massimo.ganassi@kcl.ac.uk


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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contribution FSHD muscle dysfunction. Ongoing 
epigenomics analysis will clarify upstream regulation of 
sarcomere integrity and expand understanding of FSHD 
pathogenesis.  
Key Words: FSHD; DUX4; sarcomere; myotubes; 
muscular dystrophy. 
References 
1. Lassche S, Stienen GJ, Irving TC, van der Maarel 

SM, Voermans NC, Padberg GW, Granzier H, van 
Engelen BG, Ottenheijm CA. Sarcomeric 
dysfunction contributes to muscle weakness in 
facioscapulohumeral muscular dystrophy. 
Neurology. 2013 Feb 19;80(8):733-7. doi: 
10.1212/WNL.0b013e318282513b. Epub 2013 Jan 
30. PMID: 23365058; PMCID: PMC3589299. 

2. Banerji CRS, Panamarova M, Pruller J, Figeac N, 
Hebaishi H, Fidanis E, Saxena A, Contet J, Sacconi 
S, Severini S, Zammit PS. Dynamic transcriptomic 
analysis reveals suppression of PGC1α/ERRα drives 
perturbed myogenesis in facioscapulohumeral 
muscular dystrophy. Hum Mol Genet. 2019 Apr 
15;28(8):1244-1259. doi: 10.1093/hmg/ddy405.  

3. Ganassi M, Figeac N, Reynaud M, Ortuste Quiroga 
HP, Zammit PS. Antagonism Between DUX4 and 
DUX4c Highlights a Pathomechanism Operating 
Through β-Catenin in Facioscapulohumeral Muscular 
Dystrophy. Front Cell Dev Biol. 2022 Sep 
7;10:802573. doi: 10.3389/fcell.2022.802573.  

4. Ganassi M, Zammit PS. Involvement of muscle 
satellite cell dysfunction in neuromuscular disorders: 
Expanding the portfolio of satellite cell-opathies. Eur 
J Transl Myol. 2022 Mar 18;32(1):10064. doi: 
10.4081/ejtm.2022.10064. 

 
Pdm3 March 29 - April 1, 2023 

***** 

THURSDAY March 30, 2023  
Conference Hall, Hotel Petrarca, Thermae of 

Euganean Hills (Padua) Italy  
 

02:00 PM - SESSION VI: Twenty Years of AIM 
  

Daniela Tavian, Corrado Angelini, Chairs 
 

 
2023Pdm3 March 30 - Abstract 38 
 
Phenotype variabilities of laminopathies 
 
Gabriele Siciliano (1), Gabriele Vadi (1), Francesca 
Torri (1), Mariaconcetta Rende (1), Giovanna Lattanzi 
(2), Giulia Ricci (1) 
 
(1) Department of Clinical and Experimental Medicine, 
University of Pisa, Pisa, Italy; (2) CNR Institute of 
Molecular Genetics Unit of Bologna; IRCCS Istituto 
Ortopedico Rizzoli, Bologna, Italy. 
E-mail: gabriele.siciliano@unipi.it   
 
LMNA-related disorders, or laminopathies, are rare 
diseases caused by mutations in the LMNA gene, which 
encodes for the nuclear envelope proteins, lamin A and 
C, via alternative splicing. The main functions of lamins 
are to provide structural support to the nucleus, 
maintenance of nuclear shape and spacing of nuclear pore 
complexes. Over the years, numerous reports have 
suggested that lamins also take part in other process: 
chromatin organization, DNA replication, epigenetics, 
transcription, cell cycle regulation, cell development and 
differentiation, nuclear migration, and apoptosis. Lamins 
together with integral membrane proteins of nuclear 
envelope and associated proteins participate in the 
regulation of chromatin organization and formation of 
chromatin microdomains associated with nuclear 
envelope. Laminopathies are associated with a wide 
range of disease phenotypes, including neuromuscular, 
cardiac, metabolic disorders and premature aging 
syndromes. Different phenotypes with skeletal muscle 
involvement have been linked to LMNA mutations: 
limb-girdle muscular dystrophy type 1B (LGMD1B, old 
nomenclature); autosomal dominant Emery-Dreifuss 
muscular dystrophy (EDMD2) and the rarer recessive 

       
  

       
  

  
 
 
 
 
 
 
 
 
 
 
 
 
 
Expression of a sarcomere regulator is 
significantly suppressed in both FSHD cultured 
myotubes and muscle biopsies compared to 
healthy-matched controls. 

Healthy 
FSHD 

R
N

A 
ex

pr
es

si
on

 
Cultured Myotubes 

p<0.0001 

R
N

A 
ex

pr
es

si
on

 

Muscle Biopsies 

Healthy 
FSHD 

mailto:gabriele.siciliano@unipi.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 38 - 
 

 

form (EDMD3), a form of congenital muscular 
dystrophy, the LMNA-related congenital muscular 
dystrophy (L-CMD). Although lamins A/C are expressed 
in almost all cells and tissues, the high degree of tissue-
specificity (i.e., skeletal muscle, cardiac muscle, adipose 
tissue, peripheral nerve) and the resulting different 
phenotypes observed in laminopathies are not completely 
elucidated. Moreover, therapeutic approaches to 
laminopathies are as yet symptomatic and no cure is 
currently available for any of these diseases. These 
considerations provide evidence of the extent to which an 
Italian Network for Laminopathies (NIL), involving 
centers spread throughout Italy and involved in clinics, 
research, industry and patients and their associations can 
help in addressing the study of those diseases and finding 
a therapeutic strategy.  The use of corticosteroids to 
improve muscle power in of patients withL-CMD has 
been proposed, despite to date there is no clear 
indications to support the use of corticosteroids in these 
patients and reliable biomarkers to demonstrate (or 
monitor) the effectiveness of the treatment is not 
available. Corticosteroids have anti-inflammatory 
activity and are able to modify the secretion of some 
cytokines. A study in a cohort of patients affected by 
muscular laminopathies found that TGF beta 2 secretion 
is consistently elevated in subjects with EDMD2 or other 
muscular laminopathies, except in L-CMD. Interestingly, 
our studies indicate that patients affected by L-CMD 
have a strongly altered profile of inflammatory cytokine 
secretion. This profile is also very different from that 
observed in patients affected by EDMD2, a form with 
later onset and slow progression of muscle disease. In 
fact, in L-CMD patients we observed an increase of 

interleukin 17, interleukin 9 and interleukin 1 receptor, 
whereas in patients with EDMD2 we reported a constant 
increase in TGFbeta 2 which was normal in L-CMD 
children. It is therefore reasonable to suppose that a 
different profile of the secretome may be related to the 
greater severity of the clinical picture of L-CMD. 
Starting from the collaborative approach and the 
multidisciplinary effort of the Italian Network for 
Laminopathies, we are performing an open-label 
prospective cohort pilot study to evaluate the effect of the 
treatment with Deflazacort in a cohort of clinically and 
molecularly well-characterized L-CMD patients. 
Key Words: Lamin A/C; laminopathies; limb-girdle 
muscular dystrophy type 1B; Emery-Dreifuss muscular 
dystrophy (EDMD2), LMNA-related congenital 
muscular dystrophy (L-CMD). 
References 
1. Kang SM, Yoon MH, Park BJ. Laminopathies; 

Mutations on single gene and various human genetic 
diseases. BMB Rep. 2018 Jul;51(7):327-337. doi: 
10.5483/bmbrep.2018.51.7.113. PMID: 29764566; 
PMCID: PMC6089866. 

2. Montano V, Mancuso M, Simoncini C, Torri F, Chico 
L, Ali G, Rocchi A, Baldinotti F, Caligo MA, Lattanzi 
G, Mattioli E, Cenacchi G, Barison A, Siciliano G, 
Ricci G. A Single mtDNA Deletion in Association 
with a LMNA Gene New Frameshift Variant: A Case 
Report. J Neuromuscul Dis. 2022;9(3):457-462. doi: 
10.3233/JND-220802. PMID: 35466949. 

3. Cappelletti C, Tramacere I, Cavalcante P, Schena E, 
Politano L, Carboni N, Gambineri A, D'Amico A, 
Ruggiero L, Ricci G, Siciliano G, Boriani G, Mongini 
TE, Vercelli L, Biagini E, Ziacchi M, D'Apice MR, 
Lattanzi G, Mantegazza R, Maggi L, Bernasconi P. 
Cytokine Profile in Striated Muscle Laminopathies: 
New Promising Biomarkers for Disease Prediction. 
Cells. 2020 Jun 23;9(6):1532. doi: 
10.3390/cells9061532. PMID: 32585971; PMCID: 
PMC7348753. 

4. Maggi L, D'Amico A, Pini A, Sivo S, Pane M, Ricci 
G, Vercelli L, D'Ambrosio P, Travaglini L, Sala S, 
Brenna G, Kapetis D, Scarlato M, Pegoraro E, Ferrari 
M, Toscano A, Benedetti S, Bernasconi P, Colleoni 
L, Lattanzi G, Bertini E, Mercuri E, Siciliano G, 
Rodolico C, Mongini T, Politano L, Previtali SC, 
Carboni N, Mantegazza R, Morandi L. LMNA-
associated myopathies: the Italian experience in a 
large cohort of patients. Neurology. 2014 Oct 
28;83(18):1634-44. doi: 
10.1212/WNL.0000000000000934. Epub 2014 Oct 
1. PMID: 25274841. 

5. Bernasconi P, Carboni N, Ricci G, Siciliano G, 
Politano L, Maggi L, Mongini T, Vercelli L, Rodolico 
C, Biagini E, Boriani G, Ruggiero L, Santoro L, 
Schena E, Prencipe S, Evangelisti C, Pegoraro E, 
Morandi L, Columbaro M, Lanzuolo C, Sabatelli P, 
Cavalcante P, Cappelletti C, Bonne G, Muchir A, 
Lattanzi G. Elevated TGF β2 serum levels in Emery-

     

 
Phenotypic spectrum of muscular laminopathies (A,B L-CMD; 
C,D EDMD; E,F LGMD2B) 



2023 Pdm3 - Post meeting book of abstracts 
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- 39 - 
 

 

Dreifuss Muscular Dystrophy: Implications for 
myocyte and tenocyte differentiation and fibrogenic 
processes. Nucleus. 2018 Jan 1;9(1):292-304. doi: 
10.1080/19491034.2018.1467722. PMID: 29693488; 
PMCID: PMC5973167. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 39 
 
Pharmacological profile of the most promising CFTR 
corrector for sarcoglycanopathy treatment 
 
Alberto Benetollo (1), Martina Scano (1), Sofia Parrasia 
(2), Lucia Biasutto (1,3), Francesco Dalla Barba (1), 
Paola Caccin (1), Marcello Carotti (1), Nogara Leonardo 
(1), Bert Blaauw (1), Dorianna Sandonà (1) 
 
(1) Department of Biomedical Sciences, (2) Department 
of Biology, University of Padova, Padova, Italy, (3) 
National Research Council, Neuroscience Institute, 
Padova, Italy 
E-mail: alberto.benetollo@phd.unipd.it  
 
Sarcoglycanopathies (LGMDR3-6) are the most severe 
forms of autosomal recessive limb-girdle muscular 
dystrophies. Sarcoglycanopathies, due to mutations in 
sarcoglycan (SG) genes, are characterized by progressive 
weakness of the shoulder and pelvic muscles. Most of 
these genetic defects, accounting for about the 65%, are 
missense mutations. They lead to a non-properly folded, 
even though potentially functional protein that is 
removed from the cellular context through the quality 
control (QC) system. Treatments with a small  molecule 
called C17, belonging to the CFTR modulator family, 
resulted in the effective rescue of the mutant R98H-
alpha-SG in vivo in a mouse model characterized by 
“humanized hind-limbs” expressing the mutated-SG. In 
particular, this compound produced a general 
amelioration of the pathological phenotype, and, most 
importantly, the recovery of the muscle force. These very 
promosing results moved us toward an in-depth 
investigation of the pharmacological properties of this 
compound, performing preliminary ADME (adsorption, 
distribution, metabolism and elimination) studies. We 
assessed the concentration-time (C-T) kinetic 
relationship, the biodistribution, the formation of drug 
metabolites in vitro and in vivo, and the elimination from 
the body. The in vitro drug biotransformation studies 
resulted in no formation of C17 derivatives using both 
human and mouse hepatic fractions (microsomes and S9 
fraction). On the other hand, the analysis of urine and 
faeces of C17-treated mice evealed the presence of 2 
metabolites in urine and 5 metabolites in faeces. These 
results could suggest that C17 is not metabolized at the 
level of liver, but rather through the activity of intestinal 
drug metabolizing enzymes.  The analysis of gut content 

of C17-treated mice is ongoing. The concentration-time 
kinetic relationship revealed that C17 reaches the 
maximum concentration in the plasma after 2 hours from 
the administration and it is well distributed in all the 
mouse body compartments. Through the C17 steady-
state study, we observed that C17 achieves the 
pharmacological plateau after 3 days. It was interesting 
to observe that at the level of the brain, heart and 
particularly skeletal muscle, our target-tissue, the pattern 
is compatible with the way of administration and the 
concentration-time kinetic of the plasma. After 48 hours 
from the injection, the C17 corrector is still detectable in 
skeletal muscles, and this information allowed us to 
perform a new chronic treatment with a lengthened 
regimen of administration that resulted, as in Scano et al. 
(2022), in an effective recovery of the tibialis anterior 
force as the rescue of the sarcoglycans mutant and the 
sarcoglycan complex at the sarcolemma. 
Key Words: Sarcoglycanopathies; CFTR correctors; 
pharmacokinetics; in vitro drug biotransformation. 
References 
1. Mariz Vainzof, Lucas S. Souza, Juliana Gurgel-

Giannetti, Mayana Zatz, Sarcoglycanopathies: an 
update, Neuromuscular Disorders, Volume 31, Issue 
10, 2021, Pages 1021-1027, ISSN 0960-8966. 

2. Martina Scano, Alberto Benetollo, Leonardo Nogara, 
Michela Bondì, Francesco Dalla Barba, Michela 
Soardi, Sandra Furlan, Eylem Emek Akyurek, Paola 
Caccin, Marcello Carotti, Roberta Sacchetto, Bert 
Blaauw, Dorianna Sandonà, CFTR corrector C17 is 
effective in muscular dystrophy, in vivo proof of 
concept in LGMDR3, Human Molecular Genetics, 
Volume 31, 4, 15 February 2022, Pages 499–509. 

3. M. Schrag, K. Regal, Chapter 4 - Pharmacokinetics 
and Toxicokinetics, Editor(s): Ali Said Faqi, A 
Comprehensive Guide to Toxicology in Nonclinical 
Drug Development (Second Edition), Academic 
Press, 2013, Pages 69-106, ISBN 9780128036204. 

4. J. Vrbanac, R. Slauter, Chapter 3 - ADME in Drug 
Discovery, Editor(s): Ali Said Faqi, A 
Comprehensive Guide to Toxicology in Nonclinical 
Drug Development (Second Edition), Academic 
Press, 2017, Pages 39-67, ISBN 9780128036204. 

 
Summary panel of ADME studies performed with 
the CFTR corrector C17.  

 

mailto:alberto.benetollo@phd.unipd.it


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5. Lu, F.C., 1996. Biotransformation of toxicants, in: 
Basic Toxicology: Fundamentals, Target Organs and 
Risk Assessment, third ed., Taylor and Francis: 
Washington, DC, pp. 27–39. 

Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 40 
 
Zebrafish and sarcoglycanopathies: characterization 
of models suitable for phenotype-based screening of 
drugs 
 
Francesco Dalla Barba (1), Marcello Carotti (1), 
Alberto Benetollo (1), Martina Scano (1), Paola Caccin 
(1), Francesco Argenton (2), Dorianna Sandonà (1) 
 
(1) Dept. of Biomedical Sciences, (2) Dept. of Biology, 
University of Padova, Padova, Italy, 
E-mail: francesco.dallabarba@phd.unipd.it  
 
Sarcoglycanopathies (LGMDR3-6) are four severe 
autosomal recessive limb-girdle muscular dystrophies 
caused by mutations in the SGCA, SGCB, SGCG and 
SGCD genes, resulting in the strong reduction of alpha, 
beta, gamma and delta-sarcoglycan (SG) proteins. The 
consequence is the disruption of a key complex 
protecting striated muscle membrane (sarcolemma) from 
contraction stress. The typical clinical phenotype is 
characterized by early onset and includes progressive 
weakness of the proximal pelvic girdle and shoulder 
muscles, with variable cardiac and respiratory 
involvement (1). For the in vivo modelling of 
sarcoglycanopathies, different KI and KO mouse lines 
have been generated so far, while in zebrafish only 
morpholino KD models have been produced. Several are 
the advantages of using zebrafish as animal model, 
especially considering the similarity of the skeletal 
muscle structure and function with those of mammals. In 
addition, the conservation of several components of the 
DGC and sarcoglycan proteins (particularly beta- and 
delta- SG) prompted us to focus on zebrafish for 
modelling LGMDR4 and LGMDR5 (2).  
We exploited the CRISPR/Cas9 technology to generate 
two KO zebrafish mutants, the beta-SG-KO and delta-
SG-KO lines (3). Despite the absence of a sarcoglycan 
subunit, the characterization of the two single KO 
mutants during the first 6dpf revealed a mild phenotype. 
We observed a small reduction in the embryo dimension, 
as well as a slight alteration in the organization of the 
skeletal muscle fibers (4). At resting conditions, KO 
embryos performed like wild type zebrafish and only if 
subjected to stressful conditions, it was possible to 
highlight a slight reduction in the swimming 
performance.  
The advantage of using zebrafish, especially for drug 
screening, lies in the possibility of performing 
experiments during the early stages of the fish's life. 

Therefore, in order to accelerate the onset of the disease 
traits, we decided to use two approaches: 
- Induce the manifestation of the dystrophic features by 

growing from 2 to 5dpf delta-SG-KO and wild type 
zebrafish in a viscous medium (fish water added with 
1% methyl cellulose)(5). By swimming in a high-
density water since from hatching, muscles experiment 
a greater than normal effort. If the sarcolemma of delta-
SG-KO zebrafish is more fragile than the wild type one, 
the expected outcome is the appearance of muscle 
damage.  

- Production of a double knock out zebrafish (bd-SG-
DKO), by breeding beta-SG-KO with delta-SG-KO. In 
this case, a reduced dimension of the body length was 
clear evident as early as 3dpf, as well as the presence of 
larvae with altered phenotype. The swimming ability 
was severely impaired as expected by the presence of 
damaged skeletal muscle fibers.  

In both cases the phenotype of the larvae closely 
resembles the characteristics observed in 
sarcoglycanopathies, suggesting them as useful tools for 
the study of the disease and for development of in vivo 
phenotype-based screening of new drugs. 

 
Both delta- and beta-SG-KO zebrafish present a 
mild myopathic phenotype at the larval stage. 

Two strategies were adopted to accelerate the onset 
of the disease traits early during development:  
• growing the larvae in viscous medium  
• generating a double KO line for delta- and 
beta-sarcoglycan. 
In both cases, zebrafish larvae presented damaged 
sarcomeres. 

mailto:francesco.dallabarba@phd.unipd.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 41 - 
 

 

Key Words: Sarcoglycanophaties, CRISPR/Cas9, 
zebrafish model, drug screening. 
References: 
1. Vainzof M, Souza LS, Gurgel-Giannetti J, Zatz M. 

Sarcoglycanopathies: an update. Neuromuscul 
Disord. 2021 Oct;31(10):1021-1027. doi: 
10.1016/j.nmd.2021.07.014. Epub 2021 Jul 28. 
PMID: 34404573. 

2. Cheng L, Guo XF, Yang XY, Chong M, Cheng J, Li 
G, Gui YH, Lu DR. Delta-sarcoglycan is necessary 
for early heart and muscle development in zebrafish. 
Biochem Biophys Res Commun. 2006 Jun 
16;344(4):1290-9. doi: 10.1016/j.bbrc.2006.03.234. 
Epub 2006 Apr 19. PMID: 16650823. 

3. Andrew P.W. Gonzales, Jing-Ruey Joanna Yeh, 
Chapter Eighteen - Cas9-Based Genome Editing in 
Zebrafish, Editor(s): Jennifer A. Doudna, Erik J. 
Sontheimer, Methods in Enzymology, Academic 
Press, Volume 546, 2014, Pages 377-413, ISSN 
0076-6879, ISBN 9780128011850, 
https://doi.org/10.1016/B978-0-12-801185-0.00018-
0. 

4. Smith, L. L., Beggs, A. H., Gupta, V. A. Analysis of 
Skeletal Muscle Defects in Larval Zebrafish by 
Birefringence and Touch-evoke Escape Response 
Assays. J. Vis. Exp. (82), e50925, doi:10.3791/50925 
(2013). 

5. Ruparelia AA, Oorschot V, Vaz R, Ramm G, Bryson-
Richardson RJ. Zebrafish models of BAG3 
myofibrillar myopathy suggest a toxic gain of 
function leading to BAG3 insufficiency. Acta 
Neuropathol. 2014 Dec;128(6):821-33. doi: 
10.1007/s00401-014-1344-5. Epub 2014 Oct 2. 
PMID: 25273835 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 29 - Abstract 41 
 
Exploring triheptanoin as treatment for neutral lipid 
storage disease with myopathy  
 
Sara Missaglia, Daniela Tavian, Nelida Inés Noguera, 
Corrado Angelini, Francesca Cortese, Massimiliano 
Filosto, Matteo Garibaldi, Ariela Smigliani, Alessandra 
Zaza, Elena Maria Pennisi 
 
Department of Psychology, Università Cattolica del 
Sacro Cuore, Milan, Italy; Laboratory of Cellular 
Biochemistry and Molecular Biology, CRIBENS, 
Università Cattolica del Sacro Cuore, Milan, Italy 
Email: Sara.Missaglia@unicatt.it  
 
On-site presentation of unpublished results. The 
authors denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 

Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 29 - Abstract 42 
 
New avenues for treatment of Facioscapulohumeral 
Muscular Dystrophy 
 
Giulia Ricci, Francesca Torri, Beatrice Ciurli, Gabriele 
Siciliano 
 
Department of Clinical and Experimental Medicine, 
University of Pisa, Italy 
E-mail: giulia.ricci@unipi.it    
Facioscapulohumeral muscular dystrophy (FSHD) is one 
of the most common forms of muscular dystrophy 
overall. Symptoms can present during childhood  up until 
late adulthood, with an average age at onset of 30 years; 
a selective pattern of skeletal muscle weakness and a 
wide spectrum of disease expression are commonly 
observed, also within the families. The pathogenic 
molecular mechanism is believed to reside in an aberrant 
expression of the DUX4 gene due to abnormal levels of 
hypomethylation in the D4Z4 region on chromosome 
4q35. DUX4 is a double-homeobox transcription factor 
that is normally expressed during em-bryogenesis and 
activates a core set of genes involved in zygotic   
development; it is then silenced in most adult tissues 
except thymus and testis. While evidence is growing 
about phenotypical variability and possible dif-ferent 
disease courses, knowledge of pathophysiologic 
mechanisms underlying those differences is still far from 

       

 
       

 

Possible targeted therapeutic approaches to FSHD 
(Wang and Tawil 2021) 

mailto:Sara.Missaglia@unicatt.it
mailto:giulia.ricci@unipi.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 42 - 
 

 

comprehensive. As clinical trials are finally approaching 
also for FSHD, understanding of the interplaying factors 
determining disease course, phenotypic characterization 
of patients, and choosing appropriate outcome measures 
is crucial for correct selection of molecules, trials’ design 
and selection of endpoints. To date, there are no approved 
treatments for FSHD and standard of care only implies 
personalized physical therapy and management of motor 
disability. In the last years we observed the evolution of 
FSHD clinical trials from non-specific anabolic or anti-
inflammatory/oxidant strategies, to cutting-edge 
molecular therapies targeting DUX4. The accepted 
hypothesis involving aberrant DUX4 expression in 
skeletal muscle has guided the research pipeline for 
targeted therapies, in particular treatments reducing 
DUX4 gene expression. Among them, Losmapimod, a 
p38-mitogen activated protein kinase inhibitor that has 
been studied in multiple fields from oncology to 
cardiovascular medicine, has been proposed as a novel 
treatment for FSHD and a phase III clinical trial is 
currently recruiting patients. 
Key Words: Facioscapolohumeral Muscular Dystrophy 
(FSHD); D4Z4; DUX4; D4Z4 methylation; epigenetic 
modifiers. 
References 
1. Wang LH, Tawil R. Current Therapeutic Approaches 

in FSHD. J Neuromuscul Dis. 2021;8(3):441-451. 
doi: 10.3233/JND-200554. PMID: 33579868; 
PMCID: PMC8203219. 

2. Caputo V, Megalizzi D, Fabrizio C, Termine A, 
Colantoni L, Caltagirone C, Giardina E, Cascella R, 
Strafella C. Update on the Molecular Aspects and 
Methods Underlying the Complex Architecture of 
FSHD. Cells. 2022 Aug 29;11(17):2687. doi: 
10.3390/cells11172687. PMID: 36078093; PMCID: 
PMC9454908. 

3. Mocciaro E, Runfola V, Ghezzi P, Pannese M, 
Gabellini D. DUX4 Role in Normal Physiology and 
in FSHD Muscular Dystrophy. Cells. 2021 Nov 
26;10(12):3322. doi: 10.3390/cells10123322. PMID: 
34943834; PMCID: PMC8699294. 

4. Nikolic A, Jones TI, Govi M, Mele F, Maranda L, 
Sera F, Ricci G, Ruggiero L, Vercelli L, Portaro S, 
Villa L, Fiorillo C, Maggi L, Santoro L, Antonini G, 
Filosto M, Moggio M, Angelini C, Pegoraro E, 
Berardinelli A, Maioli MA, D'Angelo G, Di Muzio A, 
Siciliano G, Tomelleri G, D'Esposito M, Della 
Ragione F, Brancaccio A, Piras R, Rodolico C, 
Mongini T, Magdinier F, Salsi V, Jones PL, Tupler R. 
Interpretation of the Epigenetic Signature of 
Facioscapulohumeral Muscular Dystrophy in Light 
of Genotype-Phenotype Studies. Int J Mol Sci. 2020 
Apr 10;21(7):2635. doi: 10.3390/ijms21072635. 
PMID: 32290091; PMCID: PMC7178248. 

5. Ricci G, Ruggiero L, Vercelli L, Sera F, Nikolic A, 
Govi M, Mele F, Daolio J, Angelini C, Antonini G, 
Berardinelli A, Bucci E, Cao M, D'Amico MC, 
D'Angelo G, Di Muzio A, Filosto M, Maggi L, 

Moggio M, Mongini T, Morandi L, Pegoraro E, 
Rodolico C, Santoro L, Siciliano G, Tomelleri G, 
Villa L, Tupler R. A novel clinical tool to classify 
facioscapulohumeral muscular dystrophy 
phenotypes. J Neurol. 2016 Jun;263(6):1204-14. doi: 
10.1007/s00415-016-8123-2. Epub 2016 Apr 28. 
PMID: 27126453; PMCID: PMC4893383. 

Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 43 
 
Two plasma circulating-miRs for the diagnosis of 
idiopathic inflammatory myopathies 
 
Roberta Costa (1), Cristina Morsiani (2), Giovanni 
Merola (1), Rita Rinaldi (3), Erika Ciurca (2), Federica 
Longo (2), Miriam Capri (2,4), Giovanna Cenacchi (1) 
 
(1) Department of Biomedical and Neuromotor Sciences 
(DIBINEM), Alma Mater Studiorum University of 
Bologna, Bologna, Italy, (2) Department of Medicine and 
Surgery (DIMEC), Alma Mater Studiorum University of 
Bologna, Bologna, Italy; (3) IRCCS Istituto delle Scienze 
Neurologiche di Bologna, Bologna, Italy, (4) 
Interdepartmental Center "Alma Mater Research Institute 
on Global Challenges and Climate Change (Alma 
Climate)", Alma Mater Studiorum University of 
Bologna, Bologna, Italy. 
E-mail: giovanna.cenacchi@unibo.it  
 

A 

 
 
 

B 

 
 

A. Ratio among miR206 and miR409-3p. B. ROC 
curve calculated on the values of the c-miRs ratio.             

mailto:giovanna.cenacchi@unibo.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 43 - 
 

 

Idiopathic inflammatory myopathies (IIMs) are a group 
of rare diseases characterized by muscle pain and 
weakness associated with lymphocyte infiltration in the 
muscle tissue. Etiopathogenesis is not yet fully 
understood and the diagnosis is long-lasting and costly, 
often leading to a delay in the therapy. The diagnosis 
requires several steps, including an accurate clinical and 
laboratory investigation, EMG and muscle biopsy. The 
latter permits to define the diagnosis, distinguishing 
between IIM and hereditary myopathies, but it is an 
invasive procedure. The identification of new biomarkers 
able to differentiate patients with myositis by simple, low 
cost and non-invasive tests could improve the diagnostic 
efficiency, reducing the time to diagnosis/handling 
patients, and the costs generated by wrongly or untreated 
patients. MicroRNAs (miRs) are post transcriptional 
regulators of gene expression and the circulating ones are 
appealing non-invasive potential biomarkers. We have 
analyzed the expression of plasma circulating-miRs (c-
miRs) in patients with or without IIM, compared with 
healthy subjects, and we have identified an index, based 
on the ratio between two c-miRs, which is able to 
distinguish with high specificity and sensitivity among 
patients with IIM or with other neuromuscular disorders 
with clinical signs similar to myositis. The study has been 
conducted in blind and confirmed by standard diagnostic 
tools. The index, based on a simple and rapid method of 
analysis, is patent protected and has a great potential as 
non-invasive diagnostic biomarkers for IIMs. Current 
experiments are focused on the identification of 
molecular mechanisms underpinning the alteration of the 
two identified c-miRs. 
Key Words: Idiopathic inflammatory myopathies; 
microRNA; biomarkers.  
References 
1. Lundberg IE, Tjärnlund A, Bottai M, et al. 2017 

European League Against Rheumatism/American 
College of Rheumatology classification criteria for 
adult and juvenile idiopathic inflammatory 
myopathies and their major subgroups. Ann Rheum 
Dis. 2017;76(12):1955-1964. 
doi:10.1136/annrheumdis-2017-211468. 

2. Leclair V, Lundberg IE. New Myositis Classification 
Criteria-What We Have Learned Since Bohan and 
Peter. Curr Rheumatol Rep. 2018 Mar 17;20(4):18. 
doi: 10.1007/s11926-018-0726-4. 

3. Olivieri F, Rippo MR, Monsurrò V, Salvioli S, Capri 
M, Procopio AD, Franceschi C. MicroRNAs linking 
inflamm-aging, cellular senescence and cancer. 
Ageing Res Rev. 2013 Sep;12(4):1056-68.doi: 
10.1016/j.arr.2013.05.001. 

4. Georgantas RW, Streicher K, Greenberg SA, 
Greenlees L, Zhu W, Brohawn P, Higgs BW, Czapiga 
M, Morehouse C, Amato A, Richman L, Jallal B, Yao 
Y, Ranade K. Inhibition of myogenic MicroRNAs-1, 
133, and 206 by inflammatory cytokines links 
inflammation and muscle degeneration in adult 

inflammatory myopathies. Arthritis Rheumatol. 2014 
Apr;66(4):1022-33. doi: 10.1002/art.38292. 

Pdm3 March 30 - April 1, 2023 

***** 
2023Pdm3 March 30 - Abstract 44 
 
Morpho-functional characterization of Transportin3 
in myogenic differentiation of a cell model of LGMD 
D2 
Roberta Costa (1,2), Maria Teresa Rodia (1,2), Serafina 
Pacilio (1,2), Claudia Zacchini (1,2), Matteo Bergonzoni 
(1), Martina Fazzina (3), Flavia Frabetti (3), Monica 
Borgatti (4), Spartaco Santi (5), Giovanna Cenacchi (1,2) 
 
(1) Department of Biomedical and Neuromotor Sciences 
DIBINEM, Alma Mater Studiorum University of 
Bologna, Italy; (2) Applied Biomedical Research 
Center–CRBA, IRCCS St. Orsola Hospital, Alma Mater 
Studiorum University of Bologna, Bologna, Italy; (3) 
QuVi - Department for Life Quality Studies, Alma Mater 
Studiorum University of Bologna, Rimini, Italy; (4) 
Department of Medicine and Surgery (DIMEC), Alma 
Mater Studiorum University of Bologna, Italy; (5) 
Department of Life Sciences and Biotechnology, Ferrara 
University, Ferrara, Italy. 
E-mail: giovanna.cenacchi@unibo.it  
 

A WT TNPO3  B MUT TNPO3      

 
 

 
C WT TNPO3  D MUT TNPO3 

 

 
If staining for TNPO3 (red) and SRSF1 (green) 
during myogenesis after cell transfection with WT 
TNPO3 or MUT TNPO3.  
A and B undifferentiated cells, C and D cells at 
middle differentiation. 

mailto:giovanna.cenacchi@unibo.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 44 - 
 

 

Limb Girdle Muscular Dystrophy D2 (LGMD D2) is 
caused by a heterozygous mutation in the termination 
codon of the TNPO3 gene. This mutation gives a protein 
which is 15-aminoacids longer in its C-terminal domain. 
TNPO3 gene encodes for TNPO3, which normally 
mediates the translocation to the nucleus of SR proteins, 
a family of splicing factors and other proteins related to 
RNA metabolism. Recently a relationship among 
TNPO3 mutation and alteration in myogenic pathways 
has been suggested.  
The goal of this work was to investigate the pathogenetic 
mechanism of LGMD D2 creating a cell model of disease 
in which would be possible to study the role of TNPO3 
in the myogenic process and in possible muscle-specific 
molecular pathways. Murine C2C12 myoblasts were 
transfected  with a plasmid carring respectively the wild 
type (WT) or the mutated (MUT) sequence of TNPO3. 
We monitored the gene and protein expression profiles of 
TNPO3, of myogenic regulatory factors (MRFs), 
myomiRNA and muscle-specific proteins. Preliminary 
data suggest morphological and expression changes of 
genes and proteins involved in myogenic differentiation 
in comparison to the C2C12 control line. 
 The approach used is a first step to understand the role 
of TNPO3 in muscle physiology and in the pathogenetic 
mechanism underlying LGMD D2 which is still 
unknown. 
 
Key Words: LGMD D2; TNPO3; myogenesis; myogenic 
regulatory factors: myomiRNA. 
 
References 
1. Torella A, Fanin M, Mutarelli M, et al. Next-

generation sequencing identifies transportin 3 as the 
causative gene for LGMD1F. PLoS One. 
2013;8(5):e63536. Published 2013 May 7. 
doi:10.1371/journal.pone.0063536. 

2. Costa R, Rodia MT, Vianello S, et al. Transportin 3 
(TNPO3) and related proteins in limb girdle muscular 
dystrophy D2 muscle biopsies: A morphological 
study and pathogenetic hypothesis. Neuromuscul 
Disord. 2020;30(8):685-692. 
doi:10.1016/j.nmd.2020.05.006. 

3. Costa R, Rodia MT, Zini N, et al. Morphological 
study of TNPO3 and SRSF1 interaction during 
myogenesis by combining confocal, structured 
illumination and electron microscopy analysis 
[published online ahead of print, 2021 Jan 15]. Mol 
Cell Biochem. 2021;10.1007/s11010-020-04023-y. 
doi:10.1007/s11010-020-04023-y. 

4. Costa R, Rodia MT, Pacilio S, Angelini C, Cenacchi 
G. LGMD D2 TNPO3-Related: From Clinical 
Spectrum to Pathogenetic Mechanism. Front Neurol. 
2022 Mar 4;13:840683. doi: 
10.3389/fneur.2022.840683.  

5. Pegoraro V, Angelini C. Circulating miR-206 as a 
Biomarker for Patients Affected by Severe Limb 

Girdle Muscle Dystrophies. Genes (Basel). 2021 Jan 
12;12(1):85. doi: 10.3390/genes12010085. 

 
Pdm3 March 30 - April 1, 2023 

***** 
2023Pdm3 March 29 - Abstract 45 
 
N-glycosylation inhibition impairs C2C12 and L6 
myoblast differentiation and IGF-1 signalling 
 
Giosuè Annibalini (1), Matteo Bocconcelli (1), Roberta 
Saltarelli (1), Giacomo Valli (2), Laura Barberi (3), 
Antonio Musarò (3), Elena Barbieri (1) 
 
(1) Department of Biomolecular Sciences, University of 
Urbino Carlo Bo, Italy; (2) Neuromuscular Physiology 
laboratory, Department of Biomedical Sciences, 
University of Padua, Italy (3) DAHFMO-Unit of 
Histology and Medical Embryology, University of Rome 
La Sapienza Rome, Italy 
E-mail: giosue.annibalini@uniurb.it  
 
Several muscular diseases are associated with aberrant 
protein glycosylation, suggesting essential glycan-
mediated functions in myogenesis and muscle 
development (1). However, the role played by protein N-
glycosylation in the process of muscle differentiation 
remains poorly characterized. Here, we used C2C12 and 
L6 muscle cell cultures to investigate the effects of 
pharmacological inhibition of N-glycosylation by 
Tunicamycin (TUN) on myoblast differentiation. 
Non-toxic doses of TUN (0.01µg/ml) inhibited C2C12 
and L6 myoblast fusion and disrupted the coordinated 
temporal expression of myogenic regulator genes Ccnd1, 

 
 
The pharmacological inhibition of N-glycosylation 
by Tunicamycin or by genetic knockdown of 
PMM2 gene inhibited C2C12 and L6 myoblast 
differentiation, disrupted the coordinated temporal 
expression of myogenic regulatory genes, decreased 
lectin binding, IGF-1R expression and signalling 
pathway. 

mailto:giosue.annibalini@uniurb.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 45 - 
 

 

MyoD, Myogenin and Mrf4. C2C12 control myotubes 
also showed an increase lectin binding (ConA; PHA-L 
and AAL) compared to myoblasts, while lectin 
reactivities decreased in TUN-treated myotubes 
indicating a N-glycosylation deficiency. Intrestingly, 
similar resulst were obtained by genetic knockdown of 
phosphomannomutase 2 (PMM2) gene in C2C12 cells, 
which encode an enzyme essential for catalysing an early 
step of the N-glycosylation pathway (2). Finally, TUN 
treatment decreased the IGF-1R level and markedly 
attenuated the IGF-1-induced ERK-1/2 and Akt 
phosphorylation (3). These results suggest that impaired 
myoblast differentiation could be a key factor in the 
pathophysiology of muscle-related manifestations  
commonly found in congenital disorders of N-
glycosylation. Our data form a valuable resource to 
further understand the glycobiology of myogenesis and 
will aid to explain the association between abnormal N-
glycosylation and defects in muscle development and 
regeneration commonly found in individuals with 
Congenital disorders of glycosylation (CDG), such as 
PMM2-CDG, and other disease associated with protein 
hypo-Nglycosylation. 
Acronyms 
PMM2, Phosphomannomutase 2; Ccnd1, Cyclin D1; 
PCNA, Proliferating Cell Nuclear Antigen; MyoD, 
Myogenic differentiation 1; Mrf4, Myogenic Factor 6; 
Con A, Concanavalin A; PHA-L, Phaseolus vulgaris 
leucoagglutinin; AAL, Aleuria Aurantia (AAL); IGF-1R, 
Insulin-like growth factor-1 receptor; AKT, 
Serine/threonine protein kinase B; ERK1/2 Extracellular 
signal-regulated kinase 1/2. 
 
Key Words: Myoblast differentiation; N-glycosylation; 
IGF-1 pathway; PMM2; Congenital Disorders of 
Glycosylation. 
 
References 
1. Blazev R, Ashwood C, Abrahams JL, Chung LH, 

Francis D, Yang P, Watt KI, Qian H, Quaife-Ryan 
GA, Hudson JE, Gregorevic P, Thaysen-Andersen M, 
Parker BL. Integrated Glycoproteomics Identifies a 
Role of N-Glycosylation and Galectin-1 on 
Myogenesis and Muscle Development. Mol Cell 
Proteomics. 2021;20:100030. doi: 
10.1074/mcp.RA120.002166. Epub 2020 Dec 19. 
PMID: 33583770; PMCID: PMC8724610. 

2. Freeze HH, Jaeken J, Matthijs G. CDG or not CDG. 
J Inherit Metab Dis. 2022 May;45(3):383-385. doi: 
10.1002/jimd.12498. Epub 2022 Apr 1. PMID: 
35338706; PMCID: PMC9121739. 

3. Di Patria L, Annibalini G, Morrone A, Ferri L, 
Saltarelli R, Galluzzi L, Diotallevi A, Bocconcelli M, 
Donati MA, Barone R, Guerrini R, Jaeken J, Stocchi 
V, Barbieri E. Defective IGF-1 prohormone N-
glycosylation and reduced IGF-1 receptor signaling 
activation in congenital disorders of glycosylation. 
Cell Mol Life Sci. 2022 Feb 24;79(3):150. doi: 

10.1007/s00018-022-04180-x. PMID: 35211808; 
PMCID: PMC8873121. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 30 - Abstract 46 
 
Clinical and genetic characterization of Neutral lipid 
storage disease with myopathy (NLSDM) 
 
Massimiliano Filosto (1,2), Stefano Cotti Piccinelli 
(1,2), Filomena Caria (2), Barbara Risi (2), Beatrice 
Labella (1,3), Loris Poli (3), Alessandro Padovani (1,3) 
 
(1) Department of Clinical and Experimental Sciences, 
University of Brescia, Italy; (2) NeMO-Brescia Clinical 
Center for Neuromuscular Diseases, Brescia, Italy; (3) 
Unit of Neurology, ASST Spedali Civili, Brescia, Italy 
E-mail: massimiliano.filosto@unibs.it  
 
Neutral lipid storage disease with myopathy (NLSD-M) 
is an autosomal recessive muscle disorder characterized 
by triglyceride-containing cytoplasmic droplets in 
leukocytes and muscle tissue. It presents with adult onset 
slowly progressive proximal muscle weakness often 
associated with hypertrophic cardiomyopathy. Here, we 
report a 42-year-old patient who presented progressive 
proximal upper limb weakness since age 38. Clinical 
examination showed asymmetrical (right> left) proximal 
upper limb weakness and muscle hypotrophy, mild 
weakness of both orbicularis oculi muscles and difficulty 
in walking on heels. Diffuse accumulation of lipid 
droplets in muscle cells was detected on muscle biopsy 
and Jordan anomaly, a well-known NLSD marker, was 
revealed by peripheral blood smear. Genetic analysis 
displayed a novel homozygote deletion in the PNPLA2 
gene (exon2: c [45_47de]) causing the in frame  
p.[Gly16Del]. Both unaffected parents harbored the 
heterozygote deletion. Upper-limb muscle MRI showed 
atrophy of the supraspinatus and infraspinatus muscles, 
especially on the right side. Cardiac focal inferolateral 
intramural fibrosis was noted by MRI as a possible 
manifestation of lipid accumulation. However, no cardiac 
involvement was clinically detected. Our study confirms 
that 1) distal muscle involvement can be a feature of 
NLSD-M, 2) in Italian patients cardiac involvement is 
usually mild, differently from Far East subjects in which 
it is frequent and often leads to heart transplantation, 3) 
infraspinatus muscle is one of the most radiologically 
affected muscles and 4) Italian families usually harbor 
private mutations. Moreover, our patient presents with 
orbicularis oculi muscle weakness, therefore indicating 
that facial muscles can also be involved and confirming 
clinical heterogeneity of this disease. 
Key Words: Skeletal muscle weakness; lipid storage 
myopathy; NLSD-M. 
References 

mailto:massimiliano.filosto@unibs.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 46 - 
 

 

1. Pennisi EM, Arca M, Bertini E, Bruno C, Cassandrini 
D, D'amico A, Garibaldi M, Gragnani F, Maggi L, 
Massa R, Missaglia S, Morandi L, Musumeci O, 
Pegoraro E, Rastelli E, Santorelli FM, Tasca E, 
Tavian D, Toscano A, Angelini C; Italian NLSD 
Group. Neutral Lipid Storage Diseases: 
clinical/genetic features and natural history in a large 
cohort of Italian patients. Orphanet J Rare Dis. 2017 
May 12;12(1):90. doi: 10.1186/s13023-017-0646-9. 
PMID: 28499397; PMCID: PMC5427600. 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 30 - Abstract 47 
 
Estrogens recover muscle regeneration impaired by 
the pathogenic gene, DUX4, in orthotopic human 
xenograft 
 
Silvia Maiullari (1,2), Giorgia di Blasio (1,2), Giada 
Mele (1,2), Isabella Manni (3), Emanuela Teveroni (1), 
Patrizia Calandra(1), Ludovica Giorgini(1,2) Fabio 
Mancino (2), Luca Proietti (2), Fabio Maiullari (4,5), 
Roberto Rizzi (4), Enzo Ricci (2), Cesare Gargioli (5), 
Alfredo Pontecorvi (2), Siro Luvisetto (1), Giancarlo 
Deidda (1), Fabiola Moretti (1) 
E-mail: fabiola.moretti@cnr.it  
 
(1) Institute of Biochemistry and Cell Biology, National 
Research Council of Italy, Monterotondo, Italy; (2) 
Catholic University of Rome, Roma, Italy; (3) National 
Cancer Institute "Regina Elena", Roma, Italy; (4) 
National Institute of Molecular Genetics, Milan, Italy; (5) 
University of Rome "Tor Vergata", Rome, Italy 
 
Facioscapulohumeral dystrophy (FSHD) is an autosomal 
dominant muscular dystrophy and one of the more 
frequent hereditary myopathy. The pathology shows a 
wide range of clinical signs, with modifying factors 
contributing to this variability. Among these factors, the 
beneficial activity of estrogen hormones is still 
controversial.  We investigated the effect of the estrogens 
17β-estradiol (E2) and the 5α-dihydrotestosterone-

derived 3β-androstenediol (3β-diol) on muscle 
regeneration. To recapitulate human cell hormone 
sensitivity, we exploited a humanized heterokaryon 
FSHD mouse model, constituted by engrafting of human 
primary muscle mesenchymal stroma cells with 
perivascular cells (PVCs)-like phenotype in surgery-
treated murine muscle. Lentiviral expression of the 
pathogenic FSHD gene, DUX4, in these cells impaired 
muscle structural and functional recovery. Notably, both 
hormones counteracted DUX4 activity and rescued 
structural and functional muscle performance impaired 
by DUX4 expression. Interestingly, E2 and 3β-diol act 
differently on muscle recovery by reducing muscle 
fibrosis and improving muscle differentiation, 
respectively. These results demonstrate that estrogens 
recover murine muscle regeneration reduced by DUX4 
expression and support the hypothesis of their beneficial 
activity on human FSHD muscle. 
Key Words: DUX4/ Estrogen/ FSHD/ Muscle 
regeneration/ muscle mesenchymal stroma cells 
(MMSC) 
References: 
1. Teveroni E, Pellegrino M, Saccon S, Calandra P, 

Cascino I, Farioli-Vecchioli S, Puma A, Garibaldi M, 
Morosetti R, Tasca G, Ricci E, Trevisan CP, Galluzzi 
G, Pontecorvi A, Crescenzi M, Deidda G, Moretti F. 
Estrogens enhance myoblast differentiation in 
facioscapulohumeral muscular dystrophy by 
antagonizing DUX4 activity. J. Clin. Invest. 2017; 
127:1531-1545, doi: 10.1172/JCI89401, PMID: 
28263188. 

2. Mul K, Horlings CGC, Voermans NC, Schreuder 
THA, van Engelen BGM. Lifetime endogenous 
estrogen exposure and disease severity in female 
patients with facioscapulohumeral muscular 
dystrophy. Neuromuscul Disord. 2018 
Jun;28(6):508-511. doi: 10.1016/j.nmd.2018.02.012. 
Epub 2018 Mar 8. PMID: 29655530. 

3. Zatz M, Marie SK, Cerqueira A, Vainzof M, 
Pavanello RC, Passos-Bueno MR. The 
facioscapulohumeral muscular dystrophy (FSHD1) 
gene affects males more severely and more frequently 
than females. Am J Med Genet. 1998 May 
1;77(2):155-61. PMID: 9605290. 

4. Ricci E, Galluzzi G, Deidda G, Cacurri S, Colantoni 
L, Merico B, Piazzo N, Servidei S, Vigneti E, Pasceri 
V, Silvestri G, Mirabella M, Mangiola F, Tonali P, 
Felicetti L. Progress in the molecular diagnosis of 
facioscapulohumeral muscular dystrophy and 
correlation between the number of KpnI repeats at the 
4q35 locus and clinical phenotype. Ann Neurol. 1999 
Jun;45(6):751-7. doi: 10.1002/1531-
8249(199906)45:6<751::aid-ana9>3.0.co;2-m. 
PMID: 10360767. 

 
Pdm3 March 29 - April 1, 2023 

 

 
 
Model of E2 and 3β-diol activity on murine muscle 
implanted with human DUX4-expressing PVCs 

mailto:fabiola.moretti@cnr.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 47 - 
 

 

2023Pdm3 March 30 - Abstract 48 
 
Perturbations of cholesterol metabolism in the 
dystrophic muscle in DMD 
 
Abbass Jaber (1,2), Ai Vu Hong (1,2), Nathalie Bourg 
(1,2), Isabelle Richard (1,2), David Israeli (1,2) 
 
(1) Genethon, Evry, France; (2) Paris-Saclay university, 
Evry university, Inserm, Integrare Research Unit 
UMR_S951, Evry, France 
E-mail: ajaber@genethon.fr  
 
Duchenne muscular dystrophy (DMD), an X-linked 
progressive muscular dystrophy, is characterized by 
muscle wasting, fibrosis, fat accumulation, loss of motor 
functions and cardio-respiratory failure. DMD is caused 
by an absent or a dysfunctional dystrophin. Dystrophin is 
thought to stabilize the sarcolemma, with suggestions for 
additional biochemical functions. Incomplete 
understanding of dystrophin’s functions is a barrier for 
the development of improved therapeutic approaches. 
Previously, we profiled miRNA in the plasma of DMD 
patients and found high level of miRNA dysregulation 
(Amor et al. 2021), which predicted mitochondrial 
dysfunction (Sanson et al. 2020; Vu Hong et al. 2022) 
and perturbations of cholesterol metabolism (Amor et al. 
2021; Israeli et al. 2022). 
The goal of the present study is the characterization of 
lipid metabolism perturbations in the dystrophic muscle, 
with the prospect of development of improved therapy 
(Bourg et al. 2022). Our preliminary data show that 
cholesterol accumulates in the endolysosomal system in 
the dystrophic muscle of the mdx mouse. This 
accumulation may affect intracellular trafficking. We are 
also developing an in vitro screening system for the 
identification of compounds to accelerate cholesterol 
removal from the endolysosomal system. A progress in 
the understanding of the partipation of the endolysosomal 
system in DMD pathophysiology may offer new 
therapeutic perspective in muscular dystrophy. 
Key Words: Duchenne Muscular Dystrophy; cholesterol; 
lysosome; combined therapy; miRNA. 
References 
1. Amor F, Vu Hong A, Corre G, Sanson M, Suel L, 

Blaie S, Servais L, Voit T, Richard I, Israeli D, et al. 
2021. Cholesterol metabolism is a potential 
therapeutic target in Duchenne muscular dystrophy. J 
Cachexia Sarcopenia Muscle 12: 677–693. 
https://onlinelibrary.wiley.com/doi/10.1002/jcsm.12
708. 

2. Bourg N, Hong AV, Lostal W, Jaber A, Guerchet N, 
Tanniou G, Bordier F, Bertil-Froidevaux E, Georger 
C, Daniele N, et al. 2022. Co-Administration of 
Simvastatin Does Not Potentiate the Benefit of Gene 
Therapy in the mdx Mouse Model for Duchenne 
Muscular Dystrophy. Int J Mol Sci 2022, Vol 23, 

Page 2016 23: 2016. https://www.mdpi.com/1422-
0067/23/4/2016.. 

3. Israeli D, Vu Hong A, Corre G, Miagoux Q, Richard 
I. 2022. Deciphering the Molecular Mechanism of 
Incurable Muscle Disease by a Novel Method for the 
Interpretation of miRNA Dysregulation. Non-coding 
RNA 8: 48. https://pubmed-ncbi-nlm-nih-
gov.proxy.insermbiblio.inist.fr/35893231/ 

4. Sanson M, Hog Vu A, Massourides E, Bourg N, Suel 
L, Amor F, Corre G, Bénit P, Barthelemy I, Blot S, et 
al. 2020. miR-379 links glucocorticoid treatment with 
mitochondrial response in Duchenne muscular 
dystrophy. Sci Rep 10: 9139. 
http://www.nature.com/articles/s41598-020-66016-
7. 

5. Vu Hong A, Bourg N, Sanatine P, Poupiot J, Charton 
K, Gicquel E, Massourides E, Spinazzi M, Richard I, 
Israeli D. 2022. Dlk1-Dio3 cluster miRNAs regulate 
mitochondrial functions in the dystrophic muscle in 
Duchenne muscular dystrophy. Life Sci alliance 6: 
e202201506. 
https://pubmed.ncbi.nlm.nih.gov/36265896/  

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 30 - Abstract 49 
 
Modulation of vesicles’ secretion by EPS in an in vitro 
muscle model 
 
Luca Giacomelli, Rachele Agostini, Paola Ceccaroli, 
Emanuela Polidori, Michela Battistelli, Michele 
Guescini 
 

 
 
Schematic representation of the study workflow: 
electric pulse stimulation of C2C12 myotubes, EV 
isolation from conditioned medium, quantification 
of the secreted EVs, and study of biological activity 
of the EPS-induced EVs. 

mailto:ajaber@genethon.fr
http://www.nature.com/articles/s41598-020-66016-7
http://www.nature.com/articles/s41598-020-66016-7
https://pubmed.ncbi.nlm.nih.gov/36265896/


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 48 - 
 

 

Department of Biomolecular Sciences, University of 
Urbino “Carlo Bo”, 61029 Urbino, Italy 
E-mail: michele.guescini@uniurb.it  
 
Skeletal muscle (SkM) has emerged as an important 
secretory organ releasing myokines and, as demonstrated 
in recent literature, also extracellular vesicles (EVs) 
during aerobic exercise, which contributes mainly to 
exercise adaptations in an autocrine, paracrine or 
endocrine manner.1 There is a substantial interest in how 
acute and chronic exercise can promote EV release and 
its role in mediating the systemic effects of skeletal 
muscle activity. Nevertheless, most previous studies 
about EV secretion in acute and chronic exercise have 
focused on circulating EVs, which comprise a mixture of 
vesicles derived from circulating cells and other 
secretory tissues besides skeletal muscle. For these 
reasons,2 the present study aims to clarify if a prolonged 
acute session of electric pulse stimulation (EPS) in 
differentiated C2C12 myocytes, reproducing a high-
intensity exercise bout, can promote the secretion of both 
large and small extracellular vesicles. Subsequently, 
large and small EVs from contracting myocytes have 
been defined in particle concentration and vesicle marker 
content. To compare the impact of different muscle stress 
levels on EV secretion, we performed EPS sessions using 
two pulse width conditions, simulating non-damaging (1 
ms) and damaging (10 ms) contraction conditions, 
respectively. Finally, the influence of stimulated muscle-
derived EVs on SkM microenvironment has been 
investigated. Notably, we found that 10-ms EVs 
stimulated the expression of higher levels of IL-1beta 
mRNA than 1-ms EVs in RAW-264.7 macrophages. 

Altogether, these data suggest that EVs could have a role 
in regulating physical adaptations to high-intensity 
exercise. 
 
Key words: Extracellular vesicles; electric pulse 
stimulation (EPS); myokines; inflammation. 
 
References:  
1. Joshua P Nederveen, Geoffrey Warnier, Alessia Di 

Carlo, Mats I Nilsson, Mark A Tarnopolsky 
Extracellular Vesicles and Exosomes: Insights From 
Exercise Science. Front Physiol . 2021 Feb 
1;11:604274. doi: 10.3389/fphys.2020.604274 

2. Martin Whitham, Benjamin L Parker, Martin 
Friedrichsen, Janne R Hingst, Marit Hjorth, William 
E Hughes, Casey L Egan, Lena Cron, Kevin I Watt, 
Rhiannon P Kuchel, Navind Jayasooriah, Emma 
Estevez, Tim Petzold, Catherine M Suter, Paul 
Gregorevic, Bente Kiens, Erik A Richter, David E 
James, Jørgen F P Wojtaszewski, Mark A Febbraio. 
Extracellular Vesicles Provide a Means for Tissue 
Crosstalk during Exercise. Cell Metab 2018 Jan 
9;27(1):237-251.e4. doi: 10.1016/j.cmet.2017. 
12.001. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March30 - Abstract 50 
 
Activation of muscle-specific Akt1 reverts cancer-
dependent muscle wasting and reduces tumor mass 
 
Alessia Geremia et al.,  
 
University of Padua, Italy 
Email: Alessia.geremia@unipd.it  
 
On-site presentation of unpublished results. The 
authors denied also Zoom circulation, recording and 
post-meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 
 
2023Pdm3 March 30 Abstract 51 
 
Salivary irisin is induced by strenuous exercise 
stimulus and correlates with circulating irisin 
 
Ester Tommasini (1,2)*, Sara Missaglia (1,3), Paola 
Vago (1,3), Claudio Pecci (4), Christel Galvani (2), 
Andrea Silvestrini (5), Alvaro Mordente (5), Daniela 
Tavian (1,3) 
 
(1) Department of Psychology, Università Cattolica del 
Sacro Cuore, Milan, Italy; (2) Exercise & Sport Science 
Laboratory, Università Cattolica del Sacro Cuore, Milan, 

 
 
Schematic representation of the study workflow: 
electric pulse stimulation of C2C12 myotubes, EV 
isolation from conditioned medium, quantification 
of the secreted EVs, and study of biological 
activity of the EPS-induced EVs. 

mailto:michele.guescini@uniurb.it
mailto:Alessia.geremia@unipd.it


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 49 - 
 

 

Italy; (3) Laboratory of Cellular Biochemistry and 
Molecular Biology, CRIBENS, Università Cattolica del 
Sacro Cuore, Milan, Italy; (4) Human Performance 
Laboratory, MAPEI Sport Research Centre, Olgiate 
Olona (VA), Italy; (5) Department of Basic 
Biotechnological Sciences, Intensivological and 
Perioperative Clinics, Università Cattolica del Sacro 
Cuore, Rome, Italy. 
*E-mail: ester.tommasini@unicatt.it  
 
Physical activity can increase the circulating level of 
irisin, fostering several beneficial effects on health.1,2 
This exercise-induced myokine is generally analyzed in 
blood, but its collection is invasive and exposes to 
potential risks. Substitution of saliva sample for blood 
would represent a less invasive method for irisin 
detection. However, a limited number of studies 
evaluated the amount of irisin in saliva samples.3,4 Our 
purpose was to verify whether saliva could represent an 
alternative sample in which detecting irisin changes 
induced by an exogenous stimulus. Five active healthy 
adults (age: 29±14yrs; mean body mass index: 
22,9±3,7kg/m2; mean peak oxygen uptake 
54,0±16,5ml/kg/min) performed an incremental exercise 
until exhaustion on a cycle ergometer and their blood and 
saliva samples were collected before the exercise, 15min, 
24h, 48h post-exhaustion. Irisin levels were determined 
using ELISA Assay Kit (#EK-067-29). Incremental 
exercise has determined consistent changes in irisin 
levels. Indeed, serum and salivary irisin levels increased 
from baseline to 24h post-exercise, and then returned to 
basal level after 48h of rest. A significant difference of 
serum irisin levels at 15min (p≤0,01) and 24h (p≤0,001) 
compared to baseline was found. Moreover, a significant 
correlation (r=0,92, P<0,05) was found between irisin 
percentage change in serum and saliva from baseline to 
24h post-exercise.5 The findings, while preliminary, 
indicate that collecting saliva samples represents a valid 

and sensitive method of detecting irisin level changes in 
response to exercise. 
 
Key Words: irisin; saliva sample; serum sample; physical 
exercise. 
 
References: 
1. Liu S, Cui F, Ning K, Wang Z, Fu P, Wang D, Xu H. 

Role of irisin in physiology and pathology. Front 
Endocrinol. 2022; 13:962968. doi: 
10.3389/fendo.2022.962968.   

2. Bao JF, She QY, Hu PP, Jia N, Li A. Irisin, a 
fascinating field in our times. Trends Endocrinol 
Metab. 2022; 33(9):601-613. doi: 
10.1016/j.tem.2022.06.003.  

3. Aydin S, Aydin S, Kobat MA, Kalayci M, Eren MN, 
Yilmaz M, Kuloglu T, Gul E, Secen O, Alatas OD, 
Baydas A. Decreased saliva/serum irisin 
concentrations in the acute myocardial infarction 
promising for being a new candidate biomarker for 
diagnosis of this pathology. Peptides. 2014; 56:141-
145.doi: 10.1016/j.peptides.2014.04.002.  

4. Khan SU, Ghafoor  S, Khaliq S, Syed AR. Salivary 
Irisin and periodontal clinical parameters in patients 
of chronic periodontitis and healthy individuals: A 
novel salivary myokine for periodontal disease. J Pak 
Med Assoc. 2022; 72(1):27-33.doi: 
10.47391/JPMA.01367. 

5. Missaglia S, Tommasini E, Vago P, Pecci C, Galvani 
C, Silvestrini A, Mordente A, Tavian D. Salivary and 
serum irisin in healthy adults before and after 
exercise. Eur J Transl Myol. 2023. 
https://doi.org/10.4081/ejtm. 2023.11093 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 30 - Abstract 52 

Lecture 

Transcriptomic and growth responses to 
programmed resistance training in mouse, rat and 
human  
Jonathan C. Jarvis (1), Mark Viggars (1,2), Hazel 
Sutherland (1), Lauren Harlow (3), Christopher Cardozo 
(3) 
 
(1) School of Sport and Exercise Science, Liverpool John 
Moores University, UK; (2) Research Department of 
Physiology and Aging, University of Florida, 
Gainesville, Florida, USA; (3) National Center for the 
Medical Consequences of Spinal Cord Injury and 
Medical and Surgical Service, James J Peters VA 
Medical Center, Bronx, NY, USA. 
E-mail: J.C.Jarvis@ljmu.ac.uk  
 

 
 

Correlation between irisin percentage change in 
saliva and serum from baseline to 24 h 
postexercise. Reproduced with permissions from Reference5.  

mailto:ester.tommasini@unicatt.it
mailto:J.C.Jarvis@ljmu.ac.uk


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 50 - 
 

 

Mice are commonly used to investigate muscle biology 
and disease, but many labs have found it difficult to 
produce whole muscle hypertrophy without chronic 
overload or very long periods of training. We have 
established a model of muscle growth in the rat using 
programmed contractions in which the plantar flexors are 
used to resist the dorsiflexors of the ankle [1, 2]. We will 
present data from experiments in the rat that show a 
marked increase of muscle mass, showing how the acute 
transcriptomic response 1 hour after an exercise session 
changes as a muscle adapts to daily exercise over 30 days. 
We will also show that a similar degree of hypertrophy is 
achieved after 30 days with exercise every three days, 
and that the transcriptomic response in this case shows 
less change towards an ‘endurance’ expression profile. 
We will also present evidence from experiments using 
the same approach in mice, comparing the transcriptomic 
response of mouse muscle and rat muscle to the same 
protocol. In mice we see similar changes in gene 
expression but no increase in muscle mass. Future 
comparison of the transcriptomic and protein synthetic 
and degradative mechanisms in these models will be 
informative. 
 
Key Words: Skeletal muscle hypertrophy; skeletal 
muscle transcriptome; exercise response; muscle 
adaptation. 
 
References 
1. Viggars MR, Sutherland H, Lanmüller H, Schmoll M, 

Bijak M, Jarvis JC. Adaptation of the transcriptional 
response to resistance exercise over 4 weeks of daily 
training. FASEB J. 2023 Jan;37(1):e22686. doi: 
10.1096/fj.202201418R. PMID: 36468768. 

2. Schmoll M, Unger E, Sutherland H, Haller M, Bijak 
M, Lanmüller H, Jarvis JC. SpillOver stimulation: A 
novel hypertrophy model using co-contraction of the 
plantar-flexors to load the tibial anterior muscle in 
rats. PLoS One. 2018 Nov20;13(11):e0207886. doi: 
10.1371/journal.pone.0207886. PMID: 30458051; 
PMCID: PMC6245836. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 

 

 

 

 

 

 

 

FRIDAY March 31, 2023 

Conference Hall, Hotel Petrarca, Thermae of 
Euganean Hills (Padua) Italy 

 
09:00 AM SESSION VII: 

Senescence&Rejuvenation 
 

Nathan K. LeBrasseur, Christiaan Leeuwenburgh, Chairs 
 

 
2023Pdm3 March 31 - Abstract 53 
 
Cellular senescence as a driver of skeletal muscle 
aging 
 
Nathan K. LeBrasseur 
 
Department of Physical Medicine and Rehabilitation; 
Director of the Robert and Arlene Kogod Center on 
Aging, Mayo Clinic, Rochester, MN, USA 
Email: LeBrasseur.Nathan@mayo.edu  
 
Senescence is a cell fate in response to various stressors 
that has been implicated in the pathogenesis of multiple 
aging-related conditions. Despite profound age-
associated changes in skeletal muscle, the extent to which 
senescence may impact its constituent cells has not been 
methodically examined. This lecture will highlight our 
recent work (Zhang, Nature Aging, 2022) using single 
cell and bulk RNA-sequencing and complementary 
imaging methods on skeletal muscle of young and old 
mice that demonstrated that a subpopulation of old 
fibroadipogenic progenitors (FAPs) highly expresses 
p16Ink4a in concert with multiple senescence-related 
genes and, in parallel, exhibits DNA damage and 
chromatin reorganization. It will also review our analysis 
of isolated myofibers, as we observed a senescence 
phenotype within a subset of old cells, governed instead 
by p21cip1. New unpublished and published (e.g., 
Englund, Molecular Metabolism, 2023) insights into the 
contributions of senescent FAPs and p21-expressing 
myofibers to skeletal muscle aging will be shared, as will 
our efforts to discover senotherapeutic interventions to 
target these specific cell populations. Collectively, this 

 
From left: Nathan K. LeBrasseur, 
Nicola Fiotti, Maira Rossi, David A. 
Hood, Agnese De Mario. 

 

 
Christiaan Leeuwenburgh 

mailto:LeBrasseur.Nathan@mayo.edu


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 51 - 
 

 

lecture will provide compelling evidence for cellular 
senescence as a hallmark and potentially tractable 
mediator of skeletal muscle aging. 
Key words: Cellular senescence; skeletal muscle; aging. 
References 
1. Zhang X, Habiballa L, Aversa Z, Ng YE, Sakamoto 

AE, Englund DA, Pearsall VM, White TA, Robinson 
MM, Rivas DA, Dasari S, Hruby AJ, Lagnado AB, 
Jachim SK, Granic A, Sayer AA, Jurk D, Lanza IR, 
Khosla S, Fielding RA, Nair KS, Schafer MJ, Passos 
JF, LeBrasseur NK. Characterization of cellular 
senescence in aging skeletal muscle. Nat Aging. 2022 
Jul;2(7):601-615. doi: 10.1038/s43587-022-00250-8. 
Epub 2022 Jul 15. PubMed PMID: 36147777; 
PubMed Central PMCID: PMC9491365. 

2. Englund DA, Jolliffe A, Aversa Z, Zhang X, 
Sturmlechner I, Sakamoto AE, Zeidler JD, Warner 
GM, McNinch C, White TA, Chini EN, Baker DJ, 
van Deursen JM, LeBrasseur NK. p21 induces a 
senescence program and skeletal muscle dysfunction. 
Mol Metab. 2023 Jan;67:101652. doi: 
10.1016/j.molmet.2022.101652. Epub 2022 Dec 9. 
PMID: 36509362; PMCID: PMC9800630. 

3. Fielding RA, Atkinson EJ, Aversa Z, White TA, 
Heeren AA, Achenbach SJ, Mielke MM, Cummings 
SR, Pahor M, Leeuwenburgh C, LeBrasseur NK. 
Associations between biomarkers of cellular 
senescence and physical function in humans: 
observations from the lifestyle interventions for 
elders (LIFE) study. Geroscience. 2022 
Dec;44(6):2757-2770. doi: 10.1007/s11357-022-
00685-2. Epub 2022 Nov 11. PMID: 36367600; 
PMCID: PMC9768064 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 31 - Abstract 54 
 
Impact of age and sex on lysosomes and mitophagy 
during muscle use and disuse 
 
David A. Hood 
 
Muscle Health Research Centre, York University, 
Toronto, Canada. Email: dhood@yorku.ca  
 
Mitochondria are dynamic organelles that are constantly 
being synthesized (biogenesis) and recycled. This 
“turnover” promotes the maintenance of an optimally 
functioning pool of mitochondria.1 While considerable 
work has documented the processes of organelle 
biogenesis, less is understood about the recycling of 
mitochondria, termed mitophagy. In particular, 
mitochondrial content is diminished with age, suggesting 
that biogenesis could be impaired, and/or that mitophagy 
is accelerated.2 Our work has shown that mitophagy is 

accelerated up to the point of the lysosome, the organelle 
responsible for the terminal degradation of mitochondria.  
However, evidence exists for lysosomal dysfunction in 
aging muscle. In addition, there has been very little 
reported on possible biological sex differences in 
lysosomal content or function in muscle. Our recent 
research illustrates that lysosomal content is elevated in 
muscle of female mice, and that this persists and is 
exaggerated with age, suggesting that females have an 
enhanced capacity to clear dysfunctional organelles.3,4 
This is evidenced by a higher mitophagy flux in female 
muscle.  Remarkably, this is unaffected by the loss of the 
transcription factor TFE3, which is purported to be an 
important regulator of lysosomal gene expression.4  
However, when the expression of both TFE3 and its 
family member TFEB is reduced, mitophagy flux is 
attenuated and lysosomal function is impaired.5 This 
seminar will focus on how exercise can be used as a 
stimulus for both mitochondrial targeting via mitophagy 
as well as lysosomal biogenesis, and how it can serve as 
a useful behavioural therapeutic modality to reverse 
impairments in the mitophagy pathway that arise with 
age and muscle disuse. 
 
Key Words: Mitochondria; muscle adaptations; 
biological sex differences; lysosomal biogenesis; aging. 
 
References 
1. Hood DA, Memme JM, Oliveira AN, Triolo M. 

Maintenance of Skeletal Muscle Mitochondria in 
Health, Exercise, and Aging. Annu Rev Physiol. 2019 
Feb 10;81:19-41. doi: 10.1146/annurev-physiol-
020518-114310. Epub 2018 Sep 14. PMID: 
30216742. 

2. Carter HN, Chen CC, Hood DA. Mitochondria, 
muscle health, and exercise with advancing age. 
Physiology (Bethesda). 2015 May;30(3):208-23. doi: 
10.1152/physiol.00039.2014. PMID: 25933821. 

3. Triolo M, Oliveira AN, Kumari R, Hood DA. The 
influence of age, sex, and exercise on autophagy, 
mitophagy, and lysosome biogenesis in skeletal 
muscle. Skelet Muscle. 2022 Jun 11;12(1):13. doi: 
10.1186/s13395-022-00296-7. PMID: 35690879; 
PMCID: PMC9188089. 

4. Oliveira A.N., J.M. Memme, J. Wong, D.A. Hood. 
Dimorphic effect of TFE3 in determining 
mitochondrial and lysosomal content in muscle 
following denervation. J. Cachexia, Sarcopenia 
Muscle (in revision, 2023).  

5. Oliveira A.N., Y. Tamura, J.M. Memme, D.A. Hood. 
Role of TFEB and TFE3 in mediating lysosomal and 
mitochondrial adaptations to contractile activity in 
muscle cells. Autophagy Reports (in revision, 2023). 

 
Pdm3 March 29 - April 1, 2023 

***** 
 

mailto:dhood@yorku.ca


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2023Pdm3 March 31 - Abstract 55 
 
Inflammation, mitochondrial dysfunction senescense 
in skeletal muscle with aging and in peripheral artery 
disease 
 
Sunil K Saini (1), Christiaan Leeuwenburgh (2) 
 
(1) All India Institute of Medical Sciences, Department 
of Biophysics, New Delhi; India; (2) University of 
Florida, Institute on Aging, Department of Physiology 
and Aging, Gainesville, Florida, USA 
E-mail: cleeuwen@ufl.edu  
 
Aging and diseases such as cancer, peripheral artery 
disease (PAD) are associated with skeletal muscle 
inflammation, oxidative stress, increased senescense, 
altered muscle metabolism; and mitochondrial 
dysfunction [1-3]. Many of the biological changes in calf 
skeletal muscle have been associated with functional 
impairment and mobility loss [2]. We will discuss several 
recent studies which show that specific genes, miRNA, 
and biological pathways in skeletal muscle are tightly 
associated with functional performance in aging and 
clinical progression of PAD [3-6]. We found damage in 
the genes encoding polypeptides for the electron 
transport chain (ETC) in skeletal muscle was associated 
with walking performance in people with and without 
PAD [5]. We also found marked changes in cellular 
pathways in subjects with peripheral artery disease 
progression in specific genes and pathways involve in 
cellular senescense, inflammation and muscle 
contraction. Identifying what biological pathways are 
specifically associated with impaired skeletal muscle 
function may lead to new effective strategies that can 
reverse muscle dysfunction and in turn, can improve 
mobility. 
Key Words: Aging; peripheral artery disease; 
inflammation; senescense; muscle; miRNA; 
mitochondria. 
References 
1. Zhang D et al, Analysis of Biological Aging and 

Risks of All-Cause and Cardiovascular Disease-
Specific Death in Cancer Survivors. JAMA Netw 
Open. 2022. PMID: 35731518 

2. McDermott, M.M., et al., Skeletal Muscle Pathology 
in Peripheral Artery Disease: A Brief Review. 
Arterioscler Thromb Vasc Biol, 2020. 40(11): p. 
2577-2585.  

3. Picca A et al. Altered Expression of Mitoferrin and 
Frataxin, Larger Labile Iron Pool and Greater 
Mitochondrial DNA Damage in the Skeletal Muscle 
of Older Adults. 2022, Cells. PMID: 33276460  

4. Saini SK et al. Dysregulated Genes, MicroRNAs, 
Biological Pathways, and Gastrocnemius Muscle 
Fiber Types Associated With Progression of 
Peripheral Artery Disease: A Preliminary Analysis. 
2022, JAHA.PMID: 36300658 

5. Saini SK et al, Mitochondrial DNA damage in calf 
skeletal muscle and walking performance in people 
with peripheral artery disease.  Free Radic Biol Med. 
2020, PMID: 32911084  

6. Saini SK Time-Restricted Eating Regimen 
Differentially Affects Circulatory miRNA 
Expression in Older Overweight Adults. Nutrients. 
2022 PMID: 35565812. 

 
Pdm3 March 29 - April 1, 2023 

***** 
 

2023Pdm3 March 31 - Abstract 56 
 
Pharmacological modulation of MCU in skeletal 
muscle 
 
Agnese De Mario (1), Ilaria Piazza (1), Rosario Rizzuto 
(1), Cristina Mammucari (1,2) 
 
(1) Department of Biomedical Sciences, University of 
Padua, Italy; (2) Myology center (CIR-Myo), University 
of Padua, Italy. 
Email: agnese.demario@unipd.it  
 
Skeletal muscle mitochondria readily accumulate Ca2+ in 
response to SR store-releasing stimuli thanks to the 
activity of the mitochondrial calcium uniporter (MCU), 
the highly selective channel responsible for 
mitochondrial Ca2+ (mitCa2+) uptake. In skeletal muscle, 
MCU-dependent mitCa2+ positively regulates myofiber 
size by impinging on PGC1α4 and IGF1-AKT/PKB 
pathways.1 While the genetic modulation of the MCU has 
been widely applied, small molecules able to increase 
mitCa2+ uptake are rare. Spermine and related 

 
 
Amorolfine promotes skeletal muscle hypertrophy. 

mailto:cleeuwen@ufl.edu
mailto:agnese.demario@unipd.it


2023 Pdm3 - Post meeting book of abstracts 
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polyamines lower the threshold of mitCa2+ uptake.2 The 
p38 mitogen-activated protein kinase inhibitor 
SB202190 modulates mitCa2+ with a mechanism 
independent of p38 activity.3 Several natural plant 
flavonoids increase MCU activity independently of their 
antioxidant activity.4 Agonists and antagonists of the 
estrogen receptor as 4,4′,4″-(4-propyl-[1 h]-pyrazole-
1,3,5-triyl)trisphenol (PPT), diethylstilbestrol, and 17-β-
estradiol modulate the activity of the uniporter. By using 
a well-established methodology based on Aequorin, a 
calcium-sensitive probe that emits light upon Ca2+ 
binding, we screened a library of 1,600 FDA-approved 
drugs for their ability to modulate mitCa2+ uptake in 
living cells. We identified Amorolfine as a positive MCU 
modulator.5 Amorolfine is a morpholine antifungal drug 
that inhibits enzymes of the fungal sterol synthesis 
pathway and it is indicated for the topic treatment of 
mycoses. Amorolfine increases mitCa2+ uptake in Hela, 
C2C12 cells and adult isolated myofibers without 
affecting cytCa2+ and mitochondrial membrane potential. 
In agreement with the role of MCU in triggering 
hypertrophy, Amorolfine increases the size of C2C12 
myotubes in an MCU-dependent manner Moreover 
Amorolfine significantly increases the cross-sectional 
area of TA and EDL muscle fibers when injected for one 
week in TA muscles. In light of the role of mitCa2+ uptake 
in sustaining aerobic metabolism the positive modulation 
of MCU by Amorolfine increases oxygen consumption 
rate in flexor digitorum brevis (FDB)-isolated 
myofibers.5 Thus, the positive modulation of MCU by 
Amorolfine could be useful to sustain muscle trophsim in 
different conditions characterized by muscle atrophy. 
 Key Words: Skeletal muscle hypertrophy; mitochondrial 
calcium; positive MCU modulators; Amorolfine. 
References 
1. Mammucari C, Gherardi G, Zamparo I, Raffaello A, 

Boncompagni S, Chemello F, Cagnin S, Braga A, 
Zanin S, Pallafacchina G, Zentilin L, Sandri M, De 
Stefani D, Protasi F, Lanfranchi G, Rizzuto R. The 
mitochondrial calcium uniporter controls skeletal 
muscle trophism in vivo. Cell Rep. 2015 Mar 
3;10(8):1269-79. doi: 10.1016/j.celrep.2015.01.056. 
Epub 2015 Feb 26. PMID: 25732818; PMCID: 
PMC4351162. 

2. Nicchitta CV, Williamson JR. Spermine. A regulator 
of mitochondrial calcium cycling. J Biol Chem. 1984 
Nov 10;259(21):12978-83. PMID: 6238031.. 

3. Montero M, Lobaton CD, Moreno A, Alvarez J. A 
novel regulatory mechanism of the mitochondrial 
Ca2+ uniporter revealed by the p38 mitogen-
activated protein kinase inhibitor SB202190. FASEB 
J. 2002 Dec;16(14):1955-7. doi: 10.1096/fj.02-
0553fje. Epub 2002 Oct 4. PMID: 12368236. 

4. Montero M, Lobatón CD, Hernández-Sanmiguel E, 
Santodomingo J, Vay L, Moreno A, Alvarez J. Direct 
activation of the mitochondrial calcium uniporter by 
natural plant flavonoids. Biochem J. 2004 Nov 

15;384(Pt 1):19-24. doi: 10.1042/BJ20040990. 
PMID: 15324303; PMCID: PMC1134084. 

5. De Mario A, Tosatto A, Hill JM, Kriston-Vizi J, 
Ketteler R, Vecellio Reane D, Cortopassi G, 
Szabadkai G, Rizzuto R, Mammucari C. 
Identification and functional validation of FDA-
approved positive and negative modulators of the 
mitochondrial calcium uniporter. Cell Rep. 2021 Jun 
22;35(12):109275. doi: 10.1016/j.celrep.2021. 
109275. PMID: 34161774; PMCID: PMC8242467. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 57 
 
Nitrate supplementation promotes an anabolic 
response and attenuates neuromuscular alterations in 
24-months old male mice 
 
Maira Rossi (1), Lucrezia Zuccarelli (2), Lorenza 
Brocca (1), Cristiana Sazzi (1), Simone Porcelli (1), 
Bruno Grassi (2), Roberto Bottinelli (1,3,4), Maria 
Antonietta Pellegrino (1,3) 
 
(1) Department of Molecular Medicine, University of 
Pavia; (2) Department of Medicine, University of Udine; 
(3) Interdepartmental Centre for Biology and Sport 
Medicine, University of Pavia; (4) National Neurological 
Institute C. Mondino Foundation, Pavia. 
E-mail: maira.rossi@unipv.it  
Aging is associated with a progressive loss of muscle 
mass and strength, defined as sarcopenia. Neuromuscular 
junction (NMJ) deterioration plays a key role in age-
related musculoskeletal impairment. Moreover, loss of 
nitric oxide synthase in skeletal muscle is associated with 
defects at NMJ,1 and, together with a reduced age-related 
nitric oxide bioavailability,2 is causative of muscle 
wasting3 and harmed mitochondria.4 Here we 

 
 
 
 

mailto:maira.rossi@unipv.it


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investigated the ability of chronic nitrate 
supplementation to counteract neuromuscular alterations 
during aging. 22-months-old C57BL/6 male mice were 
assigned as follows: old controls (Old-CTRL) and old 
supplemented with 1.5 mM inorganic nitrate in drinking 
water for two months (Old-N). All mice were sacrificed 
at 24 months and skeletal muscles dissected for ex-vivo 
determinations. A cohort of young male mice (7 months) 
was also evaluated to quantify age-related 
changes.Compared to Old-CTRL, treated mice showed a 
positive remodelling of the NMJ morphology (evaluated 
through the confocal microscopy) and an improvement of 
fibers innervation status supported by a decreased 
postsynaptic fragmentation and a reduced number of 
NCAM‐positive fibers, respectively. Moreover, Old-N 
mice showed an improvement in mitochondrial 
respiratory function (assessed through the High-
Resolution Respirometry), despite no change in 
mitochondrial dynamics. Furthermore, nitrate treatment 
induced an anabolic response through higher activation 
of factors involved in protein synthesis (P70S6K and S6), 
consistent with higher Gastrocnemius fibers cross-
sectional area found in treated animals in comparison to 
Old-CTRL. The present data indicate that nitrate 
supplementation has the potential to counteract age-
related neuromuscular deterioration. 
 
Key Words: Neuromuscular junction; aging; nitrate 
supplementation; muscle wasting.  
 
References 
1. Adams ME, Anderson KN, Froehner SC. The alpha-

syntrophin PH and PDZ domains scaffold 
acetylcholine receptors, utrophin, and neuronal nitric 
oxide synthase at the neuromuscular junction. J 
Neurosci. 2010 Aug 18;30(33):11004-10. doi: 
10.1523/JNEUROSCI.1930-10.2010 

2. Di Massimo C, Scarpelli P, Di Lorenzo N, Caimi G, 
di Orio F, Ciancarelli MG. Impaired plasma nitric 
oxide availability and extracellular superoxide 
dismutase activity in healthy humans with advancing 
age. Life Sci. 2006 Feb 9;78(11):1163-7. doi: 
10.1016/j.lfs.2005.06.037. Epub 2005 Oct 7 

3. Samengo G, Avik A, Fedor B, Whittaker D, Myung 
KH, Wehling-Henricks M, Tidball JG. Age-related 
loss of nitric oxide synthase in skeletal muscle causes 
reductions in calpain S-nitrosylation that increase 
myofibril degradation and sarcopenia. Aging Cell. 
2012 Dec;11(6):1036-45. doi: 10.1111/acel.12003. 
Epub 2012 Oct 4 

4. Nisoli E, Clementi E, Paolucci C, Cozzi V, Tonello 
C, Sciorati C, Bracale R, Valerio A, Francolini M, 
Moncada S, Carruba MO. Mitochondrial biogenesis 
in mammals: the role of endogenous nitric oxide. 
Science. 2003 Feb 7;299(5608):896-9. doi: 
10.1126/science.1079368 

 
Pdm3 March 29 - April 1, 2023 

2023Pdm3 March 31 - Abstract 58 
 
Insulin resistance modification during bed rest: 
relationship with circulating and muscular MMP and 
TIMPs 
 
Nicola Fiotti (1), Filippo Giorgio di Girolamo (1), 
Emiliana Giacomello (1), Rado Pisot (2), Gianni Biolo 
(1) 
 
(1) Department of Medical, Surgical and health Sciences, 
University of Trieste, Italy; (2) Science and Research 
Center Koper, Institute for Kinesiology Research, Koper, 
Slovenia. 
E-mail: fiotti@units.it  
 
Physical inactivity or bed rest increase insulin resistance 
and predispose to diabetes. Matrix MetalloProteinases 
(MMPs), a class of extra and intracellular endoproteases, 
and their inhibitors, Tissue Inhibitors of MmPs (TIMPs) 
play a role in muscle remodeling but limited evidence 
exists on their relationship with metabolic changes 
following muscular inactivity.1-3 We looked for an 
association between modifications of muscle and plasma 
MMPs and TIMPs with changes in glucose tolerance 
during experimental microgravity. In ten young healthy 
males (18-33 yr) undergoing 10 days of horizontal bed 
rest, muscle expression and plasma levels of MMP-1, -2, 
-8, -9 and -13 and of their inhibitors TIMP-1 and TIMP-
2 have been compared with changes in fasting glucose, 
insulin and HOMA index. At baseline, cytoplasmic and 
pericellular MMP13 positively correlated with 
circulating glucose, while MMP-8 and -9 plasma levels 
positively correlate with Homa index and insulin levels 
(P<.008). These MMP13 and MMP8 correlations with 
the glucose tolerance test were lost by day 5 and that of 
MMP9 by the end (day 10) of bed rest. During bed rest, 
changes (i.e. final/initial) in cytoplasm TIMP1 

 
Figure. Changes in insulin resistance indicators 
(expressed as ratio final/baseline) according to 
muscle cytoplasm TIMP1 pattern. 
 

mailto:fiotti@units.it


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expression negatively correlated with those of HOMA 
index (-.721, P=0.019) and insulin (-.697, P= 0.025). In 
detail, Homa index and insulin increased substantially 
(>15% from baseline) in 6 subjects and remained stable 
in 4 (insulin: +57 Vs -1.5 and HOMA-IR: + 47% Vs -7%, 
respectively, P=0.01). The six subjects with worsening of 
glucose tolerance also had a stable or reduced cytoplasm 
TIMP1 (-27 %, range -80-0%) during bed rest, while it 
remained increased in the other 4 (+37% range 7-78%), 
as in Figure. Homa index and Insulin reached and AUC 
of 1.0 (p=.011) on ROC curve when compared according 
to TIMP1 pattern (stabe or reduced Vs increased). In 
conclusions, short term glucose levels regulation seems 
associated with cellular and pericellular MMP-13, and 
MMP-8 and -9 at baseline. Worsening of glucose 
tolerance during bed rest is observed in subjects with 
lowering of TIMP-1 cytoplasm muscle content during 
physical inactivity. 
Key Words: Insulin resistance; bed rest; TIMP-1, 
immunofluorescence, Physical inactivity. 
References: 
1. Kologrivova IV et al. System of matrix 

metalloproteinases and cytokine secretion in type 2 
diabetes mellitus and impaired carbohydrate 
tolerance associated with arterial hypertension. Bull 
Exp Biol Med. 2014 Mar;156(5):635-8.  

2. Kadoglou NP et al. Exercise ameliorates serum 
MMP-9 and TIMP-2 levels in patients with type 2 
diabetes. Diabetes Metab. 2010 Apr;36(2):144-51. 

3. Hopps E et al. Gelatinases and their tissue inhibitors 
in a group of subjects with metabolic syndrome. J 
Investig Med. 2013 Aug;61(6):978-83. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 
 
 
FRIDAY March 31, 2023 

ROOM B, Hotel Petrarca, Thermae of Euganean 
Hills (Padua) Italy 

 
09:30 AM  Practical Course on functional 

analysis of the stomatognathic 
system 

 
Claudia Dellavia, Riccardo Rosati, Chairs 

 
For dentists who want to expand the analyses of the stomatognathic 
system developed at the Laboratory of Functional Anatomy of the 
Stomatognathic Apparatus (LAFAS) of the University of Milan, Italy 
 
 

2023Pdm3 March 31 - Abstract 59 
 
Instrumental evaluations of the stomatognathic 
apparatus: static and dynamic tests. 
 
Claudia Dellavia, Riccardo Rosati 
 
Department of Biomedical, Surgical and Dental 
Sciences, Università degli Studi di Milano, Italy 
E-mail: claudia.dellavia@unimi.it  
 
The stomatognathic apparatus constantly performs 
complex activities, such as deglutition, mastication, 
speech, suction. The muscles that move mandibula, 
tongue, hyoid, soft palate and lips generate mechanical 
forces dissipated by the hard tissues (bones, 
temporomandibular joint, teeth). Several muscle groups 
are involved and coordinated by the central nervous 
system under the influence of peripheral inputs. Surface 
electromyography (sEMG) is a non-invasive low-cost 
method usable in research and in dental clinical practice 
for the quantitative and qualitative analysis of head and 
neck muscles. sEMG does not directly assess the 
muscular fibers then, to remove (or reduce) technical and 
biological artefacts, a well-standardized protocol should 

be used. In addition, the crosstalk from different muscles, 
the instrumental noise, the thickness of the hypodermis, 
the position of the electrodes relative to the muscle fibers 
and other factors can influence the sEMG signal. Taking 
into consideration these technical features, a correct 
sEMG assessment should be performed only with a 
reproducible protocol, and with standardized⁄ normalized 
potentials to remove most of biological and technical 
noises.  sEMG analysis based on standardized indexes 
computation, allow to evaluate, in a reliable way, 
occlusal-induced proprioceptive mediated muscular 
recruitment. Combining sEMG standardized indexes 
with biomechanical concepts, occlusal devices and 
prosthesis adapting procedures could be clinically 
performed to re-establish the physiological muscular 

 
Biomechanical models of the jaw, combined with 
standardized sEMG procedures, help dentists 
understand oral and neck muscle physiology. 

mailto:claudia.dellavia@unimi.it


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coordination or to reduce the muscular adaption to new 
occlusal conditions. 
 
Key Words: sEMG masticatory muscle; dental occlusion; 
dental rehabilitation; swallowing, neck muscles.  
 
References 
1. Dong Y, Wang XM, Wang MQ, Widmalm SE. 

Asymmetric muscle function in patients with 
developmental mandibular asymmetry. J Oral 
Rehabil. 2008;35(1):27-36.  

2. Ferrario VF, Tartaglia GM, Luraghi FE, Sforza C. 
The use of surface electromyography as a tool in 
differentiating temporomandibular disorders from 
neck disorders. Man Ther. 2007;12(4):372-379. 

3. Armijo–Olivo S, Magee DJ. Electromyographic 
activity of the masticatory and cervical muscles 
during resisted jaw opening movement. J Oral 
Rehabil. 2007;34(3):184-194. 

4. Botelho AL, Gentil FH, Sforza C, da Silva MA. 
Standardization of the electromyographic signal 
through the maximum isometric voluntary 
contraction. Cranio. 2011;29(1):23-31. 

5. Ferrario VF, Sforza C. Biomechanical model of the 
human mandible in unilateral clench: distribution of 
temporomandibular joint reaction forces between 
working and balancing sides. J Prosthet Dent. 
1994;72(2):169-176. 

 
Pdm3 March 29 - April 1, 2023 

***** 

FRIDAY March 31, 2023 

Conference Hall, Hotel Petrarca, Thermae of 
Euganean Hills (Padua) Italy 

 
10:30 AM SESSION VIII: Muscle Fascia, 

biology and pathology 
 
 Carla Stecco, Alessandro Martini, Chairs 
 
  

 
***** 

2023Pdm3 March 31 - Abstract 60 
 
Fascia and aging 
 
Carla Stecco, Chenglei Fan, Carmelo Pirri, Caterina 
Fede, De Caro Raffaele 
 
Department of Neuroscience, University of Padua, Italy 
E-mail: carla.stecco@unipd.it  
 
Extracellular matrix (ECM) of intramuscular connective 
tissue (IMCT) play critical role not only in maintaining 

integrity of muscle, but also in providing mechanical 
properties and local signals to modulate muscle cell 
fusion and regeneration. The aim of this study was to 
investigate whether the contents of ECM of IMCT 
change with aging. Age-related changes of ECM in 
human quadriceps femoris were compared in 10 young 
men (37.5±9.0y), 12 elderly men (79.0±12.4y) patients 
with traumatic fracture (Studio 3027P/AO/13). Age-
related ECM alterations in mice hindlimb were compared 
in 6-weeks puberty (group A); 8-months middle age 
(group B) and 2-years old (group C) C57BL/6J male 
mice. Hematoxylin Eosin, Picrosirius-red, the collagen 
type I (COLI), III (COLIII) antibody, and biotinylated 
hyaluronan binding protein (HABP) 
immunohistochemistry staining were used to evaluate the 
morphology, collagen content, COLI, COLIII and HA 
both in human and mice muscle cross-section. Alcian 
Blue, Weigert Van Gieson staining were used to evaluate 
the glycosaminoglycans and elastic fiber components in 
human male specimens. Age-related alterations of HA 
concentrations were evaluated both in human and mice 
specimens using Purple-Jelley HA assay. The collagen 
contents in IMCT were also significantly increased in 
mice with aging, above all due to an increase in COLI 
both in the human (P =0.001) and mice specimens, while 

       

 
       

 
 

Amount of collagen fibers in the endomysium of a 
young (top) and old (bottom) man. 

mailto:carla.stecco@unipd.it


2023 Pdm3 - Post meeting book of abstracts 
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there were no significantly differences in COLIII. In 
addition, the area percentage of elastic fibers in 
perimysium was significantly lower (P<0.01) in the 
elderly men group. The HA content was significantly 
decreased in the elderly men compare to the young men 
(P=0.04). In addition, the amount of HA in mouse 
hindlimb muscle was also significantly decreased with 
health aging. The accumulation of collagen content and 
decreased HA in ECM of IMCT, the decreased relative 
elastic fibers in perimysium may cause the IMCT stiffer 
and reduce its’ adaptability, changing gliding of the 
IMCT and influence the function of muscle fibers. These 
alterations of ECM in IMCT properly can partly explain 
the peripheral mechanisms of the decline of age-related 
locomotor ability 
 
Key Words: Aging; intramuscular connective tissue; 
collagen; hyaluronan. 
 
References 
1. Fede C, Fan C, Pirri C, Petrelli L, Biz C, Porzionato 

A, Macchi V, De Caro R, Stecco C. The Effects of 
Aging on the Intramuscular Connective Tissue. Int J 
Mol Sci. 2022 Sep 21;23(19):11061. doi: 
10.3390/ijms231911061.  

2. Fan C, Pirri C, Fede C, Guidolin D, Biz C, Petrelli L, 
Porzionato A, Macchi V, De Caro R, Stecco C. Age-
Related Alterations of Hyaluronan and Collagen in 
Extracellular Matrix of the Muscle Spindles. J Clin 
Med. 2021 Dec 24;11(1):86. doi: 
10.3390/jcm11010086.  

3. Gaudreault N, Benoît-Piau J, van Wingerden JP, 
Stecco C, Daigle F, Léonard G. An Investigation of 
the Association between Transversus Abdominis 
Myofascial Structure and Activation with Age in 
Healthy Adults using Ultrasound Imaging. Int J 
Sports Phys Ther. 2021 Aug 1;16(4):1093-1103. doi: 
10.26603/001c.25168.  

4. Pavan P, Monti E, Bondí M, Fan C, Stecco C, Narici 
M, Reggiani C, Marcucci L. Alterations of 
Extracellular Matrix Mechanical Properties 
Contribute to Age-Related Functional Impairment of 
Human Skeletal Muscles. Int J Mol Sci. 2020 Jun 
2;21(11):3992. doi: 10.3390/ijms21113992.  

5. Wilke J, Macchi V, De Caro R, Stecco C. Fascia 
thickness, aging and flexibility: is there an 
association? J Anat. 2019 Jan;234(1):43-49. doi: 
10.1111/joa.12902. Epub 2018 Nov 11. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 
 
 
 
 

2023Pdm3 March 31 – Abstract 61 
 
Tensor Tympani: unveiling a hidden muscle 
 
Diego Cazzador (1), Valerio Maria Di Pasquale Fiasca 
(1), Davide Brotto (1), Giovanna Albertin (3), Laura 
Astolfi (2), Elisabetta Zanoletti (1), Alessandro Martini 
(2) 
 
(1) Section of Otolaryngology, Otolaryngology Unit, 
Department of Neurosciences, University of Padua, Italy; 
(2) Bioacoustics Research Laboratory, Department of 
Neurosciences, University of Padua, Italy; (3) 
Department of Human Anatomy and Physiology, 
University of Padua Medical School, Italy. 
E-mail: diego.cazzador@unipd.it  
 
The Tensor Tympani muscle (TTM), a small muscle 
placed in the medial-anterior portion of the middle ear 
cavity, represents a subject of lively debate. Its function 
and activity have been investigated for decades, but still 
remain unclear. Aiming to collect the available 
knowledge regarding this structure, the authors 
performed a review of the literature. Particular attention 
was dedicated to its anatomy and physiology. It is known 
that the TTM reacts to different stimuli, both auditory and 
non-auditory. It was hypothesized its role in the middle 
ear reflex to protect the cochlea from high-intensity 
noises, in synergy with the stapedius muscle. Moreover, 
the activity of the TTM was demonstrated to determine a 
conductive hearing loss by stiffening the ossicular chain. 
Other triggers for TTM contraction were described, such 
as vocalization, swallowing and chewing. A relationship 
was proposed between the TTM and the tensor veli 
palatini, two muscles both developing form the first 
pharyngeal arch, and other masticatory muscles. Some 
other non-auditory triggers can activate the TTM, 
including anticipation of loud sounds, orbital air jet and 
tactile stimulation of the face. Several theories regarding 
the function of TTM are still being postulated. Its neural 
connection with the brain and other muscles are still 
object of study. Its relationship with the eustachian tube 
could provide explanation to different pathological 
processes. Indeed, the function and activity of TTM have 
been speculated for decades, and nowadays it is not 
possible to state a definitive answer to its physiological 
role. 
 
Key Words: Fascia; Tensor Tympani; Middle ear 
muscles. 
 
References  
1. Fournier P, Paquette S, Paleressompoulle D, Paolino 

F, Devèze A, Noreña A. Contraction of the stapedius 
and tensor tympani muscles explored by 
tympanometry and pressure measurement in the 
external auditory canal. Hear Res. 2022 

mailto:diego.cazzador@unipd.it


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Jul;420:108509. doi: 10.1016/j.heares.2022.108509. 
Epub 2022 Apr 27. PMID: 35568596. 

2. Stach BA, Jerger JF, Jenkins HA. The human acoustic 
tensor tympani reflex. A case report. Scand Audiol. 
1984;13(2):93-9. doi: 10.3109/01050398409043046. 
PMID: 6463558 

3. Rodríguez-Vázquez JF, Sakiyama K, Abe H, Amano 
O, Murakami G. Fetal Tendinous Connection 
Between the Tensor Tympani and Tensor Veli 
Palatini Muscles: A Single Digastric Muscle Acting 
for Morphogenesis of the Cranial Base. Anat Rec 
(Hoboken). 2016 Apr;299(4):474-83. doi: 
10.1002/ar.23310. Epub 2016 Jan 27. PMID: 
26744237 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 31 - Abstract 62 
 
Ultrasound imaging and fasciae 
 
Carmelo Pirri, Veronica Macchi, Carla Stecco, Raffaele 
De Caro 
 
Department of Neuroscience, Institute of Human 
Anatomy, University of Padua, Italy  
E-mail: carmelo.pirri@unipd.it  
 
Ultrasound (US) imaging has assumed an important role 
in the soft tissue assessments. The fascia is actually one 
of those interesting structures, and its pathologic 
characteristics are worth discussing with regard to our 
daily practice. Fasciae are extensive connective tissues 
that envelope our muscles, nerves, organs, and viscera. 
Actually, many histologic and macroscopic studies have 
described the same fascial organization in all regions of 
the body, with few regional specializations. The 
knowledge about these fasciae can help the sonographer 
easily recognize them throughout the whole body—for a 
better orientation as well as prompt diagnosis. On US 
imaging the superficial fascia is a thin hyperchoic layer 
in the subcutaneous tissue, whereas the deep/muscular 
fascia is a thick hyperchoic layer in closed relationship 
with the muscles. Some studies investigated the value of 
US examination of fasciae in different topographical 
regions. Varoius US parameters were evaluated in the 
last years, such as thickness and echogenicity. The latter 
two, in particular the thickness, showed a variability 
among the various topographical regions. Moreover, the 
reliability of US imaging for measuring these structures 
has also been assessed in various other studies, showing 
a good/optimal intra- and inter-rater reliability. US 
imaging is a reliable tool for assessing the fasciae, 
providing an excellent anatomical definition that 
accurately corresponds to histological findings. 

Key Words: Ultrasound imaging; deep fascia; superficial 
fascia; thickness; echogenicity; reliability.  
References 
1. Özçakar L, Kara M, Chang KV, Çarl AB, Akkaya N, 

Tok F, Chen WS, Wang TG, Tekin L, Ulaşl AM, 
Chen CP, Çapkn E, De Muynck M. Nineteen reasons 
why physiatrists should do musculoskeletal 
ultrasound: EURO-MUSCULUS/USPRM 
recommendations. Am J Phys Med Rehabil. 2015 
Jun;94(6):e45-9. doi: 
10.1097/PHM.0000000000000223. 

2. Stecco C, Macchi V, Porzionato A, Duparc F, De 
Caro R. The fascia: the forgotten structure. Ital J Anat 
Embryol. 2011;116(3):127-38. 

3. Pirri C, Stecco C, Fede C, Macchi V, Özçakar L. 
Ultrasound Imaging of the Fascial Layers: You See 
(Only) What You Know. J Ultrasound Med. 2020 
Apr;39(4):827-828. doi: 10.1002/jum.15148. Epub 
2019 Oct 23. 

4. Pirri C, Guidolin D, Fede C, Macchi V, De Caro R, 
Stecco C. Ultrasound Imaging of Brachial and 
Antebrachial Fasciae. Diagnostics (Basel). 2021 Dec 
2;11(12):2261. doi: 10.3390/diagnostics11122261. 

5. Pirri C, Pirri N, Porzionato A, Boscolo-Berto R, De 
Caro R, Stecco C. Inter- and Intra-Rater Reliability of 
Ultrasound Measurements of Superficial and Deep 
Fasciae Thickness in Upper Limb. Diagnostics 
(Basel). 2022 Sep 9;12(9):2195. doi: 
10.3390/diagnostics12092195. 

 
Pdm3 March 29 - April 1, 2023 

***** 
 

 
       

 

 
Examples of US imaging of fasciae. * superficial 
fascia; #: deep fascia. 

*
#

mailto:carmelo.pirri@unipd.it


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2023Pdm3 March 31 - Abstract 63 
 
How sex hormones can affect the fasciae 
 
Caterina Fede, Carla Stecco 
 
Department of Neuroscience, Institute of Human 
Anatomy, University of Padova, Italy 
E-mail: caterina.fede@unipd.it  
 
It is well established that the prevalence rate of 
musculoskeletal pain is significantly higher in women 
with respect to males, with an even greater onset of 
chronic conditions (Ceccarelli et al., 2021). It is recently 
reported that fascia can be a possible source of pain: if 
the connective tissue is altered, the behaviour of the 
fascial tissue and the underlying muscle may become 
compromised causing myofascial pain. Sex hormone 
disorders can dysregulate the fascial tissue: the 
comprehension of this mechanism is an important step 
for understanding gender differences in myofascial pain, 
helping clinicians to diagnose and treat patients (Fede et 
al., 2022).  Sex hormone receptors are expressed by 
fascial fibroblasts, with a lower expression with the 
decrease in hormone levels in post-menopausal women 
(Fede et al., 2016). The cells of the fascia can moreover 
modulate the synthesis of extracellular matrix 
components depending on hormone levels: when β-
estradiol levels are low, fascial tissue becomes enriched 
in collagen-I (from 5.2% of control sample to 8.4%), with 
a parallel decrease in collagen-III (from 2.4% to 1.5%) 
and elastic fibres (from 0.5% to 0.2%) (Fede et al., 2019). 
Consequently, the tissue becomes less elastic and more 
rigid, something that normally occurs during menopause. 
Conversely, when hormone levels are high, as they 

normally are during the ovulatory peak or during 
pregnancy, the opposite takes place: collagen-III rises to 

6.8% during ovulation and 6.7% during pregnancy as 
does Fibrillin-1 (from 0.2% in menopause to 3.6% during 
pregnancy) while collagen-I falls to 1.9% (Fede et al., 
2019). The result is softer, more elastic tissue. These 
results highlight how hormonal disorders in women can 
dysregulate the extracellular matrix synthesis (Figure), 
modifying the properties of tissue and evoking the 
sensitization of fascial nociceptors. Further studies on 
multifactorial effects of sex hormones on fasciae and pain 
mechanisms  will permit to correlate any dysfunctions in 
hormonal levels linked to pathologies, ageing and period 
of the cycle, to the onset of myofascial pain, thus making 
it possible to find out a targeted gender therapy. 
 
Key Words: Fascia; women chronic pain; sex hormones, 
β-estradiol. 
 
References 
1. Ceccarelli I, Bioletti L, Peparini S, Solomita E, Ricci 

C, Casini I, Miceli E, Aloisi AM. Estrogens and 
phytoestrogens in body functions. Neurosci Biobehav 
Rev. 2022;132:648-663. doi: 10.1016/j.neubiorev. 
2021.12.007.  

2. Fede C, Pirri C, De Caro R, Stecco C. Myofascial 
pain in females and personalized care: The key role 
played by sex hormones. Eur J Pain. 2022;26(4):939-
940. doi: 10.1002/ejp.1920. 

3. Fede C, Albertin G, Petrelli L, Sfriso MM, Biz C, De 
Caro R, Stecco C. Hormone receptor expression in 
human fascial tissue. Eur J Histochem. 
2016;60(4):2710. doi: 10.4081/ejh.2016.2710.  

4. Fede C, Pirri C, Fan C, Albertin G, Porzionato A, 
Macchi V, De Caro R, Stecco C. Sensitivity of the 
fasciae to sex hormone levels: Modulation of 
collagen-I, collagen-III and fibrillin production. 
PLoS One. 2019;14(9):e0223195 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 64 
 
Lymphatic vessels detection in subcutis and 
superficial fascia 
 
Giovanna Albertin (1), Laura Astolfi (2-4), Caterina 
Fede (1), Raffaele De Caro (1), Carla Stecco (1) 
 
(1) Department of Neuroscience (DNS), Section of 
Human Anatomy, University of Padova, Italy; (2) 
Bioacoustics Research Laboratory, Department of 
Neuroscience, University of Padova, Padova, Italy; (3) I-
APPROVE-International Auditory Processing Project in 
Venice, Department of Neurosciences, University of 
Padova; (4) Santi Giovanni e Paolo Hospital, ULSS3 
Serenissima, Venezia, Italy. 
E-mail: giovanna.albertin@unipd.it  
 

 
 

Scheme of fascial cell response and extracellular 
matrix rearrangement at different hormone levels 
(estrogen and relaxin-1) (from Fede et al., PLoS 
One. 2019;14(9):e0223195). 
 
 

mailto:caterina.fede@unipd.it
mailto:giovanna.albertin@unipd.it


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Lymphedema, defined as the abnormal accumulation of 
protein-rich fluid in soft tissues, results from the 
dysfunction of lymphatic system, an imbalance between 
lymph formation and its absorption into the initial 
lymphatics. The chronic accumulation of interstitial fluid 
leads adipose deposition, fibrosis, or persistent 
inflammation on subcutis (1). Today, lymphedema's 
therapies require a detailed understanding of the anatomy 
of subcutaneous lymphatic system (2), moreover, the 
exact localization of the collectors and their relationships 
with fascial layers have not been defined yet. The aim of 
this study was to investigate the distribution, density and 
organization of lymphatic vessels (LV) with reference to 
the layered conformation of the subcutaneous tissue, that 
consist in the superficial adipose tissue (SAT), deep 
adipose tissue (DAT) and superficial fascia (SF) (3, 4). 
With this purpose, the subcutaneous tissue of three adult 
voluntary patients was harvested during abdominoplastic 
surgery and stained with a specific marker for the 
endothelial cells of lymphatic vessels, the monoclonal 
antibody D2-40 (5). LV, present massively on the 
papillary dermis, run parallel to the skin surface and are 
incorporated in the loose connective tissue to form a 
lymphatic plexus. On SAT, only thin LV, with a mean 
diameter of 11.6±7.71 µm, were visible close to the 

fibrous septa (retinacula cutis that connects the dermis to 
the deeper layers). In the DAT, the LV follow above all 
the blood vessel, they are thicker with a mean diameter 
of 22.5±12.77 µm. The SF exhibits the highest density of 
LV, with a mean diameter of 19.5±5.77 µm, they show a 
path parallel to the surface, where intertwining each other 
form a characteristic plexus. This study has shown the 
different distribution of the lymphatic vessels in the 
various subcutaneous layers and the existence of a new 
lymphatic plexus within the superficial fascia, adding 
new information on the alterations involving the 
subcutaneous tissues and consequently opening up new 
perspectives for surgery and manual treatments. 
Key Words: Lymphedema; fascial tissue; lymphatic 
vessels. 
References 
1. Mehrara BJ, Greene AK. Lymphedema and obesity: 

is there a link? Plast Reconstr Surg. 2014 
Jul;134(1)154e-160e. 

2. Savetsky IL, Torrisi JS, Cuzzone DA, Ghanta S, 
Albano NJ, Gardenier JC, Joseph WJ, Mehrara BJ. 
Obesity increases inflammation and impairs 
lymphatic function in a mouse model of lymphedema. 
Am J Physiol Heart Circ Physiol. 2014 Jul 
15;307(2):H165-72.  

3. Lancerotto L, Stecco C, Macchi V, Porzionato A, 
Stecco A, De Caro R. Layers of the abdominal wall: 
anatomical investigation of subcutaneous tissue and 
superficial fascia. Surg Radiol Anat. 2011 
Dec;33(10):835-42 

4. Fede C, Pirri C, Fan C, et al. A Closer Look at the 
Cellular and Molecular Components of the 
Deep/Muscular Fasciae. Int J Mol Sci. 2021 Jan 
30;22(3):1411.  

5. Fukunaga M. Expression of D2-40 in lymphatic 
endothelium of normal tissues and in vascular 
tumours. Histopathology. 2005 Apr;46(4):396-402. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 65 
 
The superficial fascia: Anatomy, innervation and 
vascularization 
 
Lucia Petrelli, Caterina Fede, Carmelo Pirri, Carla 
Stecco 
 
Department of Neuroscience, Section of Human 
Anatomy, University of Padua, Italy 
E-mail: lucia.petrelli@unipd.it  
 
The superficial fascia has only recently been recognized 
as a specific anatomical structure in its own right 
anatomical entity, being first considered as included in 
the hypodermis. Furthermore, whereas it is actually 
recognized that the innervation of the deep/muscular 

       

 
 

 

Immunohistochemistry with D2-40 antibody on 
superficial fascia. 

mailto:lucia.petrelli@unipd.it


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fascia plays a key role in proprioception and 
nociception,1 and there are studies highlighting the cell 
populations and the extracellular matrix characterization 
of the deep fascia,2 there are very few studies that have 
analyzed these characteristics in the superficial fascia. 
The superficial fascia is the second most highly 
innervated tissue after the skin, with a density of 
33.0 ± 2.5/cm2, and a mean nerve sizes of 19.1 ± 7.2 µm.3 
Free nerve endings innervate the tissue, and autonomic 
nerve fibers are present in the blood vessels, in the areas 
of vascularization and near adipocytes and in the 
connective tissue itself (Figure).   
A rich vascular pattern forming a fine, dense meshwork 
with an area percentage of 6.20% ± 2.10% von 
Willebrand factor stained vessels was noted in all the 
specimens of the fascia examined; the area percentage of 
the αSMA-stained vessels was 2.93% ± 1.80% . The 
diameters of the vessels fell between the 13 and 65 μm 
range; the network was composed of arteries, veins, 
capillaries and lymphatic segments.4  Fibroblasts, 
myofibroblasts, mast cells are evident in the tissue. 
Finally, the elastic fibers are more abundant in the 
superficial fascia than the deep fascia, demonstrating that 
the superficial fasciae are more adaptable.5 In the light of 
these findings is evident that the superficial fasciae have 
a clear and distinct anatomical entity, and that they 
should be considered according to their characteristics, 
innervation and vascularization to better understand their 
role in thermoregulation, exteroception and pain 
perception. The knowledge of the superficial fascia may 
improve grading and developing of different manual 
approach for treatments of fascial dysfunctions. 
Key Words: Superficial fascia; innervation; 
vascularization; autonomic innervation; arteries. 
References  
1. Fede C, Petrelli L, Guidolin D, Porzionato A, Pirri C, 

Fan C, De Caro R, Stecco C.  Evidence of a new 
hidden neural network into deep fasciae. Sci Rep, 11: 
12623, 2021. doi: 10.1038/s41598-021-92194-z. 

2.  Fede C, Pirri C, Fan C, Petrelli L, Guidolin D, De 
Caro R, Stecco C.   A Closer Look at the Cellular and 
Molecular Components of the Deep/Muscular 
Fasciae. Int J Mol Sci, 22: 1411, 2021. 

3. Fede C, Petrelli L, Pirri C, Neuhuber W, Tiengo C, 
Biz C, De Caro R, Schleip R, Stecco C.  Innervation 
of human superficial fascia.  Front Neuroanat. 2022 
Aug 29;16:981426.   doi: 
10.3389/fnana.2022.981426  

4. Pirri C, Petrelli L, Fede C, Guidolin D, Tiengo C, De 
Caro R, Stecco C.  Blood supply to the superficial 
fascia of the abdomen: An anatomical study. Clin 
Anat. 2022 Dec 28.    doi: 10.1002/ca.23993 

5.  Pirri C, Fede C, Petrelli L, Guidolin D, Fan C, De 
Caro R, Stecco C. Elastic Fibres in the subcutaneous 
tissue: Is there a difference between superficial and 
muscular fascia? A cadaver study. Skin Res Technol, 
28: 21-27, 2022.  doi: 10.1111/srt.13084 

 
Pdm3 March 29 - April 1, 2023 

***** 

2023Pdm3 March 31 – Abstract 66 
 
Biomechanical properties of the fascial system 
 
Lorenza Bonaldi (1), Alice Berardo (1,2,3), Carmelo 
Pirri (4), Carla Stecco (2,4), Chiara Giulia Fontanella 
(2,5) 
 
(1) Department of Civil, Environmental and 
Architectural Engineering, Padova, Italy; (2) Centre for 
Mechanics of Biological Material (CMBM), Padova, 
Italy; (3) Department of Biomedical Sciences, Padova, 
Italy; (4) Department of Neuroscience, Padova, Italy; (5) 
Department of Industrial Engineering, Padova, Italy. 
E-mail: lorenza.bonaldi@phd.unipd.it  
 
The "fascial system" has been defined as a fascial 
network involved in functional aspects such as force 
transmission.1 The fascial system comprises the 
superficial and deep fasciae which are connected through 
skin ligaments, also known as retinacula, providing a 
continuity from the skin to the muscular plane (See 
Figure).2 Indeed, superficial and deep fascia roles in 

       

 
       

 
 

The fascial system. 

 
Distribution of the innervation in superficial fascia: 
immunohistochemistry by S100 antibody. A = 
Adipocyte, v = vassel, c = Connective Tissue, * = 
Nerve,  Arrows = Nerve fiber.  
Reprinted with permission from Fede et al. 2022.3 

mailto:lorenza.bonaldi@phd.unipd.it


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clinical disorders have been shown to reflect their 
structures.3 Specifically, the superficial fascia has been 
described anatomically as an irregular multilamellar 
structure of interconnected substrates with islets of fat 
cells. Meanwhile, for example, the deep aponeurotic 
fascia consists of multilayered structures of dense and 
loose connective tissues, where collagen fibers follow 
specific directions.4 Since the properties of superficial 
and deep fasciae mimic their structural organization, the 
biomechanical characterization of these tissues is key to 
understanding how they influence each other. Despite the 
clinical impact of these arguments, to date, the literature 
is still poor in data comparing different substrates of the 
fascial system through mechanical tests. Therefore, the 
aim of this work is to investigate this open topic by 
presenting the biomechanical properties of both 
superficial and deep fasciae.5,6 The study highlights how 
these tissues have different biomechanical properties in 
relation to their specific structures and functions. These 
results have a direct impact in the medical field such as 
in the surgical treatment of soft tissue repair or 
reconstruction, as well as in rehabilitation intervention 
(e.g., manual treatment). 
Key Words: Connective tissue; musculoskeletal system; 
fascial system; superficial fascia; deep fascia; 
biomechanical characterization. 
References: 
1. Stecco C, Schleip R. A fascia and the fascial system. 

J Bodyw Mov Ther. 2016;20(1):139-140. 
doi:10.1016/j.jbmt.2015.11.012 

2. Stecco C, Macchi V, Porzionato A, Duparc F, De 
Caro R. The fascia: the forgotten structure. Ital J Anat 
Embryol. 2011;116(3):127-138. 

3. Stecco A, Stern R, Fantoni I, De Caro R, Stecco C. 
Fascial Disorders: Implications for Treatment. PM R. 
2016;8(2):161-168. doi:10.1016/j.pmrj.2015.06.006 

4. Stecco C. Functional Atlas of the human fascial 
system. Churchill Livingstone. 2015. 

5. Bonaldi L, Berardo A, Stecco C, Fontanella CG. 
Biomechanical characterization of human superficial 
fascia from abdomen: A case study. XI meeting: 
Italian Chapter of the ESB, 6-7 October 2022, Massa. 

6. Bonaldi L, Fontanella CG, Stecco C, Berardo A. 
Uniaxial Tensile Tests On Human Fascia Lata: Stress 
Relaxation And Failure Phenomena From Frozen 
Cadavers. 27th Congress of the ESB, 26-29 June 
2022, Porto. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 67 
 
Fascia Lata alterations in hip osteoarthritis: An 
observational cross-sectional study 
 
Ilaria Fantoni (1), Carlo Biz (1), Chenglei Fan (2), 
Carmelo Pirri (2), Caterina Fede (2), Lucia Petrelli (2), 

Pietro Ruggieri (1), Raffaele De Caro (2), Carla Stecco 
(2) 
 
(1) Orthopedics and Orthopedic Oncology, Dept. of 
Surgery, Oncology and Gastroenterology, University of 
Padua; (2) Dept. of Neurosciences, Institute of Human 
Anatomy, University of Padua, Italy. 
E-mail: ilaria.fantoni@gmail.com  
 
The present study compares the structure and 
composition of fascia lata in healthy subjects and in 
patients with hip osteoarthritis (OA), to evaluate any 
differences in the amount of Collagen type I, Collagen 
type III, and Hyaluronan. Fascia lata samples from 
voluntary healthy subjects and patients with OA were 
harvested during surgery. Collagen type I (COL I), III 
(COL III) antibody, and biotinylated hyaluronan binding 
protein (HABP) immunohistochemistry stainings were 
used to evaluate fascial morphology and COL I, COL III, 
and Hyaluronan (HA) content in both groups. Ten 
samples from healthy subjects (group A) and 11 samples 
from OA patients (group B) were collected. COL I was 
significantly more abundant in the OA group (p = 
0.0015), with a median percentage positivity of 75.2 
(IQR 13.11)%, while representing only 67 (IQR: 8.71)% 
in control cases. COL III, with median values of 9.5 (IQR 
3.63)% (OA group) and 17.10 (IQR 11)% (control cases), 
respectively, showed significant reduction in OA patients 
(p = 0.002). HA showed a median value of 10.01 (IQR 

8.11)% in OA patients, denoting significant decrease (p 
< 0.0001) with respect to the control group median 39.31 
(IQR 5.62)%.  The observed differences suggest a 
relationship between fascial pathology and hip OA. The 
observed increase in COL I in OA patients, along with 
the reduction of COL III and HA, could lead to fascial 
stiffening, which could alter fascial mechanics and be 
linked to the development and symptoms of OA. 
 
Key Words: Fascia; hip osteoarthritis; hyaluronan; 
collagen; stiffness; myofascial pain. 
 
References  
1. Fede C, Angelini A, Stern R, Macchi V, Porzionato 

A, Ruggieri P, De Caro R, Stecco C. Quantification 
of hyaluronan in human fasciae: variations with 

 
Boxplot comparing the percentage antibody 
positivity for Collagen I, Collagen III and HABP. 
 

mailto:ilaria.fantoni@gmail.com


2023 Pdm3 - Post meeting book of abstracts 
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function and anatomical site. J Anat. 2018 
Oct;233(4):552-556. doi: 10.1111/joa.12866. Epub 
2018 Jul 24. PMID: 30040133; PMCID: 
PMC6131966. 

2. Stecco C, Stern R, Porzionato A, Macchi V, Masiero 
S, Stecco A, De Caro R. Hyaluronan within fascia in 
the etiology of myofascial pain. Surg Radiol Anat. 
2011 Dec;33(10):891-6. doi: 10.1007/s00276-011-
0876-9. Epub 2011 Oct 2. PMID: 21964857. 

3. Pratt RL. Hyaluronan and the Fascial Frontier. Int J 
Mol Sci. 2021 Jun 25;22(13):6845. doi: 
10.3390/ijms22136845. PMID: 34202183; PMCID: 
PMC8269293. 

4. Rees HW. Management of Osteoarthritis of the Hip. 
J Am Acad Orthop Surg. 2020 Apr 1;28(7):e288-
e291. doi: 10.5435/JAAOS-D-19-00416. PMID: 
31800436. 

5. Grässel S, Muschter D. Recent advances in the 
treatment of osteoarthritis. F1000Res. 2020 May 
4;9:F1000 Faculty Rev-325. doi: 
10.12688/f1000research.22115.1. PMID: 32419923; 
PMCID: PMC7199286. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 

 

FRIDAY March 31, 2023 
Conference Hall, Hotel Petrarca, Thermae of 

Euganean Hills (Padua) Italy 
 

02:00 PM SESSION IX: Non-invasive 
Assessments in Myology 

 

 Paolo Gargiulo, Ugo Carraro, Chairs 
 
 

2023Pdm3 March 31 - Abstract 68 
LECTURE 

3D Quantitative Muscle Color Computed 
Tomography (3D-QMCCT) 
 
Paolo Gargiulo (1,2) 
 
(1) Institute of Biomedical and Neural Engineering, 
Reykjavik University, Reykjavik, Iceland; (2) 
Department of Science, Landspitali, University Hospital 
of Iceland, Reykjavik, Iceland. 
Email: paologar@landspitali.is  
 
In 2009 Ugo Carraro and Paolo Gargiulo introduced the 
term 3D Quantitative Muscle Color Computed 
Tomography (3D-QMCCT) as the process which, 
starting from computed tomography images, analyzes the 
distribution in Hounsfield Units (HU), that is the 
densitometry of a specific anatomical region, assigning a 
color (essentially derived from the colors of 
histologically labeled muscle biopsies) based on its 
density or morphology.1,2 3D-QMCCT has been a key 
tool primarily to assess, quantify, and monitor muscle 
atrophy in denervated tissue,3 but also to advance bone 
mineral density assessment and support surgical 
planning.4 3D-QMCCT provided the best evidence of the 
effectiveness of home-based Functional Electrical 
Stimulation of denervated muscles (hbFES) during 
validation by the Europenan project RISE.5 A 
development of 3D-QMCCT is the numerical muscle 
profile called Nonlinear Trimodal Regression Analysis  
(NTRA), which numerically summarizes the connective 
tissue, fat and muscle content from a CT cross section. 
NTRAs have significantly contributed to demonstrating 
the interactions between muscle tissue quality and 
comorbidities such as cholesterol disease and diabetes 
and correlations with lifestyle and mobility in the aging 
population.6,7 Today, with the improvement of medical 
imaging, human anatomy can be studied non-invasively 

 
 

From left: Alfonso M. Ponsiglione, Magnús K Gislason, Carlo Ricciardi, 
Paolo Gargiulo, Federica K Ciliberti, Valentina Betti, Riccardo Forni 

 
 

3D models of rectus femoris (a) at beginning and 
after 4 years of FESt; (b) chart pies showing the 
muscle composition in 2004 and 2008. 
Reproduced with permission from  BAM 19 (4): 157-161, 2009.1 

mailto:paologar@landspitali.is


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with micrometre resolution. As the dose of X-rays has 
been drastically reduced in recent years, the use of CT for 
research purposes is now much more feasible. In 
conclusion, new frontiers and applications, such as 
virtual cardiac histology, can be explored using 3D-
QMCCT and NTRA methods. 
Key words: 3D Quantitative Muscle Color Computed 
Tomography (3D-QMCCT); Nonlinear Trimodal 
Regression Analysis (NTRA); skeletal muscle atrophy 
and degeneration; home-based Functional Electrical 
Stimulation of denervated muscles (hbFES). 
References 
1.  Gargiulo P, Vatnsdal B, Ingvarsson P, Knútsdóttir S, 

Gudmundsdóttir V, Yngvason S, Kern H, Carraro U, 
Helgason T. Computational methods to analyze tissue 
composition and structural changes in denervated 
muscle undergoing therapeutic electrical stimulation. 
Basic Applied Myology 19 (4): 157-161, 2009. 

2. Gargiulo P, Kern H, Carraro U, Ingvarsson P, 
Knútsdóttir S, Gudmundsdóttir V, Yngvason S, 
Vatnsdal B, Helgason T. Quantitative color three-
dimensional computer tomography imaging of 
human long-term denervated muscle. Neurol Res. 
2010 Feb;32(1):13-9. doi: 10.1179/016164109X 
12536042424171. PMID: 20092691. 

3. Gargiulo P, Reynisson PJ, Helgason B, Kern H, Mayr 
W, Ingvarsson P, Helgason T, Carraro U. Muscle, 
tendons, and bone: structural changes during 
denervation and FES treatment. Neurol Res. 2011 
Sep;33(7):750-8. doi: 10.1179/ 
1743132811Y.0000000007. PMID: 21756556. 

4. Esposito L, Bifulco P, Gargiulo P, Gíslason MK, 
Cesarelli M, Iuppariello L, Jónsson H, Cutolo A, 
Fraldi M. Towards a patient-specific estimation of 
intra-operative femoral fracture risk. Comput 
Methods Biomech Biomed Engin. 2018 
Sep;21(12):663-672. doi: 10.1080/10255842.2018. 
1508570. Epub 2018 Oct 27. PMID: 30370789.  

5. Kern H, Carraro U, Adami N, Biral D, Hofer C, 
Forstner C, Mödlin M, Vogelauer M, Pond A, 
Boncompagni S, Paolini C, Mayr W, Protasi F, 
Zampieri S. Home-based functional electrical 
stimulation rescues permanently denervated muscles 
in paraplegic patients with complete lower motor 
neuron lesion. Neurorehabil Neural Repair. 2010 
Oct;24(8):709-21. doi: 10.1177/1545968310366129. 
Epub 2010 May 11. PMID: 20460493. 

6. Recenti M, Ricciardi C, Edmunds K, Jacob D, 
Gambacorta M, Gargiulo P. Testing soft tissue 
radiodensity parameters interplay with age and self-
reported physical activity. Eur J Transl Myol. 2021 
Jul 12;31(3):9929. doi: 10.4081/ejtm.2021.9929. 
PMID: 34251162; PMCID: PMC8495362. 

7.  Edmunds K, Gíslason M, Sigurðsson S, Guðnason V, 
Harris T, Carraro U, Gargiulo P. Advanced 
quantitative methods in correlating sarcopenic 

muscle degeneration with lower extremity function 
biometrics and comorbidities. PLoS One. 2018 Mar 
7;13(3):e0193241. doi: 10.1371/journal.pone. 
0193241. PMID: 29513690; PMCID: PMC5841751 

 
Pdm3 March 29 - April 1, 2023 

 
2023Pdm3 March 31 - Abstract 69 
 
Virtual cardiac histology: a densitometric 
characterisation of left ventricular tissue 
 
Riccardo Forni (1,2), Carmine Gelormini (3), Bjarni 
Torfason (4), Cristiana Corsi (2), Paolo Gargiulo (1,5) 
 
(1) Institute of Biomedical and Neural Engineering, 
Reykjavik University, Reykjavik, Iceland; (2) 
Department of Electrical, Electronic and Information 
Engineering, University of Bologna, Bologna, Italy; (3) 
Department of Civil Engineering and Computer Science 
Engineering, University of Rome Tor Vergata, Rome, 
Italy; (4) Department of Cardiothoracic Surgery, 
Landspitali University Hospital, Reykjavik, Iceland; (5) 
Department of Science, Landspitali, University Hospital 
of Iceland, Reykjavik, Iceland 
E-mail: riccardo21@ru.is  
 
Understanding the mechanisms behind changes in 
cardiac tissue has always been a topic of great interest. In 
recent years, biochemical, molecular, and genetic aspects 
have been studied. In this work, we investigated tissue 

 
 
3D samples segmentation graphical workflow: A) 
the first step consists in creating a mask of the 
whole heart. Pixels’ values in the [−200; 1600] HU 
range are included in the mask. Simultaneously a 
mask of the blood path is created and then excluded 
from the whole heart through boolean subtraction. 
B) Cylindrical holes are created, as negative, in a 
copy of the resulting mask, and the 3D samples are 
isolated with boolean subtraction. Each volume is 
stored separately 

mailto:riccardo21@ru.is


2023 Pdm3 - Post meeting book of abstracts 
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properties from Computed Tomography images. We 
designed a densitometric profile and assessed its relations 
with age, gender, and pathological conditions such as 
ventricular septal defect/rupture and hypertrophic 
cardiomyopathy. We developed a novel workflow to 
segment cardiac tissue to extract 3D samples from 
regions of clinical interest on the left ventricle. The 
densitometric profile evaluates the average density, 
variability, and complexity of the Hounsfield 
distribution. To assess these relationships, we 
implemented a linear mixed model, taking into account 
the non-independence of the data due to repeated 
measurements of the same subjects within different 
regions. The results showed that gender is a 
discriminating factor in average cardiac tissue density, 
while there is no real relationship between age and 
absorption. The study, including the diseases, showed 
that the mean free wall density of the left ventricle 
changes in the presence of hypertrophic cardiomyopathy. 
At the same time, there were no statistically significant 
changes between healthy subjects and patients with post-
infarction septal rupture. Moreover, we employed 
machine learning technology to evaluate the 
densitometric profile's predictive power, finding peak 
amplitude and peak position as the most promising 
features. Finally, this work shows a novel methodology 
to study cardiac tissue non-invasive, potentially 
becoming a valid clinical assessment to support an early-
stage diagnosis. 
Key Words: Virtual histology; cardiac tissue 
composition; densitometric profile; hypertrophic 
cardiomyopathy, ventricular septal rupture. 
References 
1. Mazonakis M, Damilakis J. Computed tomography: 

What and how does it measure? Eur J Radiol. 2016 
Aug;85(8):1499-504. doi: 10.1016/j.ejrad.2016.03. 
002. Epub 2016 Mar 10. PMID: 26995675. 

2. Maron BJ, Maron MS. Hypertrophic 
cardiomyopathy. Lancet. 2013 Jan 
19;381(9862):242-55. doi: 10.1016/S0140-6736(12) 
60397-3. Epub 2012 Aug 6. PMID: 22874472. 

3. Olivetti G, Melissari M, Capasso JM, Anversa P. 
Cardiomyopathy of the aging human heart. Myocyte 
loss and reactive cellular hypertrophy. Circ Res. 1991 
Jun;68(6):1560-8. doi: 10.1161/01.res.68.6.1560. 
PMID: 2036710. 

4. Recenti M, Ricciardi C, Edmunds KJ, Gislason MK, 
Sigurdsson S, Carraro U, Gargiulo P. Healthy Aging 
Within an Image: Using Muscle Radiodensitometry 
and Lifestyle Factors to Predict Diabetes and 
Hypertension. IEEE J Biomed Health Inform. 2021 
Jun;25(6):2103-2112. doi: 10.1109/JBHI.2020. 
3044158. Epub 2021 Jun 3. PMID: 33306475. 

5. Bates D, Mächler M, Bolker B, Walker S. Fitting 
linear mixed-effects models using lme4. arXiv 
preprint 2014; arXiv:1406.5823. 

6. Recenti M, Ricciardi C, Edmunds K, Jacob D, 
Gambacorta M, Gargiulo P. Testing soft tissue 

radiodensity parameters interplay with age and self-
reported physical activity. Eur J Transl Myol. 2021 
Jul 12;31(3):9929. doi: 10.4081/ejtm.2021.9929. 
PMID: 34251162; PMCID: PMC8495362. 

 
Pdm3 March 29 - April 1, 2023 

2023Pdm3 March 31 - Abstract 70 
 
Assessing early-stage Parkinson’s Disease using a 
moving platform (BioVRSea) 
 
Deborah Jacob (1), Romain Aubonnet (1), Marco 
Recenti (1), Sigrun Anna Audardottir (1), Thorbjorg Ida 
Ivarsdottir (1), Berangere Burgunder (1), Itziar Mengual 
i Escalona (1), Andrea Colacino (2), Anna Bjornsdottir 
(3), Hannes Petersen (4), Paolo Gargiulo (1) 
 
(1) Institute of Biomedical and Neural Engineering 
Reykjavik University Reykjavik, Iceland; (2) 
Department of Computer Engineering, Electrical 
Engineering and Applied Mathematics University of 
Salerno, Salerno, Italy; (3) Heilsuklasinn Parkinson’s 
Clinic Reykjavik, Iceland; (4) University of Iceland 
Reykjavik, Iceland 
E-mail: deborah20@ru.is  
 
Parkinson’s Disease is among the most prevalent 
neurological diseases in the world today. Typically 
characterised by impairments in motor function, there 
remains no known cure for the disease. Treatments 
generally take the form of medication and/or surgical 
intervention in combination with physical therapy. 
Deficits in postural control are commonly seen in 
Parkinson’s sufferers. Our work using the unique 
BioVRSea setup aims to assess early-stage Parkinson’s 
using a combination of neurphysiological 
(Electromyography and Heart Rate) and centre of 
pressure (or sway) measurements. 11 early-stage 
Parkinson’s subjects and 46 healthy over-50s took part in 
the experiment. Significant differences were found 
between the two groups in electromyographic and centre 
of pressure measurements. Correlation analysis indicated 

 
Setup of BioVRSea System and Graphic Abstract 

mailto:deborah20@ru.is


2023 Pdm3 - Post meeting book of abstracts 
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opposite correlations in skewness in the right soleus 
muscle. Finally, machine learning was able to predict 
with a maximum of 94.6% accuracy whether a subject 
belonged to the healthy or Parkinson’s group based on 
their measurements from the experiment. Our results are 
a first step in a prototype of the quantitative evaluation of 
early-stage Parkinson’s. 
 
Key Words: Parkinson’s Disease; biomarkers; 
BioVRSea; electromyography; centre of pressure; 
postural control. 
 
References 
1. Doná F, Aquino CC, Gazzola JM, Borges V, Silva 

SM, Ganança FF, Caovilla HH, Ferraz HB. Changes 
in postural control in patients with Parkinson's 
disease: a posturographic study. Physiotherapy. 2016 
Sep;102(3):272-9. doi: 
10.1016/j.physio.2015.08.009. Epub 2015 Oct 3. 
PMID: 26582134 

2. Recenti M, Ricciardi C, Aubonnet R, Picone I, Jacob 
D, Svansson HÁR, Agnarsdóttir S, Karlsson GH, 
Baeringsdóttir V, Petersen H, Gargiulo P. Toward 
Predicting Motion Sickness Using Virtual Reality and 
a Moving Platform Assessing Brain, Muscles, and 
Heart Signals. Front Bioeng Biotechnol. 2021 Apr 
1;9:635661. doi: 10.3389/fbioe.2021.635661. PMID: 
33869153; PMCID: PMC8047066.. 

3. Jacob D, Unnsteinsdóttir Kristensen IS, Aubonnet R, 
Recenti M, Donisi L, Ricciardi C, Svansson HÁR, 
Agnarsdóttir S, Colacino A, Jónsdóttir MK, 
Kristjánsdóttir H, Sigurjónsdóttir HÁ, Cesarelli M, 
Eggertsdóttir Claessen LÓ, Hassan M, Petersen H, 
Gargiulo P. Towards defining biomarkers to evaluate 
concussions using virtual reality and a moving 
platform (BioVRSea). Sci Rep. 2022 May 
30;12(1):8996. doi: 10.1038/s41598-022-12822-0. 
PMID: 35637235; PMCID: PMC9151646. 

4. Busa MA, van Emmerik REA. Multiscale entropy: A 
tool for understanding the complexity of postural 
control. J Sport Health Sci. 2016 Mar;5(1):44-51. doi: 
10.1016/j.jshs.2016.01.018. Epub 2016 Jan 21. 
PMID: 30356502; PMCID: PMC6188573. 

5. Fadil R, Huether A, Brunnemer R, Blaber AP, Lou 
JS, Tavakolian K. Early Detection of Parkinson's 
Disease Using Center of Pressure Data and Machine 
Learning. Annu Int Conf IEEE Eng Med Biol Soc. 
2021 Nov;2021:2433-2436. doi: 
10.1109/EMBC46164.2021.9630451. PMID: 
34891772. 

6. Recenti M, Ricciardi C, Edmunds K, Jacob D, 
Gambacorta M, Gargiulo P. Testing soft tissue 
radiodensity parameters interplay with age and self-
reported physical activity. Eur J Transl Myol. 2021 
Jul 12;31(3):9929. doi: 10.4081/ejtm.2021.9929. 
PMID: 34251162; PMCID: PMC8495362. 

 
Pdm3 March 29 - April 1, 2023 

2023Pdm3 March 31 - Abstract 71 
 
An in silico 3d approach to evaluate bone remodelling 
after total hip arthroplasty: a six years longitudinal 
study 
 
Valentina Betti (1), Halldór Jónsson Jr (2), Luca 
Cristofolini (1), Magnús Kjartan Gíslason (3), Paolo 
Gargiulo (3,4) 
 
(1) Dept of Industrial Engineering, University of 
Bologna, Italy; (2) Landspitali University Hospital – 
Dept. of Orthopaedics, Reykjavik, Iceland; (3) Institute 
of Biomedical and Neural Engineering, Reykjavik 
University, Reykjavik, Iceland; (4) Landspitali 
University Hospital – Dept. of Science, Reykjavik, 
Iceland. E-mail: valentina.betti9@unibo.it  
 
Nowadays, research on bone remodelling after a total hip 
arthroplasty (THA) is mainly performed using DXA-
scans, which gives a quantitative assessment but it can 
lose some pivotal features of how bone remodels since it 
is a 3d mechanism. The aim of this work was to enhance 
the understanding of the volumetric bone mineral density  
(vBMD) evolution after THA by developing a protocol 
to (i) three-dimensionally localise the changes in the 
proximal femur, and (ii) assess such changes in the long 
term. Twelve patients that underwent unilateral THA 
(with cemented/uncemented prostheses) were recruited. 
Three calibrated CT scans of the proximal femur were 
collected at different time points: 24 hours, 1 year and 6 
years after surgery. The 3D models of the proximal femur 
were extracted, and an algorithm was developed to split 
them into the Gruen zones. The bone density gain and 
loss for both the whole proximal femur and those specific 
regions was calculated by comparing density values 
between the three sets of scans. Results showed lower 
amount of trabecular bone observed in the cemented 
cohort compared to the uncemented group, and some 
differences in terms of vBMD evolution were noticed in 
the whole femur and specifically in some Gruen zones. A 
high inter-patient variability was observed, ranging from 
some cases that showed a physiological bone 
remodelling, to some pathological conditions in which an 
unexpected increase/decrease of vBMD (e.g. +340% 

 
 
Study workflow. The CT scans were collected and 
processed to obtain the 3d models of the proximal 
femur for the vBMD evaluation. 

mailto:valentina.betti9@unibo.it


2023 Pdm3 - Post meeting book of abstracts 
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after one year) was noticed. In conclusion, the presented 
analysis is an useful tool (i) to understand the vBMD 
evolution in THA patients in the long-term, and (ii) for 
the follow-up of patients where a failure of the implant is 
to be expected. 
Key Words: Bone remodeling; total hip arthroplasty; 
Gruen zones; longitudinal study.  
References 
1. Gislason MK, Lupidio F, Jónsson H Jr, Cristofolini 

L, Esposito L, Bifulco P, Fraldi M, Gargiulo P. Three 
dimensional bone mineral density changes in the 
femur over 1 year in primary total hip arthroplasty 
patients. Clin Biomech (Bristol, Avon). 2020 
Aug;78:105092. doi: 
10.1016/j.clinbiomech.2020.105092. Epub 2020 Jun 
11. PMID: 32590143. 

2. Gargiulo P, Edmunds KJ, Gíslason MK, Latour C, 
Hermannsson Þ, Esposito L, Bifulco P, Cesarelli M, 
Fraldi M, Cristofolini L, Jónsson H Jr. Patient-
specific mobility assessment to monitor recovery 
after total hip arthroplasty. Proc Inst Mech Eng H. 
2018 Oct;232(10):1048-1059. doi: 
10.1177/0954411918797971. Epub 2018 Sep 7. 
PMID: 30191747. 

3. Pitto RP, Bhargava A, Pandit S, Walker C, Munro JT. 
Quantitative CT-assisted osteodensitometry of 
femoral adaptive bone remodelling after uncemented 
total hip arthroplasty. Int Orthop. 2008 
Oct;32(5):589-95. doi: 10.1007/s00264-007-0389-7. 
Epub 2007 Jun 20. PMID: 17579860; PMCID: 
PMC2551722. 

4. Recenti M, Ricciardi C, Edmunds K, Jacob D, 
Gambacorta M, Gargiulo P. Testing soft tissue 
radiodensity parameters interplay with age and self-
reported physical activity. Eur J Transl Myol. 2021 
Jul 12;31(3):9929. doi: 10.4081/ejtm.2021.9929. 
PMID: 34251162; PMCID: PMC8495362. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 72 
 
Novel strategies for cartilage assessment, interplay 
between bone and muscles 
 
Federica Kiyomi Ciliberti (1), Romain Aubonnet (1), 
Jorgelina Ramos (1), Marco Recenti (1), Deborah Jacob 
(1), Lorena Guerrini (1), Magnus K. Gíslason (1), Olafur 
Sigurjonsson (1), Mariella Tsirilaki (2), Halldór Jónsson, 
Jr (2,3), Paolo Gargiulo (1,2) 
 
(1) Institute of Biomedical and Neural Engineering, 
Reykjavik University, Reykjavik, Iceland; (2)  
Landspitali, University Hospital of Iceland, Reykjavik, 
Iceland; (3) Medical Faculty, University of Iceland, 
Reykjavik, Iceland. E-mail: federica21@ru.is  

Assessment of human joint cartilage is a crucial tool to 
detect and diagnose pathological conditions. This 
exploratory study develop a workflow for 3D modeling  
of cartilage, muscle and bone based on multimodal 
imaging.  We present a novel methodology to evaluate 
knee condition using features extracted from magnetic 
resonance imaging (MRI) and computed tomography 
(CT) data. New evaluation metrics were created and a 
unique set of data was gathered from healthy control 
subjects and patients with clinically evaluated 
degeneration or trauma.  We developed patient specific 
3D models of the tibial, femoral, and patellar bones and 
cartilages. We compare the sensitivity of different 
metrics to classify the cartilage condition and evaluate 
degeneration based on bones and muscle densitometry. 
The present work demonstrates the potential for 
improving sensitivity in cartilage assessment. 

 
Key Words: Image segmentation; knee cartilage; 
classification; osteoarthritis; 3D models. 
 
References 
1. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. 

Clin Geriatr Med. 2010 Aug;26(3):355-69. doi: 
10.1016/j.cger.2010.03.001. Erratum in: Clin Geriatr 
Med. 2013 May;29(2):ix. PMID: 20699159; PMCID: 
PMC2920533. 

2. Roemer FW, Demehri S, Omoumi P, Link TM, 
Kijowski R, Saarakkala S, Crema MD, Guermazi A. 
State of the Art: Imaging of Osteoarthritis-Revisited 
2020. Radiology. 2020 Jul;296(1):5-21. doi: 
10.1148/radiol.2020192498. Epub 2020 May 19. 
PMID: 32427556. 

3. Ciliberti FK, Guerrini L, Gunnarsson AE, Recenti M, 
Jacob D, Cangiano V, Tesfahunegn YA, Islind AS, 
Tortorella F, Tsirilaki M, Jónsson H Jr, Gargiulo P, 
Aubonnet R. CT- and MRI-Based 3D Reconstruction 
of Knee Joint to Assess Cartilage and Bone. 
Diagnostics (Basel). 2022 Jan 22;12(2):279. doi: 
10.3390/diagnostics12020279. PMID: 35204370; 
PMCID: PMC8870751 

4. Baker JF, Von Feldt J, Mostoufi-Moab S, Noaiseh G, 
Taratuta E, Kim W, Leonard MB. Deficits in muscle 
mass, muscle density, and modified associations with 

 
 

Segmented bones and cartilages and 3D model 
 
 
 

mailto:federica21@ru.is


2023 Pdm3 - Post meeting book of abstracts 
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fat in rheumatoid arthritis. Arthritis Care Res 
(Hoboken). 2014 Nov;66(11):1612-8. doi: 
10.1002/acr.22328. PMID: 24664868; PMCID: 
PMC4551488 

5. Cai G, Otahal P, Cicuttini F, Wu F, Munugoda IP, 
Jones G, Aitken D. The association of subchondral 
and systemic bone mineral density with 
osteoarthritis-related joint replacements in older 
adults. Osteoarthritis Cartilage. 2020 Apr;28(4):438-
445. doi: 10.1016/j.joca.2020.02.832. Epub 2020 Feb 
28. PMID: 32119971. 

6. Recenti M, Ricciardi C, Edmunds K, Jacob D, 
Gambacorta M, Gargiulo P. Testing soft tissue 
radiodensity parameters interplay with age and self-
reported physical activity. Eur J Transl Myol. 2021 
Jul 12;31(3):9929. doi: 10.4081/ejtm.2021.9929. 
PMID: 34251162; PMCID: PMC8495362. 

Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 73 
 
Interplay between the age and the asymmetry of 
NTRA in elderly people 
 
Carlo Ricciardi* (1) Alfonso Maria Ponsiglione* (1), 
Marco Recenti (2), Francesco Amato (1), Paolo Gargiulo 
(2,3)  *The authors equally contributed to the work. 
 
(1) Department of Electrical Engineering and 
Information Technology, University of Naples Federico 
II, Naples, Italy; (2) Institute of Biomedical and Neural 
Engineering, Reykjavik University, 101 Reykjavik, 
Iceland; (3) Department of Science, Landspitali, 
University Hospital of Iceland, 101 Reykjavik, Iceland.  
E-mail: carloricciardi.93@gmail.com  
 
The 11 nonlinear trimodal regression analysis (NTRA) 
parameters represent the radiodensitometric distributions 
(RDD) of muscle, fat and connective tissues extracted 
from a CT scan of the mid-femur. Previous studies 
showed how these parameters are correlated with 
physiological variables (1) and can be used for building 
predictive models of cardiovascular diseases and for 
assessing the impact of lifestyle factors in aging subjects. 
The aim of this study is to assess the role of age in the 
asymmetry of the 11 NTRA parameters. The dataset 
consists of 3162 Icelandic subjects, aged between 65 and 
95 years. A statistical approach was employed to 
investigate the interplay between the age and the NTRA 
asymmetry. A paired Student’s t test was performed to 
compare right- and left-femur NTRA parameters. Then, 
11 asymmetry indicators were calculated as the absolute 
difference between right- and left-femur values of each 
NTRA parameters. Finally, an analysis of variance 
(ANOVA) and a regression analysis were carried out to 
study the relationships between subjects’ age and the 
degree of asymmetry. Results demonstrate a statistically 

significant difference between the RDDs of the right- and 
lef-femur for 7 out of 11 NTRA parameters. Then, the 
variation of the asymmetry indicators with respect to age 
is shown and the three most significant age-related 
asymmetry indicators were identified, namely the 
amplitude of the RDD of the fat (Nf), the width of the 
RDD of the muscle (σm), and the width of the RDD of 
the connective tissue (σt). It is finally observed that the 
age-related curves of the identified indicators follow a 
second-order polynomial law showing an increasing 
trend of the asymmetry indicators with age 
(determination coefficients, R2, equal to 0.50 for Nf, 0.76 
for σm, and 0.75 for σt). In conclusion, the work shows 
that the NTRA are sensitive to the asymmetry, the degree 
of asymmetry increases with age, and σm is among the 
most sensitive age-related asymmetry indicator. 
Key Words: Aging; medical imaging; biomedical data 
analysis. 
References 
1. Edmunds K, Gíslason M, Sigurðsson S, Guðnason V, 

Harris T, Carraro U, Gargiulo P. Advanced 
quantitative methods in correlating sarcopenic 
muscle degeneration with lower extremity function 
biometrics and comorbidities. PLoS One. 2018 Mar 
7;13(3):e0193241. doi: 10.1371/journal.pone. 
0193241. PMID: 29513690; PMCID: PMC5841751  

2. Ricciardi C, Edmunds KJ, Recenti M, Sigurdsson S, 
Gudnason V, Carraro U, Gargiulo P. Assessing 
cardiovascular risks from a mid-thigh CT image: a 
tree-based machine learning approach using 
radiodensitometric distributions. Sci Rep. 2020 Feb 
18;10(1):2863. doi: 10.1038/s41598-020-59873-9. 
PMID: 32071412; PMCID: PMC7029006. 

3. Recenti M, Ricciardi C, Edmunds KJ, Gislason MK, 
Sigurdsson S, Carraro U, Gargiulo P. Healthy Aging 
Within an Image: Using Muscle Radiodensitometry 
and Lifestyle Factors to Predict Diabetes and 
Hypertension. IEEE J Biomed Health Inform. 2021 
Jun;25(6):2103-2112. doi: 10.1109/JBHI.2020. 
3044158. Epub 2021 Jun 3. PMID: 33306475. 

4. Recenti M, Ricciardi C, Edmunds K, Jacob D, 
Gambacorta M, Gargiulo P. Testing soft tissue 

 
 
The polynomial fitting (second order degree) 
shows the trend of the asymmetry index to increase 
with the aging of the subjects for all the parameters. 

mailto:carloricciardi.93@gmail.com


2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

- 69 - 
 

 

radiodensity parameters interplay with age and self-
reported physical activity. Eur J Transl Myol. 2021 
Jul 12;31(3):9929. doi: 10.4081/ejtm.2021.9929. 
PMID: 34251162; PMCID: PMC8495362. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 74 
 
Time shift of peak activation levels in quadriceps and 
hamstrings after ACL reconstruction during single 
leg jump 
 
Einar Einarsson (1-2), Kristín Briem (3), Rodney 
Whiteley (2), Magnus K. Gislason (1) 
 
(1) Institute for Biomedical and Neural Engineering, 
Reykjavik University (2) Research & Scientific Support, 
Aspetar Orthopaedic and Sports Medicine Hospital, 
Qatar; (3) Department of Physiotherapy, University of 
Iceland, Iceland;  
E-mail: magnuskg@ru.is  
 
Recurrance of injuries are prevalent in athletes that have 
undergone ACL reconstruction which partly can be 
attributed to weakening and the reduction of 
neuromuscular control of the hamstrings and the 
quadriceps.1,2 When using autograft for the ACL 
reconstruction, the tissue is mainly harvested either from 
the hamstring tendon or from the patellar tendon which 
can have an effect of the overall biomechanics and load 
transfer integrity of the knee joint. In the presented study 
a 30s continuous single leg jump was carried out by 
subjects from three cohorts: a healthy control, patients 
that were recovering after ACL reconstruction using both 
hamstring and patellar tendon autograft. EMG 
measurements were taken of six muscles during the jump 
sequence: 1) Vastus Lateralis, 2) Vastus Medialis, 3) 
Biceps Femoris 4) Tensor Fascia Latae, 5) 

Semitendinousus and 6) Gluteus Medius. An 
acceleorometer located at the inferior lumbar region was 
synchronized with the EMG measurements to capture the 
events of push off and landing. The jump cycle was 
normalized from push off to the next push off as can be 
seen in the figure and the EMG signals rectified and 
processed using a bandpass filter and RMS and finally 
fitted to each normalized jump cycle. The jump sequence 
was divided into three parts containing equal number of 
jumps. The average EMG values were analyzed between 
the first third and the final third of the jump sequence. 
The results demonstrated that there is a temporal shift in 
the peak activation levels of the quadriceps muscles. 
Significant shift in peak activation is seen in Control 
group for both quadriceps and hamstring, and in Injured 
HS group for quadriceps muscle and Healthy BTB for 
lateral hamstring muscle and lower peak activation levels 
of the vastus lateralis (p<0.001) and vastus medialis 
(p<0.001) and lateral hamstrings (p<0.001) in the injured 
compared to healthy legs. 
Key Words: ACL reconstruction; biomechanics; EMG; 
single leg jump .  
References  
1. Einarsson E, Thomson A, Sas B, Hansen C, Gislason 

M, Whiteley R. Lower medial hamstring activity after 
ACL reconstruction during running: a cross-sectional 
study. BMJ Open Sport Exerc Med. 2021 Mar 
11;7(1):e000875. doi: 10.1136/bmjsem-2020-
000875. PMID: 33782638; PMCID: PMC7957131. 

2. Recenti M, Ricciardi C, Edmunds K, Jacob D, 
Gambacorta M, Gargiulo P. Testing soft tissue 
radiodensity parameters interplay with age and self-
reported physical activity. Eur J Transl Myol. 2021 
Jul 12;31(3):9929. doi: 10.4081/ejtm.2021.9929. 
PMID: 34251162; PMCID: PMC8495362. 

 
Pdm3 March 29 - April 1, 2023 

***** 
 
2023Pdm3 March 31 - Abstract 75 
 
Exploring myofibril alignment in muscular tissues 
using circular statistics 
 
Ettore Rocchi (1), Sara Peluso (1), Stefano Amatori (2), 
Davide Sisti (2) 
 
(1) Independent Researcher; (2) Department of 
Biomolecular Sciences, University of Urbino Carlo Bo, 
Urbino, Italy. E-mail: stefano.amatori1@uniurb.it  
 
An interesting problem in analysing the image of muscle 
tissue is represented by the attempt to evaluate the 
linearity of myofibrillar structures and their possible 
deviation from a straight line. By indicating with αi the 
angles between two successive sarcomeres along the 
same myofibril, Cisterna et al. (2021) proposed an index 

 
Synchronized EMG and acceleration data of jump 
cycles. The landing timepoint is noted with a 
vertical line. 

mailto:magnuskg@ru.is
mailto:stefano.amatori1@uniurb.it


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that can be thought as the mean of the angles (taken in 
absolute value). In this contribution, we propose an 
alternative approach to the same problem. Our proposal, 
based on circular statistics, taking a cue from the same 
angular data αi proposed by Cisterna et al.; circular 
statistics has been used earlier to study muscle cell 
alignment. Ideally, for each angle αi, it is possible to 
construct a unit vector having the base at the centre of a 
goniometric circumference and the vertex on the 
circumference from which to calculate the resulting 
vector, which, divided by n (that is the number of angles 
or the number of sarcomeres minus 1), gives the resulting 
mean vector. From here, two parameters can be obtained: 
(a) the direction of the mean vector (if it is equal to 0, it 
means that the displacements to the right balance those to 
the left; or, as an extreme case, that the sarcomeres are 
perfectly aligned); b) the length of the mean vector r, that 
can range between 0 (representing perfect isotropy – or a 
circular uniform distribution – i.e., the maximum 
possible misalignment) and 1 (representing perfect 
anisotropy, i.e., the maximum possible alignment). It is 
also possible to perform a statistical test using the mean 
vector length r as test statistics: Rayleigh test is the best 
known in circular statistics; its null hypothesis is the 
uniform circular distribution of the angles, and the 
alternative hypothesis is a generic anisotropy. The 
method we propose, unlike the one indicated by Cisterna 
et al., uses circular analysis techniques instead of linear 
analysis methods, which makes it more elegant and gives 
greater substance to statistical analysis (but in contrast, it 
also has greater computational complexity).2 In 
conclusion, our method has potential use in several 
sarcomere-related conditions by providing a quantitative 
definition of myofibril linearity in skeletal muscle. 
 

Key Words: Circular statistics; myofibrillar structures; 
sarcomeres. 
 
References 
1. Cisterna B, Malatesta M, Zancanaro C, Boschi F. A 

computational approach to quantitatively define 
sarcomere dimensions and arrangement in skeletal 
muscle. Comput Methods Programs Biomed. 
2021;211:106437. doi: 10.1016/j.cmpb.2021. 
106437. 

2. Rocchi E, Peluso S, Amatori S, Sisti D. New indexes 
for myofibril linearity in muscle image analysis. Eur 
J Transl Myol. 2022 Oct 4;32(4):10736. doi: 
10.4081/ejtm.2022.10736. PMID: 36193819; 
PMCID: PMC9830398. 

 
Pdm3 March 29 - April 1, 2023 

***** 

FRIDAY March 31, 2023 

Conference Hall, Hotel Petrarca, Thermae of 
Euganean Hills (Padua) Italy 

 
04:30 PM  SESSION X:  Muscle Rehabilitation in 

Dentistry and beyond 
 

Riccardo Rosati, Elena P. Ivanova, Chairs 
 

2023Pdm3 March 31 - Abstract 76 
 
Standardised protocols for sEMG of the masticatory 
muscles in oral rehabilitation  
 
Gaia Pellegrini,  
University of Milan, Italy. 
Email: gaiapellegrini.perio@gmail.com  
 
On-site presentation of unpublished results. The 
author denied also Zoom circulation, recording and 
post-meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

       

 
       

 
 

Dotted line indicates the axis of each sarcomere 
composing a myofibril. Reported from Cisterna et 
al. (2021)  

 
Riccardo Rosati explains sEMG of masseter muscle 

mailto:gaiapellegrini.perio@gmail.com


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2023Pdm3 March 31 - Abstract 77 
 
Innovative methods of full dental rehabilitation 
 
Elena Ivanova (1), Frank Saxler (2), Andrey Lobanov 
(1), Sergey Andronov (1) 
 
(1) National Medical Research Center for Rehabilitation 
and Balneology, RF; (2) Pravident4D, Germany. 
E-mail: elenapivanova7@gmail.com  
 
Dentistry in the twenty first century has been marked by 
multidisciplinary approach to diagnosis and treatment. 
Functional diagnosis, functional treatment, functional 
occlusion of patients with cranio-mandibular disorders 
depend on relation with functional diagnosis and 
treatment of full body.  Innovative technologies of 
functional diagnosis and full dental rehabilitation 
calculating by 4D analysis developed on understanding 

dental and medical symptoms. Dental bruxism, abrasion 
shipping, parafunction, fracture of teeth, fracture of 
implant, fracture of prosthodontic, hyperemia of 
uninfected pulp of sensitive teeth, cranio-mandibular 
dysfunction CMD, TMJ Symptoms, structure loss with 
deflective contact, projection pain in teeth define 
function in cranio-mandibular system. Functional 
determinants of occlusion and individual tooth library 
include occlusion plane, vertical dimension, condyle 
inclination, mandibula position, inclination based on 
bones of the skull. So, we calculate complete digital 
concept of 4D Analysis connected with STL data, CAD  
device, 4D and Ray imaging of functional determinants, 
dynamic 4D moving of bone, patient adapting based to 
Fibonacci number, X-Ray and CAD with STL life on the 
screen. Digital way of examination and treatment options 
advantages changing occlusal plane, mandibular 
position, functional training device, resetting of bio 
processes and bone structure of the skull, directly 
changing of mobility of individual force, compliance of 
the patient mobility, rehabilitation functional 
determinants with new calculated functional occlusion 
after digital set up. Functional occlusion calculates with 

4D Analysis service for prosthodontics, implantology 
and orthodontics.  In every case we get the CNC file for 
high milling your functional occlusion and devices. 
 
Key words: Functional diagnosis; functional treatment; 
functional occlusion; 4D analysis; cranio-mandibular 
disorders; multidisciplinary approach. 
 
References 
1. Baldini A, Nota A, Tripodi D, Longoni S, Cozza P. 

Evaluation of the correlation between dental 
occlusion and posture using a force platform. Clinics 
(Sao Paulo). 2013 Jan;68(1):45-9. doi: 
10.6061/clinics/2013(01)oa07. PMID: 23420156; 
PMCID: PMC3552467.. 

2. Cuccia AM. Interrelationships between dental 
occlusion and plantar arch. J Bodyw Mov Ther. 
2011;15(2):242–50. doi: 10.1016/j.jbmt.2010.10.007 
PMID: 21419367 

3. Saccucci M, Tettamanti L, Mummolo S, Polimeni A, 
Festa F, Tecco S. Scoliosis and dental occlusion: a 
review of the literature. Scoliosis. 2011 Jul 29;6:15. 
doi: 10.1186/1748-7161-6-15. PMID: 21801357; 
PMCID: PMC3162939. 

4. Ohlendorf D, Seebach K, Hoerzer S, Nigg S, Kopp S. 
The effects of a temporarily manipulated dental 
occlusion on the position of the spine: a comparison 
during standing and walking. Spine J. 2014 Oct 
1;14(10):2384-91. doi: 
10.1016/j.spinee.2014.01.045. Epub 2014 Jan 31. 
PMID: 24486478. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 78 
 
Electromyographic analysis of masticatory muscles 
before and after rapid palatal expansion 
 
Francesca Ferrante, Maria Francesca Sfondrini, Andrea 
Scribante, Riccardo Rosati 
 
UDA of Orthodontics and Pediatric Dentistry, 
Department of Clinical-Surgical, Diagnostic and 
Pediatric Sciences, University of Pavia, Italy 
Email: francescaferrante@live.it  
 
Maxillary contraction (MC) is one of the most pervasive 
disorders of the craniofacial region and Rapid Palatal 
Expansion (RPE) is an orthopedic procedure widely 
accepted and routinely used in growing patients to correct 
this condition, but its effects on the neuromuscular 
system are not clear yet. Surface electromyography 
(sEMG) is a valid non-invasive tool for assesing the 
activity of the main masticatory muscles. The present 
prospective clinical study aims to evaluate the sEMG 
activity of superficial masseters (MM) and anterior 

 
4D analysis of patient with cranio-mandibular 
disorders. CAD digital diagnosis 

mailto:elenapivanova7@gmail.com
mailto:francescaferrante@live.it


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temporalis (TA) in patients with MC candidates to RPE, 
before treatment (t0), at the end of expansion (t1) and  
after 6 months (t2). sEMG activity were assessed 
bilaterally during maximum voluntary clenching (MCV).  
21 patients were selected: 11 completed the protocol 
while 10 performed only the first two measurements. 
Preliminary results did not show statistically significant 
differences of the analyzed electromyographic indices, 
before and after RPE. Although there was no statistical 
significance, the main indices showed a reduction at t1, 
compared to t0. However, the ATTIV index at t1 is 
significantly different between patients with an initial 
Maxillary Transversal Diameter (MTD) shorter than 31 
mm compared to those with an initial MTD longer than 
31 mm. The first group showed a negative index value, 
contrary to the second group, which means a major TA 
recruitment. The greater involvement of TA during 
MCV, found in subjects with a more severe initial MC, 
could indicate a greater occlusal instability after the 
expansion. Therefore, the RPE appears not to affect 
neuromuscular activity significantly, but further studies 
are needed to either confirm or deny this hypothesis. 
 
Key Words: Surface electromyography; rapid palatal 
expansion; masticatory muscles. 
 
References 
1. McNamara JA. Maxillary transverse deficiency. Am 

J Orthod Dentofacial Orthop 2000 May;117(5):567-
70. doi: 10.1016/s0889-5406(00)70202-2. 

2. Ferrario et al. An electromyographic investigation of 
masticatory muscles symmetry in normo-occlusion 
subjects. Journal of Oral Rehabilitation 2000; 27:33–
40. doi: 10.1046/j.1365-2842.2000.00490.x. 

3. Botelho AL, et al. Standardization of the 
Electromyographic Signal Through the Maximum 
Isometric Voluntary Contraction, CRANIO 29:1, 23-
31 2011. doi: 10.1179/crn.2011.005. 

4. Di Palma E et al. Longitudinal effects of rapid 
maxillary expansion on masticatory muscles activity. 
J Clin Exp Dent 2017 May 1; 9(5):e635-40. doi: 
10.4317/jced.53544. 

5. Michelotti A et al. Evaluation of masticatory muscle 
activity in patients with unilateral posterior crossbite 
before and after rapid maxillary expansion. Eur J 
Orthod 2019 Jan 23; 41(1):46-53. doi: 
10.1093/ejo/cjy019. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 79 
 
Masticatory muscles pain management 
 
Roberto Rongo 
Department of Neuroscience, Reproducive Sciences and 
Oral Sciences, University of Naples Federico II, Italy 
E-mail: roberto.rongo@unina.it  
 
Temporomandibular disorders (TMD) are a set of 
diseases or disorders that are related to alterations in 
structure, function, or physiology of the masticatory 
system that involve the temporomandibular joints 
(TMJs), the masticatory muscles and all associated 
tissues. The signs and symptoms associated with these 
disorders are diverse, and may include difficulties with 
chewing, speaking and other orofacial functions. They 
also are frequently associated with acute or persistent 
pain, and the patients often suffer from other painful 
disorders (comorbidities). The chronic forms of TMD 
pain may lead to absence from or impairment of work or 
social interactions, resulting in an overall reduction in the 
quality of life. The biopsychosocial model has been used 
to describe the complex nature of TMD along with its 
etiology. This model describes a dynamic relationship 
between physiological, psychological, and social factors 
and thus underlines the importance of the patient’s 
functional status. Diagnostic criteria for 
temporomandibular disorders are set of instruments 
useful for the diagnosis of TMD and included two axes: 
one for physical diagnoses (Axis I) and one for a 
biobehavioral assessment of pain-related disabilities 
(Axis II). TMD muscle pain included myalgia, myalgia 
with referral, and headache attributed to TMD. These 
disorders are characterized by dull pain, of moderate 
intensity that often increase after function. Management 
of these disorders in mainly linked to behavioural 
therapy, physiotherapy and the use of an occlusal splint. 
 
Key Words: Temporomandibular disorders, 
Temporomandibular joint, myalgia, physiotherapy. 

 
 
Patient with RPE who carries out sEMG analysis of 
masticatory muscles during clenching 
 
 

mailto:roberto.rongo@unina.it


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References 
1.  Nilsson IM, Ekberg E, Michelotti A, Al-Khotani A, 

Alstergren P, Conti PCR, Durham J, Goulet JP, 
Hirsch C, Kalaykova S, Kapos FP, King CD, 
Komiyama O, Koutris M, List T, Lobbezoo F, 
Ohrbach R, Palermo TM, Peck CC, Penlington C, 
Restrepo C, Rodrigues MJ, Sharma S, Svensson P, 
Visscher C, Wahlund K, Rongo R; International 
Network for Orofacial Pain and Related Disorders 
(INfORM). Diagnostic criteria for 
temporomandibular disorders-INfORM 
recommendations: Comprehensive and short-form 
adaptations for children. J Oral Rehabil. 2023 
Feb;50(2):99-112. 

2. Rongo R, Ekberg E, Nilsson IM, Al-Khotani A, 
Alstergren P, Rodrigues Conti PC, Durham J, Goulet 
JP, Hirsch C, Kalaykova SI, Kapos FP, King CD, 
Komiyama O, Koutris M, List T, Lobbezoo F, 
Ohrbach R, Palermo TM, Peck CC, Penlington C, 
Restrepo C, Rodrigues MJ, Sharma S, Svensson P, 
Visscher CM, Wahlund K, Michelotti A. Diagnostic 
criteria for temporomandibular disorders in children 
and adolescents: An international Delphi study-Part 
2-Development of Axis II. J Oral Rehabil. 2022 
May;49(5):541-552.  

3. Rongo R, Ekberg E, Nilsson IM, Al-Khotani A, 
Alstergren P, Conti PCR, Durham J, Goulet JP, 
Hirsch C, Kalaykova SI, Kapos FP, Komiyama O, 
Koutris M, List T, Lobbezoo F, Ohrbach R, Peck CC, 
Restrepo C, Rodrigues MJ, Sharma S, Svensson P, 
Visscher CM, Wahlund K, Michelotti A. Diagnostic 
criteria for temporomandibular disorders (DC/TMD) 
for children and adolescents: An international Delphi 
study- Part 1-Development of Axis I. J Oral Rehabil. 
2021 Jul;48(7):836-845.  

4. Michelotti A, Rongo R, D'Antò V, Bucci R. 
Occlusion, orthodontics, and temporomandibular 
disorders: Cutting edge of the current evidence. J 
World Fed Orthod. 2020 Oct;9(3S):S15-S18.  

5. Paduano S MD, DDS, Bucci R DDS, PhD, Rongo R 
DDS, PhD, Silva R DDS, Michelotti A DDS. 
Prevalence of temporomandibular disorders and oral 
parafunctions in adolescents from public schools in 
Southern Italy. Cranio. 2020 Nov;38(6):370-375. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 80 
 
Definite Orthodontic treatment for patients with 
Temporomandibular Joint problems and/or TMD 
 
Mauricio Gonzalez Balut 
 
Centro Ortodoncico Especializado, Mexico City, 
Mexico. Email: mgbalut@hotmail.com  

 
The recent way of life and social stress can activate latent 
Temporomandibular Joint problems which is a severe 
physiological disease that affects and deteriorates the 
quality of life of many patients and has been increasing 
among our patients due to the different stressful 
situations. For more than half a century there has been 
controversy among general dentists, prosthodontists, 
orthognathic surgeons, and orthodontists on how to 
diagnose and treat TMD problems. This means that we 
have many different concepts in dentistry regarding how 
TMD problems must be diagnosed and approached. 
Some TMJ concepts and treatments are obsolete and only 
give a temporary solution to this very complex 
craniomandibular syndrome. Some invasive surgical 
treatments are performed, but many of them give a 
temporary or provisional solution to this complicated 
disease. An evidence-based “definite and non-invasive 
therapy” with orthodontic treatment has been performed 
for the last 15 years. A definitive treatment for the 
patients suffering from this severe disease is provided to 
avoid the long-term use of "an occlusal splint” as a 
lifelong therapy device”. The prolotherapy and 
infiltration of autogenous stem cells are used to 
regenerate the damaged tissues of the TMJ and avoid its 
continued degeneration. 
Key words: Definite orthodontic treatment; patients with 
temporomandibular joint problems; TMD. 
 
Pdm3 March 29 - April 1, 2023 

***** 
 
2023Pdm3 March 31 - Abstract 81 
 
Chewing hard food and its importance for general 
health 
 
Bazar Amarsaikhan, Nomingerel Sukhbaatar  
 
School of Dentistry, Mongolian National University of 
Medical Sciences 
E-mail:  
amarsaikhan@mnums.edu.mn, 
 
Anthropological research has shown that the Japanese 
and the Mongolian populations share morphological and 
genetic similarities, although their dietary lives are not 
the same. The purpose of this study was to evaluate the 
relationship between environmental factors such as 
dietary life and stomatognathic function with a dynamic 
analysis of physiological tooth displacement. Ten 
clinically healthy subjects were recruited (mean age 24.8 
+/- 1.0 years). The subjects were divided into two groups 
1) Mongolian group: five Mongolians grown with a more 
or less natural texture diet and 2) Japanese group: five 
Japanese grown with a relatively soft diet. The 
displacement of the upper left first molar was measured 

mailto:mgbalut@hotmail.com
mailto:amarsaikhan@mnums.edu.mn


2023 Pdm3 - Post meeting book of abstracts 
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during function using a three-dimensional tooth 
displacement transducer Type M-3 developed by Miura. 
The tooth displacement in the Japanese group occurred 
mostly in an apicopalatal direction but intruded basically 
parallel to the tooth axis in the Mongolian group. The 
stress-strain curve revealed that elastic socket 
deformation and viscous elements were more 
pronounced in the Japanese group. It was concluded that 
environmental factors such as dietary life could influence 
tooth displacement during function. 
Key Words: Dentistry; chewing hard food; general health 
References 
1. Nishino M, Amarsaikhan B, Furumoto N, Hirao S, 

Bando H, Nakagawa A, Nomingerel S, Bolorchimeg 
B, Fujimoto M. Dental Caries in Children Under Five 
Years of Age in Mongolia. Int J Environ Res Public 
Health. 2020 Jul 1;17(13):4741. doi: 
10.3390/ijerph17134741. PMID: 32630306; PMCID: 
PMC7370011. 

2. Hasegawa Y, Batbayar N, Sukhbaatar N, Bazar A, 
Kageyama I. Relationship between index of 
orthodontic treatment need dental health component 
(IOTN-DHC) and caries prevalence in school-age 
children. Int J Dent Hyg. 2022 Dec 7. doi: 
10.1111/idh.12647. Epub ahead of print. PMID: 
36479593. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 82 
 
Peculiarities of the chewing muscles 
electrophysiological activity in mouth breathing 
individuals 
 
Avtandil Bakradze 
 
Dental Clinic and Training-Research Center “UniDent”, 
Tbilisi State Medical University, Tbilisi, Georgia 
Email: avt.bakradze@gmail.com  
 
Various factors, that play significant role in development 
of facial, bony structures, formation of normal growth 
and functionally correct dentition, have become the 
subject of increasing interest recently. According to the 
latest studies, neuromuscular balance is considered to be 
the main prerequisite for preventing relapse after 

orthodontic treatment and also the way to optimize its 
outcome. One of the main factors for normal growth of 
the jaws is not only masticatory muscles proper, 
coordinated work, but also its contractility (and therefore 
excitability) - physiological characteristics. It should be 
noted, that as a result of decreased muscle activity, 
significant changes in the location, size and growth of the 
jaws can develop, which can be manifested by the 
vertical growth of the face. The study was conducted on 
the group of 65 male and female volunteers. Several 
breathing tests were carried out to determine the 
breathing type. Cephalometric analysis was performed 
for all individuals to conclude the position, growth type 
and size of the jaws. In order to reduce the dentoalveolar 
proprioceptive signal, all subjects had been indicated to 
clench on the cotton rolls and the data was obtained 
during maximal voluntary contraction. In mouth 
breathing individuals, mean electromyographic activity 
of both masseter and temporalis muscles registered 
during maximal contraction, turned out to be 
inhomogeneous and asymmetric, occlusal anomalies had 
been noted, most often - skeletal second class. 
Key Words: Electromyography; mouth breathing; 
skeletal growth; masticatory muscles; neuromuscular 
balance.  
References 
1. Ferrario VF, Alessandro Miani, Chiarella Sforza, 

Antonio D’Addona. Electromyographic activityof 
human mastica- tory muscles in normal young 
people. Statistical evaluation of reference values for 
clinical application, J Oral Rehabil. 
1993,May;20(3):271-80. 

2.  Souki BQ, Pimenta GB, Souki MQ, et al. Prevalence 
of malocclusion among mouth breathing children: do 
expectations meet reality? Int J Pediatr 
Otorhinolaryngol. 2009;73:767–773. 

3. Valera FC, Travitzki LV, Mattar SE, et al. Muscular, 
functional and orthodontic changes in preschool 
children with enlarged adenoids and tonsils. J Pediatr 
Otorhinolaringol. 2003;67:761–770. 

4. Vig KW. Nasal obstruction and facial growth: the 
strength of evidence for clinical assumptions. Am J 
Orthod Dentofacial Orthop. 1998;113:603–611. 

 
Pdm3 March 29 - April 1, 2023 
 
2023Pdm3 March 31 - Abstract 83 
 
Craniomandibular dysfunctions – modern diagnostic 
methods 
 
Mariana Dimova-Gabrovska 
 
Department of Prosthetic Dentistry, Medical University 
of Sofia, Bulgaria - Email: marianadimova@abv.bg   
 
To examine the uses of thermodiagnostics as part of the 
diagnostic protocol for patients with craniomandibular 

 
 
sEMG analysis of patient with mouth breathing type 

mailto:avt.bakradze@gmail.com
mailto:marianadimova@abv.bg


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disorders (CMD) is the aim of this study. The 
investigation is based on 68 patients, divided into two 
groups: main group constituting 34 patients with CMD 
(22 women and 12 men, at 40.1± 13.6 years of age) and 
control group comprising 34 patients (20 women and 14 
men, at 45.7 ± 13,5 years of age). Thermo-visual 
diagnostics was carried out twice at an interval of 20 
days. Over that period of time only the patients with 
CMD received preprosthetic muscular preparation of the 
masticatory system. The analysis of thermal images from 
both tests in the control group indicated a high degree of 
thermal symmetry with the facial median line. Thermal 
images from patients of the main group in the first test 
revealed a significant percentage (91,4%) of high thermal 
intensities above the pathological threshold. In the 
second test, however, the positive thermographic 
findings decreased significantly in number, area and 
intensity. The results obtained demonstrate the benefit of 
infrared thermography for the visualization of basic 
muscular structures of the masticatory system with 
regard to norm and pathology. This method provides a 
clear image, documentary and diagnostic aid in the 
diagnosis for patients with CMD. 
Key Words: Craniomandibular disorders; diagnostic 
protocol; thermodiagnostics; thermal images; 
masticatory system.  
References 
1. Gratt BM, Graff-Radford SB, Shetty V, Solberg WK, 

Sickles EA. A 6-year clinical assessment of electronic 
facial thermography. Dentomaxillofac Radiol. 1996 
Nov;25(5):247-55. doi: 10.1259/dmfr.25.5.9161178. 
PMID: 9161178. 

2. Rossbach A, Tschernitschek H, Wichmann M, 
Landeberg Y. Der Einsatz der Thermographie als 
erweiterte diagnostische Möglichkeit im 
funktionsgestörten Kauorgan. [The use of 
thermography as an extended diagnostic option in the 
dysfunctional masticatory organ. German dentist 
Journal.] Dtsch. Zahnärztl. Z. 1993. 48: 561. 

3. Tschernitschek H, Bremer B. Die Kopf- und 
Halsregion im lateralen Thermographiebild [The 
head and neck region in the lateral thermographic 
image. Quintessence]. Quintessenz. 1995; 46: 1365. 

4. Dimova-Gabrovska M. Algorithm for Computerized 
Analysis of Static. Dynamic and Functional 
Occlusion in Patients with Bruxism and Bruxomania. 
Comptes rendus de l’Académie bulgare des Sciences. 
2019;72(2): 259-266.  

5. Dimova-Gabrovska M. Thermographic Assessment 
of Structural Analysis in Patients with 
Temporomandibular Disorders. Comptes rendus de 
l’Académie bulgare des Sciences. 2018;71(5):712-
716. 

 
Pdm3 March 29 - April 1, 2023 

***** 
 

2023Pdm3 March 31 - Abstract 84 
Improvement of gait, balance and coordination after 
application of Taopatch® device 
Marieta Karadjova, (1,2,3), Tanya Dimitrova (2), 
Dyliana Dobreva (3), Julia Petrova (1,2),Giuseppe 
Messina (4,5). 
 
(1) Department of Neurology, Medical University-Sofia, 
Bulgaria; (2) Clinic of Neurology, University Hospital 
“Alexandrovska”; (3) Private neurological practice 
“Happy Spine” Sofia, Bulgaria; (4) University of 
Palermo, Italy; (5)Posturalab Research Institute, Italy. 
E-mail: mkaradjova@medfac.mu-sofia.bg  
 
Multiple sclerosis (MS) is a chronic autoimmune disease 
of the central nervous system (CNS) characterized by 
inflammation, demyelination, gliosis, and neuronal loss. 
Neurological symptoms vary, depending on lesion 
location - vertigo, gait imbalance, weakness, tremor, 
spasticity, fatigue, loss of sensation, paresthesias, 
dysesthesias. The most disabling symptoms are 
imbalance, muscle weakness and fatigue. Taopatch® is a 
patented wearable nanotechnology device that combines 
acupuncture with light therapy. It contains layers of 
nanocrystals, which capture body’s heat and convert it 
into impulses of very weak light, and then emitted onto 
the specific points on the body. A recent study of Lomeo 
et al. in subjects with MS investigated the effect of 
Taopatch® and showed that the use of these devices can 
improve the proprioception, balance and movements of 
the affected limbs. The aim of the study was to evaluate 
properly the early effects of Taopatch® device on MS 
patients by applying clinical scales and tests for 
determining disability and the patient’s subjective 
perspective of their condition severity. Twelve patients 
with MS were enrolled in the study – 4 males at average 
age of 38.3 ± 4.7 years and 8 females at average age of 
44.5 ±10.5 years. The study protocol included Expanded 
Disability Status Scale (EDSS), Tandem gait - 10 m., 
Timed up and go, 9-Hole Peg Test (9-HPT test) at 
baseline and after the application of Taopatch® - one 
device on C7 and one on xyphoid process for 40 minutes. 
During Taopatch® wearing, every participant performed 
kinesitherapy and for proper hydration consumed 500 ml 
of water. The study showed no improvement in the EDSS 
score. There was a statistically significant reduction in 
tandem gait (from 40.6s. to 27.9s.) and in 9-HPT test in 
both dominant (from 39.5s. to 35.4s.) and non-dominant 
(from 37.6s. to 31.4s.) hands. We observed also 
improvement of coordination, stability and the quality of 
movements. Timed up and go test (TUG) was also 
reduced, but the change wasn’t significant. In conclusion, 
the early effect (in 40 minutes) of Taopatch® device 
application showed immediate improvement of gate 
speed, stability and coordination with reduced tremor. 
Most probably the photons of light, which are very 
similar to the biophotons help the patients’ cells to 

mailto:mkaradjova@medfac.mu-sofia.bg


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communicate with each other and give additional 
pathway of proprioception. It could allow the CNS to 
communicate with the rest of a body in a way faster and 
more efficient, bypassing the plaques of demyelination.  
Key Words: multiple sclerosis, light therapy, tandem 
gait, 9-HPT test, Taopatch®. 
References 
1. Carbonari B, Balducci F, Cesaretti G et al.  

Performance, balance and posture variations with 
occlusal splint and Taopatch® devices. J Sport Med 
Phys Fitness, 2021; 61 (2):317-323. 

2. Lomeo A, Cacciaguerra G, Garsia D, Scolaro A. 
Utilisation des dispositifs nanotechnologiques dans 
les pathologies degeneratives cerebrales. Etude 
prospective sur 28 patients de sclerose en plaques. 
Hegel. 2019:2:114 

3. Messina G, Amato A, Alioto A, Stallone R, Rizzo F, 
Ragonese P, Fischetti F, Genua D, Francavilla V, 
Iovane A, Proia P. A new road to improve vitamin D 
and balance through Taopatch® and proprioceptive 
protocol in Multiple Sclerosis patients. Eur J Transl 
Myol. 2022 Sep 16;32(4):10774. doi: 
10.4081/ejtm.2022.10774. PMID: 36112067; 
PMCID: PMC9830399. 

 
Pdm3 March 29 - April 1, 2023 
 
2023Pdm3 March 31 - Abstract 85 
 
Intra-articular ultrasound-guided injection with 
Hyaluronic Acid and corticosteroid in retrodiscal 
tissue for TMD 
 
Francesco Mantia (1), Eleonora Maria Iovane (3), 
Angelo Iovane (1), Giuseppe Messina (1,2) 
 
(1) Department of Psychological, Pedagogical and 
Educational Sciences, Sport and Exercise Sciences 
Research Unit, University of Palermo, Italy; (2) 
University of Palermo, Italy; (2) Posturalab Research 
Institute, Palermo, Italy.  
Email: giuseppe.messina17@unipa.it 
 
Temporomandibular disorders (TMD) are heterogeneous 
pathological conditions characterized by similar signs 
and symptoms. The main representative symptom is a 
dull pain near the ear that increase with the movement of 
jaw. Sometimes pain is associated with headache. In 
literature different methods of classification of TMD are 
described. The DC/TMD criteria are still fundamental for 
the diagnosis and classification of TMD.  
28 patients (16 females and 10 males, with a mean age of 
39± 8.9 years) undergone a specialist gnathological 
evaluation and MRI of the temporo-mandibular joint 
(TMJ) to value retrodiscal tissue of TMJ, were examined 
by Visual Analogical Scale (VAS) for ante-auricular pain 
and by the presence of other symptoms such as: tinnitus, 
vertigo, headache, joint click. Every evaluation were 

performed at basal time (T0) and at 7 (T1), 30 (T2) and 
90 (T3) days from treatment. After a preliminary clinical 
and ultrasound evaluation, patients were undergone 
ultrasound-guided bilateral infiltration of low molecular 
weight (LMW) hyaluronic acid and corticosteroid (1 cc 
methylprednisolone aeacetate) (T0). An individualized 
interocclusal devices was used to perform ultrasound 
evaluation and ultrasound-guided infiltration; the device 
allows the mouth to be blocked in its maximum opening 
to facilitate the localization of the glenoid fossa, which is 
empty, as the condyle is moved towards the articular 
tubercle. 80% of the patients treated reported an 
immediately disappearance of joint click. Data analysis 
revealed a statistically significant (p <0.05) reduction 
from baseline for all three subsequent measurements, but 
no significant change between measurements at 30, 60 
and 90 days. Therefore it is evident that a plateau is 
reached after the 30th day. Clinical evaluations were 
accompanied by ultrasound exam which didn’t show the 
presence of local complications. Ultrasound-guided 
infiltration seems a safe and efficacious treatment of 
TMD; the effects showed a rapid e significant reduction 
of pain. A longer follow-up and more cases are necessary 
to confirm the positive effects of this treatment. 

Key words: TMJ; hyaluronic acid; auricular pain; TMD. 
References 
1. Kapos FP, Exposto FG, Oyarzo JF, Durham J. 

Temporomandibular disorders: a review of current 
concepts in aetiology, diagnosis and management. 
Oral Surg. 2020 Nov;13(4):321-334. 

2. Reiter S, Goldsmith C, Emodi-Perlman A, Friedman-
Rubin P, Winocur E. Masticatory muscle disorders 
diagnostic criteria: the American Academy of 
Orofacial Pain versus the research diagnostic 
criteria/temporomandibular disorders (RDC/TMD). J 
Oral Rehabil. 2012 Dec;39(12):941-7.  

3. Li DTS, Leung YY. Temporomandibular Disorders: 
Current Concepts and Controversies in Diagnosis and 

  
 

 
 
US examination of temporo-mandibular joint 

mailto:giuseppe.messina17@unipa.it


2023 Pdm3 - Post meeting book of abstracts 
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Management. Diagnostics (Basel). 2021 Mar 
6;11(3):459. 

4. De Nordenflycht D, Tesch RS. Advantages of 
ultrasound guidance for TMJ arthrocentesis and intra-
articular injection: A narrative review. Dent Med 
Probl. 2022 Oct-Dec;59(4):647-656.  

5. Tanaka, E., M. S. Detamore, and L. G. Mercuri. 
"Degenerative disorders of the temporomandibular 
joint: etiology, diagnosis, and treatment. Journal of 
dental research 87.4 (2008): 296-307. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 86 
 
Effects of Platelet-Rich-Plasma injection in 
association with therapeutic exercise in the 
management of Medial Epicondylitis 
 
Francesco Mantia (1), Eleonora Maria Iovane (2), 
Micol Terrasi (3), Carlotta Mantia (3), Angelo Iovane 
(1), Giuseppe Messina (1,4) 
 
(1) Department of Psychological, Pedagogical and 
Educational Sciences, Sport and Exercise Sciences 
Research Unit, University of Palermo, Italy; (2) 
University of Palermo, Italy; (3) Centro Medico Mantia, 
Palermo, Italy; (4) Posturalab Research Institute, Italy.  
E-mail: giuseppe.messina17@unipa.it  
 
Medial epicondylitis (ME) is an inflammatory-
degenerative tendinopathy that occurs typically in people 
playing sports like throwing sports, bowling, badminton, 
tennis and golf. Platelet-Rich-Plasma (PRP) is currently 
the most exploited strategy in the clinical practice to 
provide a regenerative stimulus for tendon healing. This 
paper values the effects of the ultrasound-guided 
injections with autologous PRP in association with a 
specific physiokinesitherapy program in the management 
of ME.  We examined 18 patients (11 males and 7 
females, with a mean age of 41 ± 8.4 years) with a 
diagnosis of ME, practicing sport activities. In according 
to imaging (US and MRI) we identified two groups: 
group A (n =12) included patients with ME without 
tendon lesion; group B (n=6) included ME with a focal 
tendon lesion. Both groups have undergone injection of 
PRP (T0). Patients were evaluated by the numeral rating 
score (NRS), hand grip strength (HGS), DASH and US 
examination at baseline, after 3 weeks (T1) and after 9 
weeks from the treatment (T2). HGS wasn’t performed at 
T1 to not overstress the tendon structures. At T1 patients 
started to receive a 3-week physiokinesitherapy treatment 
for 3 days a week.  Both groups achieve significant 
improvements in NRS, DASH and HGST after 3 and 9 
weeks from the infiltrative treatment. These 
improvements were similar in the two groups.  Regarding 
the US evaluation at T1 it showed: the persistence of the 

typical signs of chronic tendinopathy, the reduction of the 
phenomena of neo-microangiogenesis, and in the group 
A the disappearance of the hypoechoic areas replaced by 
diffuse hyperechogenicity. At T2 the US exam showed 
the persistence of microangiogenesis phenomena in once 
patient out of 18. All patients resumed regular sporting 
activity. We recommend that autologous PRP injections 
should be considered in association with 
physiokinesitherapy for treating patients with newly 
diagnosed ME. 

Key Words: Medial Epicondylitys; platelet-rich-plasma; 
ultrasound-guided; non-operative; injection. 
References 
1. Maffulli N, Longo UG, Loppini M, Denaro V. 

Current treatment options for tendinopathy. Expert 
Opin Pharmacother. 2010 Sep;11(13):2177-86. doi: 
10.1517/14656566.2010.495715. PMID: 20569088.  

2. Karjalainen TV, Silagy M, O'Bryan E, Johnston RV, 
Cyril S, Buchbinder R. Autologous blood and 
platelet-rich plasma injection therapy for lateral 
elbow pain. Cochrane Database Syst Rev. 2021 Sep 
30;9(9):CD010951. doi: 10.1002/14651858. 
CD010951.pub2. PMID: 34590307; PMCID: 
PMC8481072. 

3. Cavallo C, Roffi A, Grigolo B, Mariani E, Pratelli L, 
Merli G, Kon E, Marcacci M, Filardo G. Platelet-Rich 
Plasma: The Choice of Activation Method Affects the 
Release of Bioactive Molecules. Biomed Res Int. 
2016;2016:6591717. doi: 10.1155/2016/6591717. 
Epub 2016 Sep 8. PMID: 27672658; PMCID: 
PMC5031826 

4. la Fleur P, Argáez C. Platelet-Rich Plasma Injections 
for Wound Healing and Tissue Rejuvenation: A 
Review of Clinical Effectiveness, Cost-Effectiveness 
and Guidelines [Internet]. Ottawa (ON): Canadian 

       

 
       

 
 

Top: US examination in flexor carpi radialis tendon 
lesion. Down: US-guided PRP injection in tendon 
lesion. 

mailto:giuseppe.messina17@unipa.it


2023 Pdm3 - Post meeting book of abstracts 
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Agency for Drugs and Technologies in Health; 2017 
Jun 13. PMID: 30188645. 

5. Woodley BL, Newsham-West RJ, Baxter GD. 
Chronic tendinopathy: effectiveness of eccentric 
exercise. Br J Sports Med. 2007 Apr;41(4):188-98; 
discussion 199. doi: 10.1136/bjsm.2006.029769. 
Epub 2006 Oct 24. PMID: 17062655; PMCID: 
PMC2658941. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 March 31 - Abstract 87 

LECTURE 
Mechanisms underlying exercise-dependant 
remodelling of the sarcotubular system: the role 
of temperature and pH  
 
Feliciano Protasi (1,2) 
 
(1) DMSI, Department of Medicine and Aging Sciences, 
University of Chieti; (2) CAST, Center for Advanced 
Studies and Technology, Chieti, Italy. 
E-mail: feliciano.protasi@unich.it  
 
Skeletal muscle function is regulated by intracellular 
Ca2+ levels. Two main mechanisms control movements 
of Ca2+ ions from intracellular stores (i.e. the 
sarcoplasmic reticulum, SR) and from extracellular 
space: i) excitation-contraction (EC) coupling; and ii) 
store-operated Ca2+ entry (SOCE). SOCE is a mechanism 
that allows recovery of external Ca2+ when intracellular 
stores (i.e. the sarcoplasmic reticulum, SR) are depleted. 
We recently discovered that SOCE is mediated by 
specialized intracellular junctions named Calcium Entry 
Units (CEUs), which increase in number and size during 
exercise. CEUs are formed by two elements: i) SR stacks 
containing STIM1; and ii) I-band extensions of the 
transverse tubule (TT) containing Orai1 (1-3). The 
mechanisms underlying exercise-dependent formation of 
CEUs remain to be elucidated. First, we verified that 
functional CEUs can assemble ex-vivo in absence of 
blood supply and innervation, subjecting isolated 
extensor digitorum longus (EDL) muscles from wild type 
(WT) mice to an ex-vivo exercise protocol. Then, we 
evaluated if temperature and pH, parameters that are 
influenced by exercise, may promote the assembly of 
CEUs. Results collected indicate that higher temperature 
(36°C vs. 25°C) and lower pH (7.2 vs. 7.4) promote the 
formation of CEUs increasing the percentage of fibers 
containing SR stacks, the n. of SR stacks/area, and the 
elongation of TTs at the I band. Functionally, assembly 
of CEUs at higher temperature (36°C) or at lower pH 
(7.2) correlates with increased fatigue resistance of EDL 
muscles in presence of extracellular Ca2+. 
Key words: Exercise; excitation-contraction (EC) 
coupling; skeletal Muscle; Store-Operated Ca2+ Entry 
(SOCE). 

References 
1. Boncompagni, S., A. Michelucci, L. Pietrangelo, R. 

T. Dirksen, and F. Protasi. 2017. Exercise-dependent 
formation of new junctions that promote STIM1-
Orai1 assembly in skeletal muscle. Scientific Reports. 
7(1): 14286. PMID: 29079778 

2. Michelucci, A., S. Boncompagni, L. Pietrangelo, M. 
García-Castañeda, T. Takano, S. Malik, R.T. Dirksen, 
and F. Protasi. 2019. Transverse tubule remodeling 
enhances Orai1-dependent Ca2+ entry in skeletal 
muscle.  eLife. 8: e47576. PMID: 31657717 

3. Protasi, F., L. Pietrangelo, and S. Boncompagni. 
2020. Calcium entry units (CEUs): perspectives in 
skeletal muscle function and disease. J Muscle Res 
Cell Motil. 42(2): 233-249. PMID: 32812118 

 
Pdm3 March 29 - April 1, 2023 

***** 

SATURDAY April 1, 2023 
Conference Hall, Hotel Petrarca, Thermae of 

Euganean Hills (Padua) Italy 
 
09:00 AM Session XI:  
LBI workshop on muscle rehabilitation - from 

mouse to elderly 
 

Sandra Zampieri, Feliciano Protasi, Chairs 
 

 
2023Pdm3 April 1 - Abstract 88 
 
Mimicking disuse and rehabilitation in a mouse 
model 
 
Laura Pietrangelo, Alice Brasile, Barbara Girolami, 
Feliciano Protasi (1,2) 
 

 
 
From left: Stefan Loefler, Vincent Grote, Nejc 
Sarabon, Sandra Zampieri, Antonio Musarò, 
Feliciano Protasi 

mailto:feliciano.protasi@unich.it


2023 Pdm3 - Post meeting book of abstracts 
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(1) DMSI, Department of Medicine and Aging Sciences, 
University of Chieti, Italy; (2) CAST, Center for 
Advanced Studies and Technology, Chieti, Italy. 
E-mail: feliciano.protasi@unich.it  
Proper skeletal muscle function is controlled by 
intracellular Ca2+ levels and by efficient production of 
energy (ATP).  In the last 15 years our laboratory 
collected the following results: 
a. Short-term (7-15 days) denervation of muscle fibers 

causes misplacement and damage of membrane 
structures involved in EC coupling (calcium release 
units, CRUs) and of the mitochondrial network;1 

b. Sedentary ageing causes partial disarray/damage of 
CRUs and of calcium entry units (CEUs, structures 
involved in SOCE) and loss/misplacement of 
mitochondria;2,3 

c. Re-innervation and regular exercise promote 
rescue/maintenance of the proper architecture of 
CRUs, CEUs, and mitochondria in both denervation 
and ageing.1,3 

All these structural changes were accompanied by related 
functional changes, i.e. loss/decay in function caused by 
denervation and ageing, and improved function 
following re-innervation and exercise. These data 
suggested that integrity and proper disposition of 
intracellular organelles deputed to Ca2+ handling and 
aerobic generation of ATP is challenged by inactivity (or 
reduced activity) and improved following recover of 
movements.4 To definitely test this hypothesis, we 
generated a model of short-term inactivity, and randomly 
assigned mice to two experimental groups: i) 
immobilized adult mice, in which inactivity is obtained 
for 6 days by unilateral immobilization of a hind limb; ii) 
rehabilitation group, in which mice underwent 15 days of 
treadmill running after the immobilization procedure. 
The results collected in this study indicate that: i) even 
short-term inactivity caused significant alterations to the 
membrane system and organelles previously discussed; 
and ii) 2 weeks rehabilitation rescued proper intracellular 
organization of CRUs, CEUs, and mitochondria. 
Key Words: Mitochondria; excitation-contraction 
coupling; store operated calcium entry; immobilization; 
exercise. 
References 
1. Pietrangelo L, Michelucci A, Ambrogini P, Sartini S, 

Guarnier FA, Fusella A, Zamparo I, Mammucari C, 
Protasi F, Boncompagni S. Muscle activity prevents 
the uncoupling of mitochondria from Ca2+ Release 
Units induced by ageing and disuse. Arch Biochem 
Biophys. 2019 Mar 15;663:22-33. doi: 
10.1016/j.abb.2018.12.017. Epub 2018 Dec 20. 
PMID: 30578752; PMCID: PMC6377823. 

2. Zampieri S, Pietrangelo L, Loefler S, Fruhmann H, 
Vogelauer M, Burggraf S, Pond A, Grim-Stieger M, 
Cvecka J, Sedliak M, Tirpáková V, Mayr W, Sarabon 
N, Rossini K, Barberi L, De Rossi M, Romanello V, 
Boncompagni S, Musarò A, Sandri M, Protasi F, 
Carraro U, Kern H. Lifelong physical exercise delays 

age-associated skeletal muscle decline. J Gerontol A 
Biol Sci Med Sci. 2015 Feb;70(2):163-73. doi: 
10.1093/gerona/glu006. Epub 2014 Feb 18. PMID: 
24550352. 

3. Boncompagni S, Pecorai C, Michelucci A, 
Pietrangelo L, Protasi F. Long-Term Exercise 
Reduces Formation of Tubular Aggregates and 
Promotes Maintenance of Ca2+ Entry Units in Aged 
Muscle. Front Physiol. 2021 Jan 5;11:601057. doi: 
10.3389/fphys.2020.601057. PMID: 33469430; 
PMCID: PMC7813885. 

4. Protasi F, Pietrangelo L, Boncompagni S. Improper 
Remodeling of Organelles Deputed to Ca2+ Handling 
and Aerobic ATP Production Underlies Muscle 
Dysfunction in Ageing. Int J Mol Sci. 2021 Jun 
8;22(12):6195. doi: 10.3390/ijms22126195. PMID: 
34201319; PMCID: PMC8228829. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 April 1 - Abstract 89 
 
Molecular biological basis and effects of immobility 
and training in young and aging 
 
Irene Casola (1), Gabriella Dobrowolny (1), Gaia 
Laurenzi (1), Barbara Girolami (2), Stefan Löfler (3), 
Helmut Kern (3), Sandra Zampieri (4), Feliciano Protasi 
(2), Antonio Musarò (1) 
 
(1) Department SAIMLA-Sapienza University of Rome, 
Italy; (2) CAST, Center for Advanced Studies and 
Technology; University G D'Annunzio of Chieti-
Pescara, Chieti, Italy; (3) Ludwig Boltzmann Institute for 
Rehabilitation Research, Wien, Austria; (4) Department 
of Biomedical Sciences, University of Padova, Padova, 
Italy. Email: antonio.musaro@uniroma1.it  
 
The progressive age-related decline in skeletal muscle 
mass and strength (sarcopenia), responsible for impaired 
mobility and disability in elderly is the result of multiple 
molecular and cellular changes occurring during the 
aging process, including an imbalance between protein 
synthesis and degradation, changes in 
metabolic/hormonal status and in circulating levels of 
inflammatory mediators.1,2 Loss of motor units, decrease 
in structural and functional integrity of neuromuscular 
junctions, decline in mitochondrial function, and altered 
autophagic mechanism represent other pathogenic 
mechanisms of muscle aging.3 Thus, factors/conditions 
that increase muscle mass and promote anabolic 
pathways might be of therapeutic benefit to counteract 
sarcopenia.4 Current data, also from our lab, point out 
that the development of muscle wasting is a 
multifactorial process and believed to be the result of 
both intrinsic factors, involving changes in molecular and 
cellular levels, and extrinsic ones, such as nutrition and 

mailto:feliciano.protasi@unich.it
mailto:antonio.musaro@uniroma1.it


2023 Pdm3 - Post meeting book of abstracts 
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exercise. Many factors, including motor-unit remodeling, 
decreased hormone levels with consequent negative 
effect on protein synthesis, stress oxidative damage, 
alteration in satellite cells activity may all contribute to 
decrease in muscle mass and functional performance.5-7 
Despite numerous theories and intensive research, the 
principal molecular mechanisms underlying the process 
of muscle wasting are still unknown. Here we provide 
insights into the cellular and molecular mechanisms that 
control muscle atrophy, adaptation/response of muscle to 
immobilization/disuse and exercise/training. We 
explored whether and how long-term physical exercise 
modulates relevant biomarkers of muscle function, 
atrophy, and remodeling. To reach this objective we took 
advantage of using in vivo experimental models of disuse 
and training and human samples from regularly active, 
sedentary/regularly active and athlete individuals. The 
molecular data suggest that regular activity and lifelong 
physical activity induce molecular adaptations of muscle, 
counteracting muscle atrophy and improving functional 
outcomes with positive influence on quality of life. 
Key words: Aging; sarcopenia; muscle wasting; physical 
exercise; molecular mechanisms. 
References 
1. Larsson L, Degens H, Li M, Salviati L, Lee YI, 

Thompson W, Kirkland JL, Sandri M. Sarcopenia: 
Aging-Related Loss of Muscle Mass and Function. 
Physiol Rev. 2019 Jan 1;99(1):427-511. 

2. Barberi L, Scicchitano BM, Musaro A. Molecular and 
Cellular Mechanisms of Muscle Aging and 
Sarcopenia and Effects of Electrical Stimulation in 
Seniors. Eur J Transl Myol. 2015 Aug 25;25(4):231-6. 

3. Franco-Romero A, Sandri M. Role of autophagy in 
muscle disease. Mol Aspects Med. 2021 Dec; 
82:101041. 

4. Musarò A. To the heart of the problem. mIGF-1: local 
effort for global impact. Aging (Albany NY). 2012. 

5. Musarò A, Scicchitano BM. Counteracting 
sarcopenia: the role of IGF-1 isoforms. Aging 
(Albany NY). 2019 Jun 13;11(11):3410-3411. 

6. Ascenzi F, Barberi L, Dobrowolny G, Villa Nova 
Bacurau A, Nicoletti C, Rizzuto E, Rosenthal N, 
Scicchitano BM, Musarò A. Effects of IGF-1 
isoforms on muscle growth and sarcopenia. Aging 
Cell. 2019 Jun;18(3): e12954. 

7. Scicchitano BM, Pelosi L, Sica G, Musarò A. The 
physiopathologic role of oxidative stress in skeletal 
muscle. Mech Ageing Dev. 2018 Mar; 170:37-44. 

 
Pdm3 March 29 - April 1, 2023 
 
2023Pdm3 April 1 - Abstract 90 
 
C-Terminal Agrin Fragment as a biomarker of 
muscle wasting and weakness in aging and disuse 
 
Barbara Ravara (1), Elena Monti (2,3), Fabio Sarto (4) 
Martina Maino (1), Feliciano Protasi (5), Barbara 
Girolami (5), Antonio Musarò (6), Stefan Löfler (7), 
Helmut Kern (7), Marco V. Narici (4,8), Sandra 
Zampieri (1,4,7,8) 
 
(1) Department of Surgery, Oncology, and 
Gastroenterology, University of Padova, Padova, Italy; 
(2) Blau Laboratory, Stanford School of Medicine, 
Stanford, CA, USA; (3) Baxter Laboratory for Stem Cell 
Biology, Department of Microbiology and Immunology, 
Institute for Stem Cell Biology and Regenerative 
Medicine, Stanford School of Medicine, Stanford, CA, 
USA; (4) Department of Biomedical Sciences, 
University of Padova, Padua, Italy. (5) CAST, Center for 
Advanced Studies and Technology; University G 
D'Annunzio of Chieti-Pescara, Chieti, Italy; (6) Sapienza 
University of Rome, Italy; (7) Ludwig Boltzmann 
Institute for Rehabilitation Research, Wien, Austria; (8) 
CIR-MYO Myology Center, University of Padova, 
Padova, Italy. 
E-mail: sanzamp@unipd.it  
 
In the last decades, the extended human longevity 
resulted in increasing numbers of senior individuals in 
the general population. Ageing is accompanied by a 
progressive decline in muscle mass and function. It is 
associated with increased risk of adverse outcomes 
including knee or hip injuries and degeneration, falls, or 
bone fractures, possibly determining the onset of a 
clinical syndrome termed sarcopenia. Sarcopenia is not 
only caused by ageing (primary sarcopenia) but may be 
linked to the presence of several co-morbidities 
(secondary sarcopenia), such as disuse/inactivity, 
advanced organ failure, or inadequate intake of 
energy/proteins. Denervation and NMJ impairment have 
been proposed as key determinants of age-related muscle 
wasting and weakness. Thus, screening, monitoring and 
prevention of those conditions inducing muscle 
dysfunction is essential to improve the quality of life, 
potentially reducing ageing and sarcopenia-related social 
and economic costs. To this aim, the reliability and 
accessibility of non-invasive blood derived biomarkers is 
being evaluated. C-terminal Agrin Fragment (CAF), a 
circulating C-22 kDa peptide resulting from the 
proteolytic cleavage of agrin, a protein responsible for 
the neuromuscular junction (NMJ) assembly and 

 
Schematic representation of the potential extrinsic 
factors, such as reduction in nutrition and exercise, 
and intrinsic ones, involving in muscle wasting and 
sarcopenia. 

mailto:sanzamp@unipd.it


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maintenance, has been widely investigated by us and 
numerous other groups as circulating NMJ-related 
biomarker of muscle dysfunction. Essentially, serum 
CAF concentration was observed to increase with age 
and in sarcopenic individuals when compared to age-
matched, medically stable peers. Serum CAF was 
reported also to raise following chronic inactivity or 
disuse and seemed to be lowered or maintained by 
exercise training. Finally, CAF was found to correlate 
with appendicular lean mass, handgrip and gait speed. 
Therefore, CAF seems to be a specific biomarker for 
screening and monitoring muscle wasting and weakness. 
It may be a useful tool for tailored approaches of muscle 
rehabilitation and for prevention or rescue of muscle 
dysfunction. When findings will be confirmed on larger 
cohort of subjects, future guidelines may be implemented 
for introducing CAF as a biomarker in clinical settings. 
Key Words: C-terminal Agrin Fragment; aging; 
sarcopenia; muscle wasting; muscle weakness. 
References 
1. Hettwer S, Dahinden P, Kucsera S, Farina C, Ahmed 

S, Fariello R, Drey M, Sieber CC, Vrijbloed JW. 
Elevated levels of a C-terminal agrin fragment 
identifies a new subset of sarcopenia patients. Exp 
Gerontol. 2013 Jan;48(1):69-75. doi: 
10.1016/j.exger.2012.03.002. Epub 2012 Mar 11. 
PMID: 22433628.  

2. Gonzalez-Freire M, de Cabo R, Studenski SA, 
Ferrucci L. The Neuromuscular Junction: Aging at 
the Crossroad between Nerves and Muscle. Front 
Aging Neurosci. 2014 Aug 11;6:208. doi: 
10.3389/fnagi.2014.00208. PMID: 25157231; 
PMCID: PMC4127816. 

3. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère 
O, Cederholm T, Cooper C, Landi F, Rolland Y, 
Sayer AA, Schneider SM, Sieber CC, Topinkova E, 
Vandewoude M, Visser M, Zamboni M; Writing 
Group for the European Working Group on 
Sarcopenia in Older People 2 (EWGSOP2), and the 
Extended Group for EWGSOP2. Sarcopenia: revised 
European consensus on definition and diagnosis. Age 
Ageing. 2019 Jan 1;48(1):16-31. doi: 
10.1093/ageing/afy169. Erratum in: Age Ageing. 
2019 Jul 1;48(4):601. PMID: 30312372; PMCID: 
PMC6322506. 

4. Stephan A, Mateos JM, Kozlov SV, Cinelli P, Kistler 
AD, Hettwer S, Rülicke T, Streit P, Kunz B, 
Sonderegger P. Neurotrypsin cleaves agrin locally at 
the synapse. FASEB J. 2008 Jun;22(6):1861-73. doi: 
10.1096/fj.07-100008. Epub 2008 Jan 29. PMID: 
18230682. 

5. Monti E, Sarto F, Sartori R, Zanchettin G, Lofler S, 
Kern H, Narici M, Zampieri S. C-terminal agrin 
fragment as a biomarker of muscle wasting and 
weakness: a narrative review. Journal of Cachexia, 
Sarcopenia and Muscle, 2023 in press. DOI: 
10.1002/jcsm.13189. 

Pdm3 March 29 - April 1, 2023 

2023Pdm3 April 1 - Abstract 91 
 
Exercise intervention in elderly: a novel system 
within the Centre of Active Aging in Bratislava  
 
Jan Cvecka 
University of Bratislava, Slovakia 
Email: cvecka@fsport.uniba.sk  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 April 1 - Abstract 92 
 
Relationship between 24-h movement behaviors and 
physical performance among older adults: insight 
into cross-sectional findings from CAA study 
 
Nejc Sarabon (1-3, 5), Kaja Kastelic (3), Stefan Löfler 
(4-6) 
 
(1) Faculty of Health Sciences, University of Primorska, 
Polje 42, 6310 Izola, Slovenia; (2) Andrej Marušič 
Institute, University of Primorska, Koper, Slovenia; (3) 
InnnoRenew CoE, Izola, Slovenia; (4) Physiko-& 
Rheumatherapie, Institute for Physical Medicine and 
Rehabilitation, St. Pölten, Austria; (5) Ludwig 
Boltzmann Institute for Rehabilitation Research, St. 
Pölten, Austria; (6) Centre of Active Ageing - 
Competence Centre for Health, Prevention and Active 
Ageing, St. Pölten, Austria. 
E-mail: nejc.sarabon@fvz.upr.si  
 
Studies showed that engaging in physical activities play 
a very important role in preserving physical abilities 
among older adults. While engaging in physical exercise 
has been consistently shown to have favourable impact, 
less is known about the impact of free-living physical 
activity, sedentary behaviour and/or sleep duration (i.e., 
24-h movement behaviours) on physical performance. 
Objectives: The objective of this study is to provide an 
insight into cross-sectional findings on the relationship 
between 24-h movement behaviours and physical 
performance among older adults that participated in 
Centre of Active Aging (CAA) study. We recruited 103 
older adults (62 female, 41 males; 68 ± 5 years old; BMI: 
28 ± 4; EQ-5D index score: 96 ± 5; SF-12 PCS score: 89 
± 13; SF-12 MCS score: 82 ± 10) for baseline assessment. 
Participants were asked to wear activPAL accelerometer 
for 7 full days (24-h per day), and they underwent a 
battery test that included several tests of physical 
performance: handgrip, knee extension strength, 30 s 
chair stand, 5-x chair rise, 30 s arm curl, 2 min step test, 
sit and reach test, back scratch test, up and go test, 10 m 

mailto:cvecka@fsport.uniba.sk
mailto:nejc.sarabon@fvz.upr.si


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preferred speed walking test, 10 m fast speed walking 
test, single leg stance test – open eyes, and single leg 
stance test – closed eyes. A series of compositional 
isotemporal substitution analyses based on a linear 
regression model was used to examine associations 
between 24-h movement behaviours (consisting of time 
spent in moderate-vigorous physical activity (MVPA), 
light physical activity (LPA), sedentary behaviour (SB), 
and sleep and physical performance tests. All models 
were adjusted for sex, age, and BMI. Our sample spent 
on average 7.5 h/day 8.9 h/day 7.2 h/day, and 20 min/day 
in sleep, SB, LPA, and MVPA, respectively. The 24-h 
movement behaviours were shown to be significantly 
associated with 9/13 physical performance test scores. 
Reallocating time to MVPA from sleep, SB, or LPA 
showed favourable associations with 8/13 test scores, 
whereas reallocating time from MVPA to other 
behaviours showed unfavourable associations. For 
example, reallocation of 20 minutes from MVPA to LPA 
was associated with a mean reduction of generated knee 
torque by 43 Nm (95% CI: 75 to 12) (Figure). Also, 
reallocating time to LPA from sleep showed favourable 
associations with 3/13 test scores. In conclusion, our 
cross-sectional results are showing towards the 
importance of engaging in free-living MVPA and LPA 
on physical performance among older adults. Based on a 
study sample, replacing SB with LPA do not suggest 
beneficial impact on physical performance. Our results 
corroborate with previous findings from studies that used 
compositional data analysis, showing favourable 
relationship between MVPA and physical performance 
(Pina et al., 2021), frailty (Kikuchi et al., 2021; Moradell 
et al., 2021) and bone health (Rodríguez-Gómez et al., 
2018) among older adults. 
 
Key Words: compositional data analysis; time-use 
epidemiology; physical activity; motor abilities. 
 

References 
1. Kikuchi, H., Inoue, S., Amagasa, S., Fukushima, N., 

Machida, M., Murayama, H., Fujiwara, T., Chastin, 
S., Owen, N., & Shobugawa, Y. (2021). Associations 
of older adults' physical activity and bout-specific 
sedentary time with frailty status: Compositional 
analyses from the NEIGE study. Experimental 
Gerontology, 143, 111149. Doi: 
10.1016/j.exger.2020.111149  

2. Moradell, A., Rodríguez-Gómez, I., Fernández-
García, Á. I., Navarrete-Villanueva, D., Marín-
Puyalto, J., Pérez-Gómez, J., Villa-Vicente, J. G., 
González-Gross, M., Ara, I., Casajús, J. A., Gómez-
Cabello, A., & Vicente-Rodríguez, G. (2021). 
Associations between Daily Movement Distribution, 
Bone Structure, Falls, and Fractures in Older Adults: 
A Compositional Data Analysis Study. International 
Journal of Environmental Research and Public 
Health, 18(7), 3757. https://www.mdpi.com/1660-
4601/18/7/3757  

3. Pina, I., Mendham, A. E., Tomaz, S. A., Goedecke, J. 
H., Micklesfield, L. K., Brooks, N. E., Gallagher, I. 
J., Crockett, R., Dudchenko, P., & Hunter, A. M. 
(2021). Intensity Matters for Musculoskeletal Health: 
A Cross-Sectional Study on Movement Behaviors of 
Older Adults from High-Income Scottish and Low-
Income South African Communities. International 
Journal of Environmental Research and Public 
Health, 18(8). Doi: 10.3390/ijerph18084310  

4. Rodríguez-Gómez, I., Mañas, A., Losa-Reyna, J., 
Rodríguez-Mañas, L., Chastin, S. F. M., Alegre, L. 
M., García-García, F. J., & Ara, I. (2018). 
Associations between sedentary time, physical 
activity and bone health among older people using 
compositional data analysis. PloS One, 13(10), 
e0206013. Doi: 10.1371/journal.pone.0206013. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 April 1 - Abstract 93 
 
AMB-REMOB – results of an early outpatient 
rehabilitation program  
 
Stefan Löfler (1), Špela Matko (1), Ferdinand Prüfer (1), 
Jan Cvecka (2), Matej Vajda (2), Helmut Kern (1). 
 
(1) Ludwig Boltzmann Institute for Rehabilitation 
Research, Vienna, Austria; (2) Faculty of Physical 
Education and Sport, Comenius University Bratislava, 
Slovakia,  
Email: stefan.loefler@rehabilitation.lbg.ac.at  
 
Aquatic exercise has been explored in a number of 
studies as a potential tool for early rehabilitation 
following total knee and total hip arthroplasty surgeries. 
A systematic review by Niu et al. (2020) reported that 

 

mailto:stefan.loefler@rehabilitation.lbg.ac.at


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aquatic exercise was effective in improving range of 
motion, reducing pain, and enhancing physical function 
in patients undergoing total knee or hip arthroplasty. 
Similar findings were reported in a systematic review by 
Wallis et al. (2018), which concluded that aquatic 
exercise could improve physical function and reduce pain 
in patients undergoing total knee or hip arthroplasty. A 
randomized controlled trial by Wang et al. (2020) 
investigated the effects of a 6-week aquatic exercise 
program on patients with total knee arthroplasty. The 
authors reported that the aquatic exercise group had 
significantly improved knee function and quality of life 
compared to the control group. A similar study by Jang 
et al. (2021) investigated the effects of a 4-week aquatic 
exercise program on patients with total hip arthroplasty. 
The authors reported that the aquatic exercise group had 
significantly improved physical function and pain 
compared to the control group. Aquatic exercise has also 
been compared to land-based exercise in some studies. A 
randomized controlled trial by Cheung et al. (2016) 
compared aquatic exercise to land-based exercise in 
patients with total knee arthroplasty. The authors 
reported that both groups had significant improvements 
in physical function and pain, but the aquatic exercise 
group had greater improvements in knee flexion range of 
motion. A systematic review by Wallis et al. (2018) also 
reported that aquatic exercise was more effective than 
land-based exercise in improving physical function in 
patients undergoing total knee or hip arthroplasty. In the 
INTERREG SK-AT cross border project AMB-REMOB 
we investigaged the effects of early (10 days after 
operation) vs. late (6 weeks) after operation) therapy 
onset of the use of a 4 week program including 
underwater therapy, underwater pressure jet massage and 
electrical stimulation. In addition, we compared the 
results with a group of inpatients at the time points 6 and 
10 weeks after surgery. In line with the current scientific 
literature our study shows that aquatic exercise can be an 
effective tool for early rehabilitation following total knee 
and total hip arthroplasty surgeries. 
Key Words: Rehabilitation, total knee arthroplasty, total 
hip arthroplasty, aquatic exercise, outpatient 
References 
1. Niu, X., Zhang, Y., Li, C., & Guo, X. (2020). The 

effectiveness of aquatic exercise for patients with 
total knee or hip arthroplasty: a systematic review 
and meta-analysis. Clinical Rehabilitation, 34(6), 
685-695. 

2. Wallis, J. A., Taylor, N. F., & Prendergast, L. A. 
(2018). Therapeutic aquatic exercise in the 
treatment of low back pain: a systematic review. 
Clinical Rehabilitation, 32(2), 139-150. 

3. Wang, H., Zhang, Y., & Li, X. (2020). Effects of 
aquatic exercise on knee function and quality of life 
in patients with total knee arthroplasty: a 
randomized controlled trial. Journal of Physical 
Therapy Science, 32(9), 611-615. 

4. Jang, E. H., Koo, H. M., & Jung, D. Y. (2021). The 
effects of aquatic exercise on physical function and 
pain in patients with total hip arthroplasty. Journal 
of Physical Therapy Science, 33(1), 18-22. 

5. Cheung, C., Wyman, J. F., Resnick, B., Savik, K., 
& Halcon, L. (2016). Does aquatic exercise 
improve pain and disability associated with 
osteoarthritis? A meta-analysis. Journal of Geriatric 
Physical Therapy, 39(2), 38-52. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 April 1 - Abstract 94 
 
Outcomes of early rehabilitation in elderly patients  
 
Vincent Grote (1), Michael J. Fischer (1, 2) 
 
(1) Ludwig Boltzmann Institute for Rehabilitation 
Research, Vienna, Austria, (2) Rehabilitation Center 
Kitzbühel, Austria. 
E-mail: vincent.grote@rehabilitation.lbg.ac.at  
 
In recent years, the prevalence of chronic diseases has 
increased, especially in the aging population. 
Rehabilitation plays a key role in alleviating and even 
preventing the physical limitations associated with aging 
and living with chronic diseases. Unfortunately, many 
older people who could benefit from inpatient follow-up 
rehabilitation (WHO Phase II) do not have access to it 
because of their fragile health status after hospitalization. 
To bridge the gap between primary/acute care and 
rehabilitation, the concept of transitional rehabilitative 
care was introduced. This has allowed patients to spend 
fewer days in the hospital, avoiding long hospital stays 
and the need for long-term care.  To evaluate the 
effectiveness of this transitional care, a pilot project was 
conducted in 2022 with 114 patients. Of these, 50 
patients participated in at least three measurement time 
points (with a mean length of stay of 7 ± 3 weeks), and 
36 patients were followed up 24 weeks after admission 
(t4). The sample had a mean age of 82 ± 7 years, with 
88% of patients being female.  The results of the study 
showed significant improvements in care needs (Barthel 
Index, HAQ), quality of life (pain, EQ-VAS), and 
physical mobility (Timed Up-and-Go Test, 10m gait 
speed) from the beginning (t1) to the end (t3) of the stay. 
This was especially true for the first three weeks of 
treatment (t1-t2). However, at follow-up 24 weeks after 
admission (t4), there was a marked deterioration in 
quality of life. Nevertheless, after six months, more than 
80% of geriatric patients received both private (5 ± 7 
hours per week) and/or professional (13 ± 12 hours per 
week) care at home, and only 15% of patients were in a 
long-term care facility. Qualified transitional care and 
rehabilitation is essential to enable elderly, multimorbid 
patients to return to independent living at home. The 

mailto:vincent.grote@rehabilitation.lbg.ac.at


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results of this study provide evidence for this and will be 
used to develop an evidence-based treatment pathway for 
early rehabilitation of geriatric patients. 
Key Words: Chronic diseases; ageing; transitional care; 
geriatrics; rehabilitation. 
References 
1. Grote V, Unger A, Böttcher E, Muntean M, Puff H, 

Marktl W, Mur E, Kullich W, Holasek S, Hofmann P, 
Lackner HK, Goswami N, Moser M. General and 
Disease-Specific Health Indicator Changes 
Associated with Inpatient Rehabilitation. J Am Med 
Dir Assoc. 2020 Dec;21(12):2017.e10-2017.e27. doi: 
10.1016/j.jamda.2020.05.034. Epub 2020 Jul 28. 
PMID: 32736990. 

2. Grote V, Böttcher E, Unger A, Hofmann P, Moser M, 
Fischer MJ. Observational study of an inpatient 
program for musculoskeletal disorders: The effects of 
gender and physical activity. Medicine (Baltimore). 
2021 Oct 29;100(43):e27594. doi: 
10.1097/MD.0000000000027594. PMID: 34713836; 
PMCID: PMC8556041. 

3. Tschuggnall M, Grote V, Pirchl M, Holzner B, 
Rumpold G, Fischer MJ. Machine learning 
approaches to predict rehabilitation success based on 
clinical and patient-reported outcome measures. 
Informatics in Medicine Unlocked 2021, 24, 100598, 
doi:10.1016/j.imu.2021.100598. 

4. Wagner B, Zdravkovic A, Pirchl M, Puhan MA, 
Zwick RH, Grote V, Crevenna R, Fischer MJ. 
Performance Score (T2D)-A New Perspective in the 
Assessment of Six-Minute Walking Tests in 
Pulmonary Rehabilitation. Diagnostics (Basel). 2022 
Oct 3;12(10):2402. doi: 10.3390/diagnostics 
12102402. PMID: 36292092; PMCID: 
PMC9601141. 

5. Zdravkovic A, Grote V, Pirchl M, Stockinger M, 
Crevenna R, Fischer MJ. Comparison of patient- and 
clinician-reported outcome measures in lower back 
rehabilitation: introducing a new integrated 
performance measure (t2D). Qual Life Res. 2022 
Jan;31(1):303-315. doi: 10.1007/s11136-021-02905-
2. Epub 2021 Jun 15. PMID: 34129172; PMCID: 
PMC8800917. 

 
Pdm3 March 29 - April 1, 2023 

***** 

 

 

 

 

 

 

 

SATURDAY April 1, 2023 
Conference Hall, Hotel Petrarca, Thermae of 

Euganean Hills (Padua) Italy 
 
03:20 AM Session XIIa: European Medical 

Thermalism and the World 
Federation Hydrotherapy 
(FEMTEC) 

 
Stefano Masiero, Ugo Carraro, Chairs 

 
2023Pdm3 April 1 - Abstract 95 

LECTURE 
Acute therapy (0-5 days) and outpatient 
remobilization (10-40 days) program after total 
knee arthroplasty  
 
Helmut Kern 
Ludwig Boltzmann Institute for Rehabilitation 
Research, Vienna, Austria 
Email: helmut@kern-reha.at  
 
Total knee arthroplasty (TKA) is a commonly performed 
procedure to relieve pain and improve function in 
patients with advanced osteoarthritis. Appropriate 
management in the acute and early postoperative period 
is crucial for optimal outcomes. Recent literature 
highlights the importance of acute and early therapies 
after TKA, including pain management, early 
mobilization, and physiotherapy. Effective pain 
management strategies are essential for early recovery 
after TKA. Various analgesic techniques have been 
studied, including opioids, nonsteroidal anti-
inflammatory drugs (NSAIDs), and regional anesthesia. 
A meta-analysis by Smith et al. (2020) showed that 
multimodal analgesia, including opioids, NSAIDs, and 
regional anesthesia, resulted in better pain control and 
reduced opioid use compared to opioid monotherapy 

 
 

From left: Stefano Masiero, Ugo Carraro, Helmut Kern 

mailto:helmut@kern-reha.at


2023 Pdm3 - Post meeting book of abstracts 
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alone. Early mobilization after TKA is also important for 
preventing complications such as deep vein thrombosis 
and pulmonary embolism, reducing length of hospital 
stay, and improving functional outcomes. A systematic 
review by Ficklscherer et al. (2020) found that early 
mobilization, defined as the initiation of physical therapy 
within 24 hours of surgery, was associated with improved 
functional outcomes, reduced length of stay, and lower 
rates of complications. Physiotherapy plays a critical role 
in the postoperative management of TKA patients. A 
randomized controlled trial by Artz et al. (2021) found 
that a six-week structured physiotherapy program 
following TKA resulted in significant improvements in 
physical function, pain, and quality of life compared to 
usual care. In summary, recent literature highlights the 
importance of acute and early therapies after TKA, 
including multimodal analgesia, early mobilization, and 
structured physiotherapy programs. These interventions 
can lead to better pain control, reduced opioid use, 
improved functional outcomes, and shorter hospital 
stays. This talk provides practical descriptions starting on 
the day of operation until the first 10 weeks.  
Key Words: Acute therapy; total knee arthroplasty; early 
rehabilitation; mobilization; physiotherapy.  
References  
1. Smith, M. T., et al. (2020). Multimodal analgesia 

after total knee arthroplasty: A systematic review and 
meta-analysis. British Journal of Anaesthesia, 125(5), 
e420-e434. 

2. Ficklscherer, A., et al. (2020). Early mobilization 
after total knee arthroplasty: A systematic review and 
meta-analysis of randomized controlled trials. Journal 
of Arthroplasty, 35(3), 749-756. 

3. Artz, N., et al. (2021). Six-week postoperative 
structured physiotherapy intervention following total 
knee arthroplasty: Randomised controlled trial. 
British Journal of Surgery, 108(2), 165-174. 

 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 April 1 - Abstract 96 
 
Case Study: The use of Balneotherapy in a 
comprehensive integrative medicine treatment plan 
for Fibromyalgia 
 
Marcus Coplin 
Director of Hydrothermal Medicine - Balneology 
Association of North America; Medical Director - The 
Springs Resort, Pagosa Springs, Colorado, USA 
E-mail: DrMarcusCoplin@gmail.com  
 
The successful treatment of Fibromyalgia is multifaceted 
and requires a patient specific approach.  The addition of 
Balneotherapy into the treatment plan for Fibromyalgia 
represents a multi-system intervention that can be 
incorporated alongside conventional and integrative 

therapies. The rationale for Balneotherapy will be 
reviewed along with the synergistic applications between 
Balneotherapy and integrative treatment plans.1-5 
A case review will be presented highlighting the use of a 
Health Resort intervention focusing on Balneotherapy in 
the on-going management of a patient with Fibromyalgia, 
and case management concepts will be presented for 
discussion. 
Key Words: Balneotherapy; fibromyalgia; health resort 
medicine; integrative medicine; physical medicine. 
References 
1. Evcik D, Kizilay B, Gökçen E. The effects of 

balneotherapy on fibromyalgia patients. Rheumatol 
Int. 2002 Jun;22(2):56-9. doi: 10.1007/s00296-002-
0189-8. Epub 2002 Mar 29. PMID: 12070676. 

2. Ardiç F, Ozgen M, Aybek H, Rota S, Cubukçu D, 
Gökgöz A. Effects of balneotherapy on serum IL-1, 
PGE2 and LTB4 levels in fibromyalgia patients. 
Rheumatol Int. 2007 Mar;27(5):441-6. doi: 
10.1007/s00296-006-0237-x. PMID: 17033835. 

3. Fraioli A, Grassi M, Mennuni G, Geraci A, Petraccia 
L, Fontana M, Conte S, Serio A. Clinical researches 
on the efficacy of spa therapy in fibromyalgia. A 
systematic review. Ann Ist Super Sanita. 
2013;49(2):219-29. doi: 10.4415/ANN_13_02_13. 
PMID: 23771266. 

4. Cao CF, Ma KL, Li QL, Luan FJ, Wang QB, Zhang 
MH, Viswanath O, Myrcik D, Varrassi G, Wang HQ. 
Balneotherapy for Fibromyalgia Syndrome: A 
Systematic Review and Meta-Analysis. J Clin Med. 
2021 Apr 3;10(7):1493. doi: 10.3390/jcm10071493. 
PMID: 33916744; PMCID: PMC8038322. 

5. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 
2014 Apr 16;311(15):1547-55. doi: 
10.1001/jama.2014.3266. PMID: 24737367. 

 
Pdm3 March 29 - April 1, 2023 

***** 
 
 

 
The Springs Resort, Pagosa Springs, Colorado, USA 

mailto:DrMarcusCoplin@gmail.com


2023 Pdm3 - Post meeting book of abstracts 
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2023Pdm3 April 1 - Abstract 97 
 
Event-related potential analysis in healthy and spinal 
cord injured individuals: some results  
 
Thordur Helgason,  
Reykjavik University, Reykjavik, Iceland:  
Email: thordur@landspitali.is  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 April 1 - Abstract 98 
 
World Thermal Clusters  
 
Umberto Solimene 
Center Integrative Medicine, State University Milan, 
Italy. Email: umberto.solimene@unimi.it  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 April 1 – Abstract 99 
 
Health Resort Medicine and rehabilitation in the 
Euganean Hills Thermae: Building the future  
 
Maria Chiara Maccarone (1), Ugo Carraro (2,3), 
Stefano Masiero (1,2,4), 
 
(1) Physical Medicine and Rehabilitation School, 
Department of Neuroscience, University of Padua; (2) 
CIR-Myo - University of Padua; (3) Department of 
Biomedical Sciences, University of Padua; (4) 
Department of Neuroscience, Section of Rehabilitation, 
University of Padua, Italy. 
E-mail: mariachiara.maccarone@phd.unipd.it 
 
In recent years rapid and epoch-making changes have 
taken place in all the medicine fields. Rehabilitation has 
been one of the areas most affected by these changes, 
accelerated also by the COVID-19 pandemic. In this 
context, it is essential to determine new rehabilitation 
settings, which can represent appropriate alternatives to 
the hospital setting, closer to the community. Health 
resort facilities, thanks to the presence of a 
multidisciplinary staff and the possibility of exploiting 
synergies between traditional spa treatments and 
rehabilitative interventions (physical energies, 

respiratory, balance and muscle strengthening exercises, 
water massage, therapeutic massage, etc.),1 can be 
appropriate rehabilitative settings for patients suffering 
from musculoskeletal, cardiorespiratory and neurological 
disabilities.1 Aquatic exercise has several well-known 
therapeutic effects due to the physical properties of the 
immersion in water. To these, the anti-inflammatory, 
myorelaxant and antalgic effects of the thermal mineral-
rich waters must be added. Rehabilitation programs 
conducted in the Health Resort settings also have a 
positive impact on quality of life, as the environment 
itself promotes patients' sociality and general well-being. 
Innovative rehabilitative approaches can be proposed in 
the Health Resort setting due to its many properties. 
Recently, research projects that broaden the horizons of 
Health Resort Medicine are being conducted at the 
Euganean Hills Thermae with the scientific support of the 
University of Padua. Innovative rehabilitation protocols 
have been proposed for the management of patients with 
musculoskeletal disabilities resulting from orthopedic 
surgery, for patients suffering of movement disorders 
secondary to neurodegenerative diseases and for subjects 
with Long Covid outcomes.2-5 All protocols allow 
integration between traditional spa treatments (Figure) 
and advanced technologies, including Telerehabilitation, 
and demonstrated positive effects in ameliorating 
patients motor function and quality of life. The increasing 
development of innovative rehabilitation protocols in the 
Health Resort setting may have significant social, health 

 
 

 
 

Fango (mud, top) and balneo physiotherapy for the 
hands (bottom) at the Thermae of Euganean Hills, 

Padua, Italy 

mailto:thordur@landspitali.is
mailto:umberto.solimene@unimi.it
mailto:mariachiara.maccarone@phd.unipd.it


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and economic consequences. Therefore, in the future 
comprehensive scientific research should be conducted in 
order to confirm their efficacy and safety. 
Key Words: Balneotherapy; aquatic exercise, 
telerehabilitation, long covid, COVID-19 pandemic 
syndrome. 
References 
1. Tognolo L, Coraci D, Fioravanti A, Tenti S, Scanu A, 

Magro G, Maccarone MC, Masiero S. Clinical Impact 
of Balneotherapy and Therapeutic Exercise in 
Rheumatic Diseases: A Lexical Analysis and Scoping 
Review. Applied Sciences. 2022; 12(15):7379. 

2. Lobanov AA, Irina A Grishechkina, Andronov SV, 
Gleb N Barashkov, Andrey I Popov, Anatoliy D 
Fesyun, Elena P Ivanova, Maccarone MC, Stefano 
Masiero. Can aquatic exercises contribute to the 
improvement of the gait stereotype function in 
patients with Long COVID outcomes? Eur J Transl 
Myol. 2022 Jul 14;32(3):10698. doi: 
10.4081/ejtm.2022.10698. PMID: 35833897; 
PMCID: PMC9580543. 

3. Masiero S, Maccarone MC. Health resort therapy 
interventions in the COVID-19 pandemic era: what 
next? Int J Biometeorol. 2021 Nov;65(11):1995-
1997. doi: 10.1007/s00484-021-02134-9. Epub 2021 
Apr 21. PMID: 33880643; PMCID: PMC8057917. 

4. Maccarone MC, Masiero S. Can spa rehabilitative 
interventions play a role for patients suffering from 
neurodegenerative disorders at the early stages? A 
scoping review. Int J Biometeorol. 2022 
Dec;66(12):2369-2377. doi: 10.1007/s00484-022-
02369-0. Epub 2022 Sep 21. PMID: 36129582; 
PMCID: PMC9684286 

5. Maccarone MC, Magro G, Albertin C, Barbetta G, 
Barone S, Castaldelli C, Manica P, Marcoli S, 
Mediati M, Minuto D, Poli P, Sigurtà C, Raffaetà G, 
Masiero S. Short-time effects of spa rehabilitation on 
pain, mood and quality of life among patients with 
degenerative or post-surgery musculoskeletal 
disorders. Int J Biometeorol. 2023 Jan;67(1):29-36. 
doi: 10.1007/s00484-022-02381-4. Epub 2022 Oct 8. 
PMID: 36207541; PMCID: PMC9546417. 

 
Pdm3 March 29 - April 1, 2023 

***** 
 
2023Pdm3 April 1 - Abstract 100 
 
Technological transition of different rehabilitation 
approaches: challenges and answers 
 
Daniele Coraci (1), Lucrezia Tognolo (1), Maria Chiara 
Maccarone (1), Ugo Carraro (2-4), Stefano Masiero (1,2) 
 
(1) Department of Neuroscience, Section of 
Rehabilitation, University of Padua, Italy; (2) CIR MYO 
- Interdepartmental Research Centre of Myology, 

University of Padua, Italy; (3) Department of Biomedical 
Sciences, University of Padua, Italy; (4) Armando & 
Carmela Mioni-Carraro Foundation for Translational 
Myology, Padua, Italy. 
 
Medicine, in its history, has shown important innovations 
fundamental for increasing life duration and for 
implementing quality of life. In the last decades, 
Medicine has seen a constant transformation, with a 
larger and larger dialogue between physicians and high-
tech tools. Rehabilitation is an emblematic field where 
this technological innovation is regularly present. Indeed, 
in rehabilitation, we have a lot of new tools useful for 
evaluation and treatment. However, one of the main 
issues only poorly analyzed in research is the 
implications for society and policies of the technological 
transition. In fact, the simple adaptation of an industrial 
device (for example a robot) for medical application does 
not necessarily imply a real clinical and efficient 
applicability for patients. A complex relationship of 
multiple systems on multiple levels is required: different 
networks (research, industrial, cultural, financial, user-
related) mutually interact and they interact with the 
sociotechnical progress. Concerning the technologies 
used in rehabilitation, this complex interaction should be 
assessed to understand how single innovations can 
transform the medical and social systems and how the 
worldwide recent challenges (pandemic, war, 
economic/financial crisis) can modulate the future 
technological transformation of Medicine. We analyzed 
the literature data about three common technology-based 
rehabilitation approaches: robotics, virtual reality and 
telerehabilitation (including rehabilitation in additional 
settings, like the thermae). The analysis was performed 
in order to assess the consequences on the medical and 

 
 

 
 

 
 
 

Rehabilitation AND (robot* OR virtual reality 
OR tele rehabilitation) 

 



2023 Pdm3 - Post meeting book of abstracts 
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social systems of the approaches. The analysis revealed a 
continuous high interest in the approaches but confirms 
the rare estimation of their consequences from a multi-
system point of view. In conclusion, rehabilitation should 
have a key role in the future development of Medicine, 
but we need a large implementation of our vision. Future 
research should focus on the factors determining the 
applicability and the success of the different 
rehabilitation approaches to get a real and efficient 
technological transition. 
 
Key Words: Rehabilitaation; robotics; virtual reality; 
tele-rehabilitation; technology transition.  
 
References 
1. McLeish C, Johnstone P, Schot J. The changing 

landscape of deep transitions: Sociotechnical 
imprinting and chemical warfare. Environmental 
Innovation and Societal Transitions 2022;43:146-
159. 

2. Coraci D, Capobianco SV, Romano M, Calvaruso S, 
Vecchio M, Giovannini S, Loreti C, Fusco A, 
Masiero S, Santilli V, Padua L. Neuropathic Pain and 
Ultrasonography: A Multiperspective Literature 
Evaluation. Diagnostics (Basel). 2021 Sep 
17;11(9):1705. doi: 10.3390/diagnostics11091705. 
PMID: 34574046; PMCID: PMC8470278. 

 
Pdm3 March 29 - April 1, 2023 
 

SATURDAY April 1, 2023 
Conference Hall, Hotel Petrarca, Thermae of 

Euganean Hills (Padua) Italy 
 
03:20 AM Session XIIb: European Medical 

Thermalism and the World 
Federation Hydrotherapy FEMTEC 

 
Stefano Masiero, Elena P. Ivanova, Chairs 

 
 
2023Pdm3 April 1 - Abstract 101 
 
Balneotherapy - prospects for the development of 
health tourism in Bulgaria 
 
Anna Mihaylova (1), Boris Djurdjev (2), Antonya 
Yaneva (3), Dobromira Shopova (4), Maria 
Semerdzhieva (1), Desislava Bakova (1) 
 
(1) Department of Health Care Management, Faculty of 
Public Health, Medical University of Plovdiv, Bulgaria; 
(2) Department of Physical and Rehabilitation Medicine, 
Faculty of Medicine, Medical University of Plovdiv, 
Bulgaria; (3) Department of Prosthetic Dentistry, Faculty 
of Dental Medicine, Medical University of Plovdiv, 

Bulgaria; (4) Department of Medical Informatics, 
Biostatistics and E-learning, Faculty of Public Health, 
Medical University of Plovdiv, Bulgaria. 
E-mail: anna.mihaylova@mu-plovdiv.bg  
 
European countries are among the most popular health 
tourism destinations worldwide. Currently, the European 
health market is undergoing intense processes of 
transformation and the identification of new trends for 
this type of tourism in conditions of great competition. 
Their research is essential in order to draw attention to 
balneo resorts and to support Bulgarian health (medical) 
tourism. Bulgaria has significant potential to develop 
health tourism with an emphasis on balneology (Medical 
SPA and Wellness SPA). The results of the systematic 
review in the scientific databases PubMed, Scopus, 
Medline, etc., indicate that among the European countries 
with the largest number of balneo resorts and developed 
rehabilitation tourism are Italy (180), Germany (131) and 
Spain (106). These countries also have the largest 
number of patients who used the services of spa and 
wellness resorts. There are 47 balneological resorts in 
Bulgaria with over 225 mineral springs of different 
composition and temperature. The healing properties of 
the waters have a scientifically proven effect in the 
treatment of a wide range of diseases. Currently, the 
prices of the medical services offered in our country are 
extremely attractive, and our country has the potential to 
receive patients from other countries. The climate, 
mineral springs, nature and cultural attractions allow 

 

 
       

 

Balneological resorts offerd different rehabilitation 
proceedures with mineral water, hydrotherapy, 
showers, pearl and mud baths, tangentor, jacuzzi, 
balneotherapy, etc. 

mailto:anna.mihaylova@mu-plovdiv.bg


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combining rest and prevention with treatment and 
rehabilitation of a number of socially significant diseases. 
Promoting health SPA treatments as preventive medicine 
and enhancing specific rehabilitation training programs 
are the future perspective of developing health tourism in 
Bulgaria. 
 
Key Words: Balneotherapy; health tourism; spa and 
wellness; rehabilitation; hydrotherapy. 
 
References 
1. Yurcu G, Wellness and Spa Tourism. J Tourism 

Hospit. 2017;6:2 DOI: 10.4172/2167-0269.1000274 
ISSN: 2167-0269. 

2. https://globalwellnessinstitute.org/wpcontent/upl 
oads/2018/10/Dr.-Natalia-Tchaourskaia-European-
Association-of-Patients-and-Users-of-Thermal-
Centers-Activities-and-Programs.pdf 

 (Visited 18.01.2023) 
3. https://www.mh.government.bg/bg/informaciya-za-

grazhdani/rehabilitaciya-i-balneoturizm/spisk-na-
bazite-za-rehabilitaciya/ (Visited 18.01.2023) 

4. https://www.tourism.government.bg/bg/kategorii 
/strategicheski-dokumenti/nacionalna-strategiya-za-
ustoychivo-razvitie-na-turizma-v 

 (Visited 19.01.2023) 
5. https://www.eaptc.net/ (Visited 19.01.2023) 
 
Pdm3 March 29 - April 1, 2023 

***** 
 
2023Pdm3 April 1 - Abstract 102 
 
Modern methods of neuro-rehabilitation  
 
Andrey Rachin 
Rehabilitation and Balneology Center, Moscow, Russia 
Email: RachinAP@nmicrk.ru  
 
On-site presentation of unpublished results. The 
author denied Zoom circulation, recording and post-
meeting dissemination by YOUTUBE 
 
Pdm3 March 29 - April 1, 2023 
 
 
 
 
 
 
 
 
 
 
 

2023Pdm3 April 1 - Abstract 103 
 
Correction of increased meteosensitivity of obese 
patients when using Terrainkur, taking into account 
the bioclimatic characteristics during stay in health 
resorts 
 
Maxim Yu. Yakovlev, Anatoliy D. Fesyun, Irina A. 
Grishechkina, Igor P. Bobrovnitkyi, Andrey A. Parfenov, 
Elena A. Valtseva, Michail V. Nikitin, Sergey A. 
Pavlovskyi  
 
National medical research center for rehabilitation and 
balneology, Moscow, Russia 
Email: YakovlevMY@nmicrk.ru  
 
Obesity (overweight) is a common multifactorial 
multisystem disease associated with a high incidence of 
cardiovascular diseases.1,2  Graduated physical exercise 
is the main therapeutic intervention.3 The combination of 

exercise with climatotherapy (terrainkur) cumulates the 
therapeutic effect. However, external meteorological 
conditions and meteotropic reactions that occur in the 
patient must be taken into account, which can neutralise 
the achieved therapeutic effect.4 The aim of the work is 
to improve the effectiveness and safety of the use of the 
health resort in the treatment of overweight patients by 
using digital bioclimatic prediction technology and 
microclimatic zoning. Evaluation of the bioclimatic 
potential of Krasnodar territory and microzonation of the 
area where “Vulan” sanatorium and resort complex is 
located. Verbal and communicative examination of 735 
patients in “Vulan” sanatorium and resort complex using 
"Method of evaluation of human meteosensitivity" 
(Patent No. 2736612 C1 of 19.11.2020) was carried out. 
Based on data from weather stations in Gelendzhik, 
Novorossiysk, Krasnodar and Vulan sanatorium and 
resort complex, a risk model for the development of 

 
Types of climate in the Krasnodar Territory. The 
climate of the study area is indicated by colors: 
pink - dry subtropical climate, black - high-
mountain climate, green - mid- and low-mountain 
temperate continental forest climate 

https://globalwellnessinstitute.org/wpcontent/upl%20oads/2018/10/Dr.-Natalia-Tchaourskaia-European-Association-of-Patients-and-Users-of-Thermal-Centers-Activities-and-Programs.pdf
https://globalwellnessinstitute.org/wpcontent/upl%20oads/2018/10/Dr.-Natalia-Tchaourskaia-European-Association-of-Patients-and-Users-of-Thermal-Centers-Activities-and-Programs.pdf
https://globalwellnessinstitute.org/wpcontent/upl%20oads/2018/10/Dr.-Natalia-Tchaourskaia-European-Association-of-Patients-and-Users-of-Thermal-Centers-Activities-and-Programs.pdf
https://globalwellnessinstitute.org/wpcontent/upl%20oads/2018/10/Dr.-Natalia-Tchaourskaia-European-Association-of-Patients-and-Users-of-Thermal-Centers-Activities-and-Programs.pdf
https://www.tourism.government.bg/bg/kategorii%20/strategicheski-dokumenti/nacionalna-strategiya-za-ustoychivo-razvitie-na-turizma-v
https://www.tourism.government.bg/bg/kategorii%20/strategicheski-dokumenti/nacionalna-strategiya-za-ustoychivo-razvitie-na-turizma-v
https://www.tourism.government.bg/bg/kategorii%20/strategicheski-dokumenti/nacionalna-strategiya-za-ustoychivo-razvitie-na-turizma-v
https://www.eaptc.net/
mailto:RachinAP@nmicrk.ru
mailto:YakovlevMY@nmicrk.ru


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- 90 - 
 

 

hypertensive crisis was made for the first time for this 
area. It has been established that the macroclimatic 
characteristics of Krasnodar territory vary over a wide 
range throughout the year, which is due to the physical 
and geographical features of the region, namely a sharp 
transition from a continental dry climate in Taman and 
on the border with Stavropol territory to a moderately 
continental one in the Kuban lowlands, from a cold 
climate in the highlands to a subtropical one on the Black 
Sea coast (Figure).  
Based on the meteorological data obtained, a risk model 
for the development of hypertensive crisis was built. A 
binary logistic regression formula was obtained, which 
allows predicting days with an increased risk of 
hypertensive crisis development and giving individual 
recommendations to obese patients on physical training 
and on the selection of a terrainkur route based on the 
results of the microclimatic zoning. Analysis of 
subjective evaluation of meteosensitivity showed that 
overweight patients had meteopathic reactions of the 
following nature in 95,5% of cases: headache (59,49%), 
increased blood pressure (47,03%), weakness, decreased 
activity (42,49%), drowsiness (41,36%), joint pain 
(40,51%). An association between the severity of 
meteopathy and the presence of more comorbidities was 
found (χ2=20.83, p < 0.01). The methods for the 
correction of increased meteosensitivity using terrainkur, 
taking into account the bioclimatic characteristics of the 
weather conditions during the period of stay in health 
resort in obese patients enable the correction of the 
emerging weather-related reactions and consequently 
maintain and enhance the achievable therapeutic effects. 
Key words: Obesity; cardiovascular diseases; 
meteopathic reactions; weather-related diseases. 
References 
1. Forouzanfar M.H., Afshin A., Alexander L.T., et al. 

Global, regional, and national comparative risk 
assessment of 79 behavioural, environmental and 
occupational, and metabolic risks or clusters of risks, 
1990-2015: a systematic analysis for the Global 
Burden of Disease Study 2015. Lancet. 2016; 
388(10053): 1659-1724. 

2. Nguyen NT, Magno CP, Lane K, et al. Association of 
Hypertension, Diabetes, Dyslipidemia, and 
Metabolic Syndrome with Obesity: Findings from the 
National Health and Nutrition Examination Survey, 
1999 to 2004. J. Am. Coll. Surg. 2008; 6(207): 928-
34 

3. Bessesen D., Kushner R. Evaluation & Management 
of Obesity. Рhiladelphia: Hanley & Belfus. 2002, 6. 

4. Barashkov G.N., Sergeev V.N. Physical training by 
walking and health path - modern approaches and 
opportunities at the resort. Vestnik fizioterapii i 
kurortologii (Bulletin of physiotherapy and 
balneology). 2020; 26 (1): 47-54. (In Russian). 

 
Pdm3 March 29 - April 1, 2023 
 

2023Pdm3 April 1 - Abstract 104 
 
Video analysis of patients’ gait during Terrainkur in 
obese people 
 
Kirill V. Terentev (1), Andrey A. Lobanov (2), Sergey 
V. Andronov (2), Andrey I. Popov (2), Irina A. 
Grishechkina (2), Michail A. Eremushkin (2), Rinat R. 
Bogdanov (1) 
 
(1) Moscow regional research clinical institute named 
after M.F. Vladimirsky, Moscow, Russia, RF; (2) 
National medical research center for rehabilitation and 
balneology, Moscow, Russia, RF 
Email: Kirillterentev184@gmail.com  
 
Overweight and obesity is a multifactorial, multisystem 
disease that the World Health Organization (WHO) 
declared a global epidemic back in 1997.1 In Russia, at 
least 30% of the Russian working-age population is 
overweight.2 The use of physical activity as an essential 
(basic) part of treating obesity and maintaining the body 
weight achieved during the body weight treatment can 
provide a durable and long-lasting treatment result, as 
well as significant changes in body composition (body fat 
/ lean body mass ratio).3,4 The combination of physical 
activity (Terrainkur) and climatotherapy results in the 
cumulation and mutual potentiation of the therapeutic 
effect. One of the problems in performing physical 
activity in obese individuals is the difficulty experienced 
by this category of patients in performing physical 
activity as a result of impaired walking patterns due to 
imbalances in the muscular circuits, including the pelvic 
region, cervical region, which reduces endurance and 
commitment to physical activity.5,6 The study revealed  
that the exposure group (Terrainkur) demonstrated lower 
values of "total fat", "metabolic age", " basic calorie 
intake" compared to baseline results and the control 
group; the exposure group (Terrainkur) revealed a 
decrease in the deviation of the centre of body axis 
projection from the proper axis, percentage of 
nonconformity with the proper fluctuations of ankle 

 
Schematic representation of measurement points, 
the size and deviation of the main directions of 
movement, the trajectory of movement of the main 
body parts. 

mailto:Kirillterentev184@gmail.com


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- 91 - 
 

 

underextension. These changes contributed to the 
elimination of restrictions during the terrainkur and, as a 
result, increased compliance of the patients with the 
terrainkur exercises. 
Key words: Overweight; habilect; walking; gait; 
software. 
References: 
1. Guénard, F.; Houde, A., Bouchard, L., Tchernof, A., 

Deshaies, Y., Biron, S., Lescelleur, O., Biertho, L., 
Marceau, S., Pérusse, L., Vohl, M.C. Association of 
LIPA gene polymorphisms with obesity-related 
metabolic complications among severely obese 
patients. Obesity (Silver Spring). 2012; 20(10): 2075-
82.  

2. Mel'nichenko, G.A., Romantsova, T.I. Ozhirenie: 
epidemiologiya, klassifikatsiya, patogenez, 
klinicheskaya simptomatika i diagnostika [Obesity: 
epidemiology, classification, pathogenesis, clinical 
symptoms and diagnosis]; MIA, Moscow, Russian 
Federation, 2004. 456 p. [In Russian]. 

3. Wimalawansa, S.J. Controlling Obesity and Its 
Complications by Elimination of Causes and 
Adopting Healthy Habits: «Cause-Driven» 
Approach. Advances in Medical Sciences. 2014; 3 
(1): P. 1-15.  

4. Salimgareeva, I.A., Ahmadullin, R.V., 
Gil'mutdinova, L.T., Gabdullin, N.T. Dietoterapiya 
ozhireniya v usloviyah sanatoriya [Diet therapy of 
obesity in a sanatorium]. Actual problems of 
restorative medicine, balneology and physiotherapy, 
Proceedings of the International Congress. "All-
Russian forum "Zdravnitsa 2003", Moscow, Russian 
Federation, 2003. P. 172. 

5. Platonov, V.N. Sohranenie i ukreplenie zdorov'ya 
lyudej – prioritetnoe napravlenie sovremennogo 
zdravoohraneniya [Preservation and strengthening of 
people's health is a priority direction of modern health 
care]. Sportivnaya medicina 2006; 2: P. 3–14. 

6. Barieva, Yu.B., Botvineva, L.A., Kajsinova, A.S., 
Samsonova, N.A. Rol' fizicheskih nagruzok i pit'evyh 
mineral'nyh vod v profilaktike i lechenii 
abdominal'nogo ozhireniya - osnovy 
metabolicheskogo sindroma [The role of physical 
activity and drinking mineral water in the prevention 
and treatment of abdominal obesity - the basis of the 
metabolic syndrome]. Fizioterapiya, bal'neologiya i 
reabilitaciya 2017; 16 (5): P. 228-233. 

 
Pdm3 March 29 - April 1, 2023 

***** 
 
 
 
 
 
 

2023Pdm3 April 1 - Abstract 105 
 
Comparative characteristics of long-term outcomes of 
rehabilitation programmes in patients with post-
COVID syndrome 
 
Irina A. Grishechkina (1), Andrey A. Lobanov (2), 
Sergey V. Andronov (2), Elena P. Ivanova (1), Natalia P. 
Sanina (3) 
 
(1) Department for Studying of the Physical Factors 
Action Mechanisms, National Medical Research Center 
of Rehabilitation and Balneology, Russia; (2) Center for 
Bioelementology and Human Ecology, Sechenov 
University; (3) Department of Therapie, Moscow 
regional research clinical institute named after V.F. 
Vladimirsky, Russia. 
E-mail: Irina A. Grishechkina: 
GrishechkinaIA@nmicrk.ru  
 
Post-COVID-19 syndrome (Long-COVID-19 syndrome) 
occurs in persons with a history of probable or confirmed 
SARS-CoV-2 infection, usually within 3 months of the 
onset of COVID-19 and characterized by the presence of 
symptoms for at least 2 months and failure to explain 
them with an alternative diagnosis.1 In order to develop 
rehabilitation programmes for this condition, there have 

been many studies that focus on short-term data on the 
effectiveness of different rehabilitation programmes in 
terms of duration and content, but the data on long-term 
rehabilitation outcomes are very limited.2,3 The aim of the 
study was to evaluate the long-term outcomes of different 
rehabilitation programmes for post-COVID-19 
syndrome. A prospective cohort study was conducted 
from August 2021 until March 2022, involving 113 
patients with post-COVID-19 syndrome (Figure). The 
patients in the main group (n=25) underwent the 
rehabilitation programme under study,4,5 while the 
patients in the other three groups (n=29, n=34, n=25 
respectively) received interventions using rehabilitation 
protocols other than those under study (Oriental medicine 
techniques; balneo- and physiotherapy; self-training and  
physical training). The groups were comparable in terms 
of gender, age and rehabilitation routing scale. During the 
follow-up period, the groups recorded: the frequency of 
hospital admissions due to exacerbation of post-COVID-

 
Study design. 

mailto:GrishechkinaIA@nmicrk.ru


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19 syndrome, death or disability, and the need for other 
types of care. The patients in the comparison groups were 
more and more likely to seek therapeutic care for 
emerging post-COVID syndrome symptoms (χ2=6.635, 
p=0.001; χ2=13.463, p=0.001; χ2=10.949, p=0.001) and 
were also more likely to be hospitalized (χ2=5.357, 
p=0.021; χ2=0.125, p=0.724; χ2=0.856, p=0.355) than 
those in the main group. The relative risk (RR) of hospital 
admissions in the observed cohort was 0.143(CI: 0.019; 
1.078); 0.580 (CI: 0.056; 6.022); 0.340(CI: 0.040; 2.860). 
The reduction of the relative risk of hospital admissions 
when analysing the results of the methods under study 
compared to alternative rehabilitation methods for 
patients with post-COVID-19 syndrome was 85.7%; 
42.0% and 66.0%, respectively. The best outcomes in 
patients with 6 months post-COVID were observed after 
application of rehabilitation programme designed with 
respiratory rehabilitation principles in mind. 
 
Key Words: Post-COVID-19 syndrome; rehabilitation 
programs; treatment strategies; exercise therapy; relative 
risk. 
 
References 
1. WHO: Clinical case definition post-COVID-19 by 

Delphi consensus. 06.10.2021. Available online: 
URL 
https://apps.who.int/iris/bitstream/handle/10665/345
824/WHO-2019-nCoV-Post-COVID-19-condition-
Clinical-case-definition-2021.1-rus.pdf (accessed on 
29 May 2022). 

2. Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey 
O, McLean L, Walshaw C, Kemp S, Corrado J, Singh 
R, Collins T, O'Connor RJ, Sivan M Post discharge 
symptoms and rehabilitation needs in survivors of 
COVID-19 infection: A cross-sectional evaluation. J 
of Medical Virology.2021;93(2):1013–1022. 
doi:10.1002/jmv. 

3.  Rutsch M, Frommhold J, Buhr-Schinner H, 
Djeiranachvili L, Gross Th, Schüller Per O, Katalinic 
A, Deck R Study protocol medical rehabilitation after 
COVID-19 disease: an observational study with a 
comparison group with obstructive airway disease / 
Re_Co. BMC Health Serv Res.2021;21: 373. 
doi:10.1186/s12913-021-06378-4. 

4. Lobanov AA, Irina A Grishechkina, Andronov SV, 
Gleb N Barashkov, Andrey I Popov, Anatoliy D 
Fesyun, Elena P Ivanova, Maccarone MC, Stefano 

Masiero. Can aquatic exercises contribute to the 
improvement of the gait stereotype function in 
patients with Long COVID outcomes? Eur J Transl 
Myol. 2022 Jul 14;32(3):10698. doi: 
10.4081/ejtm.2022.10698. 

5. Lobanov AA, Grishechkina IA, Fesyun AD, Rachin 
AP, Yakovlev MYu, Andronov SV, Barashkov GN, 
Lebedeva OD, Popov AI, Styazhkina EM, Ansokova 
MA, Vasil’eva VAInvestigation of the Effectiveness 
and Safety of the Rehabilitation Program for Patients 
with Long Covid Using Aquatic Training. Bulletin of 
Rehabilitation Medicine. 2022; 21(3): 45-57. 
https://doi.org/10.38025/2078-1962-2022-21-3-45-
57. 

Pdm3 March 29 - April 1, 2023 

***** 
2023Pdm3 April 1 - 106 
 
Final remarks 
 
Stefano Masiero 
Department of Neuroscience, Section of Rehabilitation; 
Physical Medicine and Rehabilitation School, University 
of Padua; CIR-Myo - University of Padua; Italy. 
Email: stefmasiero@unipd.it  
 
Pdm3 March 29 - April 1, 2023 

***** 
 
2023Pdm3 April 1 - 107 
 
Adijo, Adiós, Arrivederci, Auf Wiedersehen, 
Aurevoir, Goodbye to the 2024 Padua Days on 
Muscle and Mobility Medicine (2024 Pdm3), Padua, 
Italy - February 27 to March 02, 2024. 
 
Ugo Carraro 
(1) Department of Biomedical Sciences, University of 
Padua; (2) CIR-Myo - University of Padua; (3) A-C M-
C Foundation for Translational Myology, Padua, Italy. 
Email: ugo.carraro@unipd.it  
 
Pdm3 March 29 - April 1, 2023 

***** 
 

  

mailto:stefmasiero@unipd.it
mailto:ugo.carraro@unipd.it


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93 
 

 

Index: Chairs, Lecturers, Speakers, Authors 
 

Agostini Rachele, 47  
Albertin Giovanna, 28, 57, 59 
Alcázar Caminero Julian, 13  
Amarsaikhan Bazar, 73 
Amato Francesco, 68 
Amatori Stefano, 69 
Ambrosi Alessandro, 31 
Andronov Sergey V., 71 90, 91 
Angelini Corrado, 37, 41 
Annibalini Giosuè, 44 
Argenton Francesco, 40 
Armani A., 24 
Astolfi Laura, 57, 59  
Aubonnet Romain, 65, 67 
Audardottir Sigrun Anna, 65 
Azaam Ahmad M., 27 
Bakova Desislava, 88 
Bakradze Avtandil, 73 
Balut Mauricio Gonzalez, 73 
Barberi Laura, 44  
Barbieri Elena, 44 
Barone Mara, 23 
Barton Elisabeth R., 32, 34 
Battistelli Michela, 47 
Beltrà Marc, 20 
Benetollo Alberto, 39, 40 
Bensalah Mona, 35 
Berardo Alice, 61 
Bergonzoni Matteo, 43 
Bersch Ines, 1, 25, 25  
Betti Valentina, 66  
Biasutto Lucia, 39 
Bigot Anne, 35 
Biolo Gianni, 14, 54 
Biz Carlo, 62  
Bjornsdottir Anna, 65 
Blaauw Bert, 24, 39 
Bobrovnitkyi Igor P., 89 
Bocconcelli Matteo, 44 
Bogdanov Rinat R., 90 
Bonaldi Lorenza, 61 
Borgatti Monica, 43 
Bottinelli Roberto, 12, 13, 53 
Bottino Cinzia, 20 
Bouchè Marina, 33 
Boulinguiez Alexis, 35 
Bourg Nathalie, 47 
Brandt Zachary, 34 
Brasile Alice, 78 
Briem Kristín, 68  
Brocca Lorenza, 53 
Brotto Davide, 57 
Burgunder Berangere, 65 
Butler-Browne Gillian, 35 
Caccin Paola, 39, 40 

Calandra Patrizia, 46 
Capri Miriam, 42  
Cardozo Christopher, 49 
Caretti Giuseppina, 20 
Caria Filomena, 45 
Carotti Marcello, 39, 40 
Carraro Ugo, 1, 15, 17, 28, 29, 
63, 84, 86, 92 
Casola Irene, 24, 79 
Catalucci D., 24 
Cazzador Diego, 57 
Ceccaroli Paola, 47 
Cenacchi Giovanna, 42, 43 
Chiappa Michela, 23  
Ciana Paolo, 23  
Ciliberti Federica Kiyomi, 67 
Ciurca Erika, 42 
Ciurli Beatrice, 41 
Colacino Andrea, 65 
Coplin Marcus, 85 
Coraci Daniele, 87 
Corsi Cristiana, 64 
Cortese Francesca, 41 
Costa Roberta, 42, 43 
Cotti Piccinelli Stefano, 45 
Cristofolini Luca, 66 
Cvecka Jan, 81, 82 
Dalla Barba Francesco, 39, 40 
De Caro Raffaele, 4, 56, 58, 59, 
62 
De Mario Agnese, 52 
De Vito Giuseppe, 15 
Deibener-Kaminsky Joëlle, 33 
Deidda Giancarlo, 46 
Dellavia Claudia, 55, 55 
di Blasio Giorgia, 46 
di Girolamo Filippo Giorgio, 54 
Di Mauro V., 24 
Di Pasquale Fiasca Valerio Maria, 
57 
di Patrizio Soldateschi Emanuele, 
19 
Dimitrova Tanya, 75 
Dimova-Gabrovska Mariana, 75 
Djurdjev Boris, 88 
Dobreva Dyliana, 75 
Dobrowolny Gabriella, 24, 79 
Dokshokova L., 24 
Dowling Paul, 32, 35 
Einarsson Einar, 69 
Eremushkin Michail A., 90 
Fan Chenglei, 56, 62 
Fantoni Ilaria, 62 
Favaro G., 24 
Fazzina Martina, 43 

Fede Caterina, 59, 59, 60, 62 
Feillet François, 33  
Ferrante Francesca, 71 
Ferrari Francesco, 19 
Fesyun Anatoliy D., 89 
Filosto Massimiliano, 41, 45, 
Fiotti Nicola, 54  
Fischer Michael J., 83  
Fontanella Chiara Giulia, 61 
Forni Riccardo, 64,  
Forti Mara, 23 
Frabetti Flavia, 43 
Franchi Martino, 14 
Franco-Romero A., 24 
Galvani Christel, 18, 48  
Ganassi, Massimo, 36 
Gargan Stephen, 32 
Gargioli Cesare, 46  
Gargiulo Paolo, 1, 63, 64, 65, 66, 
67, 68 
Garibaldi Matteo, 41 
Gelormini Carmine, 64  
Geremia Alessia, 48 
Giacomelli Luca, 47 
Giacomello Emiliana, 54 
Giorgini Ludovica, 46 
Girolami Barbara, 78, 79, 80 
Gislason Magnus K., 66, 67, 68 
Giuriati Walter, 15 
Gorgey Ashraf S., 27 
Grassi Bruno, 13, 53 
Grishechkina Irina A., 89, 90, 91 
Grote Vincent, 83 
Grumati Paolo, 24 
Guerrini Lorena, 67 
Guescini Michele, 24, 47 
Guha Shalini, 21 
Harlow Lauren, 49 
Helgason Thordur, 86 
Henley-BeasleySpencer C., 34 
Hepple Russell T., 12 
Hockerman Gregory H., 21 
Hong Ai Vu 47 
Hood David, 51 
Hoppeler Hans, 23 
Iovane Angelo, 76, 77 
Iovane Eleonora Maria, 76, 77 
Israeli David, 47 
Ivanova Elena P., 70, 71, 88, 91 
Ivarsdottir Thorbjorg Ida, 65 
Jaber Abbass, 47 
Jacob Deborah, 65, 67 
Jarvis Jonathan C., 49 
Jaussaud Roland, 33 
Jónsson Halldór Jr., 66 



2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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Kaminsk Pierre V, 33 
Karadjova Marieta, 75 
Katelic Kaja, 81 
Kern Helmut, 1, 25, 28, 79, 80, 
82, 84,  
Khalil Refka E., 27 
Klein Arianna, 24 
Koran Jennifer, 21  
Labella Beatrice, 45 
Lacau-St Guily Jean, 35 
Lanzuolo Chiara, 19 
Lattanzi Giovanna, 37 
Laurenzi Gaia, 79 
LaVigne Emily, 21 
LeBrasseur Nathan, 1,50, 50 
Leeuwenburgh Christiaan, 1, 50, 
52 
Lo Verso F., 24 
Lobanov Andrey A., 71, 90, 91 
Löfler Stefan, 79, 80, 81, 82 
Lømo Terje, 24 
Longo Federica, 42 
Lucini Federica, 19 
Luvisetto Siro, 46 
Maccarone Maria Chiara, 15, 
86, 87 
Macchi Veronica, 58 
Maggi Adriana, 25 
Maino Martina, 73, 80 
Maiullari Fabio, 46 
Maiullari Silvia, 46 
Mammucari Cristina, 52  
Mancino Fabio, 46 
Manni Isabella, 46  
Mantia Carlotta, 77 
Mantia Francesco, 76, 77 
Martini Alessandro, 56, 57 
Marzorati Mauro, 13 
Masiero Stefano, 15, 84, 86, 87, 
88, 92 
Matko Špela, 82 
Mayr Winfried, 25, 28 
Mazzaro Antonio, 24, 24 
McClure Natalie, 21 
Mele Giada, 46  
Mengual i Escalona Itziar, 65 
Merola Giovanni, 42 
Messina Giuseppe, 68, 69, 75, 76, 
77 
Mihaylova Anna, 88 
Missaglia Sara, 18, 44, 48  
Mongillo Marco, 24, 24 
Monti Elena, 15, 80,  
Mordente Alvaro, 18, 48 
Moretti Fabiola, 46 
Morsiani Cristina, 42 
Mouly Vincent, 35 
Muraine Laura, 35 

Musarò Antonio, 27, 44, 79, 80 
Mutarelli Margherita, 19 
Narici Marco V., 1, 12, 14, 15, 
80, 
Negro F., 15 
Negroni Elisa, 35 
Nevi Lorenzo, 20 
Nikitin Michail V., 89 
Njå Arild, 24 
Nogara Leonardo, 39 
Noguera Nelida Inés, 41  
Ohlendieck Kay, 32, 35 
Pacilio Serafina, 43 
Padovani Alessandro, 45 
Parfenov Andrey A., 89 
Parrasia Sofia, 39 
Pavesi Giulio, 20 
Pavlovskyi Sergey A., 89 
Pecci Claudio, 18, 48 
Pegoraro Giovanni, 31 
Pellegrini Gaia, 70 
Pellegrino Maria Antonietta, 53 
Peluso Sara, 69 
Penna Fabio, 20 
Pennisi Elena Maria, 41 
Perie Sophie, 35 
Perrin Philippe, 33 
Petersen Hannes, 65 
Petrelli Lucia, 60, 62 
Petrini Cristiano, 19  
Petrova Julia, 75  
Peultier-Celli Laetitia, 33 
Piazza Ilaria, 52 
Piccirillo Rosanna, 21, 23 
Pietrangelo Laura, 78 
Pirri Carmelo, 58, 60, 61, 62 
Pisot Rado, 54 
Poli Loris, 45 
Polidori Emanuela, 47  
Pond Amber, 21, 21 
Ponsiglione Alfonso Maria, 68 
Pontecorvi Alfredo, 46 
Popov Andrey I., 90 
Porcelli Simone, 13, 53 
Porzionato Andrea, 28 
Prando V., 24 
Proietti Luca, 46 
Protasi Feliciano, 78, 78, 78, 79, 
80 
Pruefer Ferdinand, 82 
Rachin Andrey, 89 
Ramos Jorgelina, 67 
Ravara Barbara, 15, 80 
Re Cecconi Andrea, 23 
Recenti Marco, 65, 67 
Reggiani Carlo, 12 
Rende Mariaconcetta, 37  
Ricci Enzo, 46  

Ricci Giulia, 38, 41  
Ricciardi Carlo, 68 
Richard Isabelle, 47 
Rinaldi Rita, 45 
Risi Barbara, 45 
Rizzi Nicoletta, 23 
Rizzi Roberto, 46 
Rizzuto Rosario, 52 
Rocchi Ettore, 69 
Rodia Maria Teresa, 43 
Ronfini Marco, 24, 24 
Rongo Roberto, 72 
Rosati Riccardo, 1, ,55, 55, 71 
Rossi Maira, 53 
Rosti Valentina, 19 
Ruggieri Pietro, 62 
Saini Sunil K, 52 
Saltarelli Roberta 44 
Salviato Elisa, 19 
Sandonà Dorianna, 39, 40 
Sandri Marco, 19, 19, 24, 
Sanina Natalia, 91 
Santarelli Philina, 19 
Santi Spartaco, 43 
Sarabon Nejc, 1, 81 
Sarto Fabio, 15, 80  
Saxler Frank, 71  
Sazzi Cristiana, 53 
Scano Martina, 39, 40 
Scionti Isabella, 20 
Scribante Andrea, 71 
Semerdzhieva Maria, 88 
Sfondrini Maria Francesca, 71 
Shopova Dobromira, 88 
Siciliano Gabriele, 37, 41 
Sigurjonsson Olafur, 67 
Silvestrini Andrea, 18,48 
Sirago G., 15 
Sisti Davide, 69 
Smeriglio Piera, 19, 20 
Smigliani Ariela, 41 
Solimene Umberto, 86 
Sorarù Gianni, 24, 24,  
Stecco Carla, 56, 56, 58, 59, 59, 
60, 61,62 
Sukhbaatar Nomingerel, 73 
Sutherland Hazel, 49 
Swandulla Dieter, 32 
Sweeney H. Lee, 32, 32, 34, 37 
Tavian Daniela, 18, 37, 41, 48  
Terentev Kirill V., 90 
Terrasi Micol, 77 
Teveroni Emanuela, 46  
Tognolo Lucrezia, 87 
Tommasini Ester, 18, 48 
Torfason Bjarni, 64  
Torri Francesca, 37, 41 
Trollet Capucine, 34, 35 



2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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Tsirilaki Mariella, 67 
Ummu Guven, 20 
Vadi Gabriele, 37 
Vago Paola, 18, 48 
Vajda Matej, 82 
Valli Giacomo, 15, 44, 47 
Valtseva Elena A., 89 
van der Maarel Silvère, 21 
Viggars Mark, 49 

Villani Katelyn, 34 
Vita Veronica, 24 
Wei-LaPierre Lan, 34 
Whiteley Rodney, 68 
Yakovlev Maxim Yu., 89 
Yaneva Antonya, 88 
Zacchini Claudia, 43 
Zaglia Tania, 24, 24 
Zammit Peter S., 36 

Zampieri Sandra, 1,15,78, 79, 80 
Zanoletti Elisabetta, 57 
Zaza Alessandra, 41 
Zentilin Lorena, 23 
Zhong Renjia, 34 
Zuccarelli Lucrezia, 13, 53 

  



2023 Pdm3 - Post meeting book of abstracts 
Eur J Transl Myol 33 (2) 11427, 2023. doi: 10.4081/ejtm.2023.11427 

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