1. Spinal mechanisms in post-activation potentiation : facilitation of presynaptic inhibition contrasts h-reflex amplitude reductionMiloš Kalc, Aleš Holobar, Matej Kramberger, Nina Murks, Jakob Škarabot, 2026, original scientific article Abstract: This study invesƟgated the spinal neural mechanisms underlying post‐acƟvaƟon potenƟaƟon in ten16healthy young males (21.9 ± 4.8 years). ParƟcipants performed a 10‐second maximal isometric17plantarflexion, aŌer which we measured twitch torque and assessed spinal excitability using the18soleus H‐reflex, D1 presynapƟc inhibiƟon and heteronymous Ia facilitaƟon (HF). High‐density surface19EMG was decomposed to track single motor unit responses. The condiƟoning contracƟon increased20twitch torque by 12.2 Nm (p < 0.001) immediately and returning to baseline within nine minutes. This21mechanical potenƟaƟon was accompanied by a 29% reducƟon in H‐reflex amplitude (p < 0.001),22which recovered within three minutes. Paradoxically, neurophysiological indices of presynapƟc23inhibiƟon, D1 and HF were significantly increased (D1: p<0.017; HF: p<0.001), resulƟng in spinal24facilitaƟon. Single MU analysis revealed increased discharge probability, parƟcularly in higher‐25threshold units indicaƟng overall spinal facilitaƟon. These results demonstrate that post‐acƟvaƟon26potenƟaƟon involves a complex dissociaƟon: H‐reflex pathway inhibiƟon along with facilitaƟon of27presynapƟc spinal mechanisms. This paradox can be explained by either post‐acƟvaƟon depression28(caused by depleƟon of neurotransmiƩer at the Ia–motoneuron synapse) or muscle thixotropy, a29contracƟon history‐dependent decrease in muscle spindle sensiƟvity, which reduces the efficacy of30the Ia afferent volley independently of spinal inhibitory mechanisms. Our findings highlight a31dissociaƟon between spinal presynapƟc facilitaƟon and the decreased H‐reflex, underscoring the32need for future studies to explicitly test the roles of post‐acƟvaƟon depression and muscle thixotropy33aŌer condiƟoning contracƟons. Keywords: HDsEMG, Ia afference, soleus, heteroniumous Ia facilitation, spinal reflex, muscle contraction, neural mechanisms, performance enhancement Published in DiRROS: 12.05.2026; Views: 52; Downloads: 26
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2. Association between TMG-derived contractile muscle parameters and MRI-based muscle structure in sarcopeniaKatarina Puš, D. A. Madrid Fuentes, Ashley Weaver, Miloš Kalc, Jeannette R. Mahoney, Boštjan Šimunič, 2026, original scientific article Abstract: Background: Muscle fat fraction (MFF) obtained through magnetic resonance imaging (MRI) is the gold standard for assessing muscle quality, but it is expensive and time consuming. Portable methods to examine muscles such as tensiomyography (TMG) are emerging and could enable broader screening. This study aims to examine associations between TMG-derived muscle contractile parameters and MFF in older adults with and without sarcopenia. Methods: A sample of 51 Slovenian older adults (53% females) were scanned with Dixon MRIs to evaluate muscle MFF and contractile parameters were assessed with TMG estimating delay time (Td), maximal displacement (Dm) and radial contraction velocity (Vc). Right leg vastus lateralis (VL) and biceps femoris (BF) were analyzed. Sarcopenia was defined using both European Working Group on Sarcopenia in Older People (EWGSOP2) and Sarcopenia Definition and Outcomes Consortium (SDOC) criteria. Regression models adjusted for age and sex were used to assess associations between TMG-derived contractile parameters and MFF. Results: Age- and sex-adjusted models revealed associations between increased MFF and reduced Dm (R2 = .29, p = .003) and Vc (R2 = .32, p = .002) for the VL. SDOC-classified sarcopenic individuals showed increased VL MFF (27.2% vs 22.5%, p = .019),while EWGSOP2 classified sarcopenia displayed no differences. Discussion: The study reveals that increased MFF is associated with reduced muscle contractility in VL. MFF differs between sarcopenic and non-sarcopenic groups using only SDOC criteria. Since the TMG Dm increase is regularly found in atrophic muscles after bed rest, in sarcopenic muscle MFF explains lowering of the Dm, highlighting the TMG potential for early detection of changes in aging muscle. Keywords: sarcopenia, contractile parameters, tensiomyography, muscle fat fraction, muscle function, older adults Published in DiRROS: 23.03.2026; Views: 199; Downloads: 146
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3. Tensiomyography-derived contractile parameters in sarcopenic and non-sarcopenic older adultsKatarina Puš, Miloš Kalc, Boštjan Šimunič, 2026, original scientific article Abstract: Background: Sarcopenia, the progressive decline in skeletal muscle mass and function, is a major public health concern linked to falls, hospitalization and loss of independence among older adults. Initially defined by reduced muscle mass, later also by reduced muscle strength and function, it is now recognized that standard diagnostic tools do not fully capture complexity of sarcopenia. Tensiomyography (TMG) is a non-invasive method that assesses skeletal muscle contractile parameters, which undergo change with aging and sarcopenia. The aims of this exploratory study are to determine whether TMG could be a method for contractile parameters assessment in sarcopenia classification and to evaluate the relationship between TMG-derived parameters and sarcopenia classification tests. Methods: We included 654 older adults (70.6% women) and included demographics, sarcopenia classification (EWGSOP2, SDOC), muscle strength (handgrip strength, five sit-to-stand), TMG of three leg muscles, muscle mass (bioimpedance), and physical performance (gait speed, timed up-and-go). MANOVA was used to analyze contractile properties and due to low agreement between classifications, we used both classifications. A partial correlation for each sex was conducted to determine the associations between sarcopenia classification tests and TMG-derived parameters of delay time (Td), contraction time (Tc), radial displacement (Dm) and contraction velocity (Vc), controlling for age. Results: One-way MANOVA confirmed difference between sarcopenic and nonsarcopenic participants according to EWGSOP2 and SDOC classifications in TMG-derived contractile parameters in all three muscles, Td was consistently longer and Dm consistently lower in sarcopenic individuals. Post-hoc univariate tests further demonstrated specific differences due to sarcopenia presence. Ageadjusted partial correlations were weak to moderate, ranging between −0.430 and 0.369. Conclusion: Sarcopenic individuals exhibited longer Td and Tc, and smaller Dm, though not consistently across all muscles. Td was longer in all three muscles, reflecting electromechnical delays linked to aging. Dm was consistently lower, suggesting increased muscle stiffness. Correlations between TMG parameters and sarcopenia classification tests indicated that shorter Td and Tc, higher Dm, and greater Vc were associated with higher muscle volume, muscle strength and performance. The findings indicate that TMG parameters may be associated with neuromuscular degeneration and sarcopenia, supporting further exploration of muscle- and sex-specific differences. Keywords: tensiomyography, muscle function, older adults, sarcopenia, seniors Published in DiRROS: 04.02.2026; Views: 604; Downloads: 233
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4. Prevalenca sarkopenije in povezani dejavniki tveganja v Sloveniji : raziskovalni podatki, obravnavani v doktorskem deluKatarina Puš, Miloš Kalc, Saša Pišot, Kaja Teraž, Jure Urbanc, Matej Kleva, Uroš Marušič, Manca Peskar, Luka Šlosar, Boštjan Šimunič, 2026, complete scientific database of research data Abstract: Podatkovni niz vsebuje anonimizirane presečne podatke, zbrane pri 654 starejših odraslih (≥ 60 let) iz Slovenije. Podatki so bili pridobljeni v okviru presečne raziskave, usmerjene v razvrščanje sarkopenije in analizo mišičnih značilnosti. V podatkovni niz so vključeni demografski podatki (starost, spol), antropometrične meritve ter rezultati meritev mišične jakosti, telesne zmogljivosti in telesne sestave. Mišična jakost je bila ocenjena z merjenjem jakosti stiska pesti in testom petkratnega vstajanja s stola. Telesna zmogljivost je bila ocenjena s hitrostjo hoje in testom vstani in pojdi. Podatki o telesni sestavi in mišični masi so bili pridobljeni z električno bioimpedančno analizo in vključujejo pusto telesno maso, skeletno mišično maso, apendikularno skeletno mišično maso ter indekse, prilagojene telesni višini. Kontraktilne lastnosti skeletnih mišic so bile ocenjene s tenziomiografijo treh mišic spodnjih okončin, pri čemer so bili zabeleženi parametri zakasnitvenega časa, časa kontrakcije, radialnega premika in hitrosti kontrakcije. Dodatni podatki vključujejo prehransko stanje (Mini Nutritional Assessment), gibalno aktivnost in sedentarne navade (Global Physical Activity Questionnaire) ter kognitivne funkcije (Test povezovanja – del A in B). Preiskovanci so bili razvrščeni v skupine glede na več diagnostičnih algoritmov sarkopenije (EWGSOP, EWGSOP2 in njegove različice, SDOC, IWGS in FNIH). Podatki so bili zbrani po standardiziranih protokolih, anonimizirani in opremljeni z metapodatki, kar omogoča njihovo ponovno uporabo v skladu z načeli FAIR. Keywords: sarkopenija, analiza mišičnih značilnost, mišična jakost, telesna sestava, telesna zmogljivost, telesna masa, gibalna aktivnost, sedentarne navade Published in DiRROS: 03.02.2026; Views: 378; Downloads: 311
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5. Acute effects of orofacial, neck, and shoulder relaxation exercises and chewing on soleus H-reflex and motor unit discharge patternsMarša Magdič, Aleš Holobar, Matej Kramberger, Matjaž Vogrin, Nina Murks, Anita Fekonja, Miloš Kalc, 2025, original scientific article Abstract: The interconnected nature of orofacial, neck musculature, and the neural system suggests that localised19activities, such as teeth clenching, can influence remote spinal excitability. While stretching exercises are20known to have both local and remote effects, the specific impact of orofacial muscle stretching remains21underexplored. This study investigates the effects of two interventions: 25 guided orofacial and neck22stretching and mobility exercises (Exercises), and chewing six chewing gums for six minutes (Chewing),23on the soleus H-reflex and D1 presynaptic inhibition. Ten volunteers (mean age: 28.75 ± 9 years)24participated, with H-reflex measurements collected using high-density electromyography (HDsEMG)25before and after each intervention. Latency (HLAT ), duration (H DUR ), peak-to-peak (H P2P, D1 PSP ) and positive26peak (H POS ) amplitudes were extracted from unconditioned and conditioned H-reflexes. The ratio27(D1 P2P/H P2P) between conditioned (D1 P2P ) and unconditioned (H P2P ) H-reflex was calculated to study the28D1 presynaptic inhibition mechanisms. Additionally, 8,400 firings from 376 distinct motor units (MUs),29categorised by firing threshold were analysed for latency, firing ratio, and inhibition probability (D1 PROB ).30HP2P, HPOS decreased and HDUR was significantly increased after the Exercise intervention, while the31Chewing intervention had no effect on these parameters. The D1 P2P/H P2P ratio and D1 PROB remained32unchanged, suggesting that the observed drop in H P2P is not mediated by presynaptic inhibition33mechanisms. Single MU analysis confirmed the H-reflex findings. The results of this study suggest that34stretching and mobility exercises targeting the neck and orofacial region can reduce neuromuscular35excitability, offering potential for non-pharmacological management of conditions associated with36motoneuron hyperexcitability and general whole-body relaxation Keywords: high-density electromyography (HDsEMG), remote effect, stretching Published in DiRROS: 13.10.2025; Views: 459; Downloads: 270
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6. Twenty-one days of bed rest alter motor unit properties and neuromuscular junction transmission in young adultsFabio Sarto, Miloš Kalc, Evgeniia Motanova, Martino V. Franchi, Daniel W Stashuk, Nina Murks, Giacomo Valli, Samuele Negro, Tomaž Prašnikar, Mladen Gasparini, Giovanni Martino, Giuseppe De Vito, Aleš Holobar, Boštjan Šimunič, Rado Pišot, Marco Vincenzo Narici, 2025, original scientific article Abstract: Previous studies showed that properties of higher‐threshold motor units (MUs) and neuromuscular junction (NMJ) function are preserved during short‐term disuse. This study aimed to test how a longer disuse period affects MU properties, NMJ transmission, and NMJ morphology remodeling. Nine young healthy males (age: 18‐29 years) underwent 21 days of horizontal bed rest. Pre‐ (BR0) and post‐bed rest (BR21), quadriceps maximal voluntary contraction (MVC), and size were assessed. We combined intramuscular electromyography (iEMG) and high‐density surface electromyography (HDsEMG) recordings on the vastus lateralis to assess MU properties at 25% and 50% of MVC. Muscle biopsies and blood samples were also collected. Quadriceps MVC and size decreased at BR21. We found alterations in MU properties at both contraction intensities, including reduced discharge rate, MU potential area changes, and increased complexity. NMJ transmission was found to be reduced at BR21 at 25% MVC. This functional NMJ impairment was biochemically corroborated by an increase in serum C‐terminal agrin fragment concentration, a biomarker of NMJ instability. In addition, a direct assessment of NMJ morphology revealed the presence of some denervated NMJs exclusively at BR21. In conclusion, 21‐day bed rest altered MU properties across different contraction intensities and impaired NMJ transmission with initial signs of remodeling/denervation. Disuse duration appears to be a critical factor, as previous shorter studies failed to detect some of these changes. We believe these findings are clinically relevant for disuse after trauma, surgery, or illness, and may support the development of effective countermeasures. Keywords: disuse, unloading, physical inactivity, electrophysiology, electromyography Published in DiRROS: 13.05.2025; Views: 1034; Downloads: 514
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7. Prevalence of sarcopenia among Slovenian older adults and associated risk factorsKatarina Puš, Saša Pišot, Uroš Marušič, Manca Peskar, Kaja Teraž, Miloš Kalc, Helena Blažun Vošner, Peter Kokol, Jernej Završnik, Boštjan Šimunič, 2025, original scientific article Abstract: Introduction: Sarcopenia is a multifaceted condition affecting between 10 and 16% of the global population, and although multiple classification algorithms exist, no prevalence has been reported for a representative sample of the Slovenian population. Furthermore, multiple behavioural factors, such as malnutrition, physical inactivity, sedentary lifestyle and lower cognitive function, can contribute to the risk of sarcopenia. This study aims to: a) determine sarcopenia prevalence among Slovenian older adults according to different classification algorithms, b) compare the agreement among the algorithms and c) evaluate the relationship between proposed risk factors and sarcopenia. Methods: 654 participants (≥60 years, 30.4% males) have been classified into sarcopenia groups according to eight algorithms, and agreement (Fleiss K) between them was calculated. Additionally, age, sex, nutritional status, physical activity, sedentary levels and cognitive function were assessed as sarcopenia risk/protective factors. Results: The prevalence of sarcopenia according to EWGSOP2 was 4.1%, ranging from 2.1% to 15.3%, when classified by all eight algorithms. Overall agreement between algorithms was weak (K=.429; 95% CI .414 to .444) with 0.6% of participants classified as sarcopenic by all eight algorithms. Adequate nutrition and physical activity were identified as protective factors, while age, lower cognitive function and sedentary lifestyle were considered risk factors. Conclusion: Sarcopenia prevalence among the Slovenian general population was lower than in the global population. We can conclude that different sarcopenia algorithms lead to a different prevalence of sarcopenia. It is of great importance to be cautious when comparing prevalences among studies and to further validate the classification algorithms. Keywords: sarcopenia, prevalence, epidemiology, classification algorithms, risk factors Published in DiRROS: 03.03.2025; Views: 930; Downloads: 547
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8. Cortico-muscular phase connectivity during an isometric knee extension task in people with early Parkinson’s diseaseNina Omejc, Tomislav Stankovski, Manca Peskar, Miloš Kalc, Paolo Manganotti, Klaus Gramann, Sašo Džeroski, Uroš Marušič, 2025, original scientific article Abstract: — Introduction: Parkinson’s disease (PD) is characterized by enhanced beta-band activity (13–30 Hz) in the motor control regions. Simultaneously, corticomuscular (CM) connectivity in the beta-band during isometric contractions tends to decline with age, in various diseases, and under dual-task conditions. Objective: This study aimed to characterize electroencephalograph (EEG) and electromyograph (EMG) power spectra during a motor task, assess CM phase connectivity, and explore how these measures are modulated by an additional cognitive task. Specifically, we focused on the beta-band to explore the relationship between heightened beta amplitude and reduced beta CM connectivity. Methodology: Early-stage people with PD and age-matched controls performed an isometric knee extension task, a cognitive task, and a combined dual task, while EEG (128ch) and EMG (2x32ch) were recorded. CM phase connectivity was assessed through phase coherence and a phase dynamics model. Results: The EEG power spectrum revealed no cohort differences in the beta-band. EMG also showed no differences up to 80 Hz. However, the combined EEG-EMG analysis uncovered reduced beta phase coherence in people with early PD during the motor task. CM phase coherence exhibited distinct scalp topography and frequency ranges compared to the EEG power spectrum, suggesting different mechanisms for pathological beta increase and CM connectivity. Additionally, phase dynamics modelling indicated stronger directional coupling from the cortex to the active muscle and less prominent phase coupling across people with PD. Despite high inter-individual variability, these metrics may prove useful for personalized assessments, particularly in people with heightened CM connectivity. Keywords: electroencephalography, brain modeling, electromiography, coherence, motors, diseases, couplings, electrodes, oscillators, protocols Published in DiRROS: 13.01.2025; Views: 1088; Downloads: 705
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9. Acute myotonometric changes in the masseter and upper trapezius muscles after upper body quarter stretching and coordination exercises or chewingMarša Magdič, Miloš Kalc, Matjaž Vogrin, 2025, original scientific article Abstract: Pathologies in neck and masticatory muscles affect muscle tone and biomechanical and viscoelastic properties, necessitating precise assessment for treatment. This study evaluated the impact of two guided interventions—relaxing exercises targeting the neck and masticatory muscles (“Exercise”) and heavy chewing using six chewing gums (“Chewing”)—on the masseter and upper trapezius muscles. Twelve participants (aged 19–40 years) underwent myotonometric assessment pre- and post-intervention, measuring tone, stiffness, decrement, relaxation time, and creep. The results showed significant changes in the masseter muscle after exercise, with increased stiffness (14.46%, p < 0.001) and tone (7.03%, p < 0.001) but decreased creep (−9.71%, p < 0.001) and relaxation time (−11.36%, p < 0.001). Conversely, chewing decreased stiffness (−8.82%, p < 0.001) and tone (−5.53%, p < 0.001), while it increased creep (9.68%, p < 0.001) and relaxation time (9.98%, p < 0.001). In the trapezius muscles, tone decreased after both interventions (Exercise: −7.65%, p < 0.001; Chewing: −1.06%, p = 0.003), while relaxation increased (Exercise: 1.78%, p < 0.001; Chewing: 2.82%, p < 0.001). These findings reveal the distinct effects of exercise and chewing on muscle properties, emphasising the complexity of their therapeutic potential and the need for further investigation. Keywords: muscle tonus, relaxation, masseter muscle, trapezius muscle, intervention studies Published in DiRROS: 07.01.2025; Views: 987; Downloads: 653
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10. The effectiveness of neuromuscular training warm-up program for injury preventionin adolescent male basketball playersArmin Paravlić, Peter Bakalár, Katarina Puš, Saša Pišot, Miloš Kalc, Kaja Teraž, Luka Šlosar, Manca Peskar, Uroš Marušič, Boštjan Šimunič, 2024, original scientific article Abstract: This study evaluated the effects of a neuromuscular training (NMT) warm-up program on injury incidence,neuromuscular function, and program adherence, maintenance and acceptance in adolescent basketballplayers. A total of 275 players from 20 Slovenian teams (15 ± 1.7 years of age), were randomized into anintervention group (IG, n=129) and a control group (CG, n=146). Over three months, the IG incorporatedNMT into their warm-ups, while the CG followed their usual practice. Measurements of body anthro-pometry, muscle contractile properties, and balance were taken before and after the intervention. Also,the injury incidence, training adherence and maintenance were reported. Both groups showed improvedbalance, with no significant difference between them. However, IG demonstrated reduced delay times inspecific muscles, indicating improved neuromuscular function. Injury prevalence proportion (%) duringthe whole study period was higher in the control group compared to intervention (IG: 10.9% vs. CG:23.3%), and incidence rate. Moreover, the incidence rate ratio for sustaining an injury was 2.6 on average(ranging from 0.88 to 7.07 for tendon and muscle injuries, respectively), indicating significantly lowerinjury risk in IG than CG. These findings highlight the effectiveness of NMT warm-ups in reducing injuryrisk and enhancing neuromuscular function, emphasizing the value of structured injury preventionstrategies in youth sports. Keywords: muscle contractile properties, balance, injury prevalence, training adherence Published in DiRROS: 18.11.2024; Views: 1216; Downloads: 685
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