Zullo Alberto, Fleckenstein Johannes, Schleip Robert, Hoppe Kerstin, Wearing Scott, Klingler Werner
Department of Sciences and Technologies, University of Sannio, Benevento, Italy.
CEINGE Advanced Biotechnologies, Naples, Italy.
Front Physiol. 2020 Jun 24;11:592. doi: 10.3389/fphys.2020.00592. eCollection 2020.
Aging is a one-way process associated with profound structural and functional changes in the organism. Indeed, the neuromuscular system undergoes a wide remodeling, which involves muscles, fascia, and the central and peripheral nervous systems. As a result, intrinsic features of tissues, as well as their functional and structural coupling, are affected and a decline in overall physical performance occurs. Evidence from the scientific literature demonstrates that senescence is associated with increased stiffness and reduced elasticity of fascia, as well as loss of skeletal muscle mass, strength, and regenerative potential. The interaction between muscular and fascial structures is also weakened. As for the nervous system, aging leads to motor cortex atrophy, reduced motor cortical excitability, and plasticity, thus leading to accumulation of denervated muscle fibers. As a result, the magnitude of force generated by the neuromuscular apparatus, its transmission along the myofascial chain, joint mobility, and movement coordination are impaired. In this review, we summarize the evidence about the deleterious effect of aging on skeletal muscle, fascial tissue, and the nervous system. In particular, we address the structural and functional changes occurring within and between these tissues and discuss the effect of inflammation in aging. From the clinical perspective, this article outlines promising approaches for analyzing the composition and the viscoelastic properties of skeletal muscle, such as ultrasonography and elastography, which could be applied for a better understanding of musculoskeletal modifications occurring with aging. Moreover, we describe the use of tissue manipulation techniques, such as massage, traction, mobilization as well as acupuncture, dry needling, and nerve block, to enhance fascial repair.
衰老为单向过程，与机体深刻的结构和功能变化相关。事实上，神经肌肉系统会经历广泛重塑，涉及肌肉、筋膜以及中枢和外周神经系统。因此，组织的内在特性及其功能和结构耦合受到影响，整体身体机能下降。科学文献中的证据表明，衰老与筋膜硬度增加、弹性降低以及骨骼肌质量、力量和再生潜能丧失有关。肌肉和筋膜结构之间的相互作用也会减弱。至于神经系统，衰老会导致运动皮层萎缩、运动皮层兴奋性和可塑性降低，进而导致失神经支配的肌纤维积累。结果，神经肌肉装置产生的力量大小、其沿肌筋膜链的传递、关节活动度和运动协调性均受损。在本综述中，我们总结了衰老对骨骼肌、筋膜组织和神经系统产生有害影响的证据。特别是，我们阐述了这些组织内部和之间发生的结构和功能变化，并讨论了炎症在衰老过程中的作用。从临床角度来看，本文概述了用于分析骨骼肌组成和粘弹性特性的有前景的方法，如超声检查和弹性成像，这些方法可用于更好地理解衰老过程中发生的肌肉骨骼改变。此外，我们描述了使用组织操作技术，如按摩、牵引、松动术以及针灸、干针疗法和神经阻滞，以促进筋膜修复。
