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Related Concept Videos

Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
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Muscle Recovery and Fatigue01:24

Muscle Recovery and Fatigue

Muscle fatigue refers to the decline in a muscle's ability to maintain the force of contraction after prolonged activity. It primarily stems from changes within muscle fibers. Even before experiencing muscle fatigue, one may feel tired and have the urge to stop the activity. This response, known as central fatigue, occurs due to changes in the central nervous system, namely the brain and spinal cord. While there is no single mechanism that induces fatigue, it may serve as a protective response...
Energy Supply for Muscle Contraction01:25

Energy Supply for Muscle Contraction

Skeletal muscle fibers have the unique ability to switch between rest and contraction states, using different sources of ATP for energy. The contraction cycle and Ca2+ transport back into the sarcoplasmic reticulum for relaxation require significant ATP. However, the ATP reserves in muscle fibers are limited and can only sustain contractions for a few seconds. Additional ATP production becomes necessary for prolonged contractions. As a result, muscle fibers generate ATP through various sources,...
Disorders of the Skeletal Muscle01:28

Disorders of the Skeletal Muscle

The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin01:26

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin

Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...

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Updated: May 10, 2026

Application of Chronic Stimulation to Study Contractile Activity-induced Rat Skeletal Muscle Phenotypic Adaptations
09:50

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Published on: January 25, 2018

Creatine for treating muscle disorders.

Rudolf A Kley1, Mark A Tarnopolsky, Matthias Vorgerd

  • 1Department of Neurology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany. rudolf.kley@rub.de.

The Cochrane Database of Systematic Reviews
|June 7, 2013
PubMed
Summary
This summary is machine-generated.

Creatine supplementation significantly improves muscle strength and functional performance in individuals with muscular dystrophies and idiopathic inflammatory myopathies. However, it shows no benefit for muscle strength in metabolic myopathies and may worsen symptoms in McArdle disease.

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Area of Science:

  • Neurology
  • Muscle physiology

Background:

  • Progressive muscle weakness is a hallmark of many hereditary and acquired muscle diseases.
  • Creatine is known to enhance muscle performance in healthy individuals.
  • This review is an update of previous Cochrane reviews on creatine for muscle disorders.

Purpose of the Study:

  • To evaluate the efficacy of creatine compared to placebo for treating muscle weakness in various muscle diseases.
  • To synthesize evidence from randomized controlled trials (RCTs) on creatine's effects in neuromuscular conditions.

Main Methods:

  • Comprehensive literature search of multiple databases (Cochrane, MEDLINE, EMBASE) up to September 2012.
  • Inclusion of randomized controlled trials (RCTs) and quasi-RCTs comparing creatine to placebo in hereditary muscle diseases and idiopathic inflammatory myopathies.
  • Independent assessment of trial quality and data extraction by two authors, with efforts to obtain missing data.

Main Results:

  • Meta-analysis of six trials (192 participants) in muscular dystrophies showed a significant increase in muscle strength (8.47%) with creatine.
  • Creatine treatment led to a higher self-reported sense of well-being in 115 participants across four trials (Risk Ratio 4.51).
  • One trial in idiopathic inflammatory myopathies demonstrated improved functional performance; no clinically relevant adverse events were reported across studies. In metabolic myopathies, no significant strength improvement was observed, and high-dose creatine worsened daily activities and increased pain in McArdle disease.

Conclusions:

  • High-quality evidence supports short- and medium-term creatine use for increasing muscle strength and functional performance in muscular dystrophies and idiopathic inflammatory myopathy.
  • Creatine is generally well-tolerated in these patient populations.
  • Limited evidence indicates no significant muscle strength improvement in metabolic myopathies, with potential negative effects from high-dose creatine in McArdle disease.