Recent advancements in the understanding of Duchenne muscular dystrophy (DMD) have highlighted the importance of objective biomarkers for tracking disease progression. A study by Ricotti et al. utilized wearable full-body motion tracking technology to assess daily activities in DMD patients and age-matched controls. The findings indicated that the digital readouts of movement behavior could effectively predict disease trajectory, offering a more reliable alternative to traditional subjective assessments (ref: Ricotti doi.org/10.1038/s41591-022-02045-1/). This innovative approach underscores the potential of artificial intelligence in enhancing clinical trial methodologies and patient monitoring. Furthermore, the exploration of orthobiologics by Shapiro et al. emphasizes the growing interest in regenerative therapies for musculoskeletal conditions, which may hold promise for DMD management. Their tiered approach to orthobiologics suggests a careful consideration of biologic substances that could aid in treating various musculoskeletal disorders, including DMD (ref: Shapiro doi.org/10.1136/bjsports-2022-106494/). Additionally, the classification of hamstring injuries, as discussed by Paton et al., reveals the complexities in diagnosing and treating muscle injuries, which may also be relevant in the context of DMD where muscle integrity is compromised (ref: Paton doi.org/10.1136/bjsports-2021-105371/).

The interplay between mitochondrial dynamics and muscle inflammation has emerged as a critical area of research in myopathies. Irazoki et al. demonstrated that disruptions in mitochondrial morphology can trigger distinct inflammatory responses through the activation of DNA sensors, highlighting the role of mitochondrial dysfunction in muscle inflammation (ref: Irazoki doi.org/10.1038/s41467-022-35732-1/). This study opens avenues for understanding how mitochondrial health impacts muscle fitness and inflammation. In juvenile dermatomyositis (DM), Curiel et al. reported significant improvements in disease activity following abatacept therapy, with a notable reduction in glucocorticoid dosage among patients (ref: Curiel doi.org/10.1002/art.42450/). This suggests that targeted immunomodulatory therapies can effectively manage inflammation in myopathies. Complementing these findings, Gofshteyn et al. identified specific blood markers associated with disease activity in juvenile DM, emphasizing the need for reliable biomarkers to enhance disease management (ref: Gofshteyn doi.org/10.1002/art.42446/). Together, these studies underscore the importance of understanding immune responses and inflammation in the context of myopathies.

Research into muscle regeneration has revealed the pivotal role of fibro-adipogenic progenitors (FAPs) in the repair process following muscle injury. Sastourné-Arrey et al. highlighted that FAPs not only proliferate in response to injury but also create a supportive environment for satellite cells, which are essential for effective muscle regeneration (ref: Sastourné-Arrey doi.org/10.1038/s41467-022-35524-7/). This finding emphasizes the complexity of muscle repair mechanisms and the need for further investigation into the differentiation of regenerative cell subtypes. Additionally, the exploration of orthobiologics by Shapiro et al. continues to gain traction, as these therapies aim to enhance muscle repair through biologic substances (ref: Shapiro doi.org/10.1136/bjsports-2022-106494/). The classification of hamstring injuries, as noted by Paton et al., also plays a role in understanding muscle repair, as accurate classification can inform treatment strategies and rehabilitation protocols (ref: Paton doi.org/10.1136/bjsports-2021-105371/). Furthermore, the investigation of mesenchymal stromal cells (MSCs) by Song et al. demonstrated their potential in ameliorating diabetes-induced muscle atrophy, suggesting that MSC-derived therapies could be beneficial in enhancing muscle regeneration (ref: Song doi.org/10.1002/jcsm.13177/).

The genetic underpinnings of myopathies have been further elucidated through studies focusing on alternative splicing and protein interactions. Nitschke et al. revealed that the loss of MBNL1 leads to compensatory upregulation of MBNL2, with implications for muscle function and disease progression (ref: Nitschke doi.org/10.1093/nar/). This highlights the intricate regulatory mechanisms at play in muscle biology and the potential for targeting these pathways in therapeutic strategies. Additionally, Garcia-Pardo et al. provided insights into the structural characteristics of hnRNPDL-2 fibrils, which are associated with limb-girdle muscular dystrophy D3, emphasizing the role of amyloid formation in muscle pathology (ref: Garcia-Pardo doi.org/10.1038/s41467-023-35854-0/). Furthermore, He et al. explored the therapeutic potential of AGGF1 in skeletal muscle atrophy, demonstrating its role in regulating muscle cell processes and suggesting that protein therapy could be a viable approach for treating muscle wasting conditions (ref: He doi.org/10.1002/jcsm.13179/). Together, these studies underscore the importance of genetic and molecular research in advancing our understanding of myopathies.

The clinical management of myopathies has evolved with the introduction of innovative treatment strategies, particularly in the realm of orthobiologics. Shapiro et al. discussed a tiered approach to utilizing orthobiologics, which are biologic substances aimed at treating musculoskeletal conditions, including myopathies (ref: Shapiro doi.org/10.1136/bjsports-2022-106494/). This approach reflects a growing body of evidence supporting the efficacy of these therapies, although caution is advised due to the novelty of the field. In juvenile dermatomyositis, Curiel et al. reported significant improvements in disease activity following treatment with abatacept, indicating that targeted therapies can effectively reduce disease burden and improve patient outcomes (ref: Curiel doi.org/10.1002/art.42450/). Additionally, the classification of hamstring injuries by Paton et al. highlights the need for reliable diagnostic frameworks to guide treatment decisions and rehabilitation protocols (ref: Paton doi.org/10.1136/bjsports-2021-105371/). These advancements in clinical management underscore the importance of integrating innovative therapies and robust classification systems to enhance patient care in myopathies.

Understanding skeletal muscle function and performance is crucial for developing effective interventions in both healthy and pathological populations. Ortega et al. provided updated reference values for health-related fitness in European children and adolescents, utilizing a comprehensive dataset to establish benchmarks for various fitness parameters (ref: Ortega doi.org/10.1136/bjsports-2022-106176/). This foundational work supports the development of targeted fitness programs and public health initiatives aimed at improving youth fitness levels. Furthermore, Jacobs et al. investigated the autoregulation of blood flow restriction training, revealing that autoregulated protocols resulted in fewer adverse effects and better performance outcomes compared to non-autoregulated methods (ref: Jacobs doi.org/10.1136/bjsports-2022-106069/). This study highlights the importance of tailoring training protocols to individual responses to optimize performance and safety. Together, these studies emphasize the need for evidence-based approaches to enhance muscle function and performance across different populations.

The relationship between myopathies and associated comorbidities is an area of increasing interest, particularly in the context of treatment strategies. Shapiro et al. discussed the role of orthobiologics in managing musculoskeletal conditions, which may intersect with various comorbidities often seen in patients with myopathies (ref: Shapiro doi.org/10.1136/bjsports-2022-106494/). Their tiered approach emphasizes the need for a comprehensive understanding of patient profiles to optimize treatment outcomes. In juvenile dermatomyositis, Curiel et al. demonstrated that abatacept therapy not only improved disease activity but also allowed for a significant reduction in glucocorticoid use, which is critical given the potential side effects of long-term glucocorticoid therapy (ref: Curiel doi.org/10.1002/art.42450/). Additionally, the classification of hamstring injuries by Paton et al. highlights the importance of accurate diagnosis and management strategies that consider the broader context of comorbidities in athletes and active individuals (ref: Paton doi.org/10.1136/bjsports-2021-105371/). These insights underscore the complexity of managing myopathies in the presence of comorbid conditions.

Emerging therapies and innovations in the treatment of myopathies are paving the way for more effective management strategies. Shapiro et al. highlighted the growing field of orthobiologics, which encompasses a range of biologic substances aimed at treating musculoskeletal conditions, including myopathies (ref: Shapiro doi.org/10.1136/bjsports-2022-106494/). Their tiered approach suggests a careful evaluation of these therapies to ensure safety and efficacy. In juvenile dermatomyositis, Curiel et al. reported promising results with abatacept therapy, demonstrating significant improvements in disease activity and a reduction in glucocorticoid dosage, which is crucial for minimizing long-term side effects (ref: Curiel doi.org/10.1002/art.42450/). Furthermore, the classification of hamstring injuries by Paton et al. emphasizes the need for reliable diagnostic frameworks that can inform treatment decisions and rehabilitation protocols, ultimately enhancing patient outcomes (ref: Paton doi.org/10.1136/bjsports-2021-105371/). These advancements reflect a shift towards more personalized and evidence-based approaches in myopathy treatment.