Minimum effective plyometric training volume in sedentary individuals: Impact on lower limb viscoelastic properties and functional performance in a randomised controlled trial.

Sedentary lifestyles reduce muscle mass, strength, power, and alter viscoelastic properties. Plyometric jump training (PJT) shows promise in countering these effects, but the optimal training volume for individuals with low athletic performance remains unclear. This study aimed to determine the minimal PJT volume required to improve muscle and tendon viscoelastic properties, strength, and power in sedentary individuals. A double-blind randomised controlled trial included 44 participants divided into three groups: Control Group (CG) (n = 16), Reduced Volume Training Group (RVTG) (n = 16), and Training Group (TG) (n = 12). The four-week PJT programme involved three weekly sessions with gradual volume increments; RVTG performed 50% less volume than TG. Baseline and follow-up assessments included the isokinetic standing up (SU) and sitting down (SD) phases at 15 cm/s and 5 cm/s, and myotonometer measurements. In the SU phase at 15 cm/s, significant differences were found (p = 0.01) with higher values in TG (10.0 ± 3.3 N/kg) compared to CG and RVTG. At 5 cm/s, differences in SD were observed (p = 0.002). For Achilles tendon properties in RVTG: stiffness (p = 0.04), decrement (p = 0.01), and relaxation (p = 0.02). A PJT volume of 2,414 jumps improved muscle strength, while 1,207 jumps altered tendon properties.

Weakness Status is Differentially Associated with Time to Diabetes in Americans.

Background: The purpose of this study was to evaluate the associations of (1) individual absolute and body size normalized weakness cut-points, and (2) the collective weakness classifications on time to diabetes in Americans. Methods: We analyzed data from 9577 adults aged at least 50-years from the Health and Retirement Study. Diabetes diagnosis was self-reported. A handgrip dynamometer measured handgrip strength (HGS). Males with HGS <35.5 kg (absolute), <0.45 kg/kg (normalized to body weight), or <1.05 kg/kg/m2 (normalized to BMI) were categorized as weak. Females were classified as weak if their HGS was <20.0 kg, <0.337 kg/kg, or <0.79 kg/kg/m2. Compounding weakness included falling below 1, 2, or all 3 cut-points. Results: Persons below the body weight normalized weakness cut-points had a 1.29 (95% confidence interval (CI): 1.15-1.47) higher hazard for incident diabetes, while those below the BMI normalized cut-points had a 1.30 (CI: 1.13-1.51) higher hazard. The association between absolute weakness and incident diabetes was insignificant (hazard ratio: 1.06; CI: 0.91-1.24). Americans below 1, 2, or all 3 collective weakness categories had a 1.28 (CI: 1.10-1.50), 1.29 (CI: 1.08-1.52), and 1.33 (CI: 1.09-1.63) higher hazard for the incidence of diabetes, respectively. Conclusions: Our findings indicate that while absolute weakness, which is confounded by body size, was not associated with time to diabetes, adjusting for the influence of body size by normalizing HGS to body weight and BMI was significantly associated with time to diabetes. This suggests that muscle strength, not body size, may be driving such associations with time to diabetes.

Reference data for the hand grip and palmar pinch force sense errors and the relationship between school-entry-age in young adults.

BACKGROUND: Hands execute intricate tasks vital for everyday life and professions such as cooking, tailoring, and craftsmanship. OBJECTIVE: This study aimed to establish reference data for hand grip and palmar pinch force sense in young adults, accounting for gender differences, and to determine the correlation between these data and school-entry ages. METHODS: The cross-sectional observational study comprised 284 participants (156 females and 128 males). Demographic details, including age, gender, weight, and height, were recorded. Participant ages ranged from 18 to 29, representing the youth workforce population as defined by the International Labour Organization. Factors like hand dominance and school-entry age were ascertained based on participants' self-reports. Hand grip and palmar pinch force senses were separately assessed in the dominant and non-dominant hands of 130 randomly chosen participants to evaluate test-retest reliability. RESULTS: Hand grip (dominant: p < 0.001, non-dominant: p = 0.002) and palmar pinch force sense errors were significantly lower in male participants compared to females. Palmar pinch force sense error for the dominant hand was reduced in males (p = 0.002), but no significant disparity existed between genders for the non-dominant hand (p = 0.222). Healthy adults who began school at age five or earlier exhibited a decreased force sense error rate (p < 0.05). CONCLUSIONS: Force sense error reference values vary based on gender and school-entry age. This reference data will aid rehabilitation specialists working with young adults in physiotherapy and occupational therapy fields in identifying potential impairments.

Collective Weakness and Fluidity in Weakness Status Associated With Basic Self-Care Limitations in Older Americans.

Aims: To examine the associations of 1) absolute and normalized weakness cut-points, 2) collective weakness categories, and 3) changes in weakness status on future activities of daily living (ADL) limitations in older Americans. Methods: The analytic sample included 11,656 participants aged ≥65-years from the 2006-2018 waves of the Health and Retirement Study. ADL were self-reported. A handgrip dynamometer measured handgrip strength (HGS). Males were classified as weak if their HGS was <35.5-kg (absolute), <0.45-kg/kg (body mass normalized), or <1.05-kg/kg/m2 (body mass index (BMI) normalized); females were considered weak if their HGS was <20.0-kg, <0.337-kg/kg, or <0.79-kg/kg/m2. Collective weakness categorized those below 1, 2, or all 3 absolute and normalized cut-points. These collective categories were also used to classify observed changes in weakness status over time (onset, persistent, progressive, recovery). Results: Older Americans below absolute and normalized weakness cut-points had greater future ADL limitations odds: 1.34 (95% confidence interval (CI): 1.22-1.47) for absolute, 1.36 (CI: 1.24-1.50) for BMI normalized, and 1.56 (CI: 1.41-1.73) for body mass normalized. Persons below 1, 2, or 3 cut-points had 1.36 (CI: 1.19-1.55), 1.60 (CI: 1.41-1.80), and 1.70 (CI: 1.50-1.92) greater odds for future ADL limitations, respectively. Those in each changing weakness classification had greater future ADL limitation odds: 1.28 (CI: 1.01-1.62) for onset, 1.53 (CI: 1.22-1.92) for persistent, 1.72 (CI: 1.36-2.19) for progressive, and 1.34 (CI: 1.08-1.66) for recovery. Conclusions: The presence of weakness, regardless of cut-point and change in status over time, was associated with greater odds for future ADL limitations.

Exploring lower limb muscle activity and performance variations during instrumented Sit-to-Stand-to-Sit in sedentary individuals: Influence of limb dominance and testing modalities.

PURPOSE: to explore lower limb muscle activity concerning limb dominance, as well as variations in force and power during the standing up and sitting down phases of the instrumented sit-to-stand-to-sit test in sedentary individuals, across isokinetic and isotonic modalities. METHODS: 33 sedentary individuals underwent testing using a functional electromechanical dynamometer in both isokinetic and isotonic modes, accompanied by surface electromyography. RESULTS: In the isokinetic mode, the non-dominant gastrocnemius medialis and vastus medialis exhibited significantly (p < 0.05) higher muscle activity values during the standing up and sitting down phase compared to dominant counterparts. In the isotonic mode standing up phase, significant differences in muscle activity were noted for non-dominant gastrocnemius medialis, vastus medialis, and biceps femoris compared to their dominant counterparts. The sitting down phase in isotonic mode showed higher muscle activity for non-dominant vastus medialis compared to dominant vastus medialis. Regard to performance outcomes, significantly lower (p < 0.0001) values were observed for standing up (12.7 ± 5.1 N/kg) compared to sitting down (15.9 ± 6.1 N/kg) peak force, as well as for standing up (18.7 ± 7.8 W/kg) compared to sitting down (25.9 ± 9.7 W/kg) peak power in isokinetic mode. In isotonic mode, lower values were found for sitting down (6.5 (6.3-7.1) N/kg) compared to standing up (7.8 (7.3-8.9) N/kg) peak force and for sitting down (18.5 (13.2-21.7) W/kg) compared to standing up (33.7 (22.8-41.6) W/kg) peak power. CONCLUSIONS: Limb dominance influences lower-limb muscle activity during the instrumented sit-to-stand-to-sit test, and the choice of testing mode (isokinetic or isotonic) affects muscle engagement and performance outcomes.

Acute effect of static stretching and pilates stretching on the concentric muscle strength of the knee extensors and flexors.

INTRODUCTION: The effects of stretching exercises on muscle strength have been widely researched in the literature, however, there are no studies investigating the effects of Pilates stretching. OBJECTIVE: To compare the effects of static stretching and Pilates stretching on the concentric muscle strength of the knee extensors and flexors. METHOD: 102 trained young adults were randomized into three groups: static stretching (n = 33); Pilates stretching (n = 34); control (n = 35). Isokinetic evaluation of the knee extensor and flexor muscles was performed at 60°/s and 180°/s, pre and post acute intervention with stretching. Interventions in the static stretching and Pilates stretching groups occurred in 3 sets x 30 s for each body region considered (a-knee extensor muscles; b-knee flexor muscles). The control group did not perform any intervention. RESULTS: No difference (p > 0.05) was observed between the groups after the intervention. There was only a significant intragroup improvement for the control group on the isokinetic muscle strength of the knee flexors at 180°/s, with a moderate effect size, considering the entire sample (p = 0.040; d = 0.42) and when considering only male gender (p = 0.010; d = 0.60). CONCLUSION: Static stretching or Pilates stretching performed as a warm-up did not impair or enhance the concentric muscle strength performance of the knee extensors and flexors. In this way, both forms of stretching can be considered as preparatory exercises before muscle strength training.

Relationship between natural muscle oscillation frequency and lower limb muscle performance during instrumented sit-to-stand and stand-to-sit movements on a novel device in sedentary subjects.

BACKGROUND: Despite the significance of muscle oscillation frequency, previous research has not established a correlation with muscle performance due to the challenges of applying resistance without altering natural motion during functional tests. RESEARCH QUESTION: What is the correlation between muscle oscillation frequency and lower limb muscle strength, power, and work during an instrumented sit-to-stand and stand-to- sit (iSTS-TS) task among sedentary subjects? METHODS: In a cross-sectional study, the oscillation frequency of the gastrocnemius medialis (GM), biceps femoralis (BF), and vastus medialis (VM) muscles in both the dominant (D) and non-dominant (ND) legs was assessed with a handheld myotonometer in 34 sedentary individuals before performing the iSTS-TS task. RESULTS: In the isokinetic mode, no significant correlations were found. In the isotonic mode, the BF muscle oscillation frequency in the D and ND legs exhibited significant positive correlations with peak force, peak power, and work during sitting down, as well as peak power and work during standing up. Positive correlations were observed in both legs between the GM oscillation frequency and sitting down peak force and work. Additionally, significant positive correlation was found with standing up work in the D leg. Muscle oscillation frequency of the VM exhibited a positive correlation with sitting down peak force in the ND leg. SIGNIFICANCE: Due to a greater number of correlations found, it is advisable to use the isotonic mode when assessing muscle oscillation frequency in relation to muscle performance during functional iSTS-TS tasks in sedentary subjects.

Reliability and validity of new isokinetic strength assessment for rotator cuff muscles in a muscle architecture-based position.

Background/aim: Isokinetic strength assessment of the rotator cuff muscle is frequently applied in a variety of shoulder postures, but none of these consider muscular architecture, which is one of the most important aspects of improving strength development. This study aimed to examine the test and retest reliability and validity of the muscle architecture-based position (MABP), which is 25° abduction and 20° external rotation, in healthy subjects to be able to select a better isokinetic assessment position for shoulder rotator cuff muscles. Materials and methods: A total of 54 healthy males with a mean age of 21.0 ± 1.2 years and mean body mass index of 22.8 ± 1.7 kg/m2 completed an isokinetic measurement session. All of the tests were performed on an IsoMed 2000 isokinetic dynamometer concentrically and eccentrically for both upper limbs at 60°/s angular velocity. All of the participants completed 3 measurement sessions: the first represented the isokinetic testing and was performed in the scapular neutral position (SNP) (45° shoulder flexion and abduction), the second represented the MABP (25° abduction and 20° ER) for shoulder rotator cuff muscles, and the third represented the test and retest of the MABP. Results: The correlations between the 2 techniques for assessing concurrent validity ranged from 0.908 to 0.994. The values obtained from the MABP were higher than those obtained in the SNP. There was no systematic bias for any measurements between the MABP and the retest of the MABP (p > 0.05). The intraclass correlation coefficients representing the test and retest reliability results for each variable measured with the MABP was higher than 0.98 and this value was considered as excellent reliability. Conclusion: In conclusion, the MABP can be used to assess the isokinetic strength of the rotator cuff muscles safely and confidently, with increased quantities of force being released and measurement at optimal muscle tension.

Weakness Thresholds Are Differentially Linked to Cognitive Function by Obesity Status in Older Americans.

Background: Weakness can be operationalized with several thresholds, which in turn, could impact associations with cognitive impairment when considering obesity status. Objective: We examined the associations of absolute, normalized, and collective weakness thresholds on future cognitive impairment by obesity status in older adults. Methods: We performed a secondary data analysis on the 2006-2018 waves of the Health and Retirement Study. A spring-type dynamometer collected handgrip strength (HGS). Males were categorized weak if their HGS was <35.5-kg (absolute), <0.45-kg/kg (body mass normalized), or <1.05-kg/kg/m2 (body mass index (BMI) normalized), while females were defined as weak if their HGS was <20.0-kg, <0.337-kg/kg, or <0.79-kg/kg/m2. The modified Telephone Interview of Cognitive Status examined cognitive function. Persons scoring ≤10 had a cognitive impairment. Obesity was categorized as BMI ≥30 kg/m2. Results: We included 7,532 and 3,584 persons aged ≥65-years living without and with obesity, respectively. Those without obesity but beneath the absolute weakness threshold had 1.54 (95% confidence interval (CI): 1.24-1.91) greater odds for future cognitive impairment. Persons with obesity and beneath each threshold also had greater odds for future cognitive impairment: 1.89 (95% CI: 1.28-2.78) for absolute, 2.17 (95% CI: 1.02-4.62) for body mass normalized, and 1.75 (95% CI: 1.10-2.80) for BMI normalized. Older Americans without obesity but underneath all the weakness thresholds had 1.32 (95% CI: 1.00-1.74) greater odds for impairment in cognitive function, while persons with obesity had 2.76 (95% CI: 1.29-5.93) greater odds. Conclusions: There should be consideration for how body size and different weakness thresholds may influence future cognitive outcomes.

Test-Retest Reliability of Isokinetic Strength in Lower Limbs under Single and Dual Task Conditions in Women with Fibromyalgia.

Background: Previous research has established good test-retest reliability for isokinetic dynamometry in fibromyalgia. However, the reliability of this test under dual-task conditions has not been investigated in fibromyalgia. Methods: A total of 10 women with fibromyalgia participated in this study. Participants completed the concentric/concentric test. The dual-task condition involved subtracting two by two while performing the test. Results: Reliability analysis under the single condition showed "poor" to "excellent" values for maximum peak torque in knee extension and "moderate" to "excellent" values for average. "Poor" to "excellent" reliability values were found in knee flexion for the maximum and average. Dual-task condition in knee extension ranged from "moderate" to "excellent" for maximum and average values, and in knee flexion, it ranged from "poor" to "excellent" for maximum value and from "moderate" to "excellent" for average value. Conclusions: Isokinetic dynamometry demonstrated sufficient reliability for measuring strength in knee extension maximum and average during single-task and dual-task conditions, along with knee flexion dual-task average in fibromyalgia. For knee flexion single-task maximum and average and knee flexion dual-task maximum, we did not obtain sufficiently reliable measurements. Only the concentric/concentric test has been studied, and future studies with a larger sample size are needed in order to generalize the results.

Effects of active exergames on physical performance in older people: an overview of systematic reviews and meta-analysis.

This overview assessed the available body of published peer-reviewed systematic reviews and meta-analyses related to the effects of active exergames compared with active/passive control on physical performance outcomes in older people. The methodological quality and certainty of evidence were assessed using PRISMA, AMSTAR 2, and GRADE. The protocol was registered in PROSPERO (code: CRD42023391694). The main outcomes indicate that 4,477 records, five systematic reviews, and 10 meta-analyses were included. The AMSTAR-2 reported six meta-analyses with high methodological quality, four moderate quality, two systematic reviews with low quality, and three very-low quality. Meta-analysis was performed on balance using the Berg Balance Scale (BBS) and Timed Up-and-Go (TUG) tests, on cardiorespiratory fitness using the 6-min walk test, and on upper and lower limbs muscle strength using the handgrip strength, knee extension, and 30-s chair stand tests. Significant differences in favor of the active exergames groups concerning active/passive groups were reported in BBS (SMD = 0.85; 95% CI = 0.12-1.58; I2 = 96%; p = 0.02), TUG (SMD = 1.44; 95% CI = 0.71-2.16; I2 = 97%; p < 0.0001), and 30-s chair stand test (SMD = 0.79; 95% CI = 0.33-1.25; I2 = 88%; p = 0.0008). However, no significant differences were reported in favor of the active exergames groups in 6-min walk (SMD = 0.93; 95% CI = -0.64 to 2.50; I2 = 95%; p = 0.24), handgrip strength (SMD = 0.67; 95% CI = -0.04 to 1.38; I2 = 84%; p = 0.06), and knee extension tests (SMD = 0.20; 95% CI = -0.05 to 0.44; I2 = 95%; p = 0.12) compared to active/passive control. However, it was impossible to perform a meta-analysis for the variables of walking speed as a fall risk due to the diversity of instruments and the small number of systematic reviews with meta-analysis. In conclusion, interventions utilizing active exergames have shown significant improvements in the static and dynamic balance and lower limb muscle strength of apparently healthy older people, compared to control groups of active/inactive participants, as measured by BBS, TUG, and 30-s chair stand tests. However, no significant differences were found in the 6-min walk, HGS, and knee extension tests. Systematic review registration: PROSPERO, CRD42023391694.

Benefits and limitations of isokinetic force assessments in swimmer's shoulders: A systematic review.

OBJECTIVE: To indicate the benefits and limitations of the isokinetic test results for the performance of the main shoulder joint movements in swimmers, considering the different competitive levels, swimming techniques, race distances, and sex. METHODS: Search on the PubMed, CENTRAL, Medline, LILACS, and SCOPUS databases for the oldest records up to October 2022. Risk of bias, methodological quality, and level of evidence were evaluated based on the NHLBI checklist. RESULTS: 29 articles met the criteria and were included in this study. The quality analysis classified three as "good" and 26 as "regular", with a KAPPA index of 0.87. The main benefits found involved assessments of the clinical condition of the shoulder joint complex, relationships with performance, and reliability studies. The limitations found point to the participant's positioning in the instrument, use of angular velocity above 180°/s, and sample size. CONCLUSION: The use of the isokinetic dynamometer allows verifying the levels of strength, endurance, balance, and asymmetries among swimmers of different techniques, distances, competitive levels, and sex. Thus, it helps in the analysis and monitoring of the clinical conditions of swimmers' shoulder joints, contributing to the decision-making process of physiotherapists and coaches.

Frailty and Survivability of Polish Caucasian Nonagenarians and Centenarians.

Frailty is a major geriatric problem leading to an increased risk of disability and death. Prevention, identification, and treatment of frailty are important challenges in gerontology and public health. The study aimed to estimate the prevalence of the frailty phenotype (FP) among the oldest-old Polish Caucasians and investigate the relationship between the FP and mortality. Baseline data were collected from 289 long-lived individuals, including 87 centenarians and 202 subjects aged 94-99. Mortality was obtained from population registers over the following 5 years. Sixty percent of subjects were classified as frail, 33% as prefrail, and 7% as robust. Frailty was more common in women than men and among centenarians than nonagenarians. During the 5-year observation period, 92.6% of the frail women and all frail men died, while mortality rates were lower among prefrail, 78.8% and 66.7%, and robust individuals, 60% and 54.5%, respectively. In the survival analysis, frailty was the strongest negative risk factor: HR = 0.328 (95% CI: 0.200-0.539). The inability to perform handgrip strength measurement was an additional predictor of short survival. In conclusion, the FP is prevalent in nonagenarians and centenarians and correlates with lower survivability. Future studies should address differences between unavoidable age-associated frailty and reversible disability in long-lived individuals.

Handgrip strength and upper limb functional performance measures in people over 18 years old: Analysis of relationships and influencing factors.

BACKGROUND: Handgrip strength is a common, simple, and inexpensive method to measure muscle strength. On the other hand, the functional performance measurement involves a usual task which implies repeating elements between the individuals' interaction and the environment. This is fundamental for projecting their results to daily life situation. PURPOSE: To explore the relationship between grip strength and measures of functional performance of the upper limbs (ULs) in people over 18 years of age, and to determine the influence of sociodemographic and anthropometric variables on the relationship. STUDY DESIGN: A cross-sectional study was conducted under the analytical empirical approach, using linear associations between handgrip strength and functional performance measurement tests (correspondence analysis). METHODS: Three hundred sixty-two male and female individuals between 18 and 91 years of age from 4 Colombian cities participated. The grip strength of both ULs measured with a digital dynamometry was associated with the Box and Block Test (BBT, manual dexterity), Nine-Hole Peg Test (NHPT, daily living tasks), and Jebsen-Taylor Hand Function Test (JJT, ability to grasp, pick up, and place). Multiple linear regression analyzes were performed to assess possible explanatory factors of a sociodemographic and anthropometric order. RESULTS: A significant association was found between the grip strength of dominant and non-dominant ULs with all functional performance tests (ρ > 0.27 and p < .001), except for the writing and simulated feeding subtests of the JJT (ρ ≤ 0.16). An interactive effect of age was found in the relationship between grip strength and the 3 functional performance tests. CONCLUSIONS: These results support the association between grip strength with the NHPT, JJT, and BBT measures and the interactive effect of age on the performance of all tests.

[Normative values for handgrip strength in Colombian older adults: Estimation by quantile regression]. / Valores normativos para la fuerza prensil manual en adultos mayores colombianos estimados mediante regresión cuantílica.

INTRODUCTION: Handgrip strength is a robust indicator of the biological health of elderly. OBJECTIVE: The purpose of this study is twofold: 1) estimate the normative values of absolute and relative handgrip strength, specific to adults over 60 years of age in Colombia, using quantile regression models: 2) compare the normative values of absolute and relative handgrip strength in Colombian older adults with those from different countries. METHODS: A cross-sectional analysis of a sample of 5377 older adults. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). Relative handgrip strength was estimated by dividing by weight in kilograms. The absolute and relative handgrip strength normative values were estimated through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90 and P95, they were developed independently for each sex; all analyzes were adjusted for the expansion factor. RESULTS: Absolute handgrip strength values were considerably higher in men (P50 60-64 years = 32.0 kg, P50 >85 years = 18.0 kg) compared to women (P50 60-65 years = 19.0 kg; P50 >85 years = 12.0 kg), in all age groups. Additionally, as age increases in both sexes, there is a decrease in the values of absolute and relative manual grip strength. CONCLUSIONS: The estimated normative values in the Colombian population were generally lower than those reported in other studies around the world. These results could be related with methodologies used variability to evaluate handgrip strength and the estimation methods, which could influence the discrepancies between the different reports.

Does the elbow position change the handgrip strength in Parkinson's disease? / A posição do cotovelo altera a força de preensão manual na doença de Parkinson?

Abstract The flexed elbow is a standardization position on the handgrip strength test, however the literature shows divergence in the values obtained from extended elbow. The aim of this study was to verify if there is such difference in people with Parkinson's disease. Cross-sectional study. Thirty-one elderly individuals with clinical diagnosis of Parkinson's disease, performed 2 handgrip tests, first with extended elbow and second with flexed elbow, with 48 hours of interval. There was not significantly different between positions for handgrip strength (p > 0.05). As well as, the effect size was insignificant (d < 0.19). The main results indicate there was no significant difference between the flexed and the extended protocol, the effect size was negative and very small, it shows there is no clinical effect. Since, there are no difference between elbow positions, The American Society of Hand Therapists standardized position is recommended for testing of handgrip strength.

Resumo O cotovelo flexionado é uma posição padronizada no teste de força de preensão manual, no entanto, a literatura mostra divergências nos valores obtidos com o cotovelo estendido. O objetivo deste estudo foi verificar se existe tal diferença em pessoas com a doença de Parkinson. Estudo transversal. Trinta e um idosos com diagnóstico clínico da doença de Parkinson realizaram 2 testes de preensão manual, o primeiro com o cotovelo estendido e o segundo com o cotovelo flexionado, com intervalo de 48 horas. Não houve diferença significativa entre as posições para a força de preensão manual (p > 0,05). Além disso, o tamanho do efeito foi insignificante (d < 0,19). Os principais resultados indicam que não houve diferença significativa entre o protocolo flexionado e o estendido, o tamanho do efeito foi negativo e muito pequeno, o que mostra que não há efeito clínico. Portanto, não há diferença entre as posições do cotovelo, recomenda-se a posição padronizada da Sociedade Americana de Terapeutas de Mão para o teste de força de preensão manual.

Association Between Typologies of Sedentary Behavior and Muscle Strength, Gait Speed, and Balance in Community-Dwelling Older Adults.

Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3-4, and ≥5 hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5 hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3-4 and ≥5 hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled.

Association between ankle torque and performance-based tests, self-reported pain, and physical function in patients with knee osteoarthritis.

Objectives: This study aimed to investigate the association between ankle torque and performance-based tests, self-reported pain, and physical function in patients with knee osteoarthritis (OA). Patients and methods: The cross-sectional study was conducted with 39 individuals (24 females, 15 males; mean age: 57.3±6.2 years; range, 40 to 65 years) with knee OA between January 2014 and July 2015. Ankle torque was determined using an isokinetic dynamometer. The 40-m fast-paced walk test and a stair climb test were used to assess functional performance. Self-reported pain and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pearson's correlation coefficients were calculated to test correlations between the dependent variables (40-m fast-paced walk test, stair climb test, WOMAC pain and physical function domains, sex, age, body mass index, and radiologic evidence of OA) and the independent variables (mean plantar flexor torque and dorsiflexor peak torque). A multiple linear regression analysis was applied to quantify the association between the dependent and independent variables. Results: Dorsiflexor and plantar flexor peak torques in the concentric and eccentric modes were negatively correlated with the 40-m fast-paced walk and stair climb tests (r=-0.33 to -0.51, p≤0.05). A negative correlation was found between concentric plantar flexor torque and the WOMAC physical function score (r=-0.35, p=0.03). No correlation was found between ankle torques and the WOMAC pain score (p>0.05). The multiple linear regression analysis showed that the eccentric plantar flexor and dorsiflexor torques were significantly associated with the stair climb test (ß=-0.001, 95% confidence interval [CI]: -0.001 to 0.000, p=0.03, and ß=-0.002, 95% CI: -0.004 to 0.000, p=0.05, respectively). No significant associations were found between concentric plantar flexor and dorsiflexor torques and the stair climb test (p>0.05). No significant associations were found between the ankle torques and the 40-m fast-paced walk test and WOMAC physical function (p>0.05). Conclusion: Ankle torque plays an important role in functional performance. Thus, ankle torque deficit, especially eccentric plantar flexor and dorsiflexor torques, may exert a negative influence on stair climbing performance in patients with knee osteoarthritis.

The relationship between the clinical severity of chronic venous insufficiency and the calf muscle pump: A cross-sectional study.

PURPOSE: To investigate the connection between the clinical severity of chronic venous insufficiency (CVI) and the biomechanics of the calf muscle pump (CMP). MATERIAL AND METHODS: Through a cross-sectional observational study, we analyzed women on the age range between 30 and 80 years with chronic venous insufficiency, stratified according to the clinical classification. Ninety-nine women were assessed and classified into groups with different levels of severity: C1 (n = 22); C2 (n = 22); C3 (n = 22); C4 (n = 22); C5 (n = 8); C6 (n = 3). The main purpose was to investigate the strength of the calf muscle pump through total work (TW) and peak torque (PT), and the range of motion (ROM) of the ankle joint. For a secondary analysis, the fatigue index was assessed. All results were run through the Humac®/NORMT isokinetic dynamometer to obtain the data. RESULTS: Our findings pointed out that as the clinical severity of CVI increases, there is a reduction on the PT, the TW, the maximum active ROM and the ROM at 120°/sec. As severity increased, there was a reduction of 24Nm in the TW at 30°/sec.and a reduction of 3Nm in the PT at 30°/sec. OUTCOMES: When increased, clinical severity of CVI may trigger downgrading in the strength of the CMP and the ROM in the ankle. These findings are of relevance to the clinician, since through these findings, individuals with venous insufficiency may be treated more precisely for each classification.

Comparative effects of lymphatic drainage and soft tissue mobilization on pain threshold, shoulder mobility and quality of life in patients with axillary web syndrome after mastectomy.

PURPOSE: The purpose was to compare the effects of manual lymphatic drainage and soft tissue mobilization on pain threshold, shoulder mobility and quality of life in patients with axillary web syndrome. METHODS: This randomized clinical trial was conducted on 36 breast cancer patients with developed axillary web; participants were randomly divided into two groups. One group was treated with manual lymphatic drainage; the other group was treated with soft tissue mobilizations in addition to therapeutic exercises, i.e., stretching, strengthening and range of motion (ROM) exercises. The duration of treatment was four weeks (5 sessions/week), with therapeutic exercises as a common treatment protocol. Outcome measures were Breast-Cancer specific quality of life questionnaires, Disabilities of the Arm, Shoulder and Hand (DASH), Numeric Pain Rating Scale (NPRS), Patient Specific Functional Scale (PSFS), Dynamometer and Goniometer. All outcome measure readings were recorded at baseline and the end (4th week) of the treatment. RESULTS: The compliance of the variable distribution with normal distribution was verified using the Shaphiro-Wilk test. Parametric tests were applied, and both groups showed significant effects (p < 0.05) in pairwise comparison (paired t-test). The comparison group analysis (independent t-test) showed that there was no significant difference in pain, upper limb strength, range of motions and fatigue component of quality of life questionnaire parameters (p > 0.05). Two parameters (DASH, PSFS) and one component of the quality of life questionnaire (global health) showed a significant difference (p < 0.05). CONCLUSION: Manual lymphatic drainage showed more improvement in functional movements. It was concluded that both groups, manual lymphatic drainage and soft tissue mobilization groups were clinically equally effective. TRIAL REGISTRATION NUMBER: This trial is registered at ClinicalTrial.gov PRS under trial number NCT05463185 on date 18/07/2022.