Effects of neuromuscular electrical stimulation on patellofemoral pain: A randomized controlled trial.

INTRODUCTION: Patellofemoral Pain (PFP) is a common dysfunction that can compromise the performance of daily activities. Neuromuscular electrical stimulation (NMES) has been proposed as a complementary tool in the therapeutic approach. OBJECTIVE: To analyze the effects of adding NMES to therapeutic exercises in women with PFP. METHODS: Randomized controlled trial involving 34 women with PFP (mean age 23.8 ± 4.1), randomly assigned to two groups: exercises combined with NMES (ESG) and exercises only (ExG). The ExG followed an exercise protocol, while the ESG performed the same exercises combined with NMES. Interventions were performed twice a week for eight weeks. Primary outcome measures included pain and functional disability, while secondary outcomes encompassed electromyographic activity of the quadriceps and hip abductors, along with isokinetic performance. Assessments were performed before the intervention, after 4 and 8 weeks from the start of the protocol and 8 weeks after the conclusion of the treatment. RESULTS: We did not observe difference between the groups in any of the analyzed variables. Both groups showed a reduction in pain and an improvement in functional disability during intragroup comparisons. CONCLUSION: A reduction in pain and an improvement in functional disability were observed; however, there was no additional effect of NMES. TRIAL REGISTRATION: NCT03918863.

Effects of a mat Pilates-based exercise program for low back pain in helicopter pilots of the Brazilian Air Force: Randomized controlled trial.

INTRODUCTION: Helicopter pilots may present chronic low back pain due to vibration exposure and asymmetric posture during flight. OBJECTIVES: To analyze the effects of a Pilates-based exercise program on low back pain of helicopter pilots of the Brazilian Air Force. METHODS: This is a randomized controlled trial with fifteen helicopter pilots of the Brazilian Air Force, who were assessed for pain intensity (Numerical Pain Rating Scale), disability associated with low back pain, and spine muscle endurance in three positions: trunk extension (Ito test) and left and right lateral bridge. Individuals were randomly distributed into the regular exercises group (REG) (n = 7), oriented to maintain their exercise routine, and Pilates group (PG) (n = 8), which performed an exercise program based on Pilates method twice a week for 12 weeks. Reassessments occurred after 6 and 12 weeks. Data were analyzed on SPSS 20.0 software using a significance level of 5%. RESULTS: PG showed a significant reduction in low back pain after 12 weeks of training compared with REG (mean difference of 3.5 points, p < 0.0001). We also observed increased endurance of trunk extensors (p = 0.002) and right (p = 0.001) and left lateral muscles (p = 0.001) in the PG compared with REG. However, the indexes of disability did not change between groups. CONCLUSION: Pain intensity was significantly reduced while spine muscle endurance increased in PG compared with REG after intervention; thus, Pilates-based exercises should be considered in physical conditioning programs for helicopter pilots.

Comparing exercises with and without electromyographic biofeedback in subacromial pain syndrome: A randomized controlled trial.

BACKGROUND: Deficits in movement and muscle activation of scapulohumeral joint are related to Subacromial Pain Syndrome. Electromyography biofeedback during exercise may enhance muscle activation and coordination, and consequently improve pain and shoulder function. METHODS: This study compared the effects of an exercise protocol with and without using electromyographic biofeedback on pain, function and movement of the shoulder complex in subjects with Subacromial Pain Syndrome. A total of 24 patients with subacromial pain (mean age = 46.2 + 8.1;18 women) were randomized to either therapeutic exercise or exercise plus biofeedback to the trapezius and serratus muscles. Pain and shoulder function were evaluated as the primary outcome and range of motion, muscle strength, electromyographic activity and scapulohumeral kinematics as secondary outcomes. The subjects underwent eight weeks of intervention and comparisons were made between groups in baseline, at 4 weeks, 8 weeks, and at 4 weeks post intervention. FINDINGS: There were differences between groups for pain [mean difference = 1.5 (CI 0.3, 3.2) p = 0.01] at 8 weeks in the Exercise group and scapular upward rotation at 60° of arm elevation [mean difference = 13.9 (CI 0.9, 9.3), p = 0.006] in the Biofeedback group. There was no difference for the other variables of scapular kinematics as well as for shoulder function (DASH), muscle strength, range of motion and electromyographic variables. INTERPRETATION: The addition of Biofeedback to the exercise protocol increased upward rotation of the scapula. However, the volunteers who performed only the Exercises had a better response in reducing pain.

The influence of Kinesio Taping on muscle fatigue in individuals with low back pain: A randomised controlled trial.

OBJECTIVE: To evaluate the effect of different taping techniques on back muscle fatigue in people with low back pain. METHODS: Sixty women with chronic non-specific low back pain were randomly assigned to four groups of 15 participants each: control (CG), Kinesio Taping (KT) with tension (KTT), KT no tension (KTNT) and Micropore® (MP), which were applied over the erector spinae muscles. The median frequency (MF) fatigue slopes of the longissimus muscle and sustained contraction time during a trunk fatigue test (Ito test), and pain using the numerical pain rating scale (NPRS) were collected at three time points: pre-treatment, three and ten days after intervention at a university laboratory. RESULTS: Significant differences were seen in the MF slopes between groups (p= 0.01, η2= 0.20), with the KTT showing a mean difference (MD = 0.31, p= 0.04) and KTNT (MD = 0.28, p= 0.04) compared with CG. Significant reductions in NPRS were seen between time points (p< 0.001, η2= 0.28), with a reduction between pre and 3 days (MD = 1.87, p< 0.001), and pre and 10 days (MD = 1.38, p< 0.001), with KTT and KTNT both showing clinically important changes. CONCLUSION: KT, with or without tension, has a tendency to reduce back muscle fatigue and reduce pain in individuals with chronic non-specific low back pain.

Reliability and concurrent validity of a mobile application to measure thoracolumbar range of motion in low back pain patients.

BACKGROUND: Smartphone devices have been used to measure range of motion (ROM) in different joints. OBJECTIVE: To verify the concurrent validity of thoracolumbar ROM using a mobile application and a digital inclinometer, as well as the intrarater reliability of individuals with and without back pain. METHODS: One investigator was responsible for measuring the ROM during the evaluations performed on 20 asymptomatic subjects and 20 symptomatic subjects in two consecutive days. RESULTS: Regarding to the concurrent validity, the Intraclass Correlation Coefficients (ICC) were classified as very good for all analyzed movements. For intrarater reliability, the mobile application had ICC varying between good and very good for the symptomatic subjects and very good for asymptomatic subjects. CONCLUSIONS: The mobile application may be considered a valid and reliable tool to assess thoracolumbar ROM for both asymptomatic and chronic low back pain subjects.

Effects of kinesio taping on neuromuscular performance and pain of individuals affected by patellofemoral pain: A randomized controlled trial.

Patellofemoral pain (PFP) is one of the most frequent musculoskeletal dysfunctions in the knee and its treatment is controversial. This study analyzed the effects of Kinesio Taping (KT) immediately and 72 hours after its application on the electromyographic (EMG) activity of the vastus medialis oblique (VMO) muscle, on the isokinetic performance of the quadriceps femoris and on the pain of subjects with PFP. Fifty-four participants were divided into three groups and performed one of the following protocols: (1) control group (CG)-remained at rest; (2) KT tension group (TG)-KT application with tension in the VMO region; and (3) KT without tension group (WTG)-KT application without tension in the same region. VMO and vastus lateralis (VL) EMG activity (RMS and onset), isokinetic performance and pain intensity were evaluated at three moments: before KT application, immediately after and 72 hours after. A mixed model ANOVA was used for statistical analysis with a significance level of 5% (p ≤ 0.05). No differences between the evaluated groups were found in relation to EMG variables and isokinetic performance. A reduction in pain intensity was found in the WTG in comparison to CG, after 72 hours. KT does not alter EMG parameters nor the isokinetic performance of subjects with PFP. However, we noticed reduced pain in the group submitted to the technique without tension 72 hours after its application.

Whole-Body Vibration on Performance of Quadriceps After ACL Reconstruction: A Blinded Randomized Controlled Trial.

CONTEXT: Whole-body vibration (WBV) has been widely used in clinical and sport practice. These devices produce constant vibrations, originating symmetrical waves that move along the vertical axis. It is suggested that mechanical stimuli produced by high vibration can be an alternative to improve neuromuscular performance and balance in different populations. However, there is still a lack of consensus in the literature regarding neurophysiological responses in the skeletal muscle immediately after the use of WBV, specifically in individuals subjected to anterior cruciate ligament reconstruction. OBJECTIVE: To investigate the immediate effects of WBV on neuromuscular performance of the quadriceps femoris and postural oscillation of individuals subjected to anterior cruciate ligament reconstruction. DESIGN: This is a blinded randomized controlled trial. SETTING: University laboratory. PARTICIPANTS: Forty-four men. INTERVENTION: Participants were randomized into 2 groups: control group (n = 22, exercise protocol on the vibrating platform turned off) and WBV group (n = 22, exercises on the vibrating platform turned on, at a frequency of 50 Hz and amplitude of 4 mm). MAIN OUTCOME MEASURES: The volunteers underwent a dynamometric evaluation of the quadriceps femoris and electromyographic activity of vastus lateralis and vastus medialis muscles, in addition to oscillation of the center of pressure at 2 different moments: before and immediately after the intervention protocol. RESULTS: The intragroup comparison evidenced differences between preassessments and postassessments for the variables of laterolateral amplitude, peak torque, and total work. However, no significant difference was observed in the intergroup comparison after WBV protocol. CONCLUSION: The use of WBV did not immediately alter the performance of the quadriceps femoris and the electromyographic activity of vastus lateralis and vastus medialis muscles. In addition, it also did not interfere with pressure center oscillation of individuals subjected to anterior cruciate ligament reconstruction.

Kinesio Taping reduces pain and improves disability in low back pain patients: a randomised controlled trial.

OBJECTIVE: To investigate the effects of Kinesio Taping® (KT) on chronic non-specific low back pain (LBP). DESIGN: Randomised controlled trial with intention-to-treat analysis. SETTING: University laboratory. PARTICIPANTS: One hundred and eight women with chronic non-specific LBP underwent an evaluation pre, 3 and 10 days after intervention. INTERVENTIONS: After randomisation, participants were assigned to four groups: KT with tension group (KTT) applied KT® with tension in the region of the erector spinae muscles; KT no tension group (KTNT) applied KT® with no tension in the same region; Micropore group (MP) applied Micropore® tape on the erector spinae muscles; and control group (CG) did not receive any intervention. MAIN OUTCOME MEASURES: The primary outcome was pain sensation, measured by numerical pain rating scale. Secondary outcomes were: disability (Roland Morris Disability questionnaire), trunk range of motion (inclinometry), strength (dynamometry) and electromyographic amplitude (electromyography). RESULTS: Improved pain relief was observed for KTT group (mean difference 2.0; 95% CI 0.5 to 3.4; P=0.003) and KTNT group [mean difference (MD) 1.9; 95% CI 0.5 to 3.4; P=0.004] compared with CG at 3days after application of the tape. For disability, there was a difference between CG and KTT group at 3days (MD 3.5; 95% CI 0.8 to 6.1; P=0.004) and 10days (MD 32; 95% CI 0.4 to 6.0; P=0.016). For all the other variables, there were no differences between groups. CONCLUSION: KT with or without tension reduces pain 3days after its application. Additionally, when applied with tension, it improves disability after 3 and 10days in patients with LBP. TRIAL REGISTRATION: NCT02550457 (clinicaltrials.gov).

Efeito do treinamento resistido na redução da dor no tratamento de mulheres com fibromialgia: revisão sistemática / Eff ect of resistance training in pain reduction on the treatment of women with fi bromyalgia: a systematic review

A fi bromialgia (FM) é uma doença reumática, de etiologia desconhecida que apresenta como principal característica a dor musculoesquelética, desencadeando um ciclo de descondicionamento. A fisioterapia exerce um papel muito importante com os programas de exercícios físicos, compostos por alongamento, exercício aeróbio e exercício resistido para reverter os sintomas apresentados. Recentemente, estudos têm apontado para o fato de que os exercícios resistidos poderiam ocasionar uma redução da dor em pacientes com FM, gerando um novo questionamento sobre os efeitos do exercício resistido nestes pacientes. Com isso, este estudo teve o objetivo de investigar o efeito do treinamento resistido na redução da dor em mulheres com FM, bem como estabelecer parâmetros, como volume e duração, para o tratamento da dor nesses pacientes. Para tanto, foi realizado uma revisão sistematizada dos estudos publicados até junho de 2016 nas bases de dados eletrônicas PubMed, PEDro, Scielo e Lilacs. O levantamento dos estudos encontrados foi realizado no período de maio a junho de 2016, usando os seguintes descritores na língua inglesa: Physical Therapy Modalities, strength training, Pain, Fibromyalgia e seus equivalentes na língua portuguesa e espanhola. Após a busca, foram encontrados 85 artigos. Após a análise dos resumos, 80 artigos foram excluídos de acordo com os critérios pré-estabelecidos, restando apenas 5 estudos randomizados controlados, sendo selecionados para análise dos seus dados. Após a análise, conclui-se que o treinamento resistido reduz a dor em mulheres com fi bromialgia, a partir da 8ª semana de treinamento, desde que esse seja realizado de forma continuada e orientada, com duração de no mínimo 30 minutos, com frequência de 2 a 3 vezes por semana....(AU)

The fi bromyalgia (FM) is a rheumatic disease of unknown etiology that has as main characteristic the musculoskeletal pain, triggering a deconditioning cycle. The physical therapy has a very important role with the physical exercise programs, compounds for stretching, aerobic exercise and resistance exercise to reverse the symptoms. Recently, studies have pointed to the fact that resistance exercise could cause a reduction of pain in patients with FM, generating a new questioning of the eff ects of resistance exercise in these patients. Therefore, this study aimed to investigate the effi cacy of resistance training in reducing pain in women with FM, as well as establishing, as volume and duration, for the treatment of the pain in these patients. For this, was performed a review of published studies ystematically until June 2016 in electronic databases PubMed, PEDro, Scielo and Lilacs. The survey found the studies was carried out from May to June 2016, using the following key words in English: Physical Therapy Modalities, strength training, Pain, Fibromyalgia and its equivalent in Portuguese and Spanish. After the search, found 85 articles. After analyzing the abstracts, 80 articles were excluded according to pre-established criteria, with only 5 randomized controlled trials, were selected for analysis of their data. After the analysis, it is concluded that resistance training interferes positively in reducing pain in women with fi bromyalgia, from the 8th week of training. This being done continuously and targeted manner, with duration of minimum 30 minutes, often 2 to 3 times per week....(AU)

Torque, power and fatigue ratio in knee flexors and extensors of soccer players / índice de torque, potência e fadiga nos flexores e extensores do joelho de jogadores de futebol / índice de par de torsión, potencia y fatiga en los flexores y extensores de la rodilla de jugadores de fútbol

ABSTRACT Introduction: Soccer is the most popular and practiced sport in the world and is characterized by high intensity movements. This high demand induces several types of locomotor system injury, and one of the intrinsic factors responsible for triggering these injuries is muscle imbalances, which can occur between limbs or between muscles groups of the same limb. Objective: To evaluate the muscular performance between knee flexor/extensor groups of both limbs in professional soccer athletes.: Methods: Isokinetic assessments were performed in 18 professional soccer athletes, with mean age of 26.9 ± 3.6 years and mean body mass index (BMI) of 23.9 ± 1.7 kg/m2.. The test protocol consisted of five concentric contractions of knee flexion and extension at angular velocity of 60o/sec, 15 contractions at 180o/sec and 30 contractions at 300o/sec in both limbs. Test paired t-test was used to verify the torque, power, and fatigue ratio of flexors and extensors of the dominant and non-dominant knee. Results: There was no significant difference between the evaluated members related to dominance (p>0.05). Regarding the torque ratio between flexors and extensors, we observed values below what is considered normal for this population, besides a higher fatigue index in knee flexor group when compared with the extensor group. Conclusion: No better performance was observed in the dominant limb, suggesting that, although this limb is preferred, this does not necessarily characterizes the better performance. The data also revealed an imbalance in the torque production capacity between the knee flexor and extensor groups, with an unfavorable ratio for the hamstrings, as well as a higher fatigue index in this group, which would make these muscles more susceptible to injures. Level of Evidence II; Diagnostic studies - Investigating a diagnostic test.

RESUMO Introdução: O futebol é o esporte mais popular e mais praticado no mundo e caracteriza-se por movimentos de alta intensidade. Essa alta demanda induz diversos tipos de lesões do aparelho locomotor, e um dos fatores intrínsecos responsável por desencadear essas lesões é o desequilíbrio muscular, que pode ocorrer entre os membros ou entre grupos musculares de um mesmo membro. Objetivo: Avaliar o desempenho muscular entre os grupos flexores/extensores do joelho de ambos os membros em atletas profissionais de futebol. Métodos: Foram realizadas avaliações isocinéticas em 18 atletas profissionais de futebol, com média de idade de 26,9 ± 3,6 anos e índice de massa corporal (IMC) médio de 23,9 ± 1,7 kg/m2. O protocolo do teste consistiu em cinco contrações concêntricas de flexão e extensão do joelho na velocidade angular de 60º/s, 15 contrações a 180º/s e 30 contrações a 300º/s, em ambos os membros. O teste t pareado foi utilizado para verificar a razão do torque, potência e fadiga de flexores e extensores do joelho dominante e do não dominante. Resultados: Não houve diferença significativa entre os membros avaliados no que se refere à dominância (p>0,05). Com relação à razão de torque entre flexores e extensores, observaram-se valores abaixo do que se considera normal para essa população, além de um maior índice de fadiga no grupo flexor quando comparado com o grupo extensor do joelho. Conclusão: Não foi observado desempenho melhor no membro dominante, sugerindo que, embora haja preferência do uso desse membro, isso não caracteriza necessariamente a melhor performance. Os dados também revelaram um desequilíbrio na capacidade de produção de torque entre o grupo flexor e extensor do joelho, com razão desfavorável para os isquiotibiais, além de maior índice de fadiga nesse grupo, o que tornaria esses músculos mais suscetíveis a lesões. Nível de Evidência II; Estudos diagnósticos - Investigação de um exame para diagnóstico.

RESUMEN Introducción: El fútbol es el deporte más popular y más practicado en el mundo y se caracteriza por movimientos de alta intensidad. Esta alta demanda induce diversos tipos de lesiones del aparato locomotor y uno de los factores intrínsecos responsables de desencadenar esas lesiones es el desequilibrio muscular, que puede ocurrir entre los miembros o entre grupos musculares de una misma extremidad. Objetivo: Evaluar el rendimiento muscular entre los grupos flexores y extensores de la rodilla de ambas extremidades en atletas profesionales de fútbol. Métodos: Se realizaron evaluaciones isocinéticas en 18 atletas profesionales de fútbol, con promedio de edad de 26,9 ± 3,6 años e índice de masa corporal (IMC) promedio de 23,9 ± 1,7 kg/m2. El protocolo del ensayo consistió en cinco contracciones concéntricas de flexión y extensión de la rodilla a la velocidad angular de 60º/s, 15 contracciones a 180º/s y 30 contracciones a 300º/s, en ambas extremidades. La prueba t pareada se utilizó para verificar la razón del par de torsión, potencia y fatiga de flexores y extensores de la rodilla dominante y no dominante. Resultados: No hubo diferencia significativa entre las extremidades evaluadas en lo que se refiere a la dominancia (p > 0,05). Con respecto a la razón de par entre flexores y extensores, se observaron valores por debajo de lo que se considera normal para esta población, además de un mayor índice de fatiga en el grupo flexor cuando se compara con el grupo extensor de la rodilla. Conclusión: No se observó un mejor desempeño en la extremidad dominante, sugiriendo que, aunque hay preferencia del uso de esa extremidad, esto no caracteriza necesariamente un mejor rendimiento. Los datos también revelaron un desequilibrio en la capacidad de producción de par de torsión entre el grupo flexor y extensor de la rodilla, con una razón desfavorable para los isquiotibiales, además de un mayor índice de fatiga en ese grupo, lo que haría que esos músculos fueran más susceptibles a las lesiones. Nivel de evidencia II; Estudios diagnósticos - Investigación de un examen para diagnóstico.

Low-level laser therapy reduces the fatigue index in the ankle plantar flexors of healthy subjects.

Low-level laser therapy (LLLT) has been suggested as a resource capable of increasing resistance to fatigue and enhancing muscle performance through its metabolic and photochemical effects. This study evaluated the immediate effects of the application of LLLT on neuromuscular performance of the plantar ankle flexors in healthy subjects through a fatigue-induced protocol. This is a randomized controlled clinical trial, attended by 60 young and physically active volunteers of both genders. The subjects were randomly assigned into three groups, control, placebo, and laser, and underwent a preliminary evaluation of the isokinetic performance of plantar flexors and electromyographic activity of the soleus muscle to ensure homogeneity between groups. After the application of the respective intervention protocols, participants were induced to fatigue by performing 100 isokinetic concentric contractions of ankle plantar flexors at a speed of 90°/s. The dynamometric fatigue index (DFI) and median frequency were recorded during the fatigue protocol for comparison between groups. The group receiving the laser application showed significantly lower dynamometric fatigue index (p = 0.036) when compared to control and placebo groups. In relation to the median frequency during the fatigue test, there was a decrease in all groups, however with no differences between them. We suggest that LLLT being applied prior to exercise can reduce the fatigue index in the ankle plantar flexors of healthy subjects.

Efeitos do aquecimento e do alongamento na resposta neuromuscular dos isquiotibiais / Effects of warm-up and stretching on the neuromuscular response of the hamstrings / Efectos del calentamiento y del alongamiento en la respuesta neuromuscular de los isquiotibiales

INTRODUÇÃO: A preparação para a atividade esportiva frequentemente envolve aquecimento e/ou alongamento, no intuito de prevenir lesões e/ou melhorar o desempenho. No entanto, a maneira como essas práticas podem interferir nos mecanismos neuromusculares de controle articular não é clara. OBJETIVO: Analisar o efeito imediato do alongamento e do aquecimento, isolados ou associados, no tempo de latência muscular (TLM) e na amplitude de ativação dos isquiotibiais, após perturbações repentinas da articulação do joelho. MÉTODOS: Sessenta voluntários do sexo feminino (média de idade de 22,3 ± 1,7 anos e IMC 21,4 ± 1,3 kg/cm2) foram divididas aleatoriamente em quatro grupos: (1) controle, (2) aquecimento, (3) alongamento, (4) aquecimento + alongamento. A atividade elétrica dos isquiotibiais foi captada por eletromiografia de superfície durante uma perturbação súbita do joelho. Um eletrogoniômetro detectou o início da variação angular, enquanto os eletrodos captaram o início e a amplitude da atividade muscular antes e após as intervenções. Como procedimento estatístico utilizou-se ANOVA two-way e post-hoc de Tukey, considerando-se como nível de significância p < 0,05. RESULTADOS: O TLM do bíceps femoral e do semitendíneo foi reduzido nos grupos 3 (p = 0,048 e 0,027, respectivamente) e 4 (p = 0,026 e 0,039, respectivamente). Não houve alteração significativa da amplitude de ativação muscular nos grupos avaliados. CONCLUSÕES: Os dados do presente estudo sugerem que, embora não tenham sido observadas alterações na amplitude eletromiográfica, o alongamento passivo e estático, utilizado de forma isolada ou associado ao aquecimento, promoveu uma redução do TLM dos isquiotibiais. ...

INTRODUCTION: The preparation for sports activities often involves warm-up and/or stretching in order to prevent injuries and/or improve performance. However, how these practices may interfere with neuromuscular mechanisms of joint control is unclear. OBJECTIVE: To analyze the immediate effect of stretching and warm-up exercises, alone or combined, on muscle latency time (MLT) and hamstrings activation amplitude after sudden knee joint disturbances. METHODS: Sixty female volunteers (mean age 22.3±1.7 years, BMI 21.4±1.3kg/cm2) were randomly divided into four groups: (1) control, (2) warm-up, (3) stretching, (4) warm-up + stretching. Hamstrings electrical activity was recorded by surface electromyography during a sudden knee disturbance. An electrogoniometer detected the onset of angular variation, while electrodes recorded the onset and amplitude of muscle activity before and after interventions. Two-way ANOVA and post hoc Tukey were used in statistical analysis, considering a significance level of p<0.05. RESULTS: The MLT of the biceps femoris and semitendinosus muscles was reduced in groups 3 (p=0.048 and 0.027, respectively), and 4 (p=0.026 and 0.039, respectively). There was no significant change in the amplitude of muscle activation amplitude in the evaluated groups. CONCLUSIONS: The results of this study suggest that although no changes in electromyographic amplitude were observed, static and passive stretching used alone or in combination with warm-up, caused a reduction in the hamstrings MLT. This reduction may prove to be a protective factor for muscle and joint injuries, after a sudden disturbance, such as those that occur in sports. .

INTRODUCCIÓN: La preparación para la actividad deportiva frecuentemente vincula calentamiento y/o alongamiento, con la intención de prevenir lesiones y/o mejorar el desempeño. Mientras tanto, la manera en cómo esas prácticas pueden interferir en los mecanismos neuromusculares de control articular no es clara. OBJETIVO: Analizar el efecto inmediato del alongamiento y del calentamiento, aislados o asociados, en el tiempo delatencia muscular (TLM) y en la amplitud de activación de los isquiotibiales, después de perturbaciones repentinas de la articulación de la rodilla. MÉTODOS: Sesenta voluntarias del sexo femenino (promedio de edad de 22,3 ± 1,7 años e IMC 21,4 ± 1,3 kg/cm2) fueron divididas aleatoriamente en cuatro grupos: (1) control, (2) calentamiento, (3) alongamiento, (4) calentamiento + alongamiento. La actividad eléctrica de los isquiotibiales fue captada por electromiografía de superficie durante una perturbación súbita de la rodilla. Un electrogoniómetro detectó el inicio de la variación angular, mientras que los electrodos captaron el inicio y la amplitud de la actividad muscular antes y después de las intervenciones. Como procedimiento estadístico se usó ANOVA two-way y post-hoc de Tukey, considerándose como nivel de significancia p < 0,05. RESULTADOS: El TLM del bíceps femoral y del semitendíneo fue reducido en los grupos 3 (p = 0,048 y 0,027, respectivamente) y 4 (p = 0,026 y 0,039, respectivamente). No hubo alteración significativa de la amplitud de activación muscular en los grupos evaluados. CONCLUSIONES: Los datos del presente estudio sugieren que, aunque no hayan sido observadas alteraciones en la amplitud electromiográfica, el alongamiento pasivo y estático, utilizado de forma aislada o asociado al calentamiento, promovió una reducción del ...

Kinesio Taping(®) does not alter neuromuscular performance of femoral quadriceps or lower limb function in healthy subjects: randomized, blind, controlled, clinical trial.

The aim of this study was to analyze the immediate effects of applying Kinesio Taping(®) (KT) on the neuromuscular performance of femoral quadriceps, postural balance and lower limb function in healthy subjects. This is a randomized, blind, controlled, clinical trial, where sixty female volunteers (age: 23.3 ± 2.5 years; BMI: 22.2 ± 2.1 kg/m(2)) were randomly assigned to three groups of 20 subjects each: control (10 min at rest); nonelastic adhesive tape (application over the rectus femoris, vastus lateralis and vastus medialis muscles); and KT (KT application over the same muscles). All individuals were assessed for single and triple hops, postural balance (by baropodometry), peak concentric and eccentric torque and electromyographic activity of vastus lateralis, before and after interventions. No significant differences in electromyographic activity of the VL or concentric and eccentric knee peak torque were recorded, between groups and initial and final assessment in any of the three groups. We also observed no significant alteration in single and triple-hop distance and one-footed static balance between the three groups. Application of KT to RF, VL and VM muscles did not significantly change lower limb function, postural balance, knee extensor peak torque or electromyographic activity of VL muscle in healthy women.

Desempenho do membro não-acometido em pacientes com reconstrução do ligamento cruzado anterior / Performance of uninjured lower limb after anterior cruciate ligament reconstruction

Défices sensoriais persistentes após a reconstrução do ligamento cruzado anterior (LCA) podem causar alterações como fraqueza muscular e comprometimento do equilíbrio e do desempenho funcional. Diversos estudos discutem se essas alterações também estão presentes no membro inferior não acometido e se esse membro pode ser utilizado como referência nas avaliações desses pacientes. O objetivo do presente estudo foi comparar o torque extensor e flexor do joelho, o equilíbrio unipodal e o desempenho funcional sobre o membro não-acometido de pacientes submetidos à reconstrução do LCA, com membros inferiores de sujeitos saudáveis. Participaram do estudo 23 indivíduos submetidos à reconstrução do LCA e 22 sujeitos saudáveis, que foram avaliados quanto ao torque extensor e flexor do joelho durante contração isocinética concêntrica a 60 graus/s no dinamômetro isocinético, à velocidade média de oscilação do centro de pressão em apoio unipodal no baropodômetro, e submetidos a dois testes de salto para avaliar o desempenho funcional. Os resultados não revelaram diferenças entre o membro não-acometido e os membros inferiores do grupo controle em todas as variáveis estudadas (p>0,05). Esses resultados sugerem que o membro não-acometido de pacientes submetidos à reconstrução do LCA pode ser utilizado como referência nos estudos de avaliação desses pacientes.

Persistent sensorial deficits after anterior cruciate ligament (ACL) reconstruction might lead to muscle weakness, balance and functional performance disorders. Several studies inquire whether these alterations also appear in the uninjured limb and whether the latter could be used as reference for patient assessment. The aim of the present study was to compare knee extensor and flexor torque, balance and functional performance of non-injured lower limb, after contralateral ACL reconstruction, with lower limbs of healthy subjects. Twenty three male patients who had had ACL reconstruction, and 22 control subjects were assessed as to knee flexor and extensor torque during concentric isokinetic contraction at 60o/s with an isokinetic dynamometer, mean speed of centre of pressure swing during single-limb stance, and submitted to two hop tests to assess functional performance. Results showed no significant differences between uninjured side and healthy subjects lower limbs at all assessed variables (p>0.05). These findings suggest that the uninjured limb may be safely used as reference in studies to assess post-ACL patients.

Atividade eletromiográfica do vasto medial oblíquo em portadoras da síndrome da dor patelofemoral / Eletromyographyc activity of the vastus medialis oblique muscle in female patients with patellofemoral syndrome

A síndrome da dor patelofemoral (SDPF) é uma das afecções que mais acometem a articulação do joelho. Embora sua etiologia não seja completamente conhecida, uma disfunção do músculo vasto medial oblíquo (VMO) tem sido apontada como possível fator desencadeante...

The patellofemoral pain syndrome (PFPS) is among the most common knee pathologies. Although its etiology is not fully known, a dysfunction of the vastus medialis oblique (VMO) muscle has been pointed out as a possible cause...

Efeito imediato da estimulação elétrica neuromuscular seletiva na atividade eletromiográfica do músculo vasto medial oblíquo / Immediate effect of selective neuromuscular electrical stimulation on the electromyographic activity of the vastus medialis oblique muscle

A Síndrome da dor patelofemoral (SDPF) é descrita como dor anterior ou retro-patelar do joelho na ausência de outras patologias associadas, sendo freqüentemente associada à disfunção do Vasto Medial Oblíquo (VMO). Entretanto, diversos estudos têm demonstrado a impossibilidade de ativar seletivamente este músculo através de exercícios. O objetivo do presente estudo foi analisar o efeito imediato da estimulação elétrica neuromuscular (EENM) seletiva no músculo VMO por meio do comportamento eletromiográfico dos músculos VMO e vasto lateral (VL). Foram avaliadas 18 mulheres saudáveis, com idade média de 23,2 anos e IMC médio de 20 Kg/m2. Os procedimentos do estudo incluíram uma análise eletromiográfica dos músculos VMO e VL, antes e imediatamente após a EENM do músculo VMO. Durante a análise eletromiográfica, as voluntárias realizaram uma contração isométrica voluntária máxima durante a extensão do joelho a 60° em um dinamômetro isocinético. A estimulação elétrica foi realizada através da corrente Russa. A análise dos dados mostrou um aumento significativo na intensidade de ativação do músculo VMO imediatamente após a estimulação do mesmo (p=0,0125), enquanto que a intensidade de ativação do músculo VL, não mostrou aumento significativo (p=0,924). Além disso, verificou-se também um aumento significativo na relação VMO/VL (p=0,048). No presente estudo, observou-se uma modificação na relação VMO/VL após a EENM, sugerindo que a mesma tem um efeito favorável no fortalecimento seletivo do VMO...

The Patellofemoral pain syndrome (PFPS) is described as an anterior or retropatellar knee pain in the absence of other associated diseases, and has often been associated with dysfunction of the vastus medialis oblique muscle (VMO). However, several studies have demonstrated the impossibility of selectively activating this muscle with exercises. The aim of the present study was to analyze the immediate effect of neuromuscular electrical stimulation of VMO muscle by means of monitoring the electromyographic activity of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles. Eighteen healthy women with a mean age of 23.2 years and mean BMI of 20 Kg/m2 were evaluated. The study protocol included electromyographic analysis of VMO and VL muscles, before and immediately after neuromuscular electrical stimulation of the VMO muscle. During the electromyographic analysis, the volunteers performed maximal voluntary isometric contraction in a 60° knee extension on an isokinetic dynamometer. ôRussian currentõ apparatus was used for electrical stimulation. Results: The data analysis demonstrated a signifi cant increase in VMO activation intensity immediately after it had been electrically stimulated (p=0.0125), whereas VL activation intensity exhibited no signifi cant increase (p=0.924). Moreover, a signifi cant increase in the VMO/VL ratio was also detected (p=0.048). In this study it was observed that electrical stimulation modifi ed the VMO/VL ratio, which suggests electrical stimulation has a benefi cial effect on VMO muscle strength...

Limites da estimulaçao eletrica neuromuscular no fortalecimento de musculos esqueleticos saudaveis e com deficit de força / Neuromuscular electrical stimulation limits in stregthening of healthy and deficient muscle

A estimulaçao Eletrica neuromuscular(EENM) tem sido usada ha varios anos como um coadjuvante no treinamento fisico.Especificamente nas ultimas decadas, esta tecnica tem sido usada no fortalecimento de musculos inervados, com base nos trabalhos do cientista russo Yakiv Kots, que usou estimulaçao eletrica de alta frequencia para ganhos de força muscular. De acordo com Kots, as bases para o uso de EENM no fortalecimento muscular seriam de que mais unidades motoras poderiam ser recrutadas pela EENM do que durante contarçaoes voluntaris maximas realizadas pelo individuo. Entretanto muitos desses resultados sao atualmente questionados e ha ainda muita controversia na literatura sobre o palel da EENM no fortalecimento dos musculos esqueleticos. O objetivo dessa revisao é avaliar as coclusaoes de estudos cientificos realizados nos ultimos vinte anos sobre o tema, bem como apresentar resultados que obtivemos avaliando o uso da EENM em musculos saudaveis e com deficit de força muscular. Nossos resultados demosntram que a EENM, associada ao treinamneto com contraçoes voluntarias maximas, nao proporcionou ganho de força adicional tanto em musculos saudaveis, como naqueles que mantiveram deficit de força apos a reabilitaçao. Assim a EENM deveria ser usada preferencialmente nas fases iniciais do processo de reabilitaçao, quando algum deficit de recrutamento motor ainda estiver presente e associado a sinais de desconforto do individuo, durante a realizaçao da contraçao muscular.

Aplicações dos recursos eletrotermofototerápicos em idosos / Applications of hypertermic and phototherapic resources in aged

Apresenta os principais recursos disponíveis dentro da eletrotermofototerapia moderna e relaciona as suas principais precauções de aplicação no idoso