Blood Flow Restriction Training in Clinical Rehabilitation: Occlusion Pressure Methods Relative to the Limb Occlusion Pressure.

CONTEXT: Resistance training with blood flow restriction (BFR) has increased in clinical rehabilitation due to the substantial benefits observed in augmenting muscle mass and strength using low loads. However, there is a great variability of training pressures for clinical populations as well as methods to estimate it. The aim of this study was to estimate the percentage of maximal BFR that could result by applying different methodologies based on arbitrary or individual occlusion levels using a cuff width between 9 and 13 cm. DESIGN: A secondary analysis was performed on the combined databases of 2 previous larger studies using BFR training. METHODS: To estimate these percentages, the occlusion values needed to reach complete BFR (100% limb occlusion pressure [LOP]) were estimated by Doppler ultrasound. Seventy-five participants (age 24.32 [4.86] y; weight: 78.51 [14.74] kg; height: 1.77 [0.09] m) were enrolled in the laboratory study for measuring LOP in the thigh, arm, or calf. RESULTS: When arbitrary values of restriction are applied, a supra-occlusive LOP between 120% and 190% LOP may result. Furthermore, the application of 130% resting brachial systolic blood pressure creates a similar occlusive stimulus as 100% LOP. CONCLUSIONS: Methods using 100 mm Hg and the resting brachial systolic blood pressure could represent the safest application prescriptions as they resulted in applied pressures between 60% and 80% LOP. One hundred thirty percent of the resting brachial systolic blood pressure could be used to indirectly estimate 100% LOP at cuff widths between 9 and 13 cm. Finally, methodologies that use standard values of 200 and, 300 mm Hg far exceed LOP and may carry additional risk during BFR exercise.

Different Time Course of Recovery in Achilles Tendon Thickness After Low-Load Resistance Training With and Without Blood Flow Restriction.

CONTEXT: Blood flow restriction research has focused on muscular strength and hypertrophy. Limited data have been reported about the blood flow restriction effect on the tendon. OBJECTIVE: To analyze and compare the time course of recovery in Achilles tendon thickness after a single bout of low-intensity resistance training (LI-RT) and low-intensity blood flow restriction training (LI-BFRT). METHODS: A total of 56 healthy participants (24.60 [4.0] y; 23.65 [3.4] body mass index) were included. The dominant leg was assigned for LI-BFRT using low load (30% 1-repetition maximum) and 30% of the total occlusion pressure (52.21 [17.89] mm Hg) in plantar-flexion exercise (1 × 30 + 3 × 15 repetitions). The nondominant leg was assumed as a control condition. MAIN OUTCOME MEASURE: Sonography images were taken before the intervention, immediately posttraining, and 24 hours after exercise (post-24) for the Achilles tendon thickness. RESULTS: Changes in Achilles tendon thickness for LI-BFRT group were significant post- (-14.5%; P < .05) and post-24 (-9.2%; P < .05). In contrast, LI-RT group showed a transient decrease after exercise (-9.67%; P < .05) followed by a recovery of thickness post-24 (-1.06%; P < .05). Thickness post-24 was different between LI-BFRT versus LI-RT (P < .01). Hedge effect size analysis showed a large effect (g = 0.90) in LI-BFRT pre-post condition and a medium effect (g = 0.57) in post- to post-24. The LI-RT obtained a medium effect (g = 0.53) in pre-post condition and a small effect (g = 0.49) in post- to post-24. CONCLUSIONS: This study showed a different time course of the acute response in Achilles tendon thickness between LI-BFRT and LI-RT. This may be associated with intratendinous fluid movement in response to LI-BFRT.

Is Acute Lower Back Pain Associated with Heart Rate Variability Changes? A Protocol for Systematic Reviews.

Acute lower back pain (ALBP) is an extremely common musculoskeletal problem. ALBP consists of a sudden onset of short-duration pain in the lower back. However, repeated attacks can make the pain chronic. It can be measured through a self-report scale as well as through physical and physiological evaluations. Heart Rate Variability (HRV) has been used to evaluate the body's response to pain. However, to the best of our knowledge, no clear consensus has been reached regarding the relationship between both variables and on an optimal protocol for ALBP evaluation based on HRV. The objective of this review is to analyze the relationship and effectiveness of HRV as an instrument for measuring ALBP. Furthermore, we consider the influence of different types of interventions in this relationship. The protocol of this review was previously recorded in the International Prospective Register of Systematic Reviews (number CRD42023437160). The PRISMA guidelines for systematic reviews and PubMed, WOS and Scopus databases are employed. Studies with samples of adults with ALBP are included. This study sets out a systematic review protocol to help identify the relationship between HRV and ALBP. Understanding this relationship could help in designing early detection or action protocols that alleviate ALBP.

Lumbo-Pelvic Rhythm Monitoring Using Wearable Technology with Sensory Biofeedback: A Systematic Review.

As an essential lower-back movement pattern, lumbo-pelvic rhythm (LPR) during forward trunk flexion and backward return has been investigated on a large scale. It has been suggested that abnormalities in lumbo-pelvic coordination are related to the risk of developing low back disorders. However, considerable differences in the approaches used to monitor LPR make it challenging to integrate findings from those investigations for future research. Therefore, the aim of this systematic review was to summarize the use of wearable technology for kinematic measurement with sensory biofeedback for LPR monitoring by assessing these technologies' specific capabilities and biofeedback capacities and exploring their practical viability based on sensor outcomes. The review was developed following the PRISMA guidelines, and the risk of bias was analyzed using the PREDro and STROBE scales. PubMed, Web of Science, Scopus, and IEEEXPLORE databases were searched for relevant studies, initially returning a total of 528 articles. Finally, we included eight articles featuring wearable devices with audio or vibration biofeedback. Differences in protocols and limitations were also observed. This novel study presents a review of wearable tracking devices for LPR motion-mediated biofeedback for the purpose of correcting lower back posture. More research is needed to determine the long-term effectiveness of these devices, as well as their most appropriate corresponding methodologies.

Development of Creative Intelligence in Physical Education and Sports Science Students through Body Expression.

Body expression can enhance movement creativity and at the same time promote the growth of creative intelligence in college age. The aim of this study was to analyze the influence of an intervention in body expression classes on the creative intelligence of university students. The 49 participants aged 19 to 38 years engaged in the body expression course for seven weeks, 3 h per week. The Creative Intelligence test (CREA) was applied as an evaluative method to obtain the initial data and after the intervention the test was reapplied. Pre- and post-test results were analyzed and compared by gender and type of sporting background (team or individual sports). The results indicate an overall improvement in creative intelligence with a significant difference between the two evaluations (p < 0.001). Women started with a higher score than men, and although an improvement in their final mean score could be observed, it was not significant. Men, on the other hand, had noted a significant increase (p < 0.001) of these values in the post-test. Regarding the type of sports, at the beginning of the study, both groups had similar results; however, in the final test, the team sports players obtained better scores. In conclusion, body expression, thanks to its content focused on artistic-creative development, has been shown to be useful in the general progression of creative intelligence in college age.

Acute Effects of Resistance Training with Blood Flow Restriction on Achilles Tendon Thickness.

The Achilles tendon is one of the strongest and thickest tendons of the human body. Several studies have reported an immediate decrease in Achilles tendon thickness after a single bout of resistance training. However, the effects of blood flow restriction training on Achilles tendon thickness have not been investigated. The purpose of this study was to investigate the acute effects of different regimens of resistance training on Achilles tendon thickness. Fiftytwo participants (27.3 ± 7 years; 177.6 ± 11 cm; 72.2 ± 13.7 kg) were randomly allocated into one of the three groups: low-intensity exercise without (LI, n = 13) and with blood flow restriction (LI-BFR, n = 24), and high-intensity exercise (HI, n = 15). Participants from LI and LI-BFR groups performed four sets (1 x 30 + 3 x 15 reps) at 30% 1RM, while the HI group performed four sets (1 x 30 with 30% 1RM + 3 x 10 reps with 75% 1RM). All groups performed a plantar flexion exercise. For the LI-BFR group, a blood pressure cuff was placed on the dominant calf and inflated at 30% of the individual´s occlusion pressure (47.6 ± 19.8 mmHg). Sonographic images of Achilles tendon thickness were taken at pre, immediately after, 60 min and 24 h following acute bouts of exercise. Achilles tendon thickness was significantly reduced immediately after, 60 min and 24 h post-LI-BFR exercise (pre: 4.4 ± 0.4 mm vs. IA: 3.8 ± 0.4 mm vs. 60 min: 3.7 ± 0.3 mm vs. 24 h: 4.1 ± 0.3 mm; p < 0.001), whereas Achilles tendon thickness was unchanged for HI and LI groups (p > 0.05). These results suggest that blood flow restriction training may be an effective strategy to stimulate a positive response in Achilles tendon thickness.

[Fraud in nutritional supplements for athletes: a narrative review]. / Fraude en suplementos nutricionales para deportistas: revisión narrativa.

INTRODUCTION: The use of nutritional supplements (NSs) is a widespread practice in both professional and amateur athletes. Their choice must be based on criteria of safety, legality, and effectiveness. There are several risks that some of these products can trigger, this being a reason for fraud to the consumer. By way of example, the presence of a legal substance in doses higher than its recommendation may cause unwanted side effects; on the other hand, its presence in quantities lower than necessary (effective threshold) may not have the effect expected or announced by the product. Therefore, the objective of this review was to describe the existence of fraud in relation to nutritional labeling and/or to the content of NSs intended for athletes. A narrative review was conducted through PubMed in which 16 studies met the inclusion criteria. The results show that nutritional labeling differs from the actual amounts of ingredients. This type of fraud has been found in protein powder supplements, pre-workout mixtures, creatine, and beverages containing vitamins and minerals, among others. Fraud due to errors in the labeling by omission of substances present in the product or by errors in the analysis or declaration of quantities, is high. This lack of transparency in the actual composition of labels can contribute to sports performance and/or health problems in the athlete. Therefore, an improvement of the legislation on NS is necessary to ensure their safety, effectiveness, and legality.

INTRODUCCIÓN: El uso de suplementos nutricionales (SN) es una práctica muy extendida tanto entre los deportistas profesionales como entre los amateurs. Su elección debe realizarse basándose en criterios de seguridad, legalidad y eficacia. Son varios los riesgos que algunos de estos productos pueden desencadenar, siendo motivo de fraude para el consumidor. A modo de ejemplo, la presencia de una sustancia legal en dosis superiores a sus recomendaciones puede ocasionar efectos secundarios indeseados; por el contrario, su presencia en cantidades inferiores a las necesarias (umbral efectivo) puede no provocar el efecto esperado o anunciado por el producto. Por ello, el objetivo de la presente revisión es describir la existencia de fraude en relación con el etiquetado nutricional y/o el contenido de los SN destinados a deportistas. Se realizó una revisión narrativa a través de Pubmed en la que 16 estudios cumplieron los criterios de inclusión. Los resultados muestran que el etiquetado nutricional difiere de la cantidad real de ingredientes. Este tipo de fraude se ha encontrado en suplementos de proteína en polvo, mezclas preentrenamiento, creatina y bebidas que contienen vitaminas y minerales, entre otros. El fraude debido a errores en el etiquetado, por omisión de sustancias presentes en el producto o por errores en el análisis o declaración de las cantidades, es alto. Esta falta de transparencia en la composición real del etiquetado puede contribuir a problemas de rendimiento deportivo y/o de salud en el deportista. Por lo tanto, es necesaria una mejora de la legislación de los SN para garantizar su seguridad, eficacia y legalidad.

Effects of mat characteristics on plantar pressure patterns and perceived mat properties during landing in gymnastics.

Shock absorption and stability during landings is provided by both, gymnast ability and mat properties. The aims of this study were to determine the influence of different mat constructions on their energy absorption and stability capabilities, and to analyse how these properties affect gymnast's plantar pressures as well as subjective mat perception during landing. Six mats were tested using a standard mechanical drop test. In addition, plantar pressures and subjective perception during landing were obtained from 15 expert gymnasts. The different mats influenced plantar pressures and gymnasts' subjective perception during landing of gymnasts. Significant correlations between plantar pressures at the medial metatarsal and lateral metatarsal zones of the gymnasts' feet with the different shock absorption characteristics of the mats were found. However, subjective perception tests were not able to discriminate mat functionality between the six mats as no significant correlations between the mechanical mat properties with the subjective perception of these properties were found. This study demonstrated that plantar pressures are a useful tool for discriminating different landing mats. Using similar approaches, ideally including kinematics as well, could help us in our understanding about the influences of different mats upon gymnast-mat interaction.

Influence of Abdominal Hollowing Maneuver on the Core Musculature Activation during the Prone Plank Exercise.

This cross-sectional study of repeated measures investigated whether integrating the abdominal hollowing maneuver (AHM) into the prone plank performance is an effective strategy for increasing both the activation of the deep and superficial core musculature. Electromyographical (EMG) responses of rectus abdominis (RA), external oblique (EO), internal oblique (IO), and lumbar erector spinae (LES), and ratings of perceived exertion (RPE) of 20 participants (13 male, 7 female; mean ± standard deviation (SD) age: 24.25 ± 3.54 years; body mass: 66.42 ± 8.40 kg; height: 1.70 ± 9.51 m) were compared across two experimental conditions: the traditional prone plank (STANDARD); and a variation including the AHM (HOLLOWING). Regarding Total Intensity, HOLLOWING resulted in significantly greater EMG response than STANDARD (p < 0.001; Effect size (ES) = 3.01). Specifically, RA showed no significant differences between STANDARD and HOLLOWING (p = 0.056; ES = 0.285). However, for the remaining analyzed muscles, HOLLOWING significantly provided higher EMG activation compared to STANDARD (LES: p = 0.004; ES = 0.619; left EO: p < 0.001; ES = 1.031; right EO: p < 0.001; ES = 1.419; left IO: p < 0.001; ES = 2.021; right IO: p < 0.001; ES = 2.269). Regarding RPE, HOLLOWING reported values significantly greater than STANDARD (p < 0.001; ES = 2.94). In conclusion, integrating the AHM into the prone plank exercise enhances overall abdominal activity, particularly in both obliques. These findings provide updated guidelines for lumbar stabilization and core strengthening in health-related physical fitness programs.

The effects of stress on cardiovascular disease and Alzheimer's disease: Physical exercise as a counteract measure.

AD is a complicated multi-systemic neurological disorder that involves different biological pathways. Several risk factors have been identified, including chronic stress. Chronic stress produces an alteration in the activity of the hypothalamic pituitary adrenal (HPA) system, and the autonomic nervous system (ANS), which over time increase the risk of AD and also the incidence of cardiovascular disease (CVD) and risk factors, such as hypertension, obesity and type 2 diabetes, associated with cognitive impairment and AD. Considering the multi-factorial etiology of AD, understanding the complex interrelationships between different risk factors is of potential interest for designing adequate strategies for preventing, delaying the onset or slowing down the progression of this devastating disease. Thus, in this review we will explore the general mechanisms and evidence linking stress, cardiovascular disease and AD, and discuss the potential benefits of physical activity for AD by counteracting the negative effects of chronic stress, CVD and risk factors.

Acute Effects of ACL Injury-Prevention Warm-Up and Soccer-Specific Fatigue Protocol on Dynamic Knee Valgus in Youth Male Soccer Players.

Childhood anterior cruciate ligament (ACL) injuries-which can pose a major risk to a child's sporting career-have been on the rise in the last few decades. Dynamic knee valgus (DKV) has been linked to an increased risk of ACL injury. Therefore, the aim of this study was to analyze the acute effects of an ACL injury prevention protocol (ACL-IPP) and a soccer-specific fatigue protocol (SSFP) on DKV in youth male soccer players. The research hypothesis was that DKV would be reduced by the ACL-IPP and increased by the SSFP. Eighteen youth male soccer players were divided according to baseline DKV. Those with moderate or large DKV performed a neuromuscular training protocol based on activation of the abductor and external rotator hip muscles. Those with little or no DKV performed a soccer-specific fatigue protocol. DKV was assessed using the single-leg squat pre- and post-protocols in both legs. The ACL-IPP significantly decreased DKV during single-leg squat (p < 0.01, effect size = 1.39), while the SSFP significantly increased baseline DKV in the dominant leg during single-leg squat (p = 0.012; effect size = 1.74). In conclusion, the ACL-IPP appears to acutely reduce the DKV in youth male soccer players, and the SSFP seems to acutely increase the DKV in those players who showed a light or no DKV in a non-fatigue situation. By using the SSFP, it may be possible to determine which players would benefit from injury prevention programs due to increased DKV during game scenarios, while hip abductor and external rotator neuromuscular training may be beneficial for players who have moderate and severe DKV during single-leg squat under non-fatigued scenarios.

High-Performance Handball Player's Time-Motion Analysis by Playing Positions.

The purpose of this study was to analyze the on-court demands of handball players during the European Handball Federation Champions League Final Four (VELUX EHF FINAL4) 2019 to define time-motion characteristics (played time; covered distances) both in offense and defense. Furthermore; we aimed to define position-specific demands and differences among them. Forty players from three teams were analyzed during the tournament using a local positioning system (LPS) for the first time in top handball. Players covered similar distances both in offense (1388.28 ± 2627.08 m), and in defense (1305.47 ± 5059.64 m) and remained on court for a similar average time (15.69 ± 8.02 min and 15.40 ± 8.94 min respectively). When locomotion activities were normalized according to the time they spent on court; significant differences were found for defense compared to offense in walking (+20%; p < 0.000; Cohen's effect size (ES) = 1.01) and jogging (-29.6%; p = 0.000; ES = 0.90), as well as a tendency for high-intensity running (+ 25.2%; p = 0.077; ES = 0.31). Per playing position; center and left back (CB = 94.86 ± 10.98 m·min-1; LB = 96.55 ± 24.65 m·min-1) showed the highest running pace in offense and mid-left; front center defender and outside right for the defense (ML = 90.38 ± 30.16 m·min-1; FCD = 87.04 ± 14.94 m·min-1; OR = 89.64 ± 34.93 m·min-1). In conclusion; profile differences existed among players' position activity; both in offense and defense; which should be taken into account when designing specific physical training programs.

[Analysis of the promoting actions of physical activity developed by Valencian public universities]. / Análisis de las acciones de promoción de la actividad física desarrolladas por las universidades públicas valencianas.

BACKGROUND: the Valencian Network of Healthy Public Universities (RVUPS) is part of the healthy environments of the World Health Organization (WHO). The aim of the network is to achieve healthier universities through different lines of action, emphasizing the promotion of physical activity and sports. AIM: the purpose of this study was to analyze and review the activities developed by the RVUPS on the promotion of FA and to assess, through key informants, the need to implement an AF service within the university context. METHODS: on the one hand, an analysis and review of the activities and services developed to promote FA and sports that are included in the "Healthy University" section of each of the universities that make up the RVUPS (n = 5) was carried out. In addition, a qualitative study was developed interviewing key informants from the University of Alicante (n = 16), with the aim to know their perception about the utility of implementing a physical activity service within the university context. RESULTS: currently, Valencian universities do not cover all the needs to achieve an adequate well-being state. In response, some universities from RVUPS offer individualized activities to prevent and treat some of the chronic pathologies that currently have a highest incidence in population. In addition, new services are being implemented, which integrate all health professionals in order to achieve a more comprehensive service to their population. The qualitative study revealed that interviewees also perceive such needs and, therefore, support these initiatives, considering that a physical activity and nutrition service would be an interesting option for implementation into universities. CONCLUSION: it is necessary to strengthen the promotion of the practice of physical activity within university population, through healthy breaks, and also with the implementation of a back pain prevention and rehabilitation service. The integration of physical activity and nutrition services could affect the improvement of the health of the university population, and would increase the physical practice, carrying out an assessment of physical fitness and a proper prescription of exercise, according to the personal health conditions of each member of the university population.

INTRODUCCIÓN: la Red Valenciana de Universidades Públicas Saludables (RVUPS) se enmarca en los entornos saludables de la Organización Mundial de la Salud (OMS). Su objetivo es conseguir universidades más saludables a través de diferentes líneas de actuación, destacando entre ellas la de la promoción de la actividad física (AF) y el deporte. OBJETIVO: este estudio tiene por objeto analizar y revisar las actividades desarrolladas por la RVUPS sobre promoción de la AF y valorar mediante informadores clave la necesidad de implantar un servicio de AF dentro del ámbito universitario. MÉTODOS: por una parte, se realizó un análisis y estudio de las actividades y servicios que se desarrollan para promocionar la AF y el deporte y que están incluidos en la sección de "Universidad Saludable" de cada una de las universidades que conforman la RVUPS (n = 5). Además, se realizó por otra parte un estudio cualitativo a informadores clave de la Universidad de Alicante (n = 16) para conocer la percepción de cada uno de ellos sobre la utilidad de implantar un servicio de actividad física dentro del ámbito universitario. RESULTADOS: actualmente, las universidades valencianas no cubren todas las necesidades para alcanzar un adecuado estado de bienestar. Como respuesta, algunas universidades ofrecen actividades individualizadas para prevenir y tratar alguna de las patologías que mayor incidencia tienen en la actualidad. Además, se están implantando nuevos servicios que integran a todos los profesionales de la salud a fin de conseguir un servicio más completo e integral a su comunidad. El estudio cualitativo reveló que entrevistados también perciben tales necesidades y, por tanto, apoyan estas iniciativas, considerando que un servicio de AF y nutrición sería una interesante opción de implantación en las universidades. CONCLUSIONES: es necesario reforzar el fomento de la práctica de AF dentro de la comunidad universitaria, a través de pautas saludables y con la implantación de un servicio de prevención del dolor de espalda. La integración de servicios de AF y nutrición podría incidir en la mejora de la salud de la comunidad universitaria, a la vez que aumentaría la práctica de AF, realizando una valoración de la condición física y una prescripción de ejercicio físico acorde a las condiciones de salud de cada persona.

Effect of Core Training on Male Handball Players' Throwing Velocity.

In handball, throwing velocity is considered to be one of the essential factors in achieving the ultimate aim of scoring a goal. The objective of the present study was to analyze the effect of a core training program on throwing velocity in 30 handball players (age 18.7 ± 3.4 years, body height 179.3 ± 7.0 cm, body mass 78.9 ± 7.7 kg), 16 of whom were in the junior category and 14 of whom were in the senior category. The 30 players were randomly divided into two groups, the control group (n = 15) and the experimental group (n = 15). For a period of ten weeks, both groups attended their regular handball training sessions (four per week), but in addition, the experimental group participated in a program specifically aimed at progressively strengthening the lumbo-pelvic region and consisting of seven exercises performed after the general warm-up in each regular session. Pre- and post-tests were carried out to analyze each player's throwing velocity from different throwing positions and thus assess the effects of this specific training program. Statistically significant differences (p ≤ 0.05) in throwing velocity were observed between the experimental group, which presented a percentage improvement of 4.5%, and the control group, which did not show any improvement. The results seem to indicate that an increase in the strength and stability of the lumbo-pelvic region can contribute to an improvement in the kinetic chain of the specific movement of throwing in handball, thus, increasing throwing velocity.

Can Graduated Compressive Stockings Reduce Muscle Activity During Running?

PURPOSE: Graduated compressive stockings (GCS) have been suggested to influence performance by reducing muscle oscillations and improving muscle function and efficiency. However, no study to date has analyzed the influence of GCS on muscle activity during running. The objective of the study was to analyze the influence of GCS on the perception of comfort and muscle activation of the main muscles of the lower leg during running. METHOD: Thirty-six participants ran on a treadmill with (GCS) or without (control) GCS. The running tests consisted of a 10-min warm-up followed by a 20-min intense run at 75% of the athlete's maximal aerobic speed. Surface electromyography of the tibialis anterior, peroneus longus, gastrocnemius lateralis (GL), and gastrocnemius medialis (GM) were recorded every 5 min during the run and analyzed using a non-linearly scaled wavelet analysis. Perception of comfort of the GCS was measured before and after the run. RESULTS: The GCS were reported as comfortable garments and reduced GL activity at Minute 0 (p < .05, [Formula: see text]= .245) and Minute 5 (p < .05, [Formula: see text]= .326) and GM activity at Minute 0 (p < .05, [Formula: see text]= .233) compared with running without garments, but their effect was temporary and disappeared after 5 min of running. CONCLUSION: Even though GCS reduced gastrocnemius muscle activity during the initial minutes of running, it is hypothesized that the GCS could have lost their initial levels of compression after some minutes of exercise, thereby reducing their influence on muscle activation. However, this hypothesis needs to be further investigated.