Scapular exercise combined with cognitive functional therapy is more effective at reducing chronic neck pain and kinesiophobia than scapular exercise alone: a randomized controlled trial.

OBJECTIVE: The aim of this study was to compare the effectiveness of scapular exercises alone and combined with cognitive functional therapy in treating patients with chronic neck pain and scapular downward rotation impairment. DESIGN: Single-blind randomized controlled trial. SETTING: Outpatient. SUBJECTS: A total of 72 patients (20-45 years old) with chronic neck pain were studied. INTERVENTION: Allocation was undertaken into three groups: scapular exercise (n = 24), scapular exercise with cognitive functional therapy (n = 24) and control (n = 24) groups. Each programme lasted three times a week for six weeks. MAIN OUTCOMES: The primary outcome measure was pain intensity measured by the visual analogue scale scores. The secondary outcome measures included kinesiophobia and muscles activity. RESULTS: Statistically significant differences in pain intensity were found when multidisciplinary physiotherapy group including a cognitive functional approach was compared with the scapular exercise alone group at six weeks (effect size (95% CI) = -2.56 (-3.32 to -1.80); P = 0.019). Regarding kinesiophobia, a significant between-group difference was observed at six-week (effect size (95% CI) = -2.20 (-2.92 to -1.49); P = 0.005), with the superiority of effect in multidisciplinary physiotherapy group. A significant between-group differences was observed in muscle activity. Also, there were significant between-group differences favouring experimental groups versus control. CONCLUSION: A group-based multidisciplinary rehabilitation programme including scapular exercise plus cognitive functional therapy was superior to group-based scapular exercise alone for improving pain intensity, kinesiophobia and muscle activation in participants with chronic neck pain.

The Impact of a 12-Week Aqua Fitness Program on the Physical Fitness of Women over 60 Years of Age.

BACKGROUND: This study aimed to assess the impact of a 12-week Aqua Fitness program on the physical fitness of older women and emphasize sustainable health practices for aging populations. We focused on evaluating the program's effectiveness, using the Senior Fitness Test to measure improvements in physical capabilities. METHODS: An experimental research design was implemented, with 30 participants aged 60 and older. The participants were divided into a control group and an experimental group, each comprising 15 individuals. The control group received aqua Fitness exercises, and the experimental group received aqua fitness exercises and isometric (combined) exercises. Lower limb muscle strength, upper limb muscle strength, lower body flexibility, upper body flexibility, dynamic balance, agility, and endurance were assessed using the Senior Fitness Test. Assessments were conducted pre- and post-training. RESULTS: For a comparison within the group, combined exercises (aqua fitness and isometric exercises) had a significant effect on lower limb muscle strength, upper limb muscle strength, lower body flexibility, upper body flexibility on the right side, dynamic balance, agility, and endurance. Aqua fitness exercises alone showed significant effects on upper limb muscle strength, lower body flexibility, and endurance and no significant effects on other variables. For the comparison between groups, no significant differences were found between the effects of aqua fitness exercises and combined exercises on lower limb muscle strength, upper limb muscle strength, lower body flexibility, upper body flexibility, and endurance. Significant differences were found only in dynamic balance and agility between the two groups of aqua fitness and combined exercises. CONCLUSIONS: Although the combined program (aqua fitness and isometric exercises) had a greater effect on improving the physical fitness of older adults than aqua fitness alone, there was no significant difference between the two groups. Therefore, the results of this study highlight the potential of aqua fitness in promoting sustainable health and physical fitness in the older adult population.

The Correlation between Malocclusion and Body Posture and Cervical Vertebral, Podal System, and Gait Parameters in Children: A Systematic Review.

Background: This study investigates the relationship between malocclusion and body posture, head posture, podal system, and gait parameters in children. Methods: A systematic review of observational studies from 2010 to 2023 was conducted and 24 cross-sectional studies involving 6199 participants were identified. These studies were categorized into those dealing with body posture (10 studies, 3601 participants), cervical vertebral column and head posture (6 studies, 644 participants), the podal system (5 studies, 1118 participants), and gait (3 studies, 836 participants). Results: Evidence suggests a significant association between malocclusion and body posture, balance, podal system, and gait parameters. Notably, eight studies found a significant relationship between malocclusion and body posture, while five studies identified this relationship with the cervical vertebral column and head posture, five with the podal system, and three with gait parameters. Conclusions: Overall, the quality of evidence was strong for the association between malocclusion and body posture and the podal system and moderate for head posture and gait parameters. These findings offer insights for therapists to design interventions tailored to children with malocclusion based on considerations of body posture, head posture, podal system, and gait parameters, though further longitudinal cohort studies are needed for better predictive understanding.

Effect of Various Hydration Strategies on Work Intensity and Selected Physiological Indices in Young Male Athletes during Prolonged Physical Exercise at High Ambient Temperatures.

Background: In high temperatures, adequate hydration is vital for sustained physical exercise. This study explores the effect of three hydration strategies on physiological indices and work intensity. Methods: The research involved 12 healthy males who engaged in three test series, each separated by a one-week interval. During the trials, participants underwent a 120 min cycling session in a thermal climate chamber (temperature: 31 ± 2 °C, humidity: 60 ± 3%, air movement: <1 m/s). Measurements of rectal temperature (Tre) and heart rate (HR), and assessment of subjective workload perception, and thermal comfort were made both before and during the exercise. The computation of the physical strain index (PSI) relied on Tre and HR values. Three hydration strategies (isotonic drink, water, and no hydration) were administered before, during, and after the exercise. Results: Regardless of the hydration strategy, the participants' mean body mass decreased as a result of the exercise. Statistically significant differences in HR were observed between the no-hydration and water groups (p < 0.036). The mean PSI values significantly varied between hydration strategies, with the no hydration group exhibiting a higher PSI compared to the isotonic drink or water groups (p < 0.001). Conclusions: All hydration strategies contribute to thermoregulatory processes and mitigate the rise in internal body temperature during sustained physical exercise in elevated ambient temperatures.

The Use of Neurofeedback in Sports Training: Systematic Review.

Biofeedback training is a method commonly used in various fields of life, for example, in medicine, sports training or business. In recent studies, it has been shown that biofeedback, and neurofeedback, can affect the performance of professional athletes. Training based on the neurofeedback method includes exercising the brain waves. The aim of the article is to evaluate the influence of neurofeedback training on the physical fitness of professional athletes representing various sports disciplines, such as judo, volleyball and soccer. Based on 10 scientific papers from various sources, including PubMed, the latest research on neurofeedback and its impact on athletes has been reviewed. On the basis of the literature review from 2012 to 2022 on the neurofeedback method in sports training, it can be stated that this type of practice has a significant impact on physical fitness and sports performance. This review comprised 10 research studies with 491 participants in the neurofeedback groups, and 62 participants in the control group. Two reviewers independently extracted data and evaluated the quality of the studies utilising the PEDro scale. Properly planned and conducted neurofeedback training affects stimulation and improvement of many variables (reducing stress levels, increasing the ability to self-control physiological factors, enhancing behavioural efficiency and meliorating the speed of reaction to a stimulus).

The Influence of Various Hydration Strategies (Isotonic, Water, and No Hydration) on Hematological Indices, Plasma Volume, and Lactate Concentration in Young Men during Prolonged Cycling in Elevated Ambient Temperatures.

BACKGROUND: Increased internal body temperature during dehydration can be accompanied by water-electrolyte imbalances, higher levels of lactate during and after physical exertion, and changes in blood volume. Adequate hydration with carbohydrate-electrolyte fluids during physical activity can prevent dehydration and delay the onset of fatigue, allowing for proper biochemical and hematological reactions during exertion. A suitable drinking plan should consider the pre-exercise hydration level as well as the requirements for fluids, electrolytes, and substrates before, during, and after exercise. The objective of this study was to assess the impact of different hydration strategies (isotonic, water, and no hydration) on hematological indicators (hemoglobin concentration, hematocrit number, erythrocyte count, leukocyte count, and mean corpuscular volume) and lactate concentration during prolonged physical exertion in a high-temperature environment in young men. METHODS: The research method was quasi-experimental. The study involved 12 healthy men aged 20.6 ± 0.9 years, who were characterized by a body height (BH) of 177.2 ± 4.8 cm, a body mass (BM) of 74.4 ± 7.6 kg, a lean body mass (LBM) of 61.1 ± 6.1 kg, and a body mass index (BMI) of 23.60 ± 0.48. Measurements were taken of body composition and hematological and biochemical indicators. The main tests consisted of three series of tests separated by a one-week break. During the tests, the men performed a 120 min exercise with an intensity of 110 W on a cycle ergometer in a thermo-climatic chamber at an ambient temperature of 31 ± 2 °C. During exertion, the participants consumed isotonic fluids or water in an amount of 120-150% of the lost water every 15 min. The participants who exercised without hydration did not consume any fluids. RESULTS: Significant differences in serum volume were observed between the use of isotonic beverage and no hydration (p = 0.002) and between the use of isotonic beverage and water (p = 0.046). Immediately after the experimental exercise, hemoglobin values were significantly higher with no hydration than with water (p = 0.002). An even stronger significance of differences in hemoglobin was observed between no hydration and isotonic beverage consumption (p < 0.001). There was a statistically significant difference in the number of leukocytes between the consumption of isotonic beverage and no hydration (p = 0.006). CONCLUSIONS: Each active hydration strategy allows for a better maintenance of water-electrolyte homeostasis during physical exertion in a high-temperature environment, and isotonic beverage consumption had a greater impact on hydrating extracellular spaces with the smallest changes in hematological indicators.

Concentration levels of selected hormones in judokas and the extent of their changes during a special performance test at different ambient temperatures.

BACKGROUND: There is little scientific literature available on the diversity of physiological responses of judokas to anaerobic interval exercises in warm environments. Understanding the dynamics of changes in the concentration of selected hormones during a special endurance test at different ambient temperatures may have significant practical value, as it provides an opportunity for optimal programming and monitoring of the training process. So, the main aim of the research was to survey interval anaerobic exercises in different ambient temperatures on Concentration levels of selected hormones in judokas. METHODS: 15 judokas athletes (age: 20.65 ± 2.03 years; body height: 178.00 ± 6.31 cm;  body mass: 76.26 ± 12.57 kg; training experience: 12.1 ± 1.57 years) volunteered for the study. The judokas performed five sequences (each lasting 7.20 min) of pulsatile exercises on a cycle ergometer and hand ergometer in a thermoclimatic chamber at temperatures of 21 ± 0.5 °C and 31 ± 0.5 °C. The exercises were different from typical interval exercises, with varying times, upper and lower limb loads, and were followed by a 15-minute break after each sequence. Total duration of the experiment, including the five sequences of pulsating exercise and four 15-minute rest breaks between each exercise sequence, amounted to 96 min and 20 s. The workload was increased by 20 W for the lower limb tests and 12 W for the upper limb tests every 2 min. Biochemical measurements of testosterone (T), cortisol (C), growth hormone (HGH), adrenocorticotropic hormone (ACTH), follicle-stimulating hormone (FSH), adrenaline (E), noradrenaline (NE), and ß-endorphin (ß-end)were performed using the enzyme-linked immunosorbent assay (ELISA) method on blood samples taken before and after five series of pulsatile exercises, at 1, 24, and 48 h. RESULTS: Pulsatile exercise at ambient temperatures of 21 and 31 °C resulted in a decrease in body weight of the studied athletes (p < 0.05) and significantly reduced body volume and plasma volume after training (p < 0.05). The concentration of HGH, testosterone, cortisol and NE showed a statistically significant difference after the end of the series of pulsating exercises at both temperatures (p < 0.05) and did not significantly affect the concentration of ACTH, FSH and adrenaline concentration. CONCLUSIONS: An increase in the concentration of growth hormone, cortisol and NE was observed after doing the work at both 21 and 31 °C ambient temperature. Physical exertion in both ambient temperatures contributed to a statistically significant decrease in testosterone concentration. Based on the obtained research results, it can be concluded that physical activity in various thermal conditions of the external environment activates the hormonal response to varying degrees, with the direction of changes depending on the external thermal factor.

Cognitive functional therapy as a complementary treatment for posture and disability of chronic neck pain: secondary analysis of a randomized controlled trial.

PURPOSE: The aim of this study was to compare the effects of scapular stabilization exercise with and without cognitive functional therapy (CFT) on disability and scapular kinematics in people suffering from chronic neck pain. METHODS: A total of 72 patients with chronic non-specific neck pain were randomized into scapular stabilization exercise alone, n = 24, combined (scapular stabilization exercise + CFT), n = 24, and a control group, n = 24. Scapular kinematic and disability were measured at baseline and after the intervention. RESULTS: Statistically significant differences in neck pain and disability scale (NPAD) were found when the multimodal physiotherapy group including a cognitive functional approach was compared with stabilization exercises group at 6 weeks (effect size (95%CI) = -1.63 (-2.55, -.71); P = 0.019)). Regarding the neck disability index (NDI), a significant between-group difference was observed at six-week (effect size (95%CI) = -2.69 (-3.80, -1.58); P = 0.007), with the superiority of effect in multimodal physiotherapy group. A significant between-group difference was observed in the scapular upward rotation and scapular osterior tilt at 30°, 60°, 90° and 120° of shoulder adduction. CONCLUSIONS: A group-based multimodal rehabilitation program including scapular stabilization exercise plus cognitive functional therapy was superior to group-based stabilization exercises alone for decreasing disability and, improving scapular kinematic in patients with chronic neck pain.

Effect of adding motor imagery training to neck stabilization exercises on pain, disability and kinesiophobia in patients with chronic neck pain.

PURPOSE: The investigation of this study was to compare the effect of adding motor imagery training to neck stabilization exercises on pain, disability, and kinesiophobia in patients with chronic neck pain. MATERIAL AND METHODS: After screening, seventy-two volunteers with chronic neck pain were randomly allocated to 3 groups: neck stabilization exercises alone, n = 24, combined ( neck stabilization exercises + motor imagery training), n = 24, and a control group, n = 24. Pain intensity, disability, and kinesiophobia before and after the intervention exercises were measured by the Visual Analog Scale, Neck Disability Index, and the Tampa Scale of Kinesiophobia , respectively. RESULTS: Statistically significant differences in pain intensity, the neck disability index, and kinesiophobia were found when a combined intervention group including neck stabilization and motor imagery training was compared with neck stabilization training alone at 6 weeks ) p ≤ 0.005). Also, there were significant between-group differences favoring experimental groups versus control for all outcomes (p ≤ 0.001). CONCLUSION: neck stabilization exercises in combination with motor imagery training was superior to neck stabilization exercises alone in decreasing pain, disability, and kinesiophobia in patients with chronic neck pain.

Pain Neuroscience Education Combined with Therapeutic Exercises Provides Added Benefit in the Treatment of Chronic Neck Pain.

BACKGROUND: Chronic neck pain is common in the adult general population. Although the etiology of chronic neck pain is under debate, it is clear that chronic neck pain is multifactorial, with both physical and psychosocial contributors. OBJECTIVE: To determine whether adding pain neuroscience education (PNE) to therapeutic exercises improved their pain-disability index, pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy in subjects with chronic nonspecific neck pain. METHODS: This study was a three-arm randomized control trial. Seventy-two patients with chronic nonspecific neck pain were allocated to three groups: therapeutic exercises alone (n = 24), combined (therapeutic exercises + PNE; (n = 24), and a control group (n = 24). Each program took place three times a week, lasting for six weeks. The disability index, pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy measured by the Neck Pain and Disability Scale (NPAD), Pain Catastrophizing Scale (PCS), Fear-Avoidance Beliefs Questionnaire (FABQ), and Pain Self-Efficacy Questionnaire (PSEQ), respectively. Participants were assessed before and after the six-week intervention, and there was no further follow-up. RESULTS: For the outcomes NPAD, PSC, and FABQ, combined intervention demonstrated more significant improvements than therapeutic exercises alone (p ≤ 0.05), whereas no differences were observed between the two intervention groups for PSEQ (p = 0.99). In addition, significant differences were favoring experimental groups versus control for all outcomes (p ≤ 0.001). CONCLUSION: Therapeutic exercises combined with pain neuroscience education reduced the pain-disability index, pain catastrophizing, and fear-avoidance beliefs more than therapeutic exercises alone in patients with chronic neck pain. For pain self-efficacy, there was no statistically significant difference between the two intervention groups; however, the combined group had a more significant effect than therapeutic exercises alone. Further studies with longer periods and follow-up are required.

Focus on the Scapular Region in the Rehabilitation of Chronic Neck Pain Is Effective in Improving the Symptoms: A Randomized Controlled Trial.

Chronic neck pain is a common human health problem. Changes in scapular posture and alteration of muscle activation patterns of scapulothoracic muscles are cited as potential risk factors for neck pain. The purpose of this study was to compare the effects of neck exercise training (NET) with and without scapular stabilization training (SST) on pain intensity, the scapula downward rotation index (SDRI), forward head angle (FHA) and neck range of motion (ROM) in patients with chronic neck pain and scapular dyskinesia. A total of sixty-six subjects with chronic neck pain and scapular dyskinesia were randomly divided into three groups: neck exercise training, n = 24, combined training (NET + SST), n = 24 and a control group, n = 24. Pain intensity, SDRI, FHA and ROM were measured by the numerical rating scale, caliper, photogrammetry and IMU sensor, respectively. When the combined intervention group consisting of NET and SST was compared with NET alone at six weeks, there was a statistically significant difference in pain intensity, SDRI, FHA and cervical ROM for flexion and extension (p ≤ 0.05). Adding scapular exercises to neck exercises had a more significant effect in decreasing pain intensity, SDRI, FHA and increased cervical ROM than neck exercises alone in patients with chronic neck pain. These findings indicate that focus on the scapular posture in the rehabilitation of chronic neck pain effectively improves the symptoms.