Vertical Jump on a Force Plate for Assessing Muscle Strength and Power in Women With Severe Obesity: Reliability, Validity, and Relations With Body Composition.

ABSTRACT: Bellicha, A, Giroux, C, Ciangura, C, Menoux, D, Thoumie, P, Oppert, J-M, and Portero, P. Vertical jump on a force plate for assessing muscle strength and power in women with severe obesity: reliability, validity, and relations with body composition. J Strength Cond Res 36(1): 75-81, 2022-Muscle strength and power, particularly when assessed during multijoint movements such as vertical jump (VJ), are important predictors of health status and physical function. Vertical jump is mainly used in athletes, also in untrained or older adults, but has not yet been used in subjects with obesity. We aimed to assess the following in this population: (a) the reliability of VJ parameters, (b) their validity compared with isokinetic testing, and (c) their relations with body composition. In 20 women with severe obesity (mean [SD] age: 41.1 [11.6] years; body mass index: 43.9 [4.4] kg·m-2) without severe orthopedic disorders, VJ parameters, knee extension torque, and body composition were assessed using a force plate, an isokinetic dynamometer, and dual-energy x-ray absorptiometry, respectively. Excellent reliability was found for absolute peak power and peak force in VJ (intraclass correlation coefficient [95% confidence interval]: 0.95 [0.88-0.98] and 0.90 [0.77-0.96], respectively), and moderate to good validity of peak power and peak force compared with isokinetic torque (r = 0.79 and r = 0.67, respectively; all p < 0.01). Positive relations were found between peak force and peak power during VJ and lean body mass (r = 0.89 and r = 0.60, respectively; p < 0.01) and a negative relation was found between peak velocity or VJ height and fat mass (r = -0.65 and -0.64, respectively; p < 0.01). These results suggest that VJ on a force plate is a reliable and valid test for assessing muscle strength and power in severely obese subjects. Vertical jump testing is easy to implement, which can facilitate its use in both research and clinical testing in this setting (ClinicalTrials.govID: NCT03325764).

Urethro-vaginal reflux during micturition: An underestimated cause of urinary incontinence in adult women.

AIMS: To evaluate if urethrovaginal reflux (UVR) is an underestimated cause of insensible or postmicturition incontinence in adult women. METHODS: An observational and retrospective study was carried out on the computerized records of a neuro-urology department. Female patients who had insensible or postmicturition incontinence were investigated. Retrograde and voiding urethrocystography (UCG), urodynamic evaluation, urethral pressure profilometry, and anamnestic and clinical examination had to be available. RESULTS: Among the 79 adult female patients with insensible or postmicturition incontinence in whom the whole set of required evaluations was achieved, 16 had a UVR (mean age 47 ± 15 years). There were no urethral diverticula, urethrocele, vesicovaginal, or urethrovaginal fistula on their UCG. All of them also had a cystoscopy and a CT urography which did not establish any abnormality. CONCLUSIONS: UVR is not an exclusive pathology of children. This mechanism seems to be an underestimated cause of urinary incontinence in adult women. Retrograde and voiding UCG appears to be the gold standard to confirm the intravaginal reflux.

Decrease in post-stroke spasticity and shoulder pain prevalence over the last 15 years.

OBJECTIVES: The usual complications after recent stroke such as disabling spasticity and shoulder pain seemed less frequent in recent years. This study examined the frequency of spasticity and shoulder pain in recent post-stroke patients over time in our physical and rehabilitation medicine department. METHODS: This was a retrospective study of post-stroke inpatients over the last 15 years. Spasticity and shoulder pain prevalence were analyzed, as were demographic, clinical and stroke characteristics. RESULTS: We reviewed medical records for 786 patients (506 men); mean age 58.1 years (SD 13.2); 530 (68%) with ischemic stroke and 256 (32.36%) hemorrhagic stroke. After a first increase from 2000 to 2006, the prevalence of disabling spasticity decreased from 2006 to 2015 (31%-10%; P<0.001). Shoulder pain at admission and during hospitalization also decreased (13% of patients in 2000 to 8% in 2015, P<0.001). Disabling spasticity was associated with shoulder pain (26% of patients with disabling spasticity presented shoulder pain at admission vs 7% with hyperreflexia of the deep tendon reflexes, P<0.05). Characteristics of stroke, time of admission after stroke and length of stay did not change over the years. We observed an increase in number of walking patients at admission and number with a functional paretic arm at admission and discharge (P<0.05), which may explain the increase in functional independence measure scores at admission and discharge (both P<0.05). Prevalence of cognitive disorders increased over the same period (24% in 2000 vs 63% in 2015, P<0.05). CONCLUSIONS: Disabling spasticity and shoulder pain frequency in recent post-stroke patients decreased over the last 15 years, and functional abilities both at admission and discharge improved. Confirmation of these results in a multicentric study may be important evidence of an improvement in stroke healthcare both in stroke and physical and rehabilitation medicine units in the last 10 years in France and could affect future estimations of the need for rehabilitation care after stroke.

Adherence to Anticholinergic Therapy and Clean Intermittent Self-Catheterization in Patients With Multiple Sclerosis.

PURPOSE: To evaluate adherence to anticholinergic therapy (AT) and clean intermittent self-catheterization (CISC) in patients with multiple sclerosis (MS) and to identify factors associated with poor adherence. METHODS: This single-center study prospectively included 49 patients suffering from MS who had been prescribed AT and/or CISC. Adherence was evaluated using a self-report questionnaire. The Expanded Disability Status Scale (EDSS), Patient Global Impression of Improvement, Mini-Mental State Examination, Urinary Symptom Profile, and Hospital Anxiety and Depression (HAD) instruments were administered, and the number of daily anticholinergic pills and/or catheterizations was noted. Whether patients were receiving concomitant intradetrusor botulinum toxin injections was assessed, as were barriers to treatment, side effects, number of spontaneous micturitions, reasons for the prescription, satisfaction, and difficulties. RESULTS: Only 38% of patients were adherent to AT. Experiencing side effects was related to nonadherence (P=0.02). Only 29% of patients were adherent to CISC. More intense voiding dysfunction (P<0.001), a higher frequency of CISC (P=0.03), and a higher EDSS score (P=0.02) were associated with better adherence. Conversely, the HAD score (P<0.001), depression (P<0.001), the persistence of spontaneous micturition (P<0.001), a blocking sensation during catheterization (P=0.04), and the need to adapt one's posture or gesture to perform catheterization (P=0.04) were associated with poorer adherence. CONCLUSIONS: Adherence to AT and CISC was poor in patients with MS suffering from bladder dysfunction. Several factors related to nonadherence were identified in this study, and addressing these factors might help to improve treatment adherence.