Effects of blood flow restriction therapy in patients with knee osteoarthritis: protocol for an overview of systematic reviews.

Background: Osteoarthritis (OA) is the most common and prevalent musculoskeletal disease associated with population aging, negatively impacting function and quality of life. A consequence of knee OA is quadriceps muscle weakness. Musculoskeletal rehabilitation using low load exercises, associated with Blood Flow Restriction (BFR) may be a useful alternative to high load exercises when those cannot be tolerated. Several systematic reviews have reported inconclusive results due to discrepancies in study findings, heterogeneity of results, evaluated time points, and research questions explored. Objective: To perform an overview of systematic reviews with meta-analyses, synthesizing the most recent evidence on the effects of muscle strength training with BFR for knee OA. Methodology: Systematic reviews that include primary controlled and randomized clinical trials will be considered for inclusion. Articles will be considered only if they present a clear and reproducible methodological structure, and when they clearly demonstrate that a critical analysis of the evidence was carried out using instrumented analysis. Narrative reviews, other types of review, overviews of systematic reviews, and diagnostic, prognostic and economic evaluation studies will be excluded. Studies must include adults aged 40 years and older with a diagnosis of knee OA. Two authors will perform an electronic search with guidance from an experienced librarian. The following databases will be searched: PubMed via MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Web of Science, and the gray literature. The search strategy used in the databases will follow the acronym PICOS (population, intervention, comparison, outcome, and study design). Screening (i.e., titles and abstracts) of studies identified by the search strategy will be selected using Rayyan (http://rayyan.qcri.org). The quality assessment will be performed using the "Assessment of Multiple Systematic Reviews" (AMSTAR-2) tool. Systematic Review Registration: PROSPERO, CRD42022367209.

Biofeedback interventions for short term upper limb function following stroke: A systematic review with meta-analysis.

BACKGROUND: Biofeedback has been used by rehabilitation professionals in the treatment of poststroke function impairments. PURPOSE: Investigate the efficacy of any type of biofeedback intervention for the treatment of upper limb function in individuals following stroke. STUDY DESIGN: Systematic review of literature with meta-analysis. METHODS: Literature searches were conducted using MESH terms and text words in PubMed, Lilacs, Scielo, Scopus, PEDro, and Web of Science databases. The main outcome was improvement in upper limb's motor function and motor function in activities of daily living. We calculated the Mean Difference and Standardized Mean Difference for the assessment scales reported as primary outcome. The methodological quality of included studies was assessed using PEDro scale. The overall quality of the evidence was assessed using GRADE system. RESULTS: From 1360 articles identified, 16 were included in the review (09 in the meta-analysis). Three forest plots of hemiparesis and one of hemiplegia showed that biofeedback therapy associated with conventional therapy has a greater improvement in participants upper limb motor function when compared to isolated conventional therapy. Two forest plots of hemiparesis and one of hemiplegia showed no superiority in participants improvement for biofeedback associated with conventional therapy when compared to isolated conventional therapy. CONCLUSION: Biofeedback therapy associated with conventional therapy showed a small clinical effect when associated to conventional therapy and very low quality of evidence. Although further research with higher quality evidence is needed.

Muscle strength in Brazilian firefighters with non-specific chronic low back pain: A cross-sectional study.

BACKGROUND: Imbalance between flexor and extensor muscles of the trunk could negatively influence spinal stability. OBJECTIVES: Investigate the strength balance between flexor and extensor muscles of the trunk in military firefighters with non-specific chronic low back pain (NSCLBP). METHODS: One hundred and two male firefighters were assessed in an isokinetic dynamometer at 120°/s and 60°/s to investigate the balance ratio between flexor and extensor (F/E) muscles. RESULTS: An F/E ratio of 0.72 (SD: 0.22; 95% CI: 0.67-0.76; SEM: 0.02) was observed at 60°/s and 0.94 (SD: 0.41; 95% CI: 0.85-1.03; SEM: 0.04) at 120°/s. The mean peak torque of the extensor muscles was 343.1 N.m/Kg (SD: 94.87; 95% CI: 322.8-363.5; SEM: 10.23) at 60°/s and 270.5 N.m/Kg (SD: 113; 95% CI 246.3-294.8; SEM: 12.18) at 120°/s. The mean peak torque of the flexor muscles was 232.4 N.m/Kg (SD: 53.86; 95% CI 220.8-243.9; SEM: 5.81) at 60°/s and 223.8 N.m/Kg (SD: 66.34; 95% CI 209.6-238.1; SEM: 7.15) at 120°/s. All torques generated by the extensor muscles were higher than the flexor muscles (p < 0.05). CONCLUSIONS: Firefighters with NSCLBP presented a normal F/E balance ratio and higher strength of extensor muscles of the trunk.

Effects of Plyometric Jump Training in Sand or Rigid Surface on Jump-Related Biomechanical Variables and Physical Fitness in Female Volleyball Players.

BACKGROUND: This study aims to assess the effects of 8 weeks of plyometric jump training (PJT) conducted on sand or a rigid court surface on jump-related biomechanical variables and physical fitness in female indoor volleyball players. METHODS: Seventeen participants were randomly divided into a sand surface group (SsG, n = 8) and rigid surface group (RsG, n = 9). Both groups completed equal indoor volleyball training routines. Participants were assessed pre and post the 8-week PJT for jump-related biomechanical variables (countermovement jump (CMJ) RSI; drop jump (DJ) reactive strength index (RSI); spike jump (SJ) height; CMJ height; CMJ rate of force development (RFD); CMJ velocity at take-off; DJ height and CMJ peak force), 20 m linear sprint time, t test for change-of-direction sprint (CODs) time, Wingate test peak power (PP), cardiorespiratory endurance, and leg-press one-repetition maximum (1RM). RESULTS: A two-way mixed analysis of variance (group × time) revealed that there was a significant group × time interaction between DJ height (p = 0.035) and CMJ peak force (p = 0.032) in favour of RsG and SsG, respectively. A significant interaction was also observed for cardiorespiratory endurance (p = 0.01) and 1RM (p = 0.002), both favouring the SsG. No other group × time interaction was observed. CONCLUSIONS: The type of surface used during PJT induced specific adaptations in terms of jump-related biomechanical variables and physical fitness in female indoor volleyball players. Based on the individual needs of the athletes, practitioners may prescribe one type of surface preferentially over another to maximize the benefits derived from PJT.

Exercise interventions can improve muscle strength, endurance, and electrical activity of lumbar extensors in individuals with non-specific low back pain: a systematic review with meta-analysis.

Exercise interventions have been recommended for people with non-specific low back pain. The literature is scarce regarding the effects of exercise on muscle strength, endurance, and electrical activity of lumbar extensor muscles. Electronic searches were carried out from May 2020 until August 2020 in the following databases: PUBMED, CENTRAL, EMBASE, PEDro, SPORTDiscus, Scielo, and LILACS. Only randomized controlled trials with passive and active control groups were included. The methodological quality of the included studies was performed using the Physiotherapy Evidence Database Scale. Eight studies, involving 508 participants, were included in metanalytical procedures. Exercise interventions demonstrated superior effects on muscle activity (Electromyography) when compared with active controls (p < 0.0001). Exercise interventions demonstrated superior effects on muscle endurance (Sorensen Test) when compared with passive (p = 0.0340) and active controls (p = 0.0276). Exercise interventions demonstrated superior effects on muscle strength (Machine) when compared with passive controls (p = 0.0092). Exercise interventions can improve muscle strength, endurance, and electrical activity in people with non-specific low back pain.

Predictive factors of functional mobility in older women after 12 weeks of resistance training / Fatores preditivos da mobilidade funcional em idosas após 12 semanas de treinamento resistido

OBJECTIVE: To analyze the association between functional mobility, anthropometric and functional characteristics of older women after 12 weeks of resistance training. METHODS: This is a quasi-experimental descriptive study with a multiple linear regression analysis. A significance level of 0.05 was adopted. Forty-seven community-dwelling older women underwent 12 weeks of supervised resistance training twice a week. The dependent variable (mobility measured by the Timed Up and Go test) and the independent variables (age, body mass index, fat-free mass of the lower limbs, waist circumference, peak knee torque at 60º/s, peak knee torque at 180º/s, functional reach test, and 30-second chair stand test) were measured before and after the intervention. RESULTS: A multivariate analysis showed that age, body mass index, waist circumference, and the 30-second stand test predicted 30% (R2 = 0.30; p = 0.001; F = 5.53) of the total variance regarding an improvement in mobility after resistance training (p < 0.0001; [95% CI 0.72­1.20]; the effect size was considered large [0.90]) when comparing women before and after the intervention. CONCLUSIONS: Age, body mass index, waist circumference, and the 30-second stand test predicted 30% of the increase in functional mobility.

OBJETIVO: Analisar a associação entre mobilidade funcional, variáveis antropométricas e funcionais de mulheres idosas após 12 semanas de treinamento resistido. METODOLOGIA: Este é um estudo descritivo quase experimental com múltipla análise de regressão linear. Foi adotado nível de significância de 0,05. Quarenta e sete idosas residentes na comunidade foram submetidas a 12 semanas de treinamento resistido supervisionado, duas vezes por semana. A variável dependente (mobilidade mensurada pelo teste Timed Up and Go) e as variáveis independentes (idade, índice de massa corporal, massa livre de gordura dos membros inferiores, circunferência da cintura, pico de torque do joelho a 60º/s, pico de torque do joelho a 180º/s, teste de alcance funcional e teste de sentar e levantar por 30 segundo na cadeira) foram medidas antes e depois da intervenção. RESULTADOS: A análise multivariada mostrou que a idade, o índice de massa corporal, a circunferência da cintura e o teste de sentar e levantar previram 30% (R2 = 0,30; p = 0,001; F = 5,53) da variância total na melhora da mobilidade após o treinamento de resistência (p < 0,0001 [95% intervalo de confiança [CI], 0,72-1,20]; o tamanho do efeito foi considerado grande [0,90]) antes e depois da intervenção. CONCLUSÕES: Idade, índice de massa corporal, circunferência da cintura e teste de sentar e levantar predizem 30% de aumento da mobilidade funcional.