Risk factors for running-related injuries: An umbrella systematic review.

PURPOSE: This umbrella systematic review of systematic reviews and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-related injuries (RRIs). METHODS: Systematic searches were conducted on June 28, 2023 across Web of Science, SPORTDiscus, Scopus, PubMed, and Cochrane Library. We included systematic reviews (SRs), whether accompanied by meta-analyses or not, that focused on investigating risk factors for running-related injuries within observational studies. The methodological quality of the SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews II (AMSTAR 2). To assess the extent of overlap across reviews, the Corrected Covered Area metric was calculated. RESULTS: From 1509 records retrieved, 13 SRs were included. The degree of overlap between SRs was low (4%) and quality varied from "critically low" (n = 8) to "low" (n = 5). Two hundred and seven outcomes assessed in 148 primary studies were identified as being associated with the occurrence of RRIs. The effect sizes of the associations for which risk measures were reported (n = 131) were classified as large (n = 30, 23%), medium (n = 38, 29%), small (n = 48, 37%) or no effect (n = 15, 11%). Running/training characteristics, health and lifestyle factors, along with morphological and biomechanical aspects, exhibit large effect sizes in increasing the risk for RRIs. CONCLUSIONS: Drawing from the outcomes of the low-quality SRs and associations with large effect sizes, our findings indicate that running/training characteristics, health and lifestyle factors, as well as morphological and biomechanical aspects, are all implicated in elevating the risk of RRIs, emphasizing the multifactorial basis of injury incidence in running. Given the low quality and heterogeneity of SR, individual findings warrant cautious interpretation.

Are visual assessments of the single-leg squat valid to be used in clinical practice? A systematic review of measurement properties based on the COSMIN guideline.

OBJECTIVE: Evaluate the discriminative and convergent validity of visual scales for the assessment of movement quality in the single-leg squat. METHODS: Searches performed in CINAHL, Cochrane, Embase, PubMed, SPORTDiscus and Web of Science databases. Studies evaluating discriminative and convergent validity of movement quality visual assessments in single-leg squats were included. The COSMIN risk of bias checklist was used to assess the risk of bias, and certainty of evidence was assessed by the GRADE modified version. RESULTS: Ten studies evaluating three different methods of visual assessment of the single-leg squat (Crossley scale; Whatman score and Medial knee displacement) were included. Very low certainty evidence suggests that the Crossley scale had sufficient discriminative validity for patient-centred outcomes. Very low to moderate certainty evidence suggests that the three visual methods of assessment of the single-leg squat had insufficient discriminative validity for surrogate outcomes and groups. None of the three methods had the convergent validity assessed. CONCLUSION: The Crossley scale exhibited sufficient discriminative validity for patient-centred outcomes, although the evidence supporting this conclusion is of very low certainty. Visual scales for the assessment of the single-leg squat movement quality should be used with caution in clinical practice as most methods had insufficient discriminative validity and no reports of convergent validity.

Desempenho no teste FMS® em mulheres e homens praticantes de exercício resistido / FMS® performance of women and men practicing resistance training

Introdução: Os exercícios resistidos (ER) compõem o programa de condicionamento físico de um grande número de indivíduos. Nesses programas são realizadas avaliações periódicas para planejamento e acompanhamento dos efeitos do treinamento. Recentemente, além das avaliações físicas tradicionais tem sido recomendada a inclusão de testes funcionais para avaliação do padrão de movimento dos indivíduos. Objetivo: Avaliar o desempenho funcional de mulheres e homens praticantes de ER. Métodos: Cinquenta e sete participantes (27 mulheres, 26,2 ± 5,1 anos; e 30 homens, 26,3 ± 5,8 anos) fisicamente ativos e experientes na prática de ER foram avaliados através da bateria de testes Functional Movement Screen (FMS®). O escore total foi comparado entre os sexos através do teste U de Mann-Whitney; já a distribuição dos escores parciais (escores de cada teste) e a proporção de escores assimétricos entre os grupos foram realizadas através do teste do Qui-Quadrado (p < 0,05). Resultados: O escore total das mulheres foi 14,6 ± 1,5 pontos, e o dos homens, 15,3 ± 1,4 pontos, de modo que não houve diferença significativa entre os grupos. Considerando os escores parciais, os homens apresentaram melhor desempenho no teste de estabilidade de tronco (p = 0,001) e de agachamento (p = 0,024), enquanto as mulheres apresentaram melhor desempenho no teste de mobilidade de ombros (p = 0,001). Neste último, além de apresentarem piores resultados, os homens foram significativamente mais assimétricos (p = 0,002). Conclusões: Os resultados deste estudo sugerem a necessidade de uma observação mais detalhada dos escores parciais para o planejamento de programas de treinamento personalizados, que atendam às necessidades de cada indivíduo.

Introduction: Resistance training (RT) is part of the physical fitness program of a large number of people. In these programs, periodic evaluations are carried out to plan and monitor the effects of training. Recently, in addition to the traditional physical evaluations, it has been recommended the inclusion of functional tests to evaluate the movement pattern of individuals. Objective: To assess the functional performance of women and men participating of RT. Methods: Fifty-seven participants (27 women, 26.2 ± 5.1 years old; and 30 men, 26.3 ± 5.8 years old), who are physically active and experienced in RT, were assessed through the use of Functional Movement Screen (FMS®). The total score was compared between the genders using the Mann-Whitney U test, and the distribution of the partial scores (scores of individual tests) and the proportion of asymmetric scores between groups was performed through the Chi-Square test (p < 0.05). Results: Women and men presented, respectively, a total score of 14.6 ± 1.5 and 15.3 ± 1.4 points, and there was no significant difference between genders. Considering the partial scores, men performed better in the trunk stability (p = 0.001) and deep squat (p = 0.024) tests, while women presented higher scores in the shoulder mobility test (p = 0.001). In the latter, besides presenting worse results, men were significantly more asymmetrical (p = 0.002). Conclusions: The results of this study suggest the necessity of a more detailed observation of the partial scores in order to plan personalized training programs that consider the participants' individual needs.

Effect of land- and aquatic-based plyometrics on spike and block reaches in young volleyball players: a pilot study

Abstract Aim: The purpose of this pilot study was to analyze the feasibility of the intervention and measures of a six-week land- and aquatic-based plyometric training on spike and block reaches in young volleyball athletes. Methods: Twelve female players were divided into a land group (LG) (n = 6, 12.4 ± 0.3 years, 1.61 ± 0.04 m, 57.0 ± 9.3 kg) and a water group (WG) (n = 6, 12.5 ± 0.5 years, 1.57 ± 0.06 m, 48.9 ± 8.5 kg). The spike and block (without step, with slide step, and with crossover step) reach and countermovement jump height were evaluated before and after a 6-week plyometric training protocol. Duration (total and of each session), adhesion and adherence, and safeness of the intervention; completion of assessments, within-trial reliability, and variability of the outcome measures and preliminary results were the variables of interest. To analyze the effect of the training on jump performance, the Wilcoxon test was used (p < 0.05), and effect sizes (r) were calculated. Results: All participants concluded the intervention and the assessments as planned. No dropouts or adverse events were registered during the study. The within-trial reliability for all assessment tests was considered excellent (ICC ≥ 0.9). Preliminary results indicate that LG improved the reach of the spike and block with the slide step; and that WG improved the spike, block with the slide step to the left, and block without movement reaches (p < 0.05; large effect size). Conclusion: An intervention of six weeks of plyometric training on land and in water is feasible, and preliminary results indicate that both training protocols may benefit the performance of spike and block in young volleyball athletes.

Differences in hip torque ratios between individuals with femoroacetabular impingement syndrome and asymptomatic individuals: A cross-sectional study.

BACKGROUND: Hip torque ratios are considered a useful measure for patients with hip pain. However, evidence regarding this measure for patients with femoroacetabular impingement syndrome is scarce. The primary aim of this study was to compare hip external-internal rotation and abduction-adduction torque ratios between patients with femoroacetabular impingement syndrome and asymptomatic individuals. The secondary aim was to compare hip torque ratios between the asymptomatic group and femoroacetabular impingement syndrome patients grouped according to the severity of symptoms and functional limitations. METHODS: Hip abduction-adduction and external-internal rotation torque ratios of 134 individuals with femoroacetabular impingement syndrome and 134 asymptomatic matched controls was assessed through isokinetic testing. Severity of symptoms and functional limitations was assessed through the iHOT-33. Mann Whitney U and Kruskall-Wallis tests were used to compare hip torque ratios between asymptomatic individuals and patients with femoroacetabular impingement syndrome and to patients with femoroacetabular impingement syndrome with different severities of symptoms and functional limitations. FINDINGS: No differences were identified in hip abduction-adduction (U = 7659.5, p = 0.192) and external-internal rotation (U = 8787.5, p = 0.764) torque ratios between patients with femoroacetabular impingement syndrome and asymptomatic individuals. Hip abduction-adduction torque ratio was higher (p = 0.0127) in patients with a severe state (median = 1.80, IQR = 0.61) when compared to asymptomatic individuals (median = 1.52, IQR = 0.45) (moderate effect size, r = 0.45). INTERPRETATION: Patients with severe symptoms and functional limitations related to FAI syndrome presented greater hip abduction-adduction torque ratio than asymptomatic individuals, suggesting a decreased adduction torque capacity relative to abduction torque in this subgroup of femoroacetabular impingement.

The Effect of Aquatic Plyometric Training on Jump Performance Including a Four-week Follow-up in Youth Female Volleyball Players.

This study aimed to analyze the effect of aquatic plyometric training (APT) on jump performance in volleyball players. Twelve female athletes (16.6 ± 0.9 years) were assessed through the following jump tests: spike height (SH), squat jump (SJ), countermovement jump (CMJ) and CMJ with an arm swing (CMJA). Jump height in each test and the eccentric utilization ratio (EUR) were the outcome measures. APT consisted of sets of drop jumps for 6 weeks (2 sessions/week) at a water depth of 0.75 m. Tests were performed at the beginning of a five-week pre-season period, before and after APT, and four weeks later for the follow-up. Repeated measures ANOVAs were used to analyze data and Hedges' g to estimate effect size (ES). Performance of all jumps did not change from baseline to Pre-APT. Performance improved in SH (p < 0.001, ES: 1.09), the SJ (p = 0.045, ES: 0.76) and the CMJA (p < 0.001, ES: 0.78) after APT when compared to Pre-APT. No changes were observed after the follow-up period. In conclusion, including six weeks of APT in the training routine of youth volleyball players improved performance of a sport-specific task (SH), the SJ and CMJA, with gains preserved after a four-week follow-up.

Comparison between side-lying and standing positions for hip abductor strength assessment.

BACKGROUND: The hip abductor muscles control the pelvis in the frontal plane and allow the maintenance of trunk position and dynamic balance during weight-bearing activities. OBJECTIVE: To compare the side-lying and standing positions for hip abductor strength assessment with regards to torque production and myolectric activity. METHOD: Concentric and eccentric hip abductor peak torque and total work, and myoelectric activity of the tensor fascia lata, gluteus medius, and inferior and superior portions of the gluteus maximus muscles were measured during maximal isokinetic tests for hip abductor strength in the side-lying and standing positions. The Wilcoxon test was used to compare variables between the positions. RESULTS: Peak torque values did not differ between side-lying and standing positions for both concentric and eccentric contraction modes (p > .05). During standing position, greater concentric total work was observed (p = .013). This position resulted in a lower activity of the tensor fascia lata muscle (p = .005) compared to side lying position. Myoelectric activity of gluteus medius, and inferior and superior portions of the gluteus maximus was similar between positions (p > .05). CONCLUSION: Both positions presented similar peak torque values and, during the standing position, a greater concentric total work and lesser activation of the tensor fascia lata was observed. Standing position can be used when emphasis on the superior portion of gluteus maximus over the tensor fascia lata is intended.

Do Individuals with History of Patellofemoral Pain Walk and Squat Similarly to Healthy Controls? A 3D Kinematic Analysis During Pain Remission Phase.

BACKGROUND: Patellofemoral pain (PFP) is typically accompanied by changes in movement pattern. However, it is unclear if these changes persist in the remission phase of symptoms. Investigating movement patterns in individuals in remission phase of PFP may help to further guide the rehabilitation process and to understand whether changes are due to high levels of pain or related to other factors. PURPOSE: To compare 3D kinematics during walking and the single leg squat (SLS) between individuals with history of PFP in remission phase and a control group without history of lower limb injuries and PFP. STUDY DESIGN: Cross-sectional case-control study. METHODS: Individuals with onset of PFP for at least one year and in phase of remission of symptoms (experimental group [EG]; n=13, 30±8 years) were compared to a control group (CG, n=13, 28±7 years). A 10-camera motion analysis system (Vicon-Nexus®) was used to record 3D ankle, knee, hip and trunk angles during walking and SLS. RESULTS: The EG presented less ankle dorsiflexion, knee and hip flexion during the stance phase of walking compared to the CG (p=0.005, large effect size ηp2 = 0.141). During the SLS, no between-group differences were observed for the ankle, knee and hip angles at the peak of knee flexion (p>0.05). A trend for increased trunk range of movement in the EG compared to the CG was observed (p=0.075, medium effect size ηp2 = 0.127). CONCLUSION: The results of this study indicate less movement in the sagittal plane during walking, and a trend towards more movement of the trunk during SLS in the EG compared to the CG. The participants of the EG had minimal symptoms, to the point of not classifying them as pathological. However, the between-group differences suggest that even in the remission phase, kinematic differences persist for some reason and may contribute to the recurring pain in PFP individuals. LEVEL OF EVIDENCE: Level 3.

Tensor fascia latae and gluteal muscles myoelectric responses to increasing levels of hip medial rotation torque.

Medial hip rotation is typically attributed to the tensor fascia latae (TFL) and lateral rotation, to the gluteus maximus. However, experimental studies in cadavers suggest that the TFL lacks a moment arm for medial rotation and that the gluteus maximus may act as hip medial rotator depending on the hip flexion angle. In order to address this contradictory thinking, we measured the myoelectric activity of TFL, gluteus medius and gluteus maximus (superior portion, GMaxS, and inferior portion, GMaxI) for increasing levels of medial rotation torque applied to the hip. To keep frontal and sagittal plane hip joint net torques constant during the experiments, the medial hip rotation torque was changed by displacing standard weights along an aluminum bar device, thereby producing pure medial hip rotation torques. The effect of increasing medial hip rotation torque was investigated for a fully extended hip (0°), and at 45° and 90° of flexion. We found an increase in the myoelectric activity of the TFL (∼90%↑, p = 0.002) at 90° of flexion and of the GMaxS (∼7%↑, p = 0.048) at the extended position with an increase in medial hip torque application (from 0 to 7.4 N.m.). For the GMed (regardless of hip position) and for the 45° position (regardless of muscle), no systematic changes across torque conditions were observed. In contrast to the common clinical assumption and current practice thinking, our results indicate that an increase in TFL activity is required to control for an increase in external torque towards hip medial rotation.

Produção cientifica sobre natação em língua portuguesa: uma análise bibliométrica / Scientific production on swimming in Portuguese language: a bibliometric analysis / Producción científica sobre natación en lengua portuguesa: un análisis bibliométrico

RESUMO O estudo analisou a produção científica sobre natação em língua portuguesa por meio da bibliometria. A busca ocorreu nas bases Scientific Electronic Library Online, Biblioteca Virtual em Saúde e Scopus, desde seu início até setembro de 2022. Duzentos e trinta e dois artigos completos foram incluídos. A produção aumentou consideravelmente nas duas últimas décadas, sendo predominantemente concentrada nas regiões Sudeste e Sul, em periódicos A2 a B2 do Qualis-CAPES 2013-2016. Biomecânica e fisiologia foram as áreas mais estudadas. A maior parte dos estudos é de natureza quantitativa, observacional e transversal, direcionados à população adolescente e atleta. A quantidade e variedade de estudos demonstra o interesse da comunidade científica em investigar aspectos relacionados à natação.

ABSTRACT This study analyzed the scientific production on swimming in Portuguese through bibliometrics. Scientific Electronic Library Online, Biblioteca Virtual em Saúde and Scopus databases were searched from their inception until September 2022. Two hundred and thirty-two studies were included. Scientific production increased considerably in the last two decades, being mainly concentrated in the Southeast and South regions, in journals classified as A2 to B2 in the Qualis-CAPES 2013-2016. Biomechanics and physiology were the most studied areas. Most studies are of a quantitative, observational, and cross-sectional nature, and included adolescent and athlete populations. The quantity and variety of studies demonstrates the interest in investigating aspects related to swimming.

RESUMEN El estudio analizó la producción científica sobre natación en portugués a través de la bibliometría. La búsqueda se realizó en las bases Scientific Electronic Library Online, Biblioteca Virtual em Saúde y Scopus, desde su inicio hasta septiembre de 2022. Se incluyeron 232 artículos completos. La producción aumentó considerablemente en las últimas dos décadas y predomino en las regiones Sudeste y Sur, en las revistas A2 a B2 de Qualis-CAPES 2013-2016. Biomecánica y fisiología fueron las áreas más estudiadas. La mayoría de los estudios son cuantitativos, observacionales y transversales, dirigidos a la población adolescente y deportista. La cantidad y variedad de estudios demuestra el interés de la comunidad científica por investigar aspectos relacionados con la natación.

Activation of the gluteus maximus, gluteus medius and tensor fascia lata muscles during hip internal and external rotation exercises at three hip flexion postures.

BACKGROUND: Hip internal and external rotation exercises are usually performed in clinical practice. However, given the synergies required to stabilize the hip in the frontal plane, it is not clear how the activation of target muscles will differ between the two exercise directions. OBJECTIVE: I) Compare the activation of the upper and lower fibers of gluteus maximus (GMax), gluteus medius (GMed) and tensor fascia lata muscles between the hip internal and external rotation exercises; ii) Compare the maximal isometric force between hip internal and external rotation exercises and; iii) Assess the effect of varying hip flexion angles on muscle activation and maximal isometric force. STUDY DESIGN: A cross sectional study. METHODS: Electromyography and force production of twenty-one participants were measured during maximum isometric hip internal and external rotation in three postures: 0°, 45° and 90° of hip flexion. RESULTS: MANOVA results showed a larger activation of the GMed, tensor fascia lata and upper GMax (p < .001) for hip internal rotation compared to external rotation regardless of hip flexion angle. For the lower GMax, the same was observed when the hip was kept at 90° of flexion. Maximal isometric force during hip external rotation was greater than during hip internal rotation at 0° posture, and lower at 90° posture (p < .001). CONCLUSION: The gluteus and the tensor fascia lata muscles were substantially recruited during the hip internal rotation exercise, and barely recruited during the hip external rotation exercise. Hip flexion influences the myoeletric activity and isometric force production during the internal rotation exercise.

Relationship between passive ankle dorsiflexion range, dynamic ankle dorsiflexion range and lower limb and trunk kinematics during the single-leg squat.

BACKGROUND: Limited passive ankle dorsiflexion range has been associated with increased knee valgus during functional tasks. Increased knee valgus is considered a contributing factor for musculoskeletal disorders in the lower limb. There is conflicting evidence supporting this association. The extent of passive ankle dorsiflexion range is associated with dynamic ankle dorsiflexion range and the way how these variables are related to lower limb or trunk kinematics is unclear. RESEARCH QUESTION: What is the association between passive ankle dorsiflexion range or dynamic ankle dorsiflexion range with shank, thigh, pelvis or trunk movements during the single-leg squat? METHODS: This is a cross-sectional study with a convenience sample. Thirty uninjured participants performed the single-leg squat with their dominant limb. Ankle, shank, thigh, pelvis and trunk 3D kinematics were recorded. Passive ankle dorsiflexion range was assessed through the weight-bearing lunge test and the dynamic ankle dorsiflexion range was defined as the ankle dorsiflexion range of motion in the sagittal plane during the single-leg squat. RESULTS: Greater passive ankle dorsiflexion range was associated with smaller thigh internal rotation (r= -0.38). Greater dynamic ankle dorsiflexion range was associated with smaller trunk flexion (r = 0.59) and pelvis anteversion (r= -0.47). Passive ankle dorsiflexion range and dynamic ankle dorsiflexion range were not associated. SIGNIFICANCE: Greater passive ankle dorsiflexion range seems to be associated with a better lower limb alignment during the single-leg squat, while dynamic ankle dorsiflexion range seems to reflect different lower limb and trunk kinematic strategies.

Muscle activation in pelvic anteversion and retroversion / Ativação muscular durante a anteversão e retroversão pélvica

Abstract Introduction: The inability to maintain good pelvic stability has been attributed to inefficient muscle coordination and deconditioning of the stabilizing muscles. Despite this, little is known about the role of the pelvic muscles in anteversion and retroversion movements. Objective: To compare the neuromuscular activity of the tensor fascia lata, gluteus medius, upper and lower portions of the gluteus maximus, and multifidus in pelvic anteversion and retroversion. Methods: The neuromuscular activity of 17 healthy young adults (aged 25.3 ± 4.6 years) was assessed during five repetitions of the pelvic anteversion and retroversion movements. The Vicon-Nexus system (10 cameras) was used for the kinematic analysis of the pelvis in the sagittal plane (anteversion and retroversion), and the TeleMyo DTS Desk Receiver electromyograph and the Myomuscle v. 3.8 software to measure neuromuscular activity. The paired samples t-test was used to compare muscle activity between pelvic anteversion and retroversion movements using the Statistica v.8 software with a significance level of p < 0.05. Results: The comparison of the movements showed greater muscle activity in the inferior gluteus maximus in retroversion and greater activity in the multifidus in pelvic anteversion. The upper portion of the gluteus maximus showed relevant activation in both movements. Conclusion: There was more pronounced activity of the lower portion of the gluteus maximus in retroversion, while the upper gluteus maximus showed relevant activation level in both movements. The multifidi were more active in retroversion.

Resumo Introdução: A incapacidade de manter uma boa estabilidade pélvica tem sido atribuída à coordenação muscular ineficiente e ao descondicionamento dos músculos estabilizadores. Apesar disso, pouco se sabe sobre a função dos músculos pélvicos nos movimentos de anteversão e retroversão. Objetivo: Comparar a atividade neuromuscular do tensor da fáscia lata, glúteo médio, porções inferior e superior do glúteo máximo e multífidos durante a anteversão e retroversão pélvica. Métodos: A atividade neuromuscular de 17 adultos jovens saudáveis (25,3 ± 4,6 anos) foi avaliada durante cinco repetições dos movimentos de anteversão e retroversão pélvica. Utilizou-se o sistema Vicon-Nexus (10 câmeras) para a análise cinemática da pelve no plano sagital (anteversão e retroversão), e o eletromiógrafo TeleMyo DTS Desk Receiver e o software MyoMuscle v. 3.8 para mensurar a atividade neuromuscular. Testes t pareados foram conduzidos para comparar a atividade muscular entre os movimentos de anteversão e retroversão pélvica, utilizando-se o software Statistica v.8 com nível de significância de p < 0,05. Resultados: Quando comparados os movimentos, maior atividade muscular foi observada para o glúteo máximo inferior durante a retroversão e maior atividade para os multífidos durante a anteversão pélvica. A porção superior do glúteo máximo apresentou ativação relevante em ambos os movimentos. Conclusão: Houve atividade mais pronunciada da porção inferior do glúteo máximo na retroversão enquanto o glúteo máximo superior apresentou nível relevante de ativação em ambos os movimentos; os multífidos se mostraram mais ativos na retroversão.

Volume of water added to crushed ice affects the efficacy of cryotherapy: a randomised, single-blind, crossover trial.

OBJECTIVE: To compare the effects of different cryotherapeutic preparations. DESIGN: Randomised, single-blind, crossover trial. SETTING: University laboratory. PARTICIPANTS: Sixteen healthy women. INTERVENTIONS: Participants were randomised to receive three cryotherapeutic preparations: pure ice (500g), watered ice (500g of ice in 500ml of water) and wetted ice (500g of ice in 50ml of water). MAIN OUTCOME MEASURES: The primary outcome was skin surface temperature after cryotherapy, measured at the central point of application, and the minimum temperature of the region of interest (ROI). The secondary outcome was the surface area cooled to <13.6°C, which is the recommended temperature to achieve therapeutic effects. RESULTS: After application of ice, mean skin surface temperature at the central point was 4.6 [standard deviation (SD) 1.9] °C for the pure ice preparation, 4.9 (SD 2.5) °C for the wetted ice preparation, and 9.6 (SD 1.8) °C for the watered ice preparation. When compared with the watered ice preparation, this represented a mean difference (MD) of 5.0°C for the pure ice preparation [95% confidence interval (CI) 4.0 to 6.0; P<0.001] and an MD of 4.7°C for the wetted ice preparation (95% CI 2.5 to 6.8; P<0.001). The minimum temperatures in the ROI were also lower for the pure ice preparation 3.0 (SD 0.9) °C and the wetted ice preparation 2.8 (SD 0.6) °C than the watered ice preparation 7.9 (SD 1.5) °C. This represented an MD of 4.8°C for the pure ice preparation (95% CI 4.0 to 5.7; P<0.001) and 5.1°C for the wetted ice preparation (95% CI 4.0 to 6.2; P<0.001]. CONCLUSIONS: Application of pure ice or wetted ice led to a greater decrease in skin surface temperature compared with watered ice. For clinical purposes, combining equal parts of water and ice could decrease this effect. CLINICAL TRIAL REGISTRATION NUMBER: Clinicaltrials.gov (NCT03414346).

Isokinetic hip muscle strength: a systematic review of normative data.

The aim of this study was to conduct a systematic review to determine the quality of evidence of studies assessing isokinetic hip muscle strength in adult non-injured individuals. We also aimed to summarise and pool data of normative values for hip muscle strength. The influence of methodological and participant-related factors on hip strength performance was explored as well. Guidelines proposed in the PRISMA were used to undertake a search strategy involving the keyword 'hip' associated with a set of keywords reflecting muscle strength. Five databases were searched: ProQuest, PubMed, Science Direct, Scopus and Web of Science. From the 2,939 records initially retained, 28 articles were included in this systematic review. Eight articles were classified as high quality. This systematic review exposed the methodological fragility of most studies assessing hip strength in non-injured adult population. Only data from studies with a small number of participants are available to be used as reference. A few individual studies suggest no differences in torque parameters between dominant and non-dominant lower limbs; differences in torque parameters between age groups; and between male and female participants. Overall, reference values for hip muscle performance in isokinetic tests are mostly unclear.

Trunk muscular endurance, lumbar spine mobility and hip flexibility in sailors with and without low back pain / Análise da resistência muscular do tronco, mobilidade da coluna lombar e flexibilidade do quadril em velejadores com e sem dor lombar

Abstract Introduction: Low back pain is one of the most common injuries in sailors. Findings in the literature indicate that poor trunk endurance, flexibility and muscle strength are common in individuals with low back pain (LBP). Objective: Analyze trunk muscle endurance, lumbar spine mobility and hip flexibility in windsurfers with and without low back pain. Method: Sailors of both sexes with at least three years' experience in the sport answered the Nordic Musculoskeletal Questionnaire and were submitted to Schober's test, the passive straight leg raise (PSLR), the modified Thomas test, and isometric endurance assessment of the flexor, extensor and lateral flexor muscles of the torso. The sailors were divided into two groups (with and without LBP) and compared using the Student's t-test or Mann Whitney U test. Results: Participants were 22 national-level sailors, 11 with low back pain (LBP) and 11 without (NLBP). The LBP group obtained longer holding times for the trunk extensors (p=0.028) and a greater difference in endurance between the right and left sides for lateral trunk muscles (p=0.030). Both groups obtained results below normative values in most of the tests performed. Conclusion: Sailors with low back pain exhibited greater trunk extensor endurance and a larger imbalance between lateral trunk muscles when compared to those with no LBP. Spinal mobility and hip flexibility were similar between groups.

Resumo Introdução: A dor lombar é uma das lesões que mais afeta os velejadores. Achados na literatura mostram que a deficiência de força do tronco, flexibilidade e resistência muscular é comum em indivíduos com dor lombar. Objetivo: Analisar a resistência muscular do tronco, a mobilidade da coluna lombar e a flexibilidade do quadril em velejadores com e sem dor lombar. Método: Velejadores de ambos os sexos e com no mínimo três anos de prática responderam ao questionário nórdico de lesões osteomusculares e realizaram os testes de Schöber, de Elevação Passiva da Perna Estendida, de Thomas Modificado e de resistência isométrica dos músculos flexores, extensores e laterais do tronco. Os velejadores foram divididos em dois grupos (com e sem dor lombar), comparados por meio do teste t de Student para amostras independentes ou U de Mann Whitney. Resultados: 22 velejadores de nível nacional, 11 com dor lombar (CDL) e 11 sem dor lombar (SDL), participaram do estudo. O grupo CDL apresentou maior tempo de permanência no teste de resistência dos extensores do tronco (p=0,028) e maior diferença entre os lados direito e esquerdo no teste de resistência dos músculos laterais do tronco (p=0,030). Na maioria dos testes realizados, os dois grupos apresentaram resultados abaixo dos valores normativos. Conclusão: Velejadores com dor lombar apresentaram maior resistência dos extensores do tronco, porém maior desequilíbrio entre as cadeias laterais do tronco, em comparação a velejadores sem dor lombar. A mobilidade da coluna e a flexibilidade do quadril foram semelhantes entre os grupos.

Hip morphology and its relationship with hip strength, mobility and lower limb biomechanics: a systematic review in adults / Relação da morfologia do quadril com força, mobilidade e biomecânica dos membros inferiores: uma revisão sistemática em adultos

Abstract This systematic review (PROSPERO registration n.43640) aimed to summarise and determine the quality of evidence relating hip bone morphology to (i) hip strength, (ii) mobility and (iii) lower limb biomechanics during functional activities. A standardized search on MEDLINE/PubMed, Web of Science, ScienceDirect and Scopus resulted in 17 papers that met inclusion criteria: i) original investigations with a minimal sample of n=10, ii) studies on humans and iii) presence of at least one quantitative hip morphological parameter and one hip functional (i.e. strength and mobility) and/or one lower limb biomechanical parameter. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool with adaptations. Sixteen out of the 17 included studies showed high risk of bias. We observed that primary evidence pointed to the influence of hip morphology on hip mobility in the transverse plane. Specifically, positive correlations between femoral anteversion angle and range of internal hip rotation in physical examination were observed. Regarding biomechanical parameters, no clear evidence of association between hip morphology, and kinematic and kinetic parameters were found. Our results point to a field that is currently under explored and future studies with low risk of bias addressing these relationships are required.

Resumo Essa revisão sistemática (PROSPERO registro no 43640) tem por objetivo sintetizar e determinar a qualidade da evidência que relaciona morfologia do quadril à (i) força do quadril, (ii) mobilidade e (iii) biomecânica dos membros inferiores durante atividades funcionais. Uma busca padronizada no MEDLINE/PubMed, Web of Science, ScienceDirect e Scopus resultou em 17 artigos em acordo com os critérios de inclusão: i) estudos originais com amostra mínima de n=10; ii) estudos em humanos e iii) presença de no mínimo um parâmetro quantitativo da morfologia do quadril e um parâmetro funcional do quadril (ex.: mobilidade e força) e/ou um parâmetro biomecânico do membro inferior. A avaliação do risco de viés foi realizada através da ferramenta Quality Assessment of Diagnostic Accuracy Studies (QUADAS) com adaptações. Dezesseis dos 17 estudos incluídos apresentaram alto risco de viés. Observamos que a evidência primária aponta para influência da morfologia do quadril em sua mobilidade no plano transverso. Foram observadas, especificamente, correlações positivas entre o ângulo de anteversão femoral e a mobilidade de rotação interna do quadril durante o exame físico. Em relação aos parâmetros biomecânicos, não foram encontradas evidências claras sobre associação entre morfologia do quadril e parâmetros cinemáticos e cinéticos. Nossos resultados apontam para um campo atualmente subexplorado e investigações futuras com baixo risco de viés que avaliem essas relações são necessárias.

The kinematics of paretic lower limb in aquatic gait with equipment in people with post-stroke hemiparesis.

BACKGROUND: Devices are commonly used in aquatic gait rehabilitation; therefore, investigating the effect of these devices is important. We evaluated the combined use of buoyancy cuffs and ankle weights during aquatic gait on paretic leg kinematics in people with hemiparesis. METHODS: Fifteen adults (58.6 ±â€¯4.8 years) in the chronic phase post-stroke walked on a 4.5 m walkway with underwater immersion at the height of the xiphoid process in five conditions: (1) without equipment; (2) with ankle weights or (3) buoyancy cuffs on both legs; (4) with a buoyancy leg cuff on the non-paretic leg and an ankle weight on the paretic leg; (5) with an ankle weight on the non-paretic leg and a buoyancy leg cuff on the paretic leg. Five trials were performed for each condition for a total of 25 trials and the kinematic data were recorded. Analysis of covariance was used with walking velocity as a covariate to analyze spatiotemporal and angular variables of the paretic leg. FINDINGS: The condition with buoyancy cuff on the paretic leg increased (~20°) the maximum angle of knee flexion in the mid-swing phase compared to that seen with weights on both legs or weight on the paretic leg. Buoyancy cuffs on the paretic leg increased the step length by 5.6 cm. The ankle weights on the paretic leg condition increased the total (6%) and single support (4%) duration compared to that seen with a buoyancy cuff on the paretic leg. INTERPRETATION: Aquatic gait with buoyancy cuffs on both legs or on the paretic leg can modify gait kinematics compared to that with weight on both legs or on the paretic leg. Long term effects of training with those conditions needs further research.