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To optimise the relationship between exercise and sleep quality, the intensity of exercise and its proximity to sleep are key factors to manage. Although low-to-moderate exercises promote sleep quality, late-evening vigorous exercise instead of morning should still be avoided. It potentially impacts the objective and subjective markers of sleep quality. In the present study, we investigated the effects of vigorous morning and evening exercise on objective and subjective sleep features in an ecological context. A total of 13 recreational runners (mean [SD] age 27.7 [7.2] years, four females) performed a 45-60 min run (70% maximal aerobic velocity) either in the MORNING (30 min to 2 h after waking-up) or in the EVENING (2 h to 30 min before sleep). The two exercise conditions were separated by a REST day. After each condition, sleep was objectively assessed using an electroencephalographic headband and subjectively using the Spiegel Sleep Inventory. Compared with REST, both MORNING and EVENING exercise increased the time spent in non-rapid eye movement (NREM, +24.9 min and +22.7 min; p = 0.01, η2 = 0.11, respectively). Longer NREM duration was mainly due to sleep stage 2 extension after both MORNING (+20.8 min) and EVENING (+22.8 min) exercise relative to REST (p = 0.02, η2 = 0.12). No other effect of exercise on either objective or subjective sleep could be observed. Exercise, independently of the time at which it takes place, leads to extended NREM sleep without other effects on sleep quality. Considering the crucial role of exercise in achieving good health, sleep hygiene guidelines should be updated to promote exercise at any time of the day.
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Qualidade do Sono , Sono de Ondas Lentas , Feminino , Humanos , Adulto , Exercício Físico , Sono , Higiene do Sono , Ritmo CircadianoRESUMO
BACKGROUND: Experimental pain during gait has been shown to interfere with learning a new locomotor task. However, very few studies have investigated the impact of clinical pain on motor learning due to the challenges associated with clinical populations. OBJECTIVE: The first objective of this proof-of-concept study was to determine the feasibility to obtain two groups of participants with chronic ankle pathology with or without residual pain while walking. The second objective was to evaluate the impact of clinical musculoskeletal pain on motor learning during gait. METHODS: Participants with chronic isolated ankle pathology were recruited and their personal and clinical characteristics were collected (functional performance, dorsiflexion maximal strength, range of motion). To assess motor acquisition (Day 1) and retention (Day 2), participants performed an adaptation task on two consecutive days that consisted of walking while experiencing a perturbing force applied to the ankle. The level of pain during the task was measured, and participants who reported pain were attributed to the Pain group and participants without pain to the No Pain group. Learning performance was assessed by measuring ankle kinematics (Mean plantarflexion absolute error) and learning strategy was assessed by measuring the Relative timing of error and the tibialis anterior (TA) electromyographic activity. RESULTS: Twenty-five participants took part in the experiment. Eight (32%) were excluded because they could not be included in either the Pain or No Pain group due to the intermittent pain, leaving eight participants in the Pain group and nine in the No Pain group. Both groups were similar in terms of baseline characteristics. Musculoskeletal pain had no influence on learning performance, but the learning strategy were different between the two groups. The No Pain group showed a TA activity reduction before perturbation between the days, while the Pain group did not. CONCLUSION: Some barriers were identified in studying musculoskeletal pain including the high rates of participants' exclusion, leading to a small sample size. However, we showed that it is feasible to investigate clinical pain and motor learning. From the results of this study, musculoskeletal pain has no influence on motor learning performance but influences the learning strategy.
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Dor Musculoesquelética , Adaptação Fisiológica , Marcha , Humanos , Aprendizagem , Dor Musculoesquelética/diagnóstico , CaminhadaRESUMO
STUDY DESIGN: Cross-sectional and longitudinal (exploratory) studies. INTRODUCTION: Rotator cuff (RC) tendinopathy is the most prevalent shoulder diagnosis, and proprioception deficits are often observed in individuals with RC tendinopathy. PURPOSE OF THE STUDY: This study aimed to evaluate upper limb proprioception during a multijoint task in participants with and without RC tendinopathy and to determine if symptoms, functional limitations, and proprioception are improved after a rehabilitation program. METHODS: Twenty participants with and 20 without RC tendinopathy were recruited for the cross-sectional study, and 23 participants with RC tendinopathy were recruited for the longitudinal study. Proprioception was evaluated by an active joint-repositioning task: The upper limb was passively moved to a predetermined position, and the participant was asked to actively replicate the movement. The difference between the predetermined position and the replicated position was measured. The mean errors in positions of lateral, medial, and neutral rotation of the shoulder and the global mean error were reported. In addition to the active-repositioning assessment in the longitudinal study, symptoms and functional limitations were evaluated by the Disability of the Arm Shoulder and Hand questionnaire. RESULTS: Significant deficits in active repositioning (p < .01), independent of the position, were observed in participants with RC tendinopathy compared with controls. The DASH score was improved after rehabilitation intervention (p < .001), and patients with active-repositioning deficits at baseline had reduced repositioning error (p < .05). CONCLUSIONS: Upper limb active joint repositioning was impaired in participants with RC tendinopathy. Symptoms and functional limitations and active joint repositioning in participants with RC tendinopathy and initial deficits were improved after a 6-week global rehabilitation program.
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Terapia por Exercício , Amplitude de Movimento Articular/fisiologia , Manguito Rotador/fisiopatologia , Tendinopatia/fisiopatologia , Tendinopatia/reabilitação , Extremidade Superior/fisiopatologia , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Propriocepção/fisiologia , Recuperação de Função Fisiológica/fisiologia , Articulação do Ombro/fisiopatologia , Resultado do TratamentoRESUMO
BACKGROUND: Loss of power has been demonstrated to have severe functional consequences to perform physical daily living tasks in old age. PURPOSE: This study aimed to assess how moment and velocity were affected for each joint of the lower limbs during squat jumping for older men in comparison with young adults. METHODS: Twenty-one healthy older men (74.5 ± 4.6 years) and 22 young men (21.8 ± 2.8 years) performed maximal squat jumps. Inverse dynamics procedure was used to compute the net joint power, moment and velocity produced at the hip, knee and ankle joints. RESULTS AND DISCUSSION: Vertical jump height of the elderly was 64 % lower than the young adults. The maximal power of the body mass center (P maxbmc ) was 57 % lower in the older population. For the instant at P maxbmc , the vertical ground reaction force and the vertical velocity of the body mass center were 26 % and 35 % less in the older adults than in the young adults, respectively (p < 0.05; ES = -1.64 for vertical ground reaction force; p < 0.05; ES = -1.10). A lower value of the hip (-60 %), knee (-72 %) and ankle (-68 %) joint powers was observed in older adults. This was explained by both lower values of joint moments (-64, -57 and -61 % for the hip, knee and ankle, respectively) and angular velocities (-59, -49 and -52 % for the hip, knee and ankle, respectively). CONCLUSION: This study showed a lower joint power when performing vertical jump. This smaller power resulted from both a lower moment and angular velocity produced at each joint.
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Envelhecimento/fisiologia , Movimento/fisiologia , Adulto , Fatores Etários , Idoso , Articulação do Tornozelo/fisiologia , Fenômenos Biomecânicos , Articulação do Quadril/fisiologia , Humanos , Articulação do Joelho/fisiologia , Masculino , Adulto JovemRESUMO
Little is known about the contralateral asymmetry in inter-joint coordination after anterior cruciate ligament reconstruction (ACL-R) during multi-segmental movements. This study aimed to evaluate inter-joint coordination asymmetry between the injured (IL) and non-injured leg (NIL) in patients after ACL-R during single-leg jumping. 12 male patients having undergone ACL-R (7.3 months post-surgery) and 12 healthy males performed maximal vertical single-leg jumps with the right and left leg. The kinematics of each jump were recorded. The inter-joint coordination between the ankle, knee and hip joints was assessed by computing the continuous relative phase (CRP) and its variability. The effect of the group and leg was tested with a mixed linear model. The CRP and its variability were similar between the dominant and non-dominant leg of the healthy group. By contrast the CRP of the coupling ankle/knee and ankle/hip was smaller (p<0.01) for IL in comparison to NIL in the ACL-R group (-30% and -22% respectively). The CRP variability of the couplings ankle/knee and knee/hip was greater (p<0.05) for IL compared to NIL (+23% and +40% respectively). In conclusion, the jumping strategy assessed through the analysis of inter-joint coordination was still affected in ACL-R patients, which may be a cause of re-injury.
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Reconstrução do Ligamento Cruzado Anterior , Perna (Membro)/fisiopatologia , Adolescente , Adulto , Articulação do Tornozelo/fisiopatologia , Atletas , Traumatismos em Atletas/reabilitação , Traumatismos em Atletas/cirurgia , Fenômenos Biomecânicos , Estudos de Casos e Controles , Articulação do Quadril/fisiopatologia , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Amplitude de Movimento Articular , Adulto JovemRESUMO
BACKGROUND: Running-related injuries (RRI) are common in novice runners. Reducing early training running volume with strengthening activities may improve RRI without impeding running performance. OBJECTIVES: 1. Gather feasibility data for a randomized, controlled trial comparing a strengthening-based program to a conventional running program; 2. Assess RRI; and 3. Assess running performance. METHODS: Seventy-four university students (38 females, 21 ± 2.3 years, 68.2 ± 10.8 kg, BMI: 22.6 ± 2.97), all novice runners, were randomized in two groups, i.e., a strengthening and running group (INT) and a running group (CON). The completed sessions, RRI, dropout, and maximal aerobic speed were recorded through an online application. RESULTS: The INT group had 52.6% attrition, while the CON group had 41.7%. The INT group had 56.6% adherence, while the CON group had 45.7%. The Chi-square test showed no significant difference in RRI incidence across groups (CHI2 = 2.958, p value = 0.08). A two-way ANOVA showed no significant difference in maximal aerobic speed across groups (p = 0.822) or before and after training (p = 0.304). CONCLUSIONS: This pilot study confirmed the feasibility of this randomized, controlled trial with a needed sample size of 194. However, novice runners had greater attrition rates when starting. Based on those limited data, strengthening activities that replaced running volume did not improve RRI or maximal aerobic speed.
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In experiments investigating vertical squat jumping, the HAT segment is typically defined as a line drawn from the hip to some point proximally on the upper body (eg, the neck, the acromion), and the hip joint as the angle between this line and the upper legs (θUL-HAT). In reality, the hip joint is the angle between the pelvis and the upper legs (θUL-pelvis). This study aimed to estimate to what extent hip joint definition affects hip joint work in maximal squat jumping. Moreover, the initial pelvic tilt was manipulated to maximize the difference in hip joint work as a function of hip joint definition. Twenty-two male athletes performed maximum effort squat jumps in three different initial pelvic tilt conditions: backward (pelvisB), neutral (pelvisN), and forward (pelvisF). Hip joint work was calculated by integrating the hip net joint torque with respect to θUL-HAT (WUL-HAT) or with respect to θUL-pelvis (WUL-pelvis). θUL-HAT was greater than θUL-pelvis in all conditions. WUL-HAT overestimated WULpelvis by 33%, 39%, and 49% in conditions pelvisF, pelvisN, and pelvisB, respectively. It was concluded that θUL-pelvis should be measured when the mechanical output of hip extensor muscles is estimated.
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Metabolismo Energético/fisiologia , Articulação do Quadril/fisiologia , Locomoção/fisiologia , Modelos Biológicos , Movimento/fisiologia , Pelve/fisiologia , Esforço Físico/fisiologia , Adulto , Simulação por Computador , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
OBJECTIVES: Knee underloading patterns have been reported mid- and long-term after return to running post-ACLR, but changes in these patterns during the reintroduction to running are unknown. We evaluated knee biomechanics in individuals within 6 months of ACL-R at the start and completion of a reintroduction to running program. DESIGN: Longitudinal laboratory study. SETTING: Three-dimensional running biomechanics during instrumented treadmill running. PARTICIPANTS: 24 participants post-ACL-R with hamstring autograft and 24 healthy, matched controls. MAIN OUTCOME MEASURES: Tibiofemoral joint (TFJ) and patellofemoral joint (PFJ) contact forces, peak knee extension moment and peak knee flexion angle. RESULTS: Significant LIMB∗GROUP interactions (all p < 0.05) but no TIME effects were found. PFJ and TFJ contact forces, peak knee flexion angle and peak knee extensor moment were lower (all p < 0.001) on the injured-limb compared to both contralateral-limb and CONTROL. PFJ and TFJ contact forces and peak knee flexion, knee extension moment were greater (all p < 0.01) on the contralateral-limb of ACL-R compared to CONTROL. There was no change in knee biomechanics after two weeks of the reintroduction to running. CONCLUSIONS: Clinicians should be aware that substantial and persistent knee underloading does not resolve upon reintroduction to running after ACL-R. LEVEL OF EVIDENCE: Longitudinal observational study, level III.
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Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Corrida , Humanos , Lesões do Ligamento Cruzado Anterior/cirurgia , Articulação do Joelho , Extremidade Inferior , Reconstrução do Ligamento Cruzado Anterior/métodos , Fenômenos BiomecânicosRESUMO
Introduction: Trunk muscle endurance (TME) tests are commonly used by clinicians to assess muscle performance changes in response to rehabilitation in patients with low back pain (LBP). The aim of this study was to assess the responsiveness of three TME-tests in patients with LBP and to evaluate the relationships between changes in TME and improvement in self-reported function. Materials and Methods: Eighty-four LBP patients were evaluated at baseline and after completion of a 6-week training program. Function was assessed with the modified Oswestry Disability Index (ODI) while TME was estimated using three tests: (1) the Biering-Sørensen, (2) the side bridge endurance tests (both sides), and (3) the trunk flexor endurance test. The standardized response mean (SRM) and the minimal clinical important difference (MCID) for each TME-test, and the relationships between changes in TME and improvement in ODI were calculated. Results: SRMs were small to large for TME-tests (range: 0.43-0.82), and large for the ODI (2.85) and no clinically useful MCID was identified for the TME-tests (area under the curve below 0.70). No significant correlations were found between changes in the TME and change in ODI scores (r < 0.15; all P > 0.05). Conclusion: Our results show a weak responsiveness of TME-tests in patients with LBP. There was no association between endurance performance change and self-reported functional change. TME-tests may not be a key component of rehabilitation monitoring in patients with LBP.
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PURPOSE: Aim of this study is to evaluate the impact of a non-weight bearing (NWB) protocol within 21 post-operative days after anterior cruciate ligament (ACL) reconstruction on static and dynamic anterior tibial translations (SATT and DATT, respectively). The hypothesis is that delayed WB would improve ATT at 9 months follow-up. METHODS: A series of patients treated with ACL reconstruction was retrospectively reviewed, comparing a group with immediate post-operative weight bearing (WB group) and a group without post-operative weight bearing (NWB group). The NWB protocol was applied to patients with posterior tibial slope (PTS) ≥ 12°, pre-operative SATT ≥ 5 mm, and/or meniscal lesions of root or radial type. SATT, and PTS were measured on 20° flexion monopodal lateral x-rays, while DATT on Telos™ x-rays at pre-operative and 9-months follow-up. RESULTS: One hundred seventy-nine patients were included (50 NWB group, 129 WB group). The SATT worsened in the WB group with a mean increase of 0.7 mm (SD 3.1 mm), while in the NWB group, the SATT improved with a mean decrease of 1.4 mm (SD 3.1 mm) from the pre-operative to 9 months' follow-up (p < 0.001). The side-to-side Telos™ evaluation showed a significant improvement in DATT within both the groups (p < 0.001), but there was no difference between the two groups (p = 0.99). CONCLUSION: The post-operative protocol of 21 days without WB led to an improvement in SATT at 9 months without an influence on DATT, and it is recommended for patients with a SATT ≥ 5 mm and/or a PTS ≥ 12° as part of an "à la carte" approach to ACL reconstruction. LEVEL OF EVIDENCE: Level IV, Retrospective case series.
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OBJECTIVE: To (1) describe return to running (RTR) programs used during rehabilitation after anterior cruciate ligament reconstruction (ACLR); and (2) provide clinical guidelines for RTR program after ACLR. DESIGN: Scoping review. LITERATURE SEARCH: We searched the MEDLINE (Pubmed), EMBASE, Web of Science and PEDro databases. STUDY SELECTION CRITERIA: We included randomized controlled trial (RCT), cases series, meta-analyses, both scoping and systematic reviews including a rehabilitation program after ACLR with a specific RTR program. A "Running program checklist" (RPC) was elaborated based on the Template for Intervention Description and Replication (TIDieR), and on the Consensus on Exercise Reporting Template (CERT) checklist. DATA SYNTHESIS: The percentage and number of studies specifying each of the running program checklist items in their RTR program were reported. Number of items reported in each study and specific analysis item-by-item were also proposed. RESULTS: The "When (2)" item was the most frequently found (92.19%) and, conversely, the "Who (1)" item appeared only in four studies (6.2%). One-third of the studies presented only one item of the RPC, and 48 of the 64 articles discussed less than three items. Two studies described in detail their RTR program by reporting 8 and 9 items out of the 10, respectively. No study presented 10 of the PRC items. CONCLUSION: There is a serious lack of information concerning RTR program following ACLR in the literature and further studies are needed to establish a program based on the best evidence.
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CONTEXT: Return to running (RTR) after anterior cruciate ligament reconstruction (ACLR) is a crucial milestone. However, how and when to start a running program are uncertain. OBJECTIVE: To explore the feasibility of a structured program to reintroduce running after ACLR and evaluate the predictive value of potential predictors of short-term success. DESIGN: Longitudinal cohort study. SETTING: Local research center and participants' homes. PATIENTS OR OTHER PARTICIPANTS: Thirty-five participants were recruited after ACLR. INTERVENTION(S): Program with a progression algorithm to reintroduce running (10 running sessions in 14 days). MAIN OUTCOME MEASURE(S): The criterion for short-term success was no exacerbation of symptoms. Potential predictors were (1) the International Knee Documentation Committee (IKDC) subjective knee form score, (2) ACL Return to Sport after Injury questionnaire score, (3) quadriceps and hamstrings strength, (4) step-down endurance test, and (5) modified Star Excursion Balance test. Descriptive statistics were performed to study the feasibility of the RTR program, and Poisson regression analysis was used to evaluate predictors of success. RESULTS: Of the 34 participants, 33 completed the RTR program. Sixteen participants experienced some temporary exacerbation of symptoms, but only 1 had to stop the program. The initial IKDC score was the only significant predictor of a successful RTR, with an area under the receiver operating characteristic curve of 80.4%. An IKDC cut-off of 63.7/100 differentiated responders and nonresponders with the highest sensitivity and specificity (77.8% and 75.0%, respectively). A participant with an IKDC score above this threshold had a 3-fold greater chance of success. CONCLUSIONS: Our results confirm the feasibility of our RTR program and progression algorithm after ACLR. Clinicians should use an IKDC score of >64 as a criterion to reintroduce running after ACLR to increase the likelihood of short-term success.
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Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Músculos Isquiossurais , Corrida , Lesões do Ligamento Cruzado Anterior/diagnóstico , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Humanos , Articulação do Joelho/cirurgia , Estudos Longitudinais , Volta ao EsporteRESUMO
BACKGROUND: The growing interest of the scientific community in trail running has highlighted the acute effects of practice at the time of these races on isolated aspects of physiological and structural systems; biological, physiological, cognitive, and muscular functions; and the psychological state of athletes. However, no integrative study has been conducted under these conditions with so many participants and monitoring of pre-, per-, and postrace variables for up to 10 days over a distance close to 100 miles. OBJECTIVE: The aim of this study was to evaluate the kinetics of the performance parameters during a 156 km trail run and 6000 m of elevation gain in pre-, per-, and postrace conditions. The general hypothesis is based on significant alterations in the psychological, physiological, mechanical, biological, and cognitive parameters. METHODS: The Trail Scientifique de Clécy took place on November 11, 2021. This prospective experimental study provides a comprehensive exploration of the constraints and adaptations of psychophysiological and sociological variables assessed in real race conditions during a trail running of 156 km on hilly ground and 6000 m of elevation gain (D+). The study protocol allowed for repeatability of study measurements under the same experimental conditions during the race, with the race being divided into 6 identical loops of 26 km and 1000 m D+. Measurements were conducted the day before and the morning of the race, at the end of each lap, after a pit stop, and up to 10 days after the race. A total of 55 participants were included, 43 (78%) men and 12 (22%) women, who were experienced in ultra-trail-running events and with no contraindications to the practice of this sport. RESULTS: The launch of the study was authorized on October 26, 2021, under the trial number 21-0166 after a favorable opinion from the Comité de Protection des Personnes Ouest III (21.09.61/SIRIPH 2G 21.01586.000009). Of the 55 runners enrolled, 41 (75%) completed the race and 14 (25%) dropped out for various reasons, including gastric problems, hypothermia, fatigue, and musculoskeletal injuries. All the measurements for each team were completed in full. The race times (ie, excluding the measurements) ranged from 17.8206 hours for the first runner to 35.9225 hours for the last runner. The average time to complete all measurements for each lap was 64 (SD 3) minutes. CONCLUSIONS: The Trail Scientifique de Clécy, by its protocol, allowed for a multidisciplinary approach to the discipline. This approach will allow for the explanation of the studied parameters in relation to each other and observation of the systems of dependence and independence. The initial results are expected in June 2022. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/38027.
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BACKGROUND: Kinesiotaping (KT) has been widely used in clinical practice. Current evidence is insufficient to support the use of KT for treating rotator cuff-related shoulder pain (RCRSP), as its mid- and long-term effects have not been investigated. HYPOTHESES: Individuals using KT will achieve faster improvements in symptoms and functional limitations compared with those not using it. They will also present a greater increase in pain-free range of motion (ROM) and acromiohumeral distance (AHD) at the end of the treatment. STUDY DESIGN: Randomized controlled trial (NCT02881021). LEVEL OF EVIDENCE: Therapy, level 1b. METHODS: A total of 52 individuals with RCRSP, randomly assigned to 1 of 2 groups (experimental: KT; control: no-KT), underwent a 6-week rehabilitation program composed of 10 physical therapy sessions. KT was added to the treatment of the KT group. Symptoms and functional limitations were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (primary outcome); Brief Pain Inventory (BPI); and Western Ontario Rotator Cuff (WORC) index at baseline, 3 weeks, 6 weeks, 12 weeks, and 6 months. AHD, pain-free ROM, and full ROM were measured at baseline and at week 6. The effects of KT were assessed using a nonparametric analysis for longitudinal data. RESULTS: No significant group × time interactions (0.112 ≤ P ≤ 0.726) were found for all outcomes. Time effects were observed as both groups showed significant improvements for all studied outcomes (DASH, BPI, and WORC, p < 0.0001; AHD, p = 0.017; pain-free ROM, p < 0.0001; and full ROM abduction, p ≤ 0.0001). CONCLUSION: Whereas symptoms, functional limitations, ROM, and AHD improved in both groups, the addition of KT did not lead to superior outcomes compared with exercise-based treatment alone, in the mid and long term, for individuals with RCRSP. CLINICAL RELEVANCE: Clinicians should not expect supplementary mid- or long-term gains with KT to reduce pain, improve shoulder function and ROM, or increase AHD if a rehabilitation program focusing on shoulder neuromuscular control is concurrently provided as treatment for individuals with RCRSP.
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Fita Atlética , Lesões do Manguito Rotador/complicações , Dor de Ombro/etiologia , Dor de Ombro/reabilitação , Terapia por Exercício , Humanos , Amplitude de Movimento Articular , Lesões do Manguito Rotador/reabilitação , Método Simples-CegoRESUMO
BACKGROUND: Explosive movement requires that the individual exerts force and power with appropriate magnitude and timing. These coordination aspects have received less attention despite being a basic prerequisite for daily mobility and physical autonomy, especially in older people. Therefore, the purpose of this study is to characterize the effect of age on inter-joint coordination during explosive movement. METHODS: Twenty-one elderly and twenty young participants performed three maximal vertical jumps, while kinematics were recorded throughout each squat jump. Inter-joint coordination and coordination variability were calculated for selected sagittal hip-knee, knee-ankle, and hip-ankle joint couplings using the continuous relative phase method. RESULTS: The young participants produced significantly greater jump height performance (0.36 ± 0.07 m vs. 0.12 ± 0.04 m, p < 0.001). The mean absolute continuous relative phase for ankle-knee and knee-hip joint couplings were significantly greater for the elderly in comparison to the young group (p < 0.01 for the both). No significant differences between senior and young participants in the mean absolute continuous relative phase for ankle-hip joint couplings (p = 0.25) was observed. However, there was significantly more variability in inter-joint coordination in the elderly marked by greater continuous relative phase variabilities in ankle-knee, ankle-hip and knee-hip joint couplings (p < 0.001) than those observed in young adults. CONCLUSION: In this study, seniors demonstrated proximodistal inter-joint coordination but with different delays in the pattern of inter-joint coordination during squat jumps compared to young adults. In addition, a higher continuous relative phase variability in the elderly may be needed to improve stability or compensate for strength deficits in jump achievement.
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Envelhecimento/fisiologia , Articulações/fisiologia , Fenômenos Mecânicos , Movimento/fisiologia , Idoso , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Adulto JovemRESUMO
BACKGROUND: Kinesiotaping is widely used for the rehabilitation of rotator cuff tendinopathy. It has been argued to reduce symptoms and functional limitations through improvement of proprioceptive feedback. In addition, kinesiotaping has been reported to increase the subacromial space in healthy subjects. However, its effects on the acromiohumeral distance and shoulder proprioception of individuals with rotator cuff tendinopathy have not been ascertained. This study investigated the immediate effects of kinesiotaping on the acromiohumeral distance and shoulder proprioception in individuals with rotator cuff tendinopathy. METHODS: Twenty-two individuals with chronic rotator cuff tendinopathy were included. The acromiohumeral distance was measured using an ultrasound scanner at rest and 60° shoulder abduction. Proprioception was measured through active joint repositioning in low- (45°-65°) and mid-amplitude (80°-100°) of shoulder flexion and abduction. A wireless inertial measurement unit system was used to quantify shoulder angles. First, measurements were taken without kinesiotaping. Thereafter, kinesiotaping was applied on the symptomatic shoulder, and the same measurements were retaken. Repeated measures ANOVAs were used for statistical analyses. FINDINGS: Kinesiotaping induced a significant increase in acromiohumeral distance at 60° abduction (∆AHDâ¯=â¯0.94â¯mm; 95%CI: 0.50-1.38, pâ¯<â¯0.001), exceeding the minimal detectable change (0.70â¯mm). No significant difference was observed in acromiohumeral distance at rest or in proprioception during active joint repositioning in both low- and mid-amplitude (pâ¯>â¯0.05). INTERPRETATION: Kinesiotaping led to an immediate increase in acromiohumeral distance at 60° of abduction that, although it seems a minor change (↑10.5%), it may be significant for symptomatic patients, whereas it had no immediate effect on active joint repositioning.
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Fita Atlética , Lesões do Manguito Rotador/fisiopatologia , Manguito Rotador/fisiopatologia , Ombro/fisiopatologia , Tendinopatia/fisiopatologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Propriocepção , Amplitude de Movimento Articular , Lesões do Manguito Rotador/terapia , Articulação do Ombro/fisiopatologia , Tendinopatia/terapiaRESUMO
BACKGROUND: A return to running after anterior cruciate ligament reconstruction (ACL-R) is critical to the clinical success of any cutting and pivoting athlete who wishes to return to sport. Knowledge of specific alterations during running after ACL-R is required to optimise rehabilitation for improving outcomes and long-term disability. OBJECTIVE: The objective of this systematic review was to summarise kinematic, kinetic and muscle activation data during running after ACL-R and the intrinsic factors (e.g. surgical technique and strength asymmetries) affecting running biomechanics. METHODS: MEDLINE, EMBASE, SPORTDiscus and CINAHL databases were searched from inception to 10 December, 2018. The search identified studies comparing kinematic, kinetic or muscle activation data during running between the involved limb and contralateral or control limbs. Studies analysing the effect of intrinsic factors in the ACL-R group were also included. Risk of bias was assessed, qualitative and quantitative analyses performed, and levels of evidence determined. RESULTS: A total of 1993 papers were identified and 25 were included for analysis. Pooled analyses reported a deficit of knee flexion motion and internal knee extension moment, compared with both contralateral or control limbs, during the stance phase of running from 3 months to 5 years after ACL-R (strong evidence). Inconsistent results were found for both peak vertical ground reaction force and impact forces after ACL-R. Patellofemoral and tibiofemoral joint contact forces differed from both contralateral or control limbs up until at least 2.5 years after ACL-R and moderate evidence indicated no difference for muscle activations during moderate speed running. Quadriceps and hamstring strength asymmetries, and knee function, but not surgical techniques, were likely to be associated with both knee kinematics and kinetics during running after ACL-R. CONCLUSION: After ACL-R, knee flexion motion and internal knee extension moment are the most affected variables and are consistently smaller in the injured limb during running when pooling evidence. Clinicians should be aware that these deficits do not appear to resolve with time and, thus, specific clinical interventions may be needed to reduce long-term disability. SYSTEMATIC REVIEW REGISTRATION: Registered in PROSPERO 2017, CRD42017077130.
Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/reabilitação , Fenômenos Biomecânicos , Corrida/fisiologia , Lesões do Ligamento Cruzado Anterior/fisiopatologia , Músculos Isquiossurais/fisiopatologia , Humanos , Articulação do Joelho/fisiopatologia , Força Muscular , Músculo Quadríceps/fisiopatologia , Amplitude de Movimento ArticularRESUMO
INTRODUCTION: Proprioception is known to be affected after a spinal cord injury (SCI). However, it is currently assessed during simple tasks that do not reflect activities of daily living. To better understand how proprioception affects movement, assessing it during a functional sensorimotor task such as walking is therefore of primary importance. Therefore, the objectives of this study were as follows: (a) measure the protocol reliability of a new robotic test in nondisabled controls; (b) evaluate the effect nonlesion-related factors such as sex, age, pain, and gait speed on ankle proprioception; and (c) assess ankle proprioception during walking in individuals with SCI. METHODS: In the current study, ankle proprioception was assessed during gait in individuals with an incomplete spinal cord injury (iSCI; n = 15) using an electrohydraulic robotized ankle-foot orthosis (rAFO). Ankle proprioceptive threshold was quantified as the participants' ability to detect torque perturbations of varied amplitude applied during swing by the rAFO. In addition, test-retest reliability and the potential effect of nonlesion-related factors (sex, age, pain, and gait speed) were evaluated in nondisabled (ND; n = 65) participants. RESULTS: During gait, individuals with iSCI had a 53% poorer proprioceptive threshold than ND controls (p < .05). Test-retest reliability was good (ICC = 0.78), and only gait speed affected proprioceptive threshold (p = .018). CONCLUSION: This study is the first to show that ankle proprioception assessed during gait is impaired in individuals with an iSCI. The developed test can now be used to better characterize proprioception in population with other neurological conditions and has potential to maximize functional recovery during gait training in those populations.
Assuntos
Tornozelo/fisiopatologia , Marcha , Propriocepção , Traumatismos da Medula Espinal/fisiopatologia , Adulto , Feminino , Órtoses do Pé , Humanos , Masculino , Exame Neurológico/instrumentação , Exame Neurológico/métodos , Robótica/instrumentação , Robótica/métodos , Limiar Sensorial , Traumatismos da Medula Espinal/diagnósticoRESUMO
OBJECTIVES: To compare hip kinematics during two functional tasks in females with and without patellofemoral pain (PFP), and to determine if hip kinematics and, symptoms and functional limitations were improved after a rehabilitation program. DESIGN: Cross sectional and longitudinal. PARTICIPANTS: Sixteen females with and 15 without PFP. SETTING: Laboratory and physical therapy clinic. MAIN OUTCOME MEASURES: Hip adduction (HADD) and medial rotation (HMR) peak angles, time integrals and inter-movement variability during step-down and vertical drop jump, symptoms and functional limitations evaluated using the Activities of Daily Living Scale of the Knee Outcome Survey (KOS-ADLS). RESULTS: At baseline, no significant differences were found in step-down and vertical drop jump between PFP and controls. Following rehabilitation, significant improvements were reported in KOS-ADLS (pâ¯<â¯0.001). There was a significant decrease in HADD and HMR variability (pâ¯<â¯0.05), a trend for decreased peak HMR (pâ¯=â¯0.06) during step-down, and a significant decrease in HADD variability (pâ¯<â¯0.05) during vertical drop jump. These kinematic changes did not correlate with changes in KOS-ADLS (all pâ¯>â¯0.05). CONCLUSION: Females with and without PFP demonstrated no hip kinematic differences during functional tasks. A rehabilitation program improved symptoms and functional status, and modified hip kinematics in females with PFP; however these changes were not correlated.