Influence of upper body stretching exercises on shot put / Influência dos exercícios de alongamento da parte superior do corpo no arremesso de peso / Influencia de los ejercicios de estiramiento de la parte superior del cuerpo en el lanzamiento de peso

ABSTRACT Introduction The technique in the shot put and the ability in the throwing stage are two important factors that determine the ability of athletes. Qualified experts and coaches attach great importance to training and research on the ability of the throwing stage and the ability to throw. Objective Compare gravity load training and single incremental load training through practical means, analyzing the impacts on throwing ability in athletes. Methods The self-assessment method was used to conduct the comparative experiment on different forms of strength training in 20 college students. The experimental scheme adopts the single incremental load strength training, and the control scheme adopts the traditional barbell training. Results : After the experiment, the hand angle of group I was significantly higher than that of group II (P < 0.05); after the experiment, the shoulder angle of group I was significantly higher than that of group II (P < 0.05); after the experiment, the performance of the seated shot placed in group I was significantly higher than that of group II (P < 0.05), and there was no significant difference in the standing performance (P > 0.05). Conclusion Single incremental load training can significantly improve the throwing ability of shot put athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução A técnica no arremesso de peso e a habilidade na etapa de arremessar são dois fatores importantes que determinam a habilidade dos atletas Especialistas e treinadores qualificados atribuem grande importância ao treinamento e pesquisa sobre a habilidade da fase de arremesso e a capacidade de arremessar. Objetivo Comparar o treinamento com carga gravitacional e o treinamento com carga incremental única através de meios experimentais, analisando os impactos na habilidade de arremesso nos atletas. Métodos O método de auto-avaliação foi usado para realizar o experimento comparativo de diferentes formas de treinamento de força em 20 estudantes universitários. O esquema experimental adota o treinamento único de força de carga incremental, e o esquema de controle adota o treinamento tradicional de barra. Resultados : Após o experimento, o ângulo da mão do grupo I foi significativamente maior do que o do grupo II (P < 0,05); após o experimento, o ângulo do ombro do grupo I foi significativamente maior do que o do grupo II (P < 0,05); após o experimento, o desempenho do tiro sentado colocado no grupo I foi significativamente maior do que o do grupo II (P < 0,05), e não houve diferença significativa no desempenho em pé (P > 0,05). Conclusão O treinamento com carga incremental única pode melhorar significativamente a capacidade de arremesso dos atletas de arremesso de peso. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La técnica en el lanzamiento de peso y la habilidad en la fase de lanzamiento son dos factores importantes que determinan la habilidad de los atletas. Los especialistas y entrenadores cualificados atribuyen gran importancia a la formación y a la investigación sobre la habilidad de la fase de lanzamiento y la habilidad de lanzamiento. Objetivo Comparar el entrenamiento con carga gravitacional y el entrenamiento con carga incremental única a través de medios experimentales, analizando los impactos en la capacidad de lanzamiento en los atletas. Métodos Se utilizó el método de autoevaluación para realizar el experimento comparativo de diferentes formas de entrenamiento de fuerza en 20 estudiantes universitarios. El esquema experimental adopta el entrenamiento de fuerza con una sola carga incremental, y el esquema de control adopta el entrenamiento tradicional con barra. Resultados : Después del experimento, el ángulo de la mano del grupo I fue significativamente mayor que el del grupo II (P < 0,05); después del experimento, el ángulo del hombro del grupo I fue significativamente mayor que el del grupo II (P < 0,05); después del experimento, el rendimiento del lanzamiento de peso sentado del grupo I fue significativamente mayor que el del grupo II (P < 0,05), y no hubo diferencias significativas en el rendimiento de pie (P > 0,05). Conclusión El entrenamiento con una sola carga incremental puede mejorar significativamente la capacidad de lanzamiento de los atletas de lanzamiento de peso. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Efeito do oncofitness na amplitude articular de pacientes com câncer de próstata / Efecto del oncofitnessen el rango de movimiento articular de pacientes con cáncer de próstata / Effect of oncofitness in joint amplitude of patients with prostate cancer

RESUMO O objetivo da pesquisa foi avaliar o efeito de um Programa de Exercício Físico Oncológico - ONCOFITNESS na amplitude articular em pacientes com câncer submetidos à radioterapia. O estudo é um tipo de ensaio clínico prospectivo randomizado controlado no qual se compara o efeito e o valor de uma intervenção, com características profiláticas ou terapêuticas, em seres humanos. Os procedimentos consideraram as normas para realização de pesquisas em seres humanos com a aprovação do projeto pelo CEP/Hospital Mário Kröeff. A avaliação da flexibilidade foi realizada seguindo o protocolo LABIFIE, com goniômetro de aço da marca Lafayette® (EUA). O grupo experimental realizou uma intervenção com Oncofitness. Após esse período, foi realizada outra avaliação, seguindo os mesmos procedimentos. A análise estatística foi realizada no programa SPSS (Statistical Package for the Social Sciences) versão 20.0. A amostra foi composta por 30 homens com idade GE (X ̅ = 59,0 ± 2,0 anos) e GC (X ̅ = 60,0 ± 1,0 anos). Os dados revelaram que os ganhos do GE foram observados em: flexão do joelho (∆%=5,0%, p=0,0011x); em abdução do quadril (∆%=15,8%, p=0,003x); em rotação interna (∆%=8,1%, p=0,0129x) e em flexão de ombro, (∆%=8,3%, p=0,0185x). Não foi observado ganho no GC, pode-se verificar que o Oncofitness proporcionou a redução de alguns dos sintomas relacionados aos tratamentos oncológicos devido à melhora da amplitude articular.

RESUMEN El objetivo de la investigación fue evaluar el efecto de un Programa de Ejercicios Físicos Oncológicos - ONCOFITNESS en la amplitud articular en pacientes oncológicos sometidos a radioterapia. El estudio es tipo ensayo clínico controlado randomizado, prospectivo en que compara el efecto y valor de una intervención, con características profilácticas o terapéuticas, en seres humanos. Los procedimientos consideraron las normas para la realización de investigación en seres humanos con la aprobación del proyecto por el CEP/Hospital Mário Kröeff. La evaluación de la flexibilidad fue realizada siguiendo el protocolo del LABIFIE, con un goniómetro de acero da marca Lafayette® (EUA). El grupo experimental realizó una intervención con el Oncofitness. Después de ese periodo, se realizó otra evaluación, siguiendo los mismos procedimientos. El análisis estadístico fue realizado mediante el SPSS (Statistical Package for the Social Sciences) versión 20.0. La muestra fue de 30 hombres con edades GE (X ̅ = 59,0 ± 2,0 años) y GC (X ̅ = 60,0 ± 1,0 años). Los datos revelaron que fueron observadas ganancias GE en: flexión de rodillas (∆%=5,0%, p=0,0011x); en la abducción de cadera (∆%=15,8%, p=0,003x); en la rotación interna (∆%=8,1%, p=0,0129x) y en flexión de hombro, (∆%=8,3%, p=0,0185x). No fue observada ganancia en el GC, se puede verificar que el Oncofitness proporcionó la reducción de algunos de los síntomas relacionados a los tratamientos oncológicos por la mejora de la amplitud articular.

ABSTRACT The research aimed to evaluate the effect of an Oncology Physical Exercises Program - ONCOFITNESS on the joint range of cancer patients undergoing radiotherapy. The study is considered a randomized controlled clinical trial, being prospective in that it compares the effect and value of an intervention, with prophylactic or therapeutic characteristics, in human beings. The procedures met the standards for researching human beings, and the project was approved. CEP/Hospital Mário Kröeff. Flexibility measurement performed following the LABIFIE protocol, with a Lafayette® brand steel goniometer (USA). The experimental group performed an intervention with Oncofitness. After this period, another evaluation was carried out, following the same procedures. Statistical analysis was performed using SPSS (Statistical Package for the Social Sciences) version 20.0. Sample of 30 men aged GE (X ̅ = 59.0 ± 2.0 years) and CG (X ̅ = 60.0 ± 1.0 years). The data revealed that gains were observed in the EG in knee flexion (∆%=5.0%, p=0.0011x); in hip abduction (∆%=15.8%, p=0.003x); in internal rotation (∆%=8.1%, p=0.0129x) and in shoulder flexion, (∆%=8.3%, p=0.0185x). As was not observed in the CG, Oncofitness provided a reduction in some of the symptoms related to oncological treatments by improving joint range of motion.

Effects of ultrasound and stretching on skeletal muscle contusion in rats: immunohistochemistry analysis / Efectos de ultrasonido y estiramiento en la contusión muscular esqueletal en ratas: análisis inmunohistoquímico

SUMMARY: The aim of this study was to evaluate the effects of stretching and therapeutic ultrasound (TUS) on desmin and laminin contents of rat muscle after contusion. Male Wistar rats (n = 35, 8-9 weeks of age, 271 ± 14g body weight) were divided into five groups: Control group (CG) (n= 03); Injured group (IG) (n= 8); Injured + ultrasound group (IUSG) (n= 8); Injured+stretching group (ISG) (n= 8); Injured +ultrasound + stretching group (IUSSG) (n= 8). The application of ultrasound started 72 hours after the contusion, using the 50 % pulsed mode, 0.5 W/cm2, 5 min, once a day, for five consecutive days. Passive manual stretching was started on the tenth day after injury, with four repetitions of 30 s each and 30 s rest between repetitions, once a day, five times per week, for a total of ten applications. After 22 days, the rats were euthanazied and the gastrocnemius of both limbs removed for desmin and laminin immunohistochemistry morphometric measurement. Analysis was conducted using ANOVA one way post-hoc Tukey to parametric data and Kruskall-Wallis for non-parametric data. The IUSSG animals showed a larger area of desmin than ISG (p<0.05). It was found a decrease in laminin comparing IUSG to IG. However, laminin area was higher in ISG than all groups (p<0.05). UST isolated or in combination with stretching influenced gastrocnemius regeneration in different manners. While stretching applied isolated enhanced gastrocnemius regeneration noticed by the increase in laminin area, in combination with TUS strengthened the muscle healing rising desmin area.

RESUMEN: El objetivo de este estudio fue evaluar los efectos del estiramiento y la ecografía en los contenidos de desmina y laminina del músculo de rata después de la lesión. Ratas Wistar macho (n = 35, 8-9 semanas de edad, 271 ± 14 g de peso corporal) se dividieron en cinco grupos: grupo de control (CG) (n = 03); Grupo lesionado (GL) (n = 8); Lesionado + grupo de ultrasonido (LGU) (n= 8); Lesionado + grupo de estiramiento (LGE) (n = 8); Lesionado + ultrasonido + grupo de estiramiento (LUGE) (n = 8). La aplicación de ultrasonido comenzó 72 horas después de la lesión, usando el modo pulsado al 50 %, 0,5W / cm2, 5 min, una vez al día, durante cinco días consecutivos. El estiramiento manual pasivo se inició el décimo día después de la lesión, con cuatro repeticiones de 30 seg cada una y 30 seg de descanso entre repeticiones, una vez al día, cinco veces por semana, para un total de diez aplicaciones. Las ratas fueron sacrificadas después de 22 días, y se extrajo el músculo gastrocnemio de ambos miembros para la medición morfométrica de desmina y laminina a través de inmunohistoquímica. El análisis se realizó utilizando ANOVA unidireccional Tukey post-hoc para datos paramétricos y Kruskall-Wallis para datos no paramétricos. Los animales LUGE mostraron un área mayor de desmina que LGE (p <0,05). Se encontró una disminución en la laminina comparando LGU con GL. Sin embargo, el área de laminina fue mayor en LGE que en todos los grupos (p <0,05). El tratamiento con ultrasonido aislado o en combinación con estiramiento influyó en la regeneración del músculo gastrocnemio de diferentes maneras. Si bien el estiramiento aplicado, en combinación con tratamiento de ultrasonido, fortaleció el área de desmina, la regeneración del músculo gastrocnemio mejoró por el aumento en el área de laminina aumentando la curación muscular.

Muscular resistance, hypertrophy and strength training equally reduce adiposity, inflammation and insulin resistance in mice with diet-induced obesity.

OBJECTIVE: To evaluate the effect of three types of muscular resistance training on adiposity, inflammation levels and insulin activity in Swiss mice with fat-rich diet-induced obesity. METHODS: Lean and obese male Swiss mice were selected and allocated to one of eight groups comprising eight mice each, as follows: standard diet + no training; standard diet + muscular resistance training; standard diet + hypertrophy training; standard diet + strength training; high-fat diet + no training; high-fat diet + muscular resistance training; high-fat diet + hypertrophy training; high-fat diet + strength training. The training protocol consisted of stair climbing for a 10-week period. Blood samples were collected for lactate analysis, glucose level measurement and insulin tolerance test. After euthanasia, adipose tissues were removed and weighed for adiposity index determination. Fragments of epididymal adipose tissue were then embedded for histological analysis or homogenized for tumor necrosis factor alpha level determination using the ELISA method. RESULTS: Ausency of differences in total training volume and blood lactate levels overall emphasize the similarity between the different resistance training protocols. Body weight loss, reduced adipocyte area and lower adiposity index were observed in trained obese mice, regardless of training modality. Different training protocols also improved insulin sensitivity and reduced inflammation levels. CONCLUSION: Resistance training protocols were equally effective in reducing body fat, inflammation levels and insulin resistance in obese mice.

The use of stretching devices for treatment of trismus in head and neck cancer patients: a randomized controlled trial.

PURPOSE: To compare the effects of two stretching devices, the TheraBite® Jaw Motion Rehabilitation System™ and the Dynasplint Trismus System®, on maximal mouth opening in head and neck cancer patients. METHODS: Patients were randomly assigned to one of two exercise groups: the TheraBite® Jaw Motion Rehabilitation System™ group or the Dynasplint Trismus System® group. Patients performed stretching exercises for 3 months. During the three study visits, maximal mouth opening was measured and the patients completed questionnaires on mandibular function and quality of life. RESULTS: In our study population (n = 27), five patients did not start the exercise protocol, eight patients discontinued exercises, and two patients were lost to follow-up. No significant differences regarding the change in mouth opening between the two devices were found. Patients had an increase in MMO of 3.0 mm (IQR - 2.0; 4.0) using the TheraBite® Jaw Motion Rehabilitation System™ and 1.5 mm (IQR 1.0; 3.0) using the Dynasplint Trismus System®. Exercising with either stretching device was challenging for the patients due to the intensive exercise protocol, pain during the exercises, fitting problems with the stretching device, and overall deterioration of their medical condition. CONCLUSIONS: The effects of the two stretching devices did not differ significantly in our study population. The factors described, influencing the progression of stretching exercises, need to be taken into account when prescribing a similar stretching regimen for trismus in head and neck cancer patients. TRIAL REGISTRATION: NTR - Dutch Trial Register number: 5589.

Muscular resistance, hypertrophy and strength training equally reduce adiposity, inflammation and insulin resistance in mice with diet-induced obesity / Exercícios físicos de resistência, hipertrofia e força muscular reduzem igualmente adiposidade, inflamação e resistência à insulina em camundongos obesos por dieta hiperlipídica

ABSTRACT Objective To evaluate the effect of three types of muscular resistance training on adiposity, inflammation levels and insulin activity in Swiss mice with fat-rich diet-induced obesity. Methods Lean and obese male Swiss mice were selected and allocated to one of eight groups comprising eight mice each, as follows: standard diet + no training; standard diet + muscular resistance training; standard diet + hypertrophy training; standard diet + strength training; high-fat diet + no training; high-fat diet + muscular resistance training; high-fat diet + hypertrophy training; high-fat diet + strength training. The training protocol consisted of stair climbing for a 10-week period. Blood samples were collected for lactate analysis, glucose level measurement and insulin tolerance test. After euthanasia, adipose tissues were removed and weighed for adiposity index determination. Fragments of epididymal adipose tissue were then embedded for histological analysis or homogenized for tumor necrosis factor alpha level determination using the ELISA method. Results Ausency of differences in total training volume and blood lactate levels overall emphasize the similarity between the different resistance training protocols. Body weight loss, reduced adipocyte area and lower adiposity index were observed in trained obese mice, regardless of training modality. Different training protocols also improved insulin sensitivity and reduced inflammation levels. Conclusion Resistance training protocols were equally effective in reducing body fat, inflammation levels and insulin resistance in obese mice.

RESUMO Objetivo Avaliar os efeitos de três tipos de treinamentos de resistência na adiposidade, na inflamação e na ação da insulina em camundongos Swiss obesos por dieta hiperlipídica. Métodos Camundongos Swiss machos magros e obesos foram selecionados e posteriormente separados em oito grupos com oito animais em cada: dieta padrão + não treinado; dieta padrão + treinamento de resistência muscular; dieta padrão + treinamento de hipertrofia; dieta padrão + treinamento de força; dieta hiperlipídica + não treinado; dieta hiperlipídica + treinamento de resistência muscular; dieta hiperlipídica + treinamento de hipertrofia; e dieta hiperlipídica + treinamento de força. O protocolo de treinamento consistiu em escaladas, por um período de 10 semanas. Amostras de sangue foram coletadas para análises de lactato, glicemia e teste de tolerância à insulina. Após eutanásia, os tecidos adiposos foram retirados e pesados para determinar o índice de adiposidade. Em seguida, parte do tecido adiposo epididimal foi emblocado para análises histológicas, e outra parte foi homogeneizada para análises de fator de necrose tumoral alfa por ELISA. Resultados O volume total de treinamento e a concentração sanguínea de lactato não diferiram entre os três treinos resistidos, sugerindo similaridade entre eles. Nos animais obesos, as três modalidades de treinamento reduziram o peso corporal, a área adipocitária e o índice de adiposidade. Os três tipos de treinamentos ainda melhoraram a tolerância à insulina e reduziram a inflamação. Conclusão Os protocolos de treinamento resistido foram igualmente efetivos em reduzir a adiposidade, a inflamação e a resistência à ação da insulina em camundongos obesos.

Effects of perioperative pelvic floor muscle training on early recovery of urinary continence and erectile function in men undergoing radical prostatectomy: a randomized clinical trial.

AIMS: Radical prostatectomy (RP) can result in urinary incontinence (UI) and erectile dysfunction (ED), which negatively impact quality of life (QoL). This study aimed to evaluate the effects of a perioperative pelvic floor muscle training (PFMT) program versus usual care on early recovery of urinary continence and erectile function after RP. MATERIALS AND METHODS: Of 59 eligible men, 31 were randomly allocated into 2 groups: Group 1 (Control, N=15) received usual post-RP care; and Group 2 (Physical therapy, N=16) received two pre-RP physical therapist-guided PFMT sessions, including exercises and electromyographic biofeedback, and verbal and written instructions to continue PFMT until RP, which was then resumed after urethral catheter removal. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire were used to evaluate UI and ED, respectively. RESULTS: Demographic characteristics were similar in both groups. Three months after RP, the UI rate was 72.7% and 70.0% in Groups 1 and 2, respectively (P >0.05). The severity and frequency of UI and its impact on QoL were evaluated by the ICIQ-Short Form, with scores of 6.9±6.26 in Group 1 and 7.0±5.12 in Group 2 (P >0.05). The IIEF-5 scores were similar in Groups 1 and 2 (5.73±7.43 vs. 6.70±6.68, respectively) (P >0.05). CONCLUSION: Our pre-RP protocol of two physical therapist-assisted sessions of PFMT plus instructions did not signifi cantly improve urinary continence or erectile function at 3 months after RP.

Effects of perioperative pelvic floor muscle training on early recovery of urinary continence and erectile function in men undergoing radical prostatectomy: a randomized clinical trial

ABSTRACT Aims: Radical prostatectomy (RP) can result in urinary incontinence (UI) and erectile dysfunction (ED), which negatively impact quality of life (QoL). This study aimed to evaluate the effects of a perioperative pelvic floor muscle training (PFMT) program versus usual care on early recovery of urinary continence and erectile function after RP. Materials and Methods: Of 59 eligible men, 31 were randomly allocated into 2 groups: Group 1 (Control, N=15) received usual post-RP care; and Group 2 (Physical therapy, N=16) received two pre-RP physical therapist-guided PFMT sessions, including exercises and electromyographic biofeedback, and verbal and written instructions to continue PFMT until RP, which was then resumed after urethral catheter removal. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire were used to evaluate UI and ED, respectively. Results: Demographic characteristics were similar in both groups. Three months after RP, the UI rate was 72.7% and 70.0% in Groups 1 and 2, respectively (P >0.05). The severity and frequency of UI and its impact on QoL were evaluated by the ICIQ-Short Form, with scores of 6.9±6.26 in Group 1 and 7.0±5.12 in Group 2 (P >0.05). The IIEF-5 scores were similar in Groups 1 and 2 (5.73±7.43 vs. 6.70±6.68, respectively) (P >0.05). Conclusion: Our pre-RP protocol of two physical therapist-assisted sessions of PFMT plus instructions did not significantly improve urinary continence or erectile function at 3 months after RP.

Muscle strength training program in nonagenarians - a randomized controlled trial

SUMMARY OBJECTIVES: The study aims to improve the functional capacity and quality of life (QOL) of nonagenarian women by implementing an individualized muscle strength training program in a geriatric residential care home. STUDY DESIGN: A randomized controlled trial METHODS: Twenty-six elderly women were randomized into a control group (CG) and an intervention group (SG). The SG carried out a strength program with TheraBands® for 12 weeks, with two weekly sessions. The assessment tools that we used pre- and post-intervention were the Barthel index of daily living activities, the five times sit-to-stand test (FTSTS) and timed up and go (TUG) test with wiva® sensors. RESULTS: The SG maintained the Barthel index scores for activities of daily living and improved in the FTSTS; the CG showed a significant decrease on both tests. The dynamic balance test showed significant differences between groups for the variables sit to stand, peak angular velocity, anterior-posterior range, turning, stand to sit, total time, and speed. CONCLUSIONS: Individualized muscle strength training programs may help promote healthy lifestyles in such populations by maintaining autonomy, improving function and balance.

RESUMO OBJETIVO: O objetivo do estudo é melhorar a capacidade funcional e a qualidade de vida (QV) de nonagenários por meio da implementação de um programa de treinamento aeróbico e de força individualizado em um centro geriátrico residencial. DESENHO DO ESTUDO: Estudo controlado randomizado. METODOLOGIA: Vinte e seis mulheres idosas foram randomizadas em grupo controle (CG) e grupo intervenção (SG). O SG realizou um programa de força com 12 semanas de duração de duas sessões semanais. As ferramentas de avaliação usadas antes e após a intervenção foram o Índice de Barthel das atividades da vida diária, o teste Five-to-Stand (FTSTS) e o Timed Up and Go (TUG) com sensores Wiva®. RESULTADOS: O SG manteve as pontuações no Índice de Barthel e melhora no FTSTS; o GC apresentou redução significativa nos dois testes. O teste de equilíbrio dinâmico mostrou diferenças significativas entre os grupos para as variáveis: Sit to Stand, pico da velocidade angular, amplitude anteroposterior, giro, posição sentada, tempo total e velocidade. CONCLUSÕES: Os programas de intervenção de força muscular podem ajudar a promover estilos de vida saudáveis nesta população para a manutenção da autonomia, a melhora da função e o equilíbrio.

The Effect of Pulmonary Rehabilitation on Non-chronic Obstructive Pulmonary Disease Patients.

BACKGROUND: Pulmonary rehabilitation has shown significant benefit for patients with chronic obstructive pulmonary disease (COPD). The effect on non-COPD pulmonary patients is less well established. OBJECTIVES: To determine whether pulmonary rehabilitation is also beneficial for non-COPD pulmonary patients. METHODS: Clinical and demographic data on non-COPD pulmonary patients who participated in our institutional pulmonary rehabilitation program between January 2009 and December 2016 were collected. Participants engaged in a 60-minute, twice-weekly, ambulatory hospital-based program lasting 12 to 24 sessions. Sessions included both endurance and muscle training as well as healthy lifestyle educational activities. The six-minute walk test (6MWT) and the St. George's Respiratory Questionnaire (SGRQ) were conducted before and after the rehabilitation program. RESULTS: We recruited 214 non-COPD patients, of whom 153 completed at least 12 sessions. Of these, 59 presented with interstitial lung disease (ILD), 18 with non-ILD restrictive lung defects, 25 with asthma, 30 with lung cancer, and 21 with other conditions (e.g., pulmonary hypertension, bronchiectasis) The groups demonstrated significant improvement in 6MWT and in SGRQ scores. Non-COPD patients gained a 61.9 meter (19%) improvement in the 6MWT (P < 0.0001) and 8.3 point reduction in their SGRQ score (P < 0.0001). CONCLUSIONS: Pulmonary rehabilitation is effective in non-COPD pulmonary patients. As such, it should be an integral part of the treatment armament provided to the vast majority of those suffering from chronic respiratory disease.

The efficacy and fidelity of clinical interventions used to reduce posterior shoulder tightness: a systematic review with meta-analysis.

BACKGROUND: Posterior shoulder tightness (PST) has been implicated in the etiology of numerous shoulder disorders and is a source of stiffness in both postoperative and nonsurgical cohorts. Identifying efficacious interventions to address PST has the potential to impact patient outcomes in both operative and nonoperative cohorts. Our purpose was to analyze the efficacy of nonoperative clinician-assisted interventions used to mitigate PST. METHODS: We performed a systematic review and meta-analysis. Relevant studies were assessed for inclusion, and selected studies were identified from the PubMed, Embase, Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases by a biomedical librarian. Data extracted from the selected studies underwent quality appraisal using Grading of Recommendations, Assessment, Development, and Evaluation analysis; fidelity assessment; and meta-analysis. RESULTS: The search identified 374 studies, with 13 ultimately retained. Grading of Recommendations, Assessment, Development, and Evaluation analysis revealed areas of concern regarding consistency and imprecision of reporting within the included studies overall. Treatment fidelity assessment showed that only 3 of the 13 studies received a rating of good to excellent, indicating a high risk of bias. When clinician-assisted interventions were compared with no treatment, meta-analysis showed a moderate effect size in favor of clinician-assisted interventions for improving range of motion. When a multimodal treatment approach for PST was compared with active comparator interventions, a small effect size was present for improving range of motion in favor of the multimodal approach. CONCLUSION: The efficacy of clinician-assisted interventions for reducing PST was identified when using both a single treatment and multimodal treatments. Current evidence focuses mostly on populations with PST who were not seeking care and the immediate- to short-term effects of clinician-assisted interventions, which may limit generalization of findings.

Effects of eccentric exercise in pressure pain threshold in subjects with functional ankle equinus condition

SUMMARY Stretching exercises are widely used by the population before sporting activities. One of the most common technique is eccentric exercise. Here, we made a clinical examination of 98 subjects with equinus condition before activity and after 30 min of running (49 participants with previous eccentric exercise and 49 with no previously eccentric exercise). The clinical assessment of the Achilles tendon was based on the pressure pain threshold (PPT). We identified significant PPT changes between the previous eccentric stretching and the non-previous eccentric stretching group in the Achilles tendon evaluations. Based on our findings, we propose that subjects with equinus condition could use eccentric stretching in order to improve the Achilles tendon status.

RESUMO Exercícios de alongamento são amplamente utilizados pela população antes da atividade esportiva. Uma das técnicas mais comuns é o exercício excêntrico. Aqui, fizemos um exame clínico de 98 indivíduos com condição de pé equino antes da atividade e após 30 minutos de corrida (49 corredores com exercício excêntrico anterior e 49 sem exercício excêntrico anterior). A avaliação clínica do tendão de Aquiles foi baseada no limiar de dor à pressão (PPT). Identificamos modificações significativas no PPT entre alongamentos prévios excêntricos e nenhum exercício anterior excêntrico de alongamento para as avaliações do tendão de Aquiles. Com base em nossos achados, propomos que sujeitos com condição de pé equino poderiam fazer alongamentos com exercícios excêntricos para melhorar o status do tendão de Aquiles.

Physical activity levels after hip and knee joint replacement surgery: an observational study.

Usual care after hip or knee joint replacement does not adequately address the problem of low physical activity levels. We aimed to determine whether exercise delivered in a group setting in the early stage of outpatient rehabilitation influenced self-reported physical activity levels after hip or knee joint replacement. A case series of 79 participants referred to a 6-week outpatient orthopaedic exercise group after total hip or knee replacement were evaluated using the International Physical Activity Questionnaire (IPAQ) short form. Physical function was evaluated using Osteoarthritis Research Society International (OARSI) recommended performance-based tests (30 s Chair Stand Test, 40 m Fast Pace Walk Test, Stair Climb Test, Timed Up and Go Test, 6 Minute Walk Test). Measures were assessed at admission, discharge and 6 weeks after group discharge. Non-parametric analysis was conducted for IPAQ scores. Analysis of functional measures was conducted with linear mixed models with time modelled as a repeated measure. Standard multiple regression and correlation analysis were conducted. Fifty-four participants completed the study. Self-reported activity levels improved significantly at program discharge but not at 6-week follow-up. All performance-based measures improved significantly at program discharge. Fast-paced walking and 6 Minute Walk Test measures continued to improve at 6-week follow-up. Group dynamics present in an outpatient rehabilitation exercise program may increase physical activity levels during group participation but not after group cessation. Performance in all functional measures improved at group discharge.

Scapular Stabilization Limits Glenohumeral Stretching in Children With Brachial Plexus Injuries.

PURPOSE: To quantify the effects of scapular stabilization on scapulothoracic and glenohumeral (GH) stretching. METHODS: Motion capture data during external rotation and abduction with and without scapular stabilization were collected and analyzed for 26 children with brachial plexus birth palsy. These positions were performed by an experienced occupational therapist and by the child's caretaker. Scapulothoracic and GH joint angular displacements were compared between stretches with no stabilization, stabilization performed by the therapist, and stabilization performed by the caretaker. The relationship between the age and ability of the therapist and caretaker to perform the stretches with scapular stabilization was also assessed. RESULTS: During external rotation there were no significant differences in either the scapulothoracic or GH joint during stabilization by either the therapist or the caretaker. During abduction, both scapulothoracic and GH joint angular displacements were statistically different. Scapulothoracic upward rotation angular displacement significantly decreased with scapular stabilization by the therapist and caretaker. Glenohumeral elevation angular displacement significantly decreased with scapular stabilization performed by the therapist and caretaker. There were only weak correlations between age and the differences in scapulothoracic and GH joint angular displacement performed by both the therapist and the caretaker. CONCLUSIONS: The findings of this study indicate that scapular stabilization may be detrimental to passive stretching of the GH joint in children, as demonstrated by a reduced stretch. Based on the findings of this study, we have changed our practice to recommend passive stretches without scapular stabilization for children aged 5 years and older with brachial plexus birth palsy. In infants and children aged less than 5 years, we now recommend stretching with and without scapular stabilization until the effect of scapular stabilization is objectively assessed in these age groups. LEVEL OF EVIDENCE/TYPE OF STUDY: Therapeutic IV.

Corticosteroid injection is the best treatment in plantar fasciitis if combined with controlled training.

PURPOSE: Plantar fasciitis is a very common (lifetime incidence ~ 10%) and long-lasting injury with major impact on daily function. Combining corticosteroid injection and physical training (strength training and stretching) was hypothesized to result in a superior effect compared to each treatment separately. METHODS: A single blinded randomized controlled superiority trial conducted in 2013-2014 with a 2-year follow-up (end Sept 2016). 123 consecutive patients (20-65 years) referred to two study centers in Denmark: Institute of Sports Medicine, Bispebjerg Hospital, University of Copenhagen and a private rheumatology clinic with symptoms of plantar fasciitis, and ultrasound measured thickness above 4.0 mm were invited. 25 did not fulfill the inclusion criteria (mainly ultrasound criteria) and 8 refused participation. 90 patients were randomized (pulling sealed envelopes) to 3 groups: (1) 3 months strength training and stretching (n = 30), (2) corticosteroid injections with monthly intervals until thickness < 4.0 mm (maximum 3 injections) (n = 31), (3) combination of the two treatments (n = 29). During the 3 months intervention period load reduction was recommended (cushioning shoes and insoles and abstaining from running and jumping). The main outcome was improvement in Pain at function on a 100-mm VAS score and in Foot Function Index (FFI, range 0-230) at 6 months (Clinicaltrials.gov Identifier: NCT01994759). RESULTS: All groups improved significantly over time, but the combination of corticosteroid injection and training (strength training and stretching) had a superior effect at all time points. The mean difference between the combined treatment and training was 40 points in FFI (95% confidence interval (CI) 63-17 points, p < 0.001) and 20 mm for VAS function pain (CI 35-5 mm, p < 0.01). The mean difference between the combined treatment and corticosteroid injections only was 29 points in FFI (CI 52-7 points, p < 0.01) and 17 mm for VAS function pain (CI 32-2 mm, p < 0.05). All differences were clinically relevant. CONCLUSION: The best treatment for plantar fasciitis is the combination of corticosteroid injections and training (strength training and stretching). This combined treatment is superior both in the short- and in the longterm. Corticosteroid injections combined with controlled training are recommended as first line treatment in patients with plantar fasciitis. LEVEL OF EVIDENCE: 1.

The development of a mechanical device to stretch skeletal muscle of young and old rats

OBJECTIVE: How much force is needed to stretch skeletal muscle is still unknown. The aim of this study was to develop a device that mechanically stretches rat muscle to compare the force (N) required to stretch the soleus muscle of young and aged rats and the tibio-tarsal angle joint at neutral and stretched positions. METHODS: Twelve female Wistar rats were divided into two groups: a young group (YG, n=6, 311±11 g) of rats 3 months old and an aged group (AG, n=6, 351±43 g) of rats 15 months old. The left soleus muscle was mechanically held in full dorsal flexion and submitted to mechanical passive stretching: 1 bout of 10 repetitions, each repetition lasted 60 seconds with an interval of 45 seconds between repetitions, performed once a day, twice a week, for 1 week. The force required during stretching was measured by a load cell, and the tibio-tarsal angle joint was measured by photometry. RESULTS: The load cell calibration showed excellent reliability, as confirmed by the intraclass correlation coefficient value of 0.93. A decrease in delta force was found in the comparison between YG and AG (0.11±0.03 N vs 0.08±0.02 N, p<0.05, repeated measures ANOVA). There was no difference between the YG and the AG in the tibio-tarsal angle at resting position (87.1±3.8° vs 87.1±3.5°, p=0.35, Kruskal Wallis) and at the end of the stretching protocol (43.9±4.4° vs 42.6±3.4°, p=0.57, Kruskal Wallis). CONCLUSION: The device presented in this study is able to monitor the force necessary to stretch hindlimb rat muscles. Aged rats required less force than young rats to stretch the soleus muscle, and there was no difference regarding the tibio-tarsal angle between the two groups.

Effects of High-Intensity Inspiratory Muscle Training Associated with Aerobic Exercise in Patients Undergoing CABG: Randomized Clinical Trial.

OBJECTIVE: Evaluate the interaction between high-intensity inspiratory muscle training (IMT) and aerobic exercise on physical capacity, respiratory muscle strength, peripheral muscle strength, and quality of life of patients who underwent coronary artery bypass grafting (CABG). METHODS: Twenty-four patients underwent CABG were randomized into two groups. During 36 sessions, one group received IMT associated with aerobic exercise and the other group received only aerobic exercise. Primary outcome was the distance in the six-minute walk distance (6MWD) test. Secondary outcomes included respiratory muscle strength, peripheral muscle strength, and quality of life. Measures were taken at the baseline, at the 12th session, the 24th session, and 36th session. RESULTS: Baseline characteristics were similar between the groups. There was no statistically significant difference between the two groups in any outcome [6MWD - P=0.935; peak oxygen consumption (PeakVO2) - P=0.853; maximal inspiratory pressure (MIP) - P=0.243; maximal expiratory pressure (MEP) - P=0.268; sitting-rising test (SRT) - P=0.212], but there was interaction in MIP (P=0.000) and all outcomes improved in the two groups (6MWD - P=0.000; PeakVO2 - P=0.000; MIP - P=0.000; MEP - P=0.000; SRT - P=0.000). CONCLUSION: There was an improvement of all outcomes in both groups, but IMT was not able to provide additional benefits. The use of this combination should be used with caution to not generate higher costs in the rehabilitation process of these patients.

Influence of proprioceptive neuromuscular facilitation on the muscle tonus and amplitude of movement in HTLV-1-infected patients with HAM/TSP.

An HTLV-1-infected patient can develop paraparesis that limits their movements. Rehabilitation techniques could improve the motor abilities of these patients. The present study investigates five cases of physical therapy intervention in HTLV-1 patients to evaluate the influence of functional rehabilitation on the tonus and range of motion (ROM) of HTLV-1 patients with spasticity. The patients had a gain of ROM, especially in the lower limb, and reduction in hypertonia/spasticity after functional treatment. The reduction in hypertonia increased the ROM. Thus, functional methods may be valuable for the rehabilitation of HTLV-1 patients with neurological damage.

Influence of proprioceptive neuromuscular facilitation on the muscle tonus and amplitude of movement in HTLV-1-infected patients with HAM/TSP

Abstract An HTLV-1-infected patient can develop paraparesis that limits their movements. Rehabilitation techniques could improve the motor abilities of these patients. The present study investigates five cases of physical therapy intervention in HTLV-1 patients to evaluate the influence of functional rehabilitation on the tonus and range of motion (ROM) of HTLV-1 patients with spasticity. The patients had a gain of ROM, especially in the lower limb, and reduction in hypertonia/spasticity after functional treatment. The reduction in hypertonia increased the ROM. Thus, functional methods may be valuable for the rehabilitation of HTLV-1 patients with neurological damage.