Risk factors for musculoskeletal injuries in military personnel: a systematic review with meta-analysis.

OBJECTIVE: To investigate the risk factors for musculoskeletal injuries in military personnel. METHODS: A systematic literature search was carried out in August 2019 and updated in July 2020 without language or time filters. The inclusion criteria were prospective studies that investigated the risk factors for injuries in military personnel. Only risk factors analyzed by at least ten studies were selected for the meta-analysis. For data analysis, the RevMan5.3 program was used to compare the number of participants with injuries between high- or low-risk groups. The measurement of dichotomous variables was one of the selected parameters for the analysis, as well as the Mantel-Haenszel statistical method, random-effects model, and analysis with a relative risk (RR) and 95% confidence interval for the included studies. RESULTS: A total of 2,629 studies were identified through databases. Thirty-four studies met the inclusion criteria. The groups considered at risk were the oldest [RR = 1.22; (95% CI 1.06-1.41)], with overweight or obesity [RR = 1.27; (95% CI 1.08-1, 48)], with previous injuries [RR = 1.15; (95% CI 1.01-1.30)], and with the worst performance in running tests of 1,600-3,200 m [RR = 1.87; (95% CI 1.28-2.71)]. Gender, ethnicity, and smoking were not associated with injuries. However, a subgroup analysis showed that among studies with a follow-up of fewer than 12 months, women presented RR = 2.44 (95% CI 1.65-3.60) more likely to develop injuries. CONCLUSION: Age, overweight or obesity, previous injuries, and performance in the 1600-3200 m run are associated with an increased risk of injury in the military.

Effect of Dance on Postural Control in People with Parkinson's Disease: A Meta-Analysis Review.

This systematic review verified the effect of dance on postural control in people with Parkinson's disease (PD) and investigated whether this practice can be as effective over a short period as when it is performed over a longer period in relation to the postural control of this population. The search was performed in April 2019 in nine databases. Only randomized/quasi-randomized controlled trials with participants with idiopathic PD were included. The meta-analysis of the 11 articles included, with 13 results, showed that the 211 participants with PD, who belonged to the group performing dance, had a standardized mean difference of postural control 0.82 [0.52, 1.12] greater than the 182 participants who were in a control situation. The statistically significant results of this meta-analysis indicate that dance can improve postural control in people with PD in a short period of time and therefore contribute to the prevention of falls.

Physical Performance Measures of Flexibility, Hip Strength, Lower Limb Power, and Trunk Endurance in Healthy Navy Cadets: Normative Data and Differences Between Sex and Limb Dominance.

ABSTRACT: Lopes, TJA, Simic, M, Alves, DdS, Bunn, PdS, Rodrigues, AI, Terra, BdS, Lima, MdS, Ribeiro, FM, Vilão, P, and Pappas, E. Physical performance measures of flexibility, hip strength, lower limb power, and trunk endurance in healthy navy cadets: Normative data and differences between sex and limb dominance. J Strength Cond Res 35(2): 458-464, 2021-The objectives were to provide normative data on commonly used physical performance tests that may be associated with musculoskeletal injuries in Navy cadets and assess for sex and limb dominance differences. A large cohort of Navy cadets were assessed for physical performance tests of flexibility (ankle dorsiflexion range of motion and sit and reach), isometric hip strength, lower limb power (single-leg hop), and trunk endurance (plank and side plank tests). Besides providing normative data tables, sex and limb dominance differences were assessed by a 2-way mixed analysis of variance. A total of 545 Brazilian Navy cadets (394 men) representing 79% of the cadets in the Academy participated. Normative reference values were reported as mean ± SD, 95% confidence interval and percentiles. For tests of muscle strength, power, and endurance, men performed better than women (p < 0.001). For flexibility tests, women achieved greater distances than men for the sit and reach test (p < 0.001), but no difference for ankle dorsiflexion (p = 0.51). Overall, there were no clinically relevant differences between limbs. In conclusion, normative data for commonly used physical performance tests were provided. Although no clinically relevant side-to-side differences were found, men presented higher values for lower limb strength and power, as well as trunk endurance than women, whereas women demonstrated increased flexibility. Valuable normative data are provided to professionals who work with young, active populations from the injury prevention or rehabilitation perspective because the current study may help professionals to identify athletes or cadets whose performance is outside the normative values and may be at risk for injury.

Internal Training Load Perceived by Athletes and Planned by Coaches: A Systematic Review and Meta-Analysis.

BACKGROUND: Rating of perceived exertion (RPE) and session RPE (sRPE) has been widely used to verify the internal load in athletes. Understanding the agreement between the training load prescribed by coaches and that perceived by athletes is a topic of great interest in sport science. OBJECTIVE: This systematic review and meta-analysis aimed to investigate differences between the training/competition load perceived by athletes and prescribed/intended/observed by coaches. METHODS: A literature search (September 2020 and updated in November 2021) was conducted using PubMed, Web of Science, Embase, and SPORTDiscus databases. The protocol was registered in the Open Science Framework (osf.io/wna4x). Studies should include athletes and coaches of any sex, age, or level of experience. The studies should present outcomes related to the RPE or sRPE for any scale considering overall training/competition sessions (physical, strength, tactical, technical, games) and/or classified into three effort categories: easy, moderate, and hard. RESULTS: Twenty-seven studies were included in the meta-analysis. No difference was found between coaches and athletes for overall RPE (SMD = 0.19, P = 0.10) and overall sRPE (SMD = 0.05, P = 0.75). There was a difference for easy RPE (SMD = - 0.44, small effect size, P = 0.04) and easy sRPE (SMD = - 0.54, moderate effect size, P = 0.04). No differences were found for moderate RPE (SMD = 0.05, P = 0.74) and hard RPE (SMD = 0.41, P = 0.18). No difference was found for moderate (SMD = -0.15, P = 0.56) and hard (SMD = 0.20, P = 0.43) sRPE. CONCLUSION: There is an agreement between coaches and athletes about overall RPE and sRPE, and RPE and sRPE into two effort categories (moderate and hard). However, there were disagreements in RPE and sRPE for easy effort category. Thus, despite a small disagreement, the use of these tools seems to be adequate for training monitoring.

Effects of prevention programmes on injury risk in military personnel: a systematic review with meta-analysis.

INTRODUCTION: Exercise programmes have been used to prevent injuries in military personnel, as they can reduce modifiable risk factors for injuries. Our aim was to review the literature to evaluate the effects of different exercise protocols on the prevention of injuries in military personnel. METHODS: A systematic literature review examined the effects of different exercise protocols on the prevention of musculoskeletal injuries in the military. Several databases were explored to find experimental studies that investigated the effects of prevention programmes on the risk of injury. We have extracted from the studies: profile of participants, sample size, study design and characteristics of the control group (CG), the type of intervention and the relative risk (RR) in the experimental group and CG, with their significance levels. For data analysis, we used the RevMan V.5.3 software. The measure of RR was investigated. The risk of publication bias was analysed with Begg's test. RESULTS: A total of 13 694 titles and studies were recovered from the databases and by manual search. After the removal of duplicate titles and studies that did not meet the eligibility criteria, 17 studies were selected. The protocols were composed of neuromuscular training, stretching, agility training or combined exercises. The meta-analysis showed that injury prevention exercise programmes reduced the risk of musculoskeletal injuries in military personnel by 14% (RR=0.86; 95% CI=0.76 to 0.98). CONCLUSION: Injury prevention exercise programmes promoted a slight reduction in the risk of musculoskeletal injuries in military personnel. LEVEL OF EVIDENCE: Very low. TRIAL REGISTRATION NUMBER: CRD 42017077946.

The Effect of Physical Activity on Motor Skills of Children with Autism Spectrum Disorder: A Meta-Analysis.

OBJECTIVE: The present study was aimed at analyzing the effect of physical activity on motor coordination in children with ASD. METHODS: On 28 June 2021, a systematic review with meta-analysis was performed using the following databases: MEDLINE, SciELO, LILACS, PEDro, SPORTDiscus, CINAHL, SCOPUS, Web of Science, Cochrane, and Science Direct. We analyzed the methodological quality and risk of bias using the Jadad scale and Cochrane tool, respectively. Motor coordination results were meta-analyzed using the RevMan program. Two independent researchers used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool to assess the level of evidence from the meta-analysis. RESULTS: We found four studies in the listed databases and five randomized clinical trials were included in the meta-analysis that included 109 children with ASD. Children with ASD who performed physical activity did not present significantly better motor coordination than control children (p = 0.12). CONCLUSIONS: Considering the clinical importance of physical activity for children with ASD, this systematic review with meta-analysis showed that physical activity had no statistically significant effects on coordination in individuals with ASD.

Trunk endurance, posterior chain flexibility, and previous history of musculoskeletal pain predict overuse low back and lower extremity injury: a prospective cohort study of 545 Navy Cadets.

OBJECTIVE: To investigate predictors of low back and lower extremity musculoskeletal injury in a cohort of Naval cadets. DESIGN: Prospective Cohort Study METHODS: 545 Naval cadets (Males, n = 394, 72%) were followed-up over eight months. Nine variables were investigated as predictors: history of musculoskeletal symptoms in the last 12 months, ankle dorsiflexion range of motion, sit and reach test, isometric hip abduction and external rotation strength, alignment during the single leg squat test, single leg hop test for distance, prone plank and side plank tests. All injuries that required medical attention were registered. Predictive associations were examined using univariable and multivariable logistic regression analyses. RESULTS: The incidence of all injuries was 7%. Cadets who failed the 60-second plank test (OR = 3.3; 95% CI, 1.2-8.8, P = 0.04), had ≤18 cm in the sit and reach test (OR = 4.0; 95% CI, 1.4-11.2, P = 0.01), or reported pain in the last 12 months in two or more body regions (OR = 2.7; 95% CI, 1.02-7.3, P = 0.04), had greater odds of sustaining an overuse injury. No predictors were identified for acute injuries. CONCLUSION: Decreased trunk endurance on the prone plank test, reduced posterior chain flexibility on the sit and reach test, and a history of pain reported in two or more sites in the last 12 months were predictors of overuse injuries in Naval cadets. Assessment and intervention of these modifiable risk factors may be clinically relevant in injury screening and prevention.

Association between movement patterns and risk of musculoskeletal injuries in navy cadets: A cohort study.

OBJECTIVE: To investigate the association of movement patterns evaluated by the Dynamic Movement Assessment (DMA) with the occurrence of musculoskeletal injuries in navy cadets. DESIGN: Cohort study. SETTING: Participants were filmed performing the six functional tests of the DMA (deep squat, step up, single-leg squat, hop, plank and side-plank tests). PARTICIPANTS: 240 navy cadets. MAIN OUTCOME MEASUREMENTS: Depending on the number of certain movement patterns on the Dynamic Movement Assessment (DMA), participants were classified as high, moderate, medium or low risk of developing injuries. Predictive associations between injuries and risk classification were examined using logistic regression analysis. RESULTS: Considering sex, previous injuries and the type of secondary school as covariates, participants who were classified as high risk were not more likely to develop injuries. Non-military high school was an independent risk factor for any injuries (OR = 3.14, 95% CI [1.43,6.91]; OR = 4.57, 95% CI [1.92,10.83]), overuse injuries (OR = 2.58, 95% CI [1.05,6.30]; OR = 2.55, 95% CI [1.06, 6.14]) and acute injuries (OR = 4.88, 95% CI [1.19,19.99]), respectively. Previous musculoskeletal symptoms also increased the chance of AI (OR = 4.45, 95% CI [1.15,17.18]; OR = 5.91, 95% CI [1.13,30.88]). CONCLUSIONS: Movement patterns evaluated by DMA are not associated with an increased risk of injuries. However, attendance of a non-military high school and previous musculoskeletal symptoms are associated with musculoskeletal injuries.

The association between the functional movement screen outcome and the incidence of musculoskeletal injuries: A systematic review with meta-analysis.

OBJECTIVE: To systematically review the literature investigating the association between the Functional Movement Screening (FMS™) score and musculoskeletal injuries in physical exercise based on relative risk (RR). METHODS: A systematic literature search was carried out in July 2018 in MEDLINE, LILACS, SCOPUS, SPORTDiscus, CINAHL and Web of Science databases. Reference lists were explored to find studies that examined the association between FMS™ and injuries. The following data were extracted from the studies: the participants' profile, sample size, classification of musculoskeletal injuries, follow-up time and RR. Participants with FMS™ score <13-14 were considered as "high risk" depending on used cut-off. The Mantel-Haenszel Test with random-effect model and the RR measure was performed. The Begg Test was used to analyze the publication bias. RESULTS: A total of 1658 studies were retrieved from the databases and 20 were selected. A meta-analysis of 964 injuries in 2227 high-risk participants and 1719 injuries in 5756 low-risk participants showed that individuals at "high risk" by FMS™ had a RR = 1.51 (95%CI = 1.35-1.69) of developing injuries. CONCLUSIONS: Individuals classified as "high risk" by FMS™ are 51% more likely to be affected by injury than those classified as having low risk, but the level of evidence is very low.

Muscle dysfunction is associated with poorer health-related quality of life in adults with sickle cell anaemia.

BACKGROUND: It is known that episodes of microvascular obstruction and oxidative stress in sickle cell anaemia (SCA) can damage muscle tissue. As a consequence, deterioration in muscle function may potentially contribute to poor health-related quality of life (HRQoL) in subjects with SCA, particularly those who do not use long-term treatment. OBJECTIVES: To evaluate muscle function in adults with SCA, to study the correlations between muscle function and HRQoL and to analyse the impact of hydroxyurea treatment. METHODS: Twenty-two adults with SCA and 20 matched controls were subjected to Short Form-36 (SF-36), respiratory muscle strength measurement, isometric hand grip strength (iHGS) measurement and knee isokinetic dynamometry. RESULTS: In relation to their healthy peers, adults with SCA had lower SF-36 scores, respiratory muscle strength and iHGS. Regarding the isokinetic test, adults with SCA showed lower values, especially in the variables measured in flexion and with an angular velocity of 240∘/s. There was a significant correlation between the peak torque (PT) at 240∘/s and the physical component summary (SF-36PCS) in both extension (r= 0.77; p< 0.001) and flexion (r= 0.82; p< 0.001). Significant correlations were also observed between the agonist/antagonist ratio at 240∘/s and the SF-36PCS (r= 0.50; p< 0.001). The use of hydroxyurea led to higher scores on the SF-36 and higher values in knee isokinetic dynamometry. CONCLUSIONS: Adults with SCA have muscle dysfunction, especially with regard to endurance of the knee flexor muscles. In these patients, there is a significant association between muscle function and HRQoL. Moreover, the use of hydroxyurea is associated with better HRQoL and less muscle dysfunction.

Patients with Subacromial Pain Syndrome Present no Reduction of Shoulder Proprioception: A Matched Case-Control Study.

BACKGROUND: Shoulder pain is common among patients with musculoskeletal pain and the prevalence of patients with subacromial pain syndrome (SAPS) is high. Despite the high prevalence, there is a lack of an extensive evaluation of the proprioception acuity in patients with SAPS. Knowledge of the proprioceptive deficit would assist clinicians in the proper treatment and may offer an alternative explanation for the mechanisms underlying SAPS, which are poorly understood. OBJECTIVE: To compare the proprioceptive function of the shoulder in patients with SAPS and matched controls. STUDY DESIGN: Matched case-control study. SETTING: Physical Functional Rehabilitation Service of an outpatient clinic. PARTICIPANTS: A total of 32 consecutive patients with SAPS who sought physical therapy for shoulder pain and 32 healthy participants (control group) matched for age, sex, and handedness. INTERVENTIONS: All participants completed a questionnaire containing sociodemographic information, pain intensity and characteristics, the Numerical Pain Rating Scale, and the Shoulder Pain and Disability Index. MAIN OUTCOME MEASUREMENTS: The proprioceptive assessment was performed through kinesthesia, passive joint position sense (PJPS), and the active joint position sense (AJPS). RESULTS: The groups showed no statistically significant differences in kinesthesia, PJPS, and AJPS for internal or external rotation. The proprioceptive acuity was not associated with pain intensity or functional disability in patients with SAPS. CONCLUSIONS: Participants with SAPS did not present proprioceptive deficits in a pain-free motion of medial and lateral rotation when compared to their matched controls. The proprioceptive deficit may not be involved with the mechanisms underlying SAPS and seems not to interfere with the clinical outcomes of patients with SAPS. LEVEL OF EVIDENCE: Level III.

Muscle function in women with systemic sclerosis: Association with fatigue and general physical function.

BACKGROUND: Individuals with systemic sclerosis have muscle functions with varying degrees of muscle weakness and atrophy, which in turn can have a negative impact on functional and health-related quality of life. This study aimed to evaluate peripheral muscle performance using isokinetic dynamometry of the knee in women with systemic sclerosis and to correlate peripheral muscle dysfunction with disability levels and general fatigue. METHODS: Twenty-six women with systemic sclerosis and a matched control group with an equal number of women underwent knee isokinetic dynamometry at angular speeds of 75°/s and 240°/s, isometric handgrip strength, the Health Assessment Questionnaire Disability Index, the Functional Assessment of Chronic Illness Therapy-Fatigue scale, and the Fatigue Impact Scale. FINDINGS: Women with systemic sclerosis showed significant reductions in almost all isokinetic parameters for the two angular velocities tested compared with the controls. An agonist/antagonist ratio with values <40% was observed in approximately one-third of the patients. These patients had lower isometric handgrip strength. These patients also performed worse on the two general fatigue scales evaluated. Significant correlations were observed between the isokinetic parameters and the measured isometric handgrip strength, and the Health Assessment Questionnaire Disability Index. INTERPRETATION: Systemic sclerosis patients have reduced strength and endurance as well as a muscle imbalance between the quadriceps and hamstrings. In these patients, lower muscle dysfunction of the knee joint is associated with lower handgrip strength and physical incapacity.

Prevalence of Musculoskeletal Symptoms Among Brazilian Merchant Navy Cadets: Differences Between Sexes and School Years.

BACKGROUND: Musculoskeletal disorders are common among military personnel, especially during the initial basic training period. Prior studies have reported the prevalence rate of overall musculoskeletal symptoms or injuries in different military population and nationalities, especially from North America and Europe; however, very limited information regarding the military population of South America exists. Although Brazil has one of the biggest military forces worldwide (≈335,000 military personnel), currently, to our knowledge, there is no study reporting musculoskeletal symptoms or injury statistics in the Brazilian Armed Forces. Thus, the aims of this study were to describe the 12-month prevalence rate of self-reported musculoskeletal symptoms in cadets and to compare this prevalence rate between sexes and school years. METHODS: We conducted a cross-sectional study that took place from January to March 2016. Participants were Navy cadets, of both sexes and from three different school years of a Brazilian Merchant Navy Academy. All volunteers completed an adapted version of the Brazilian Nordic Musculoskeletal Questionnaire that assessed the past 12-month prevalence of musculoskeletal symptoms over eight body regions of the trunk and lower extremity. The Pearson's χ2 test was conducted to compare prevalence of symptoms per body region between sexes and among the 3 school years. The study has been approved by the Naval Hospital's ethical committee. RESULTS: A total of 545 cadets (394 males), corresponding to 79% of all 688 cadets enrolled at the Merchant Navy Academy, volunteered to participate on this study. Among all cadets, 266 (49%) reported symptoms in at least one body region in the past 12-months. The knee with 116 (21%) and lower back with 96 (18%), were the most prevalent regions. In terms of sex differences, there was higher prevalence of symptoms among females 90 (60%) than males 176 (45%). Furthermore, females reported almost double the prevalence for lower back symptoms (27% vs. 14%, p = 0.001) and 11% higher prevalence of knee symptoms (29% vs. 18%, p = 0.006) than males. Finally, it is important to highlight that cadets from the second (127 [65%]) and third (77 [55%]) school years had higher prevalence of symptoms than cadets from the first year (62 [29%]). The knee and lower back were consistently the two most prevalent regions among all school years, but shin symptoms increased from 3% to 17% (p < 0.001) between the first and second school years. CONCLUSION: The prevalence of musculoskeletal symptoms in the Brazilian Merchant Navy Academy doubles between initial enrollment and the beginning of the second school year. Females have consistently higher rates of symptoms than males, particularly reporting higher prevalence of knee and lower back pain which are the two most prevalent regions in this population. Prevention efforts should concentrate on the basic training period in an attempt to decrease the prevalence of musculoskeletal symptoms in this population. Finally, prospective studies are required to verify the cause and effect relationship between training and musculoskeletal symptoms.

Explanatory models of muscle performance in acromegaly patients evaluated by knee isokinetic dynamometry: Implications for rehabilitation.

PURPOSE: To evaluate the effects of demographics and hormonal variations on knee muscle performance in patients with acromegaly and develop explanatory models of peripheral muscle function in these individuals. METHODS: This was a cross-sectional study in which 53 acromegalics and 27 healthy subjects underwent knee isokinetic dynamometry to evaluate the peak torque value for leg extension at 75°/s (PTE75) and 240°/s (PTE240). Separate multivariable linear regression models for the prediction of PTE75 and PTE240 were tested using variables commonly used as predictors in the clinical setting and other specific variables related to acromegaly. RESULTS: The final prediction model for PTE75 (R(2)=0.888; adjusted R(2)=0.820, SE of bias=16.2Nm, p<0.001) was -0.221×growth hormone+36.791×sexmale=1-27.407×statusactive=1-0.690×age+148.071. The final prediction model for PTE240 (R(2)=0.816; adjusted R(2)=0.805, SE of bias=8.8Nm, p<0.001) was -0.174×growth hormone+12.522×sexmale=1-0.520×age+98.099. CONCLUSIONS: In acromegalics, high growth hormone levels, female gender, and older age are associated with reduced muscle strength and endurance. Additionally, active disease negatively affects peripheral muscle strength in these patients.

Predictive equations for ventilatory muscle strength in the Brazilian population: a systematic review / Equações preditivas da força muscular ventilatória na população brasileira: uma revisão sistemática / Ecuaciones predictivas de la fuerza muscular respiratoria en la población brasileña: una revisión sistemática

ABSTRACT Maximal inspiratory and expiratory pressures (MIP and MEP) assess the strength index of the respiratory muscles. These measures are relevant to assess respiratory muscle strength and for clinical monitoring. This study evaluates papers that suggest predictive equations of MIP and MEP for the Brazilian population. We included studies that established prediction equations for MIP and MEP for the healthy Brazilian population, aged from 4 to 90 years old, both men and women and that had the maximum respiratory pressures measured in a sitting position. A search was carried out in March 2020 on MEDLINE, LILACS, Cochrane, SciELO, CINAHL, Web of Science, and SCOPUS databases, without date or language filters. The descriptors used were "muscle strength," "equations," "predictive respiratory muscles" and their respective synonyms. Out of the 3,920 studies found in databases, 963 were duplicates, 2,779 were excluded, 178 had their full texts analyzed, and only 9 met the inclusion criteria. The predictive equations of ventilatory muscle strength analyzed in this review used age, weight, and stature as variables. However, the studies showed methodological weaknesses, such as lack of cross-validation of the equation, exclusion of outliers, and lack of familiarization of MIP and MEP.

RESUMO As pressões respiratórias máximas (PImáx e PEmáx) avaliam o índice de força dos músculos respiratórios. Essas medidas são relevantes para a avaliação da força muscular respiratória e para o monitoramento clínico. O objetivo deste estudo foi avaliar os artigos que sugerem equações preditivas de PImáx e PEmáx para a população brasileira. Foram incluídos estudos que estabeleceram equações de predição para PImáx e PEmáx da população brasileira saudável, com idades entre 4 e 90 anos e de ambos os sexos, que mediam as pressões respiratórias máximas na posição sentada. Uma pesquisa foi realizada, em março de 2020, nas bases de dados MEDLINE, LILACS, Cochrane, SciELO, CINAHL, Web of Science e SCOPUS, sem filtros de tempo ou idioma. Os descritores utilizados foram "força muscular", "equações" e "músculos respiratórios preditivos", com seus respectivos sinônimos. Dos 3.920 estudos encontrados nas bases de dados, 963 eram duplicados e 2.779 foram excluídos, 178 tiveram seus textos analisados integralmente e apenas 9 atendiam aos critérios de inclusão. As variáveis utilizadas nas equações preditivas de força muscular ventilatória analisadas nesta revisão foram: idade, peso e estatura. No entanto, os estudos mostraram fragilidades metodológicas, como falta de validação cruzada da equação, exclusão de outliers e familiarização do PImáx e PEmáx.

RESUMEN Las presiones inspiratoria y espiratoria máximas (PImáx y PEmáx) evalúan el índice de fuerza muscular respiratoria. Estas medidas son importantes en la evaluación de la fuerza muscular respiratoria y el seguimiento clínico. El objetivo de este estudio fue evaluar los artículos proponen ecuaciones predictivas para PImáx y PEmáx a la población brasileña. Se incluyeron estudios que establecieron ecuaciones predictivas para PImáx y PEmáx a la población brasileña sana de ambos sexos, de entre 4 y 90 años de edad, y que miden las presiones respiratorias máximas en posición sentada. Se realizó, en marzo de 2020, una búsqueda en las bases de datos MEDLINE, LILACS, Cochrane, SciELO, CINAHL, Web of Science y SCOPUS, sin año de publicación específico ni idioma. Los descriptores utilizados fueron "fuerza muscular", "ecuaciones" y "músculos respiratorios predictivos" y sus respectivos sinónimos. De los 3.920 estudios encontrados, 963 eran duplicados y se excluyeron 2.779, así se analizaron 178 textos en su totalidad y solo 9 cumplieron con los criterios de inclusión. Las variables edad, peso y talla fueron las que habían sido utilizadas en las ecuaciones predictivas de fuerza muscular respiratoria analizadas por esta revisión. Sin embargo, los estudios apuntaron limitaciones metodológicas, como falta de validación cruzada de la ecuación, exclusión de outliers y familiaridad de la PImáx y PEmáx.

The effect of different physical therapy procedures in ultramarathons

Abstract Aims: To analyze the effects of physical therapy procedures in reducing acute pain in runners. A second aim was to investigate the impact of weather conditions on the number of physical therapy visits during the Ultramarathon Rio24 h. Methods: This retrospective study was performed at the Physical Education Center Admiral Adalberto Nunes (CEFAN). Medical records were analyzed. The participants were athletes that were attended by the Physical therapy team during three editions of the Ultramarathon Rio24 h. The variation in the Visual Analog Scale score (VAS) before and after each treatment were analyzed. After the evaluation procedure, another professional had decided the best procedure for the assessed athlete: massotherapy, cryotherapy by immersion, or stretching. An ANOVA was performed to assess which procedures produce pain reduction immediately after the procedure. Results: A total of 1,995 care services (228 in women) were performed in 602 athletes (84 women). Analyzing the treatments that used only one modality (n = 512 visits), the final pain decreased significantly over the initial pain for the three treatments. It was verified that massotherapy, cryotherapy, and stretching promote significant intragroup differences, with no intergroup differences. The environmental conditions were not associated with the number of visits. Conclusion: Massotherapy, cryotherapy, and stretching are effective treatments for acute pain reduction during ultramarathons. The weather conditions are not associated with the number of physical therapy visits.

The chronic effects of muscle-resistance training in arterial pressure of hypertensive older adults: a meta-analysis / Os efeitos crônicos do treinamento de resistência muscular na pressão arterial de idosos hipertensos: uma metanálise / Los efectos crónicos del entrenamiento de resistencia muscular en la presión arterial de los ancianos hipertensos: una metanálisis

Abstract Introduction: Little research has been done on the effects of muscle-resistance training (RT) in hypertensive older adults. Objective: The aim of this meta-analysis was to verify the efficacy of RT, on a chronic basis, on the systolic (SBP) and diastolic blood pressure (DBP) of hypertensive older adults. Method: Several literature databases were explored to find studies on controlled and randomized trials that evaluated the effects of RT in hypertensive older adults for more than 10 weeks. Profile of the participants, sample size, intervention protocol, and results of SBP and DBP were analyzed. The PEDro scale and the Cochrane tool were used to analyze the methodological quality of the studies and the risk of bias, respectively. The RevMan5.3 program was used to analyze the results on the SBP and DBP after the RT intervention and in the control groups. Results: The meta-analysis of five studies considering 96 hypertensive individuals who underwent RT and 104 hypertensive control subjects showed that the regular practice of RT from 12 to 16 weeks, three times a week, with three sets from 8 to 12 repetitions at an intensity of 60% to 80% of one-repetition maximum (1-RM), significantly reduced SBP by 7.26 mmHg (95%CI = -9.16 - 5.37) and DBP by 4.84 mmHg (95%CI = -5.89 - 3.79). Conclusion: The muscle-resistance training was effective in reducing, chronically, the blood pressure of hypertensive older adults. It can also decrease the need for medication inherent to hypertension.

Resumo Introdução: Pouca pesquisa foi realizada sobre os efeitos do treinamento de resistência muscular (TR) em adultos idosos hipertensos. Objetivo: O objetivo da presente metanálise foi verificar a eficácia da TR, de forma crônica, na pressão arterial sistólica (PAS) e diastólica (PAD) de idosos com hipertensão controlada. Método: Várias bases de dados da literatura foram exploradas para encontrar estudos que examinaram ensaios clínicos controlados e randomizados que avaliaram os efeitos do TR em idosos hipertensos por um período de mais de 10 semanas. Foi analisado o perfil dos participantes, o tamanho da amostra, o protocolo de intervenção e os resultados da PAS e PAD. A Escala PEDro e a ferramenta Cochrane foram utilizadas para analisar a qualidade metodológica dos estudos e o risco de viés, respectivamente. O programa RevMan5.3 foi usado para analisar os resultados na PAS e PAD após a intervenção TR e nos grupos de controle. Resultados: A metanálise de cinco estudos incluiu que, considerando os 96 indivíduos hipertensos submetidos à TR e 104 sujeitos de controle hipertensos, a prática regular de TR por 12 a 16 semanas, três vezes por semana, com três séries de 8 a 12 repetições em uma intensidade de 60% a 80% do teste de uma repetição máxima (1-RM), reduziram significativamente a PAS em 7,26 mmHg (IC 95% = -9,16 - 5,37) e PAD por 4,84 mmHg (IC 95% = -5,89 - 3,79). Conclusão: O treinamento resistido muscular foi eficaz na redução crônica da pressão arterial de idosos hipertensos controlados, podendo diminuir a necessidade de medicação anti-hipertensiva. Estes resultados implicam uma maior sobrevivência para esta população, bem como uma possível diminuição da necessidade de medicamentos inerentes à hipertensão.

Resumen Introducción: Poca investigación se realizó sobre los efectos del entrenamiento de resistencia muscular (ER) en adultos mayores hipertensos. Objectivo: El objetivo del presente metanálisis fue verificar la eficacia del ET, de forma crónica, en la presión arterial sistólica (PAS) y diastólica (PAD) de ancianos con hipertensión controlada. Método: Varias bases de datos de la literatura se exploraron para encontrar estudios que examinaron ensayos clínicos controlados y aleatorizados que evaluaron los efectos del ER en ancianos hipertensos por un período de más de 10 semanas. Se analizó el perfil de los participantes, el tamaño de la muestra, el protocolo de intervención y los resultados de la PAS y PAD. La Escala PEDro y la herramienta Cochrane se utilizaron para analizar la calidad metodológica de los estudios y el riesgo de sesgos, respectivamente. El programa RevMan5.3 fue utilizado para analizar los resultados en la PAS y PAD después de la intervención ER y en los grupos de control. Resultados: El metanálisis de cinco estudios incluyó que, considerando los 96 individuos hipertensos sometidos a ET y 104 sujetos de control hipertensos, la práctica regular de ET por 12 a 16 semanas, tres veces por semana, con tres series de 8 a 12 repeticiones en una intensidad del 60% al 80% de una repetición máxima (1-RM), redujo significativamente la PAS en 7,26 mmHg (IC 95% = -9,16 - 5,37) y DBP por 4,84 mmHg (IC 95% = -5,89 - 3,79). Conclusión: El entrenamiento resistido muscular fue eficaz en la reducción de la presión arterial de ancianos hipertensos controlados, crónicamente, y puede disminuir la necesidad de medicación antihipertensiva.

The effects of hydrogymnastics on functional autonomy in elderly women: a meta-analysis

Aim: To Verify the effects of hydrogymnastics on functional autonomy in elderly women. Method: In November 2018, a systematic review of the literature was performed in the databases MEDLINE, SciELO, LILACS, PEDro, Cochrane, Web of Science, SPORTDiscus, SCOPUS e CINAHL. Two independent researchers selected randomized clinical trials, which evaluated the effects of hydrogymnastics over healthy elderly women performance on functional tests performance on functional tests. From each study they selected the number of participants in both experimental and control groups (EG and CG), age, intervention protocol, mean and standard deviation before and after the intervention for the following variables: legs and biceps muscular strength, posterior muscle chain extensibility, and agility - all of which compose the functional autonomy on Rikli and Jones test. We analyzed the methodological quality and the risk of bias through the Jadad Scale and the Cochrane tool respectively. We performed the data analysis through the random effects model and the mean difference between CG and EG. The analysis of the publication bias was done with Egger Test. Results: We found a total of 887 studies in the aforementioned databases, and five randomized clinical trials were included in the present meta-analysis. In spite of the evidence level is very low, the hydrogymnastics promoted an increase in agility and leg muscle strength in elderly women.(AU)

Dynamic Movement Assessment and Functional Movement Screening for injury prediction: a systematic review / Dynamic Movement Assessment e Functional Movement Screen para predição de lesões: uma revisão sistemática / Dynamic Movement Assessment y Functional Movement Screen para la predicción de la lesión: una revisión sistemática

ABSTRACT Dynamic Movement AssessmentTM (DMATM) and Functional Movement ScreeningTM (FMSTM) are tools to predict the risk of musculoskeletal injuries in individuals who practice physical activities. This systematic review aimed to evaluate the association of DMATM and FMSTM with the risk of musculoskeletal injuries, in different physical activities, categorizing by analysis. A research without language or time filters was carried out in November 2016 in MEDLINE, Google Scholar, SciELO, SCOPUS, SPORTDiscus, CINAHL and BVS databases using the keywords: "injury prediction", "injury risk", "sensitivity", "specificity", "functional movement screening", and "dynamic movement assessment". Prospective studies that analyzed the association between DMATM and FMSTM with the risk of musculoskeletal injuries in physical activities were included. The data extracted from the studies were: participant's profile, sample size, injury's classification criteria, follow-up time, and the results presented, subdivided by the type of statistical analysis. The risk of bias was performed with Newcastle-Ottawa Scale for cohort studies. No study with DMATM was found. A total of 20 FMSTM studies analyzing one or more of the following indicators were included: diagnostic accuracy (PPV, NPV and AUC), odds ratios (OR) or relative risk (RR). FMSTM showed a sensitivity=12 to 99%; specificity=38 to 97%; PPV=25 to 91%; NPV=28 to 85%; AUC=0.42 to 0.68; OR=0.53 to 54.5; and RR=0.16-5.44. The FMSTM has proven to be a predictor of musculoskeletal injuries. However, due to methodological limitations, its indiscriminate usage should be avoided.

RESUMO A Dynamic Movement Assessment (DMATM) e o Functional Movement Screening (FMSTM) são ferramentas utilizadas para classificar o risco de lesões musculoesqueléticas em indivíduos que praticam exercícios físicos. O objetivo da presente revisão sistemática foi avaliar a associação de DMATM e FMSTM com o risco de lesões musculoesqueléticas em diferentes atividades físicas, categorizando por análise. Uma pesquisa sem filtros de idioma ou de tempo foi realizada em novembro de 2016 nas bases de dados MEDLINE, Google Scholar, SciELO, SCOPUS, SPORTDiscus, CINAHL e BVS, utilizando as palavras-chave: "predição de lesão", "risco de lesão", "sensibilidade", "especificidade", "functional movement screening" e "dynamic movement assessment". Foram incluídos estudos prospectivos que analisaram a associação entre DMATM e FMSTM com o risco de lesões musculoesqueléticas em atividades físicas. Foram extraídos dos estudos: perfil dos participantes, tamanho da amostra, critérios de classificação da lesão, tempo de seguimento e os resultados apresentados, subdivididos pelo tipo de análise estatística. O risco de viés foi realizado com a Escala Newcastle-Ottawa para estudos de coorte. Não foi encontrado nenhum estudo sobre a DMATM. Foram incluídos 20 estudos, que analisaram um ou mais dos seguintes indicadores: acurácia diagnóstica (VPP, VPN e AUC), razão de chances (OR) ou risco relativo (RR). O FMSTM apresentou sensibilidade=12-99%; especificidade=38-97%; VPP=25-91%; VPN=28-85%; AUC=0,42-0,68; OR=0.53-54.5; e RR=0,16-5,44. O FMSTM apresentou-se como um método preditor de lesões musculoesqueléticas. Entretanto, devido às limitações metodológicas dos estudos, seu uso indiscriminado deve ser evitado.

RESUMEN Evaluación Dinámica del MovimientoTM (DMATM) y Detección del Movimiento Funcional ™ (FMS™) son herramientas para predecir el riesgo de lesiones musculoesqueléticas en individuos que practican actividades físicas. Esta revisión sistemática tuvo como objetivo evaluar la asociación de DMATM y FMSTM con el riesgo de lesiones musculoesqueléticas en diferentes actividades físicas y categorizarlas por análisis. En noviembre de 2016 se llevó a cabo una investigación sin filtros de idioma o de tiempo en las bases de datos MEDLINE, Google Scholar, SciELO, SCOPUS, SPORTDiscus, CINAHL y BVS, utilizando las palabras clave: predicción de lesiones, riesgo de lesiones, sensibilidad, especificidad, detección del movimiento funcional y evaluación dinámica de movimientos. Se incluyeron estudios prospectivos que analizaron la asociación entre DMATM y FMSTM con el riesgo de lesiones musculoesqueléticas en actividades físicas. Los datos extraídos de los estudios fueron: perfil del participante, tamaño de la muestra, criterios de clasificación de la lesión, tiempo de seguimiento y los resultados presentados, subdivididos por el tipo de análisis estadístico. El riesgo de sesgo se realizó con la Escala Newcastle-Ottawa para estudios de cohorte. No se encontró ningún estudio con DMATM. Se incluyeron un total de 20 estudios FMSTM que analizaron uno o más de los siguientes indicadores: precisión diagnóstica (VPP, VPN y ABC), odds ratios (OR) o riesgo relativo (RR). FMSTM mostró una sensibilidad = del 12 al 99%; especificidad = del 38 al 97%; VPP = del 25 al 91%; VPN = del 28 al 85%; ABC = 0,42 a 0,68; OR = 0,53 a 54,5; y RR = 0,16-5,44. El FMSTM ha demostrado ser un predictor de lesiones musculoesqueléticas. Sin embargo, debido a limitaciones metodológicas, se debe evitar su uso indiscriminado.

Performance in the Deep Squat Test and musculoskeletal injuries: a systematic review / O desempenho no Teste de Agachamento Profundo e lesões musculoesqueléticas: uma revisão sistemática

Abstract Introduction: The Deep Squat Test has been applied in pre-season evaluations of sports teams and in military courses to predict the risk of musculoskeletal injuries. Objective: To evaluate the association of DS performance and the risk of musculoskeletal injuries. Methods: In this systematic review, a search without language or time filters was carried out in MEDLINE, SciELO, SCOPUS, SPORTDiscuss, CINAHL and BVS databases with the following title words: injury prediction, injury risk and deep squat in December 2016. Participants' profile, sample size, classification of musculoskeletal injuries, follow-up time, study design and results were extracted from the studies. Bias risk analysis was performed with the Newcastle-Ottawa Scale. Results: Five studies were included, using different analyzes, whose results varied. Odds ratio ranged from 1.21 to 2.59 (95% CI = 1.01 - 3.28); relative risk was 1.68 (95% CI = 1.50 - 1.87), sensitivity from 3 to 24%, specificity from 90 to 99%, PPV from 42 to 63%, NPV from 72 to 75% and AUC from 51 to 58%. Conclusion: The DS can be a test whose presence of movement dysfunctions is a predictor of the risk of musculoskeletal injuries in individuals who practice physical exercises. However, due to the methodological limitations presented, caution is suggested when interpreting such results. PROSPERO registration: CRD4201706922.

Resumo Introdução: O Teste de Agachamento Profundo (TAP) tem sido utilizado em avaliações pré-temporada de equipes esportivas e em cursos militares para classificar o risco de lesões musculoesqueléticas. Objetivo: Avaliar a associação do desempenho no TAP e o risco de lesões musculoesqueléticas. Métodos: Nesta revisão sistemática, uma pesquisa sem filtros de linguagem ou de tempo foi realizada nas bases de dados MEDLINE, SciELO, SCOPUS, SPORTDdiscuss, CINAHL e BVS com as seguintes palavras-título: predição de lesões, risco de lesão e agachamento profundo em dezembro de 2016. Perfil dos participantes, tamanho da amostra, classificação das lesões musculoesqueléticas, tempo de seguimento, desenho do estudo e os resultados foram extraídos dos estudos. A análise do risco de viés foi realizada com a Escala Newcastle-Ottawa. Resultados: Foram incluídos cinco estudos, utilizando diferentes análises, cujos resultados variaram. O odds ratio variou de 1,21 a 2,59 (IC 95% = 1,01-3,28); O risco relativo foi de 1,68 (IC 95% = 1,50 - 1,87), sensibilidade de 3 a 24%, especificidade de 90 a 99%, VPP de 42 a 63%, VPN de 72 a 75% e AUC de 51 a 58%. Conclusão: O TAP pode ser um teste cuja presença de disfunções de movimento é um preditor do risco de lesões musculoesqueléticas em indivíduos que praticam exercícios físicos. No entanto, devido às limitações metodológicas apresentadas, sugere-se cautela ao interpretar esses resultados. Registro PROSPERO: CRD4201706922.