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)

Characteristics and prevalence of musculoskeletal injury in professional and non-professional ballet dancers

BACKGROUND: Ballet is a high-performance activity that requires an advanced level of technical skills. Ballet places great stress on tendons, muscles, bones, and joints and may act directly as a trigger of injury by overuse. OBJECTIVES: 1) to describe the main types of injuries and affected areas related to classical ballet and 2) to compare the frequency of musculoskeletal injuries among professional and non-professional ballet dancers, considering possible gender differences among the professional dancers. METHOD: A total of 110 questionnaires were answered by professional and non-professional dancers. The questionnaire contained items related to the presence of injury, the regions involved, and the mechanism of the injury. RESULTS: We observed a high frequency of musculoskeletal injuries, with ankle sprains accounting for 69.8% of injuries in professional dancers and 42.1% in non-professional dancers. Pirouettes were the most frequent mechanism of injury in professional dancers, accounting for 67.9% of injuries, whereas in the non-professional dancers, repetitive movement was the most common mechanism (28.1%). Ankle sprains occurred in 90% of the women's injuries, and muscle sprains occurred in 54.5% of the men's injuries. The most frequent injury location was the ankle joint in both sexes among the professional dancers, with 67.6% in women and 40.9% in men. CONCLUSIONS: The identification of the mechanism of injury and time of practice may contribute to better therapeutic action aimed at the proper function of the dancers' bodies and improved performance by these athletes.

Hemodynamic responses during and after multiple sets of stretching exercises performed with and without the Valsalva maneuver

OBJECTIVE: This study investigated the acute hemodynamic responses to multiple sets of passive stretching exercises performed with and without the Valsalva maneuver. METHODS: Fifteen healthy men aged 21 to 29 years with poor flexibility performed stretching protocols comprising 10 sets of maximal passive unilateral hip flexion, sustained for 30 seconds with equal intervals between sets. Protocols without and with the Valsalva maneuver were applied in a random counterbalanced order, separated by 48-hour intervals. Hemodynamic responses were measured by photoplethysmography pre-exercise, during the stretching sets, and post-exercise. RESULTS: The effects of stretching sets on systolic and diastolic blood pressure were cumulative until the fourth set in protocols performed with and without the Valsalva maneuver. The heart rate and rate pressure product increased in both protocols, but no additive effect was observed due to the number of sets. Hemodynamic responses were always higher when stretching was performed with the Valsalva maneuver, causing an additional elevation in the rate pressure product. CONCLUSIONS: Multiple sets of unilateral hip flexion stretching significantly increased blood pressure, heart rate, and rate pressure product values. A cumulative effect of the number of sets occurred only for systolic and diastolic blood pressure, at least in the initial sets of the stretching protocols. The performance of the Valsalva maneuver intensified all hemodynamic responses, which resulted in significant increases in cardiac work during stretching exercises. .

Análise da excreção urinária de hidroxiprolina e do nível de dor em sujeitos com lombalgia após alongamento na hidrocinesioterapia / Urinary excretion of hydroxyproline analysis and pain in subjects with low back pain after stretching in hydrotherapy

Hidroxiprolina (HP) e da lombalgia, através de um programa de hidrocinesioterapia, enfatizando o alongamento em água aquecida a 34°C. Participaram do estudo 8 policiais militares do Estado do Rio de Janeiro, do sexo masculino, entre 25 e 45 anos; todos com sintomatologia de lombalgia de causa idiopática e com encaminhamento médico à hidrocinesioterapia. O estudo realizou-se no Centro de Fisiatria e Reabilitação da Polícia Militar do Rio de Janeiro. A piscina onde foi realizada a intervenção media 12 x 6 m, 1,20 de profundidade, com a água a 34°C. A intervenção consistiu de dez sessões de hidrocinesioterapia, duas vezes por semana. Durante cada sessão de 50 minutos, foram realizados os seguintes exercícios: 5 minutos de aquecimento – caminhada; 40 minutos de exercícios específicos – bicicleta em suspensão com flutuador na região axilar; e 5 minutos de alongamento de paravertebrais, bíceps femural, glúteo médio e máximo, tensor da fascia lata, quadrado lombar e tríceps sural. A dor lombar foi mensurada através da escala CR-10 de Borg, antes e após as dez sessões do tratamento, e o nível de HP através do protocolo HPROLI 2h. Os resultados demonstraram que os níveis de HP, antes e depois do tratamento, foram iguais a 53,3 ± 22,6 e 31,6 ± 11,3 mg/d, respectivamente. O teste t de Student apresentou valor para t igual a 3,93, para p = 0,008 demonstrando haver diferença significativa entre HP antes e após a hidrocinesioterapia. Os níveis de dor mensurados, antes e depois do tratamento, foram iguais a 5 ± 2 e 2 ± 1, respectivamente. O teste de Wilcoxon apresentou valor para Z igual a 2,20, para p = 0,03 demonstrando haver diferença significativa entre estes níveis antes e após a hidrocinesioterapia. Conclui-se que o método de alongamento utilizado na hidrocinesioterapia, em pacientes com lombalgia, promoveu redução dos níveis de HP e dor lombar.

The aim of this study was to measure excretion levels of hidroxyproline (HP) in subjects with low back pain through a hydrotherapy program, emphasizing the stretching in warm water 34°C. The subjects of the study were 8 military policemen of the state of Rio de Janeiro, between 25 and 45 years old, all of them with idiopathic low back pain and recommendation to practice hydrotherapy. The intervention was in the Physical Medicine and Rehabilitation Center of Military Policy of Rio de Janeiro. The swimming pool measured 12 x 6 m, with 1,20 of depth and water temperature of 34°C. The intervention consisted of ten sessions of hydrotherapy, twice a week. The exercise program, with 50 minutes each session, was as follows: 5 minutes of walking, 40 minutes of specific exercises – float suspension bicycle in the axillar area and 5 minutes of stretching of paravertebral, biceps femuralis, gluteus maximus and medius, tensor faciae latae muscle, lumbar quadrate and triceps surae. The low back pain was measured by Borg scale CR-10 before the 1st session of the intervention and after the last one, as well as HP level using HPROLI 2h protocol. The results showed that HP levels before and after treatment was 53.3 ± 22.6 and 31.6 ± 11.3 mg/d, respectively. The t Student test showed t 3.93, and for p = 0.008 showing a significant difference between HP levels before and after hydrotherapy. The low back pain before and after treatment was 5 ± 2 and 2 ± 1, respectively. The Wilconxon test showed Z 2,20 and for p = 0,03 and with significant difference between these levels before and after hydrotherapy. One concludes that the stretching method used by hydrotherapy in patients with low back pain promoted reduction in HP levels and low back pain.