Motor imagery for paediatric neurorehabilitation: how much do we know? Perspectives from a systematic review.

Background: Motor Imagery (MI) is a cognitive process consisting in mental simulation of body movements without executing physical actions: its clinical use has been investigated prevalently in adults with neurological disorders. Objectives: Review of the best-available evidence on the use and efficacy of MI interventions for neurorehabilitation purposes in common and rare childhood neurological disorders. Methods: systematic literature search conducted according to PRISMA by using the Scopus, PsycArticles, Cinahl, PUBMED, Web of Science (Clarivate), EMBASE, PsychINFO, and COCHRANE databases, with levels of evidence scored by OCEBM and PEDro Scales. Results: Twenty-two original studies were retrieved and included for the analysis; MI was the unique or complementary rehabilitative treatment in 476 individuals (aged 5 to 18 years) with 10 different neurological conditions including, cerebral palsies, stroke, coordination disorders, intellectual disabilities, brain and/or spinal cord injuries, autism, pain syndromes, and hyperactivity. The sample size ranged from single case reports to cohorts and control groups. Treatment lasted 2 days to 6 months with 1 to 24 sessions. MI tasks were conventional, graded or ad-hoc. MI measurement tools included movement assessment batteries, mental chronometry tests, scales, and questionnaires, EEG, and EMG. Overall, the use of MI was stated as effective in 19/22, and uncertain in the remnant studies. Conclusion: MI could be a reliable supportive/add-on (home-based) rehabilitative tool for pediatric neurorehabilitation; its clinical use, in children, is highly dependent on the complexity of MI mechanisms, which are related to the underlying neurodevelopmental disorder.

Attentive Processes and Blood Lactate in the Sambo.

BACKGROUND: Sambo is a martial art and combat sport that originated in the Soviet Union. There are two main stiles, Sport Sambo and Combat Sambo which resembles modern mixed martial arts. Very little literature is available about physiological aspects of Sambo and, in particular, on the possible effects on cognitive domains. The purpose of the present research was to determine if there is a correlation between a blood lactate increase and the intensity and/or selectivity of attentions. METHODS: Sixteen male athletes practicing Sambo for at least 5 years participated voluntarily in the study. Each athlete had to sustain, with an interval of one week, both a Sport Sambo match and a Combat Sambo match, each lasting 5 min. Blood lactate levels as well as attentive capacities were evaluated at three different times: at rest, i.e., 5 min before the start of the session (pre), at end of the session and 15 min after its conclusion. Reaction time protocol was used to evaluate the intensity of attention, whereas divided attention was assessed for analyzing the selectivity of attention together with errors and omissions. RESULTS: Concerning Sport Sambo, blood lactate was 1.66 mmol/L (±0.55 SD) before the session, reached a mean value of 3.40 mmol/L (±0.45 SD) at the end of the session (end) and returned to values similar to initial ones (a mean value of 1.98 mmol/L (±0.37 SD) after 15 min (15-end). None of the attentive parameters examined, showed statistically significant differences. Conversely, for Combat Sambo, it was found a significant increase in blood lactate levels that went from 1.66 mmol/L (±0.55 SD) before the session (pre), to 4.76 mmol/L (±0.60 SD) at the end (end) and then back to values similar to those observed before the session 15 min after its conclusion (15-end), i.e., 1.97 mmol/L (±0.37 SD); however, after a Combat Sambo session increases in blood lactate were associated with significant worsening of attentional mechanisms. CONCLUSIONS: In conclusion, in all the participants, the worsening of attentional mechanisms was observed only after the Combat Sambo session in which blood lactate values exceeded 4 mmol/L. This figure, also known as the Onset of Blood Lactate Accumulation (OBLA), is commonly used to determine the anaerobic threshold.

Ergojump evaluation of the explosive strength in volleyball athletes pre- and post-fascial treatment.

It has previously been demonstrated that physiological mechanisms are involved in muscle pain and fatigue, as the nociceptive afferents of the fascial system are able to modulate the afferent response of the central nervous system. The purpose of the present study was to evaluate a sample of volleyball players, and investigate whether osteopathic treatment of the lower limb muscle groups improved the explosive force of the limbs, whilst reducing spasms and tension, releasing tissue strain and correcting posture. A randomized control study was performed to evaluate 57 athletes who underwent fascial manipulative treatment to assess if such treatment affected the muscle strength of the lower limbs. The treatment group demonstrated a statistically significant improvement in the squatting jump test (P<0.0001) and in the counter movement jump test (P<0.0001). Furthermore, the control group did not exhibit any improvement in the squatting jump test (P<0.56) or in the counter movement jump test (P<0.32). The results suggested that correction of the fascial system required a minimum time of 30 days in order to obtain an improvement of fascial mechanics and sports performance. Therefore, use of a fascial protocol during athletic training will help improve the balance of the bands and, as a direct consequence, improve the efficiency of the musculoskeletal system, thereby reducing the risk of injury. It would therefore be advisable to perform osteopathic treatment techniques every two months during an athletic season to maintain the balance of the fascial system and obtain the most efficient results.