Massage protects skeletal muscle from injury during long-term heavy-duty exercise via integrin ß1 and laminin 2 channels of basement membrane.

BACKGROUND: Massage is widely used in exercise-induced skeletal muscle damage (EIMD). It has been proven that massage can improve the morphology and function of damaged skeletal muscle in multiple ways. However, whether massage can protect skeletal muscles from injury during long-term heavy-duty exercise has not yet been determined. METHODS: In this study, a rat model of overuse injury was established by eccentric running for 4 weeks, and pressing at constant pressure and frequency and massage were used as intervention methods to explore whether massage could protect skeletal muscle from injury through upregulating integrin and the basement membrane laminin. RESULTS: The results showed that compared with the model group, the ultrastructure of skeletal muscle in the massage group was relatively complete and clear, and the maximum isotonic and tetanic contraction forces were significantly increased (P < 0.01). In addition, in the massage group, ß1 integrin expression was significantly increased, p-FAK protein expression was decreased, and the co-localization of ß1 integrin and the basement membrane laminin 2 was significantly increased (P < 0.01). CONCLUSION: Our study shows that during long-term heavy-duty exercise, massage can enhance the cell adhesion function mediated by integrin ß1 and laminin 2 to protect skeletal muscle from injury and prevent the occurrence of overuse injury.

Compliance compromises an interventional study on iron supplementation in female combatants.

INTRODUCTION: Low iron levels are related to overuse injuries, poor physical performance and cognitive impairments in female recruits. The aim of this study was to evaluate iron supplement compliance in female combatants during basic training, and its effect on haemoglobin (Hgb), ferritin and injuries. METHODS: 329 female recruits to light infantry units filled induction questionnaires regarding smoking status, previous overuse injuries and iron deficiency. Blood was drawn for Hgb and ferritin. Subjects with ferritin levels below 20 ng/mL were considered iron depleted and were prescribed a ferrous fumarate supplement. After 4 months of basic training, the subjects completed a follow-up questionnaire regarding overuse injuries, reasons for failure to complete basic training and compliance with iron supplementation. Blood tests were repeated. RESULTS: Mean ferritin levels declined during training (from 18.1±18.2 to 15.3±9.6, p=0.01). Compliance with iron supplementation was observed in 26 (26.3%) of the subjects. In compliant subjects, Hgb levels remained constant and ferritin levels increased by 2.9±5.4 (p=0.07). The main reasons for reported non-compliance were forgetfulness, 26 (35.6%), and gastrointestinal side effects, 17 (23.3%). Injuries during training were not found to be associated with iron status. Smokers had a significantly higher rate of reported injuries prior to training (p<0.01). CONCLUSIONS: Ferritin levels decline during training. Compliance with iron supplementation is low. Iron supplementation has a significant effect on ferritin levels, even in the non-compliance group. Injuries were not related to iron status in this group. Further research is needed in order to clarify the most appropriate iron supplementation method.

Effect of Acute Self-Myofascial Release on Pain and Exercise Performance for Cycling Club Members with Iliotibial Band Friction Syndrome.

Cycling is a popular sport, and the cycling population and prevalence of related injuries and diseases increase simultaneously. Iliotibial band friction syndrome is a common chronic overuse injury caused by repetitive knee use in cycling. Self-myofascial release using foam rollers is an effective intervention for this syndrome; however, studies reporting positive results on self-myofascial release in cycling are limited. Therefore, this study investigated the effect of self-myofascial release on pain and iliotibial band flexibility, heart rate, and exercise performance (cadence, power, and record) in adult male cyclists with iliotibial band friction syndrome. We evaluated the pain and exercise ability of the control (n = 11) and self-myofascial release (n = 11) groups before and after cycling twice. Significant differences were observed in the pain scale, the iliotibial band flexibility, and cycling pain and power. The posterior cadence of the self-myofascial release group was 3.2% higher than that of the control group. The control group's record time increased by 74.64 s in the second cycling session compared to the first cycling session, while that of the self-myofascial release group decreased by 30.91 s in the second cycling session compared to the first cycling session. Self-myofascial release is effective in relieving pain and may improve cycling performance by increasing the iliotibial band flexibility.

Manual Therapy Facilitates Homeostatic Adaptation to Bone Microstructural Declines Induced by a Rat Model of Repetitive Forceful Task.

The effectiveness of manual therapy in reducing the catabolic effects of performing repetitive intensive force tasks on bones has not been reported. We examined if manual therapy could reduce radial bone microstructural declines in adult female Sprague-Dawley rats performing a 12-week high-repetition and high-force task, with or without simultaneous manual therapy to forelimbs. Additional rats were provided 6 weeks of rest after task cessation, with or without manual therapy. The control rats were untreated or received manual therapy for 12 weeks. The untreated TASK rats showed increased catabolic indices in the radius (decreased trabecular bone volume and numbers, increased osteoclasts in these trabeculae, and mid-diaphyseal cortical bone thinning) and increased serum CTX-1, TNF-α, and muscle macrophages. In contrast, the TASK rats receiving manual therapy showed increased radial bone anabolism (increased trabecular bone volume and osteoblast numbers, decreased osteoclast numbers, and increased mid-diaphyseal total area and periosteal perimeter) and increased serum TNF-α and muscle macrophages. Rest, with or without manual therapy, improved the trabecular thickness and mid-diaphyseal cortical bone attributes but not the mineral density. Thus, preventive manual therapy reduced the net radial bone catabolism by increasing osteogenesis, while rest, with or without manual therapy, was less effective.

Effect of Compression Therapy in the Treatment of Tibial Stress Syndrome in Military Service Members.

CONTEXT: Tibial stress syndrome (TSS) is an overuse injury of the lower extremities. There is a high incidence rate of TSS among military recruits. Compression therapy is used to treat a wide array of musculoskeletal injuries. The purpose of this study was to investigate the use of compression therapy as a treatment for TSS in military service members. DESIGN: A parallel randomized study design was utilized. METHODS: Military members diagnosed with TSS were assigned to either a relative rest group or compression garment group. Both groups started the study with 2 weeks of lower extremity rest followed by a graduated running program during the next 6 weeks. The compression garment group additionally wore a shin splints compression wrap during the waking hours of the first 2 weeks and during activity only for the next 6 weeks. Feelings of pain, TSS symptoms, and the ability to run 2 miles pain free were assessed at baseline, 4 weeks, and 8 weeks into the study. RESULTS: Feelings of pain and TSS symptoms decreased during the 8-week study in both groups (P < .05), but these changes were not significantly different between groups (P > .05). The proportion of participants who were able to run 2 miles pain free was significantly different (P < .05) between the 2 groups at the 8-week time point with the compression garment group having a significantly increased ability to complete the run without pain. CONCLUSIONS: Although perceptions of pain at rest were not different between groups, the functional ability of running 2 miles pain free was significantly improved in the compression garment group. These findings suggest that there is a moderate benefit to using compression therapy as an adjunct treatment for TSS, promoting a return to training for military service members.

Comparison of incidence, prevalence, severity and profile of health problems between male and female elite youth judokas: A 30-week prospective cohort study of 154 athletes.

OBJECTIVES: To describe and compare the incidence, prevalence, severity, and profile of injuries (acute and overuse) and illness between female and male youth elite judokas during 30 weeks of a sports season. DESIGN: Prospective cohort study. METHODS: A total of 154 elite youth judokas (83 males and 71 females) were assessed from January to August 2019 in a training period organized by the Brazilian Judo Confederation. We conducted a prospective 30-week follow-up study on acute and overuse injuries and illness among youth female and male judokas through the Oslo Sports Trauma Research Center questionnaire on health problems (OSTRC-H). Every week, the OSTRC-H was sent to all youth judokas electronically, starting in the first week of preseason. The incidence rate, prevalence, and severity of illnesses and acute and overuse injuries were compared between sexes using an independent t-test (variables with normal distribution) or Mann Whitney U test (variables with non-normal distribution) with α set a 0.05. RESULTS: Female and male judokas showed 16.96 and 16.57 injuries per 1000 athletic exposures, respectively (p = 0.383). Female judokas showed a higher average weekly prevalence of health problems (38.8%) than male judokas (29.0%). In addition, females had a greater prevalence of substantial health problems (p < 0.001), injuries (p < 0.001), and overuse injuries (p < 0.001) than males. CONCLUSION: There were no differences in the incidence rate of injuries between sexes. Youth female judokas showed a higher prevalence of all health problems than youth male judokas. For both sexes, the knee and shoulder were the most affected joints for acute and overuse injuries, respectively.

Key indicators of repetitive overuse-induced neuromuscular inflammation and fibrosis are prevented by manual therapy in a rat model.

BACKGROUND: We examined the effectiveness of a manual therapy consisting of forearm skin rolling, muscle mobilization, and upper extremity traction as a preventive treatment for rats performing an intensive lever-pulling task. We hypothesized that this treatment would reduce task-induced neuromuscular and tendon inflammation, fibrosis, and sensorimotor declines. METHODS: Sprague-Dawley rats performed a reaching and lever pulling task for a food reward, 2 h/day, 3 days/week, for 12 weeks, while simultaneously receiving the manual therapy treatment 3 times per week for 12 weeks to either the task-involved upper extremities (TASK-Tx), or the lower extremities as an active control group (TASK-Ac). Results were compared to similarly treated control rats (C-Tx and C-Ac). RESULTS: Median nerves and forearm flexor muscles and tendons of TASK-Ac rats showed higher numbers of inflammatory CD68+ and fibrogenic CD206+ macrophages, particularly in epineurium, endomysium and epitendons than TASK-Tx rats. CD68+ and CD206+ macrophages numbers in TASK-Tx rats were comparable to the non-task control groups. TASK-Ac rats had more extraneural fibrosis in median nerves, pro-collagen type I levels and immunoexpression in flexor digitorum muscles, and fibrogenic changes in flexor digitorum epitendons, than TASK-Tx rats (which showed comparable responses as control groups). TASK-Ac rats showed cold temperature, lower reflexive grip strength, and task avoidance, responses not seen in TASK-Tx rats (which showed comparable responses as the control groups). CONCLUSIONS: Manual therapy of forelimbs involved in performing the reaching and grasping task prevented the development of inflammatory and fibrogenic changes in forearm nerves, muscle, and tendons, and sensorimotor declines.

Elite athletes' experiences of musculoskeletal pain management using neuroanatomical dry needling: A qualitative study in Swedish track and field.

OBJECTIVES: To investigate how elite track and field athletes with a history of musculoskeletal pain (MSKP) describe their perceptions of clinical treatments based on dry needling guided by a neurological map (neuroanatomical dry needling (naDN)). DESIGN: Qualitative study. METHODS: In-depth interviews were conducted with eight elite Swedish track and field athletes (6 males, 2 females, median age 28.5) treated at a clinic specialised in MSKP management. All interviews were audio recorded and transcribed verbatim. The data were structured and analysed using a thematic method. RESULTS: The athletes approached clinical MSKP treatment from a performance-orientated perspective. They explained that they inevitably suffered MSKP episodes due to the intense physical demands of their sport. The use of naDN was considered an integral part of their sports practice and the study clinic's services were readily utilised when MSKP caused minor reductions in physical capacity. The athletes appreciated an unambiguous anatomical diagnosis, preferably supported by imaging scans, as this increased their confidence in clinical services. They valued the naDN treatment as it was perceived to provide fast-acting analgesia that enabled rapid return-to-play. These factors combined to reduce performance-related stress. CONCLUSIONS: Elite track and field athletes with a history of MSKP sought and appreciated clinical treatment with naDN largely because it provided fast-acting analgesia that enabled rapid return-to-play at a high-performance level. These athletes' expectations of MSKP diagnosis and management appear incongruent with current research indicating that MSKP sensitivity within the nervous system does not accurately reflect musculoskeletal tissue state or recovery following tissue damage.

Prevalence of Vitamin D Insufficiency and Deficiency in Young, Female Patients With Lower Extremity Musculoskeletal Complaints.

BACKGROUND: Low levels of vitamin D have well-known impacts on bone health, but vitamin D also has a more global role throughout many tissues, including skeletal muscle. The high prevalence of hypovitaminosis D and the vast physiological features of vitamin D have led researchers to examine the influence of vitamin D on physical performance and injury. Because of the critical role of vitamin D in maintaining musculoskeletal health and function, a high rate of hypovitaminosis D among female patients with a variety of musculoskeletal issues could be of high clinical relevance. HYPOTHESIS: There is a high prevalence of low vitamin D in female patients with both acute and overuse sports-related issues of both soft tissue and bone. STUDY DESIGN: Prospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Female patients, aged 16 to 40 years, presenting with lower extremity injury diagnosed within the past 4 weeks, no use of multivitamin or vitamin D supplement, and no history of malabsorption syndrome met the inclusion criteria. Vitamin D levels were assessed and categorized as normal (≥32 ng/mL) and low, which includes insufficient (20.01-31.9 ng/mL) and deficient (≤20 ng/mL). RESULTS: Of the 105 patients enrolled, 65.7% had low vitamin D. Within the low vitamin D cohort, 40.6% were deficient and 59.4% were insufficient. Injuries were grouped into overuse or acute with 74 overuse injuries and 31 acute injuries, exhibiting low vitamin D prevalence of 60.8% and 77.4%, respectively. Patients with ligamentous/cartilaginous injuries exhibited the highest percentage of low vitamin D (76.5%), followed by those with patellofemoral-related complaints (71.0%), muscle/tendon injuries (54.6%), and bone stress injuries (45.5%). In univariable analysis, older age, non-White race, less physical activity, less high-intensity interval training days, less endurance training days, and more rest days showed an association with low vitamin D, but none showed an independent association in multivariable analysis. CONCLUSION: The prevalence of low vitamin D in female patients with various musculoskeletal complaints was high. Clinicians should evaluate for low vitamin D in both acute and overuse injuries. CLINICAL RELEVANCE: In addition to screening, this study suggests that clinicians should evaluate for low vitamin D levels beyond bone stress injuries in the setting of acute and overuse injuries.

Gamer's Health Guide: Optimizing Performance, Recognizing Hazards, and Promoting Wellness in Esports.

Electronic sports (esports), or competitive video gaming, is a rapidly growing industry and phenomenon. While around 90% of American children play video games recreationally, the average professional esports athlete spends 5.5 to 10 h gaming daily. These times and efforts parallel those of traditional sports activities where individuals can participate at the casual to the professional level with the respective time commitments. Given the rapid growth in esports, greater emphasis has been placed on identification, management, and prevention of common health hazards that are associated with esports participation while also focusing on the importance of health promotion for this group of athletes. This review outlines a three-point framework for sports medicine providers, trainers, and coaches to provide a holistic approach for the care of the esports athlete. This esports framework includes awareness and management of common musculoskeletal and health hazards, opportunities for health promotion, and recommendations for performance optimization.

Overreaching and overtraining in strength sports and resistance training: A scoping review.

To date, little is known about overreaching (OR) and the overtraining syndrome (OTS) in strength sports and resistance training (RT) populations. However, the available literature may elucidate the occurrence of both conditions in these populations. A scoping review was conducted. SPORTDiscus, Scopus and Web of Science were searched in a robust and systematic manner, with relevant articles analysed. 1170 records were retrieved during an initial search, with a total of 47 included in the review. Two broad themes were identified during data extraction: 1) overreaching in strength sports; 2) overreaching and overtraining syndrome in RT. Short-term periods of OR achieved with either high-volume or high-intensity RT can elicit functional OR (FOR) but there is also evidence that chronic high-volume and/or intensity RT can lead to non-functional overreaching (NFOR). There is minimal evidence to suggest that true OTS has occurred in strength sports or RT based on the studies entered during this review. More research is needed to develop robust guiding principles for practitioners. Additionally, due to the heterogeneous nature of the existing literature, future research would benefit from the development of practical tools to identify and diagnose the transition from FOR to NFOR, and subsequently OTS in strength athletes and RT populations. ABBREVIATIONS: RT: Resistance training; OR: Overreaching; FOR: Functional overreaching; NFOR: Non-functional overreaching; OTS: Overtraining syndrome; WP: Weightlifting performance.

Conservative Treatment of Tendon Injuries.

Tendon injuries or tendinopathy is a common painful and disabling conditions resulting from overuse and aging. Tendinopathy remains a challenging clinical problem because response to different treatment modalities is usually unsatisfactory and recovery is slow. We performed an extensive literature review focusing on nonsurgical treatment options for tendinopathies, including nonsteroidal anti-inflammatory drugs, corticosteroid, eccentric exercise, extracorporeal shock wave therapy, therapeutic ultrasound, hyaluronic acid, platelet-rich plasma, prolotherapy, polydeoxyribonucleotide, and stem cells, aimed at providing the most updated evidence as a guideline for caregivers.

Manual therapy prevents onset of nociceptor activity, sensorimotor dysfunction, and neural fibrosis induced by a volitional repetitive task.

Painful and disabling musculoskeletal disorders remain prevalent. In rats trained to perform repetitive tasks leading to signs and dysfunction similar to those in humans, we tested whether manual therapy would prevent the development of the pathologies and symptoms. We collected behavioral, electrophysiological, and histological data from control rats, rats that trained for 5 weeks before performing a high-repetition high-force (HRHF) task for 3 weeks untreated, and trained rats that performed the task for 3 weeks while being treated 3x/week using modeled manual therapy (MMT) to the forearm (HRHF + MMT). The MMT included bilateral mobilization, skin rolling, and long axis stretching of the entire upper limb. High-repetition high-force rats showed decreased performance of the operant HRHF task and increased discomfort-related behaviors, starting after training. HRHF + MMT rats showed improved task performance and decreased discomfort-related behaviors compared with untreated HRHF rats. Subsets of rats were assayed for presence or absence of ongoing activity in C neurons and slow Aδ neurons in their median nerves. Neurons from HRHF rats had a heightened proportion of ongoing activity and altered conduction velocities compared with control and MMT-treated rats. Median nerve branches in HRHF rats contained increased numbers of CD68 macrophages and degraded myelin basic protein, and showed increased extraneural collagen deposition, compared with the other groups. We conclude that the performance of the task for 3 weeks leads to increased ongoing activity in nociceptors, in parallel with behavioral and histological signs of neuritis and nerve injury, and that these pathophysiologies are largely prevented by MMT.

Reflexoterapia podal para lombalgia aguda ocupacional: ensaio clínico randomizado duplo cego / Foot reflexology for acute occupational low back pain: a double-blind randomized clinical trial / Reflexoterapia podal para lumbago agudo ocupacional: ensayo clínico aleatorizado doble-ciego

OBJETIVO: Comparar os efeitos da reflexoterapia podal no alívio da lombalgia aguda ocupacional da equipe de enfermagem. MÉTODO: ensaio clínico randomizado, controlado, duplo-cego. Participaram 36 profissionais efetivos, randomicamente alocados. A coleta de dados foi realizada com a Escala Visual e Analógica de intensidade da dor, antes e depois das aplicações do protocolo de reflexoterapia e Questionário para Lombalgia, aplicado no início e fim da pesquisa. Para normalidade da amostra utilizou-se o teste Shapiro Wilk; teste Qui-quadrado ou Exato de Fisher para verificar a significância da associação entre variáveis categóricas; teste de Wilcoxon (dados não paramétricos) e teste t (dados paramétricos). RESULTADO: reflexoterapia podal apresentou efeito significativo (p=0,000) nas etapas de intervenção para alívio da intensidade da dor lombar aguda, tanto no escore do EVA, quanto no Questionário para Lombalgia (p=0,0002). CONCLUSÕES: a reflexoterapia apresentou efeitos estatisticamente significativos na redução da lombalgia aguda dos profissionais da Enfermagem

AIM: To compare the effects of foot reflexology in relieving acute occupational low back pain in the nursing team. METHOD: randomized, controlled, double-blind clinical trial. Participants included 36 randomly allocated, effective professionals. Data collection was performed with the Visual and Analogue Scale of pain intensity, before and after the applications of the reflexotherapy protocol and Questionnaire for Low Back Pain, applied at the beginning and end of the research. For normality of the sample the Shapiro Wilk test, Chi-square test or Fisher's exact test was used to verify the significance of the association between categorical variables; Wilcoxon test (non-parametric data) and t-test (parametric data). RESULT: reflexotherapy showed significant effect (p=0.000) in the intervention stages to alleviate the intensity of acute low back pain, both in the VAS score and in the Low Back Pain Questionnaire (p=0.0002). CONCLUSIONS: reflexotherapy showed statistically significant effects on the reduction of acute low back pain in Nursing professionals.

OBJETIVO: Comparar los efectos de la reflexoterapia podal en el alivio del lumbago agudo ocupacional del equipo de enfermería. MÉTODO: ensayo clínico aleatorizado, controlado, doble-ciego. Participaron 36 profesionales efectivos, asignados aleatoriamente. El muestreo se realizó con la Escala Visual y Analógica de intensidad del dolor, antes y después de las aplicaciones del protocolo de reflexoterapia y con el Cuestionario para Lumbago, aplicado al inicio y fin de la investigación. Para normalizar la muestra se utilizó el test Shapiro Wilk; test Chi-cuadrado o Exacto de Fisher para verificar la significancia de la asociación entre las variables categóricas; test de Wilcoxon (datos no paramétricos) y test t (datos paramétricos). RESULTADO: La reflexoterapia podal presentó efecto significativo (p=0,000) en las etapas de intervención para aliviar la intensidad del dolor lumbar agudo, tanto en el escore del EVA, como en el Cuestionario para Lumbago (p=0,0002). CONCLUSIONES: La reflexoterapia presentó efectos estadísticamente significativos en la reducción del lumbago agudo de los profesionales de Enfermería.

Modulatory effects of taurine on metabolic and oxidative stress parameters in a mice model of muscle overuse.

OBJECTIVE: The aim of this study was to investigate the regulatory effects of taurine on the biochemical parameters of muscle injury by overuse. METHODS: Male Swiss mice were divided into four groups: control (Ctrl), overuse (Ov), taurine (Tau), and overuse plus taurine (OvTau). High-intensity exercise sessions were administered for 21 d with concomitant subcutaneous injections of taurine (150 mg/kg). The mice were then sacrificed. The quadriceps muscles were surgically removed for subsequent histologic analysis and evaluation of mitochondrial function, oxidative stress parameters, tissue repair, and DNA damage markers. RESULTS: The Ov group showed significant differences compared with the Ctrl group (all P <0.05). The fiber area decreased by 49.34%, whereas the centralized nuclei contents (Ctrl = 1.33%; Ov = 28.67%), membrane potential (Ctrlsuc = 179.05 arbitrary fluorescence units (AFUs), Ctrlsuc+ADP = 198.11 AFUs; Ovsuc = 482.95 AFUs, Ovsuc+ADP = 461.6 AFUs), complex I activity (Ctrl = 20.45 nmol ⋅ min ⋅ mg protein, Ov = 45.25 nmol ⋅ min ⋅ mg protein), hydrogen peroxide (Ctrlsuc = 1.08 relative fluorescence unit (RFU) ⋅ sec ⋅ mg protein, Ctrlsuc+ADP = 0.23 RFU ⋅ sec ⋅ mg protein; Ovsuc = 5.02 RFU ⋅ sec ⋅ mg protein, Ovsuc+ADP = 0.26 RFU ⋅ sec ⋅ mg protein) and malondialdehyde (Ctrl = 0.03 nmol ⋅ mg ⋅ protein, Ov = 0.06 nmol ⋅ mg ⋅ protein) levels, and DNA damage (Ctrlfreq = 7.17%, Ovfreq = 31.17%; Ctrlindex = 4.17, Ovindex = 72.5) were increased. Taurine administration reduced the number of centralized nuclei (OvTau = 5%), hydrogen peroxide levels (OvTausuc = 2.81 RFU ⋅ sec ⋅ mg protein, OvTaussuc+ADP = 1.54 RFU ⋅ sec ⋅ mg protein), membrane potential (OvTausuc = 220.18 AFUs, OvTaussuc+ADP = 235.28 AFUs), lipid peroxidation (OvTau = 0.02 nmol/mg protein), and DNA damage (OvTaufreq = 21.33%, OvTauindex = 47.83) and increased the fiber area by 54% (all P <0.05). CONCLUSION: Taken together, these data suggest that taurine supplementation modulates various cellular remodeling parameters after overuse-induced muscle damage, and that these positive effects may be related to its antioxidant capacity.

Condições de saúde, trabalho e qualidade de vida de trabalhadores de serviços de embelezamento e de terapias complementares e estéticas / Condiciones de salud, trabajo y calidad de vida de los trabajadores del servicio de embellecimiento y terapias complementarias y estética / Health, work and quality of life beautification service workers and complementary therapies and aesthetic

Objective was to identify the profile of health and working manicures and evaluate their quality of life. Methods:this is a descriptive epidemiological study conducted in a city in Minas Gerais, using two instruments: the firsta semi-structured in order to know the reality of these subjects and the second WHOQOL-Breff, created by the World Health aiming assessing quality of life. The research was approved by the Research Ethics Committee of the Pontifical Catholic University of Minas Gerais (CAAE 0026.0.213.000-09)). Results: it was observed female predominance 72 (98.63%); average age of 33.81 years. The most reported comorbidity was RSI / MSDs in 21(28.77%) and 38 (52.05%) reported pain, and 31 (31.63%) back pain. Regarding the quality of life: education, family income, the presence of comorbidities and the presence of pain influenced the perception of quality of life of individuals. Conclusion: highlights the need for public policies aimed at worker health and health education initiatives with prophylactic measures.

Objetivo: foi identificar as condições de saúde, trabalho e qualidade de vida de trabalhadores de serviços de embelezamento e de terapias complementares e estéticas e avaliar sua qualidade de vida. Métodos: trata-se de um estudo descritivo, epidemiológico, realizado em 2015 um município de Minas Gerais, com os dados coletados por: o primeiro, semiestruturado visou conhecer a realidade desses sujeitos e o segundo o WHOQOLBREFF,criado pela Organização Mundial em Saúde, que objetivou avaliara qualidade de vida. A pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da Pontifícia Universidade Católica de Minas Gerais (CAAE08180012.3.0000.5137). Resultados: constatou-se, entre os participantes,a predominância feminina 72 (98,63%) e idade média de 33,81 anos. A comorbidade mais relatada foi Lesões por esforço repetitivo/Doenças Osteomusculares Relacionadas ao Trabalho em 21 (28,77%) e 38 (52,05%)referiram dor, sendo 31 (31,63%) lombalgias. A escolaridade, a renda familiar, a presença de comorbidades e a presença de dor influenciaram na percepção da qualidade de vida dos indivíduos. Conclusões: evidencia-se a necessidade de políticas públicas voltadas a saúde desses trabalhadores e ações de educação sanitária com medidas profiláticas.

Objetivo: identificar el perfil de la salud y la manicura de trabajo y evaluarsu calidad de vida. Métodos: se realizó un estudio epidemiológico descriptivo realizado en una ciudad en Minas Gerais, el uso de dos instrumentos: la primera semi-estructurada con el fin de conocer la realidad de estos temas y la segunda WHOQOL-Breff, creado por objetivoel Mundial de la Salud evaluación de la calidad de vida. La investigación fue aprobado por el Comité de Ética de Investigación de la Pontificia Universidad Católica de Minas Gerais (CAAE 0026.0.213.000-09). Resultados: se observó predominio femenino 72 (98,63%); promedio deedad de 33,81 años. La comorbilidad más reportado fue RSI / TME en 21(28,77%) y 38 (52,05%) informaron de dolor, y 31 (31,63%) el dolor de espalda. En cuanto a la calidad de vida: la educación, el ingreso familiar,la presencia de comorbilidades y la presencia de dolor influyeron en la percepción de la calidad de vida de los individuos. Conclusión: Se destacala necesidad de políticas públicas destinadas a iniciativas de salud yeducación para la salud de los trabajadores con medidas profilácticas.

Creatine Supplementation Supports the Rehabilitation of Adolescent Fin Swimmers in Tendon Overuse Injury Cases.

Our purpose was to investigate the effect of creatine (Cr) supplementation on regeneration periods in tendon overuse injury rehabilitation of adolescent fin swimmers. The participants of this study were injured adolescent competitive fin swimmers (n = 18). The subjects were randomly assigned the creatine (CR) or placebo (PL) groups with a double-blind research design. The subjects were given Cr supplementation or received the placebo as part of the conservative treatment of the tendinopathy. We measured the segmental lean mass (SLM;kg), the ankle plantar flexion peak torque (PFT;N·m), the pain intensity (NRS;values), prior to immobilization, after immobilization (R2) and after the 2nd (R4) and 4th (R6) weeks of the rehabilitation period of the injured limb. The creatine kinase (CK; U/L) enzyme levels were measured before immobilization, and then every 24 hours for four days. There was a significant decrease in SLM (CR by 5.6% vs. PL by 8.9%; p < 0.03) after two weeks of immobilization in both groups (p < 0.001). After four weeks rehabilitation the SLM significantly increased in both groups (CR by 5.5% vs. PL by 3.8%; p < 0.01). The percent changes in PFT after supplementation in R4 (p < 0.001) and R6 (p < 0.03) were significantly different between groups. There was a significant percent increase measured in the CR group (R4 by 10.4%; p < 0.001; R6 by 16.8%; p < 0.001), whereas significant, but lower growth found in the PL group also took place (R4 by 7.1%; p < 0.001; R6 by 14.7%; p < 0.001) after four weeks of rehabilitation. Significantly faster decrease were found in NRS of CR versus PL group during treatment (p < 0.02). We detected significantly lower CK levels increase at the CR group compared to the PL group. The results of this study indicate that Cr supplementation combined with therapeutic strategy effectively supports the rehabilitation of tendon overuse injury of adolescent fin swimmers.

Quality of Life of People with Thoracic Outlet Syndrome after Surgery

Purpose To evaluate the quality of life of patients with neurogenic thoracic outlet syndrome (N-TOS) who underwent surgery via the supraclavicular approach. Method Sociodemographic and clinical data were collected, and an evaluation of the pain and quality of life of 29 patients was performed. Results The average age of the patients was 42 years, and most of them were female. All of them had one or more associated pathologies. They all worked in occupations that involved repetitive movement of the upper limbs. The evaluation of the degree of pain showed that the pain remains preponderant and incapacitating in the life of these individuals, who consequently enjoy a low quality of life. Conclusion These patients presented low quality of life, with persistent pain probably resulting from the associated pathologies, in addition to their psychosocial context. Thus, in order to treat the TOS, an intervention of a multidisciplinary team with a holistic view of the patient is required.

Objetivo Avaliar a qualidade de vida de pacientes com síndrome do desfiladeiro torácico (SDT) do tipo neurogênico submetidos a cirurgia por via supraclavicular. Metodologia Foram coletados dados sociodemográficos e clínicos, e foram avaliadas a dor e a qualidade de vida de 29 pacientes. Resultados Os pacientes tinham idade média de 42 anos, sendo a maioria do sexo feminino, e todos com uma ou mais patologias associadas. Todas as ocupações profissionais exercidas envolviam movimentos repetitivos de membros superiores. A avaliação do quadro álgico evidenciou que a dor ainda permanece preponderante e incapacitante na vida desses indivíduos, que, consequentemente, apresentam baixa qualidade de vida. Conclusão Estes pacientes apresentaram baixa qualidade de vida, com persistência da dor, provavelmente em decorrência das patologias associadas, além do contexto psicossocial. Desse modo, para o tratamento da SDT, faz-se necessária a intervenção de uma equipe multidisciplinar com visão holística do paciente.

Injury rates in martial arts athletes and predictive risk factors for lower limb injuries.

BACKGROUND: Previous studies attempted to identify possible risk factors for acute and overuse injuries in several sports disciplines such as running, gymnastics or team sports. Given the lack of scientific works focused on risk factors for lower limb injuries in martial arts, the present study was aimed to investigate foot anatomy, anthropometric measures, and other background information as possible risk factors of injury in barefoot athletes practicing judo, karate, kung fu, Thai boxing, or aikido. In addition, the injury rates were evaluated in relation with the different martial art styles. METHODS: One group of 130 martial artists was retrospectively evaluated. Data of three morphological variables of the foot were collected: navicular height (NH), navicular drop (ND), and the rear foot (RF). In addition, each participant filled an interview questionnaire providing the following information: age, sex, body weight, height, Body Mass Index, hours of training per week, the kind of injury occurred to the lower limbs in the preceding year. RESULTS: Of 130 subjects, 70 (53.8%) did not sustain injuries, 35 (27.0%) suffered an acute injury and the remaining 25 (19.2%) reported an overuse injury. No significant differences were observed in the injury rates in relation to style and kind of martial art. Age, training volume and BMI were found as significant predictors of injury, while NH, ND, and RF were not able to predict acute or overuse injury at lower limbs. CONCLUSIONS: The injury rates were similar in karate, judo, kung fu, aikido, and Thai boxing. The foot morphology variables were not related with the presence or absence of acute and overuse injuries. Conversely, older and heavier martial artists, performing more hours of barefoot training, are at higher risk of acute and overuse injury. Athletic trainers should strongly take into account the present information in order to develop more accurate and specific injury prevention programs for martial artists.

Restrições em trabalhadores de enfermagem: perfil e intervenções da terapia ocupacional / Readjusted nursing workers: profile and occupational therapy interventions

Introdução: Os trabalhadores de Enfermagem hospitalar apresentam um alto risco de acometimento por Doença Osteomuscular Relacionada ao Trabalho (DORT), devido, principalmente, a exposição intensa a cargas de trabalho. As consequências individuais e institucionais dos DORT são devastadoras, agravando-se ainda mais no caso de trabalhadores com restrições no trabalho. Dessa forma, faz-se imperativo entender as limitações desse trabalhador e submetê-lo ao tratamento de reabilitação, visando melhora de seus sintomas e de sua capacidade funcional. Objetivo: caracterizar o trabalhador de enfermagem com restrições e avaliar o impacto de intervenções de Terapia Ocupacional. Método: estudo quantitativo, experimental, do tipo ensaio clínico aleatório não controlado, realizado em um hospital público paulista, com coleta de dados de maio a novembro de 2017, junto a 25 trabalhadores de enfermagem com restrições em membros superiores (MMSS), por meio de um questionário de caracterização sociodemográfica e laboral e três avaliações padronizadas Disabilities of the Arm, Shoulder and Hand (DASH), Questionário Nórdico de Sintomas Osteomusculares (QNSO) e Escala Visual Analógica (EVA) de dor. Após a caracterização, um subgrupo foi submetido a tratamento individual de terapia ocupacional e reavaliado ao final do tratamento. Os dados foram submetidos à análise descritiva e tratamento estatístico descritivo e analítico. Resultados: 25 trabalhadoras, sendo três enfermeiras, quatro auxiliares de enfermagem e dezoito técnicas de enfermagem, com idade média de 48 anos e média de 19 anos de trabalho, obedeceram aos critérios de inclusão. Exercendo suas funções em 11 setores diferentes, apresentavam IMC médio de 29,55, sendo oito praticantes de esportes e média de dois diagnósticos de DORT e duas restrições no trabalho, com elevado número de comorbidades. As atividades predominantes de trabalho foram: escrita, checagem de sinais vitais e medicação. Conforme o QNSO dos doze meses antecedentes, as maiores prevalências de sintomas foram 92% em ombros e punhos e mãos e 84% região lombar; nos sete dias antecedentes, 80% em ombros e 64% em punhos e mãos. Apesar dos sintomas, em média, apenas metade restringiu-se em suas atividades e consultou profissional de saúde. A EVA de dor teve escore médio de 6,64 e o DASH de 40,9, sendo as atividades desempenhadas com maiores dificuldades: atividades recreativas que exigem força, abertura de um vidro novo e tarefas domésticas pesadas. Oito trabalhadoras receberam em média cinco sessões de terapia ocupacional e três intervenções diferentes, sendo as mais utilizadas: massagem miofascial, confecção de órteses e calor superficial. Após o tratamento, as reavaliações a curto prazo mostraram melhora de 40% na intensidade média de dor e 37% de melhora na capacidade funcional. Não houve mudanças na prevalência de dor. Conclusões: o trabalhador de enfermagem com restrições de trabalho em MMSS apresenta uma elevada prevalência de sintomas osteomusculares e intensidade de dor, aliada a grande número de comorbidades e perda parcial da capacidade funcional. O tratamento de terapia ocupacional mostra-se uma estratégia eficaz em curto prazo para minimização de dor e melhora da capacidade funcional. Acreditamos que outras ações de saúde e institucionais sejam necessárias para abraçar a dimensão das repercussões dos DORT nessa população.

Introduction: Hospital nursing workers have a high risk of developing Work-Related Musculoskeletal Disorders (WMSDs), mainly due to intense exposure to workloads. The individual and institutional consequences of WMSDs are devastating and even worse in the case of readjusted workers. Thus, it is imperative to understand their limitations and perform rehabilitation treatment, aiming to improve their symptoms and their functional capacity. Objective: to identify sociodemographic, health and occupational status of readjusted workers and to evaluate the impact of occupational therapy interventions. Method: a quantitative experimental uncontrolled randomized clinical trial, in a public hospital in the city of São Paulo. Data collection occurred from May to November 2017, with 25 readjusted nursing workers with limitations in the Upper Limbs (UL); instruments used were a questionnaire containing sociodemographic, occupational and health data and three standardized ones Disabilities of the Arm, Shoulder and Hand (DASH), Nordic Musculoskeletal Questionnaire (NMQ) and the Visual Analogue Scale (VAS) of pain. After characterization, a subgroup underwent individual treatment of occupational therapy and was re-evaluated at the end of treatment. Data were submitted to descriptive analysis and descriptive and analytical statistical treatment. Results: 25 workers, women, being three nurses, four nursing aides and 18 nursing technicians, with 48 years old of average age and an average of 19 working years, followed the inclusion criteria. Working in 11 different hospital settings, they presented a mean BMI of 29,55, with eight athletes and an average of two WMSDs and two work limitations per person, also featuring a high number of comorbidities. The predominant work activities were: writing, checking vital signs and medication. According to the NMQ of the previous 12 months, the highest prevalences of symptoms were 92% in shoulders and wrists and hands and 84% in the lumbar region; in the previous seven days, 80% in shoulders and 64% in wrists and hands. Despite the symptoms, on average only half were restricted in their activities and searched for a health professional.The average VAS of pain score was 6.64 and the DASH had an average of 40.9, with activities performed with greater difficulties: recreational activities that require strength, opening of a new jar and heavy housework. Eight workers received an average of five sessions of occupational therapy and three different interventions, being the most used: myofascial massage, splinting and superficial heat. After treatment, short-term reevaluations showed a 40% improvement in the average pain intensity and 37% improvement in the average of functional capacity. There were no changes in pain prevalence. Conclusion: the readjusted worker with UL limitations features a high prevalence of musculoskeletal symptoms and pain intensity, together with a large number of comorbidities and partial loss of functional capacity. Occupational therapy treatment is an effective short-term strategy for minimizing pain and improving functional capacity. We believe that other health and institutional actions are necessary to embrace the extent of the repercussions of WMSDs in this population.