Effect of diaphragmatic breathing, respiratory muscle stretch gymnastics and conventional physiotherapy on chest expansion, pulmonary function and pain in patients with mechanical neck pain: A single group pretest-posttest quasi-experimental pilot study.

BACKGROUND: There is evidence that mechanical neck pain results in respiratory dysfunction. Physiotherapy management for mechanical neck pain is well documented but the evidence regarding inclusion of breathing strategies to improve pulmonary functions in mechanical neck pain patients is scarce. OBJECTIVE: To investigate the combined effect of diaphragmatic breathing, respiratory muscles stretch gymnastics (RMSG) and conventional physiotherapy on chest expansion, pulmonary function and pain in patient with mechanical neck pain. METHOD: Thirteen patients with mechanical neck pain (18-35years) with neck pain history of ≥ three months and NPRS (numeric pain rating scale) score ≥3 were recruited for this single group pre pretest-posttest quasi experimental pilot study. Informed consent was taken from all participants. After initial screening and assessment, diaphragmatic breathing, RSMG (5 patterns) and conventional physiotherapy (hot pack and TENS for 10 min) were given for one week. Chest expansion, spirometry (FEV1, FVC, FEV1/FVC, PEFR), NDI (neck disability index) and NPRS were assessed on baseline and after one week following the intervention. RESULTS: The normality of data was tested by using Shapiro-wilk test and the data was found to be normally distributed. Paired t-test was used to compare the baseline and post intervention values. Diaphragmatic breathing, RMSG and conventional physiotherapy had significant effect on chest expansion, FEV1, NPRS and NDI in patients with mechanical neck pain. CONCLUSION: The rehabilitation strategies should emphasize breathing exercises to improve the lung function and pain scores in addition to conventional physiotherapy in rehabilitation of mechanical neck pain patients.

Processos de reflexividade dos psicólogos do esporte e coaches: um estudo fenomenológico / Reflexivity processes of sport psychologists and coaches: a phenomenological study / Procesos de reflexividad de psicólogos del deporte y coaches: un estudio fenomenológico

O objetivo desta pesquisa é identificar e compreender fenomenologicamente, por meio de relato de Psicólogos de Esporte (PE) e de Coaches, em sua vivência prática, como ocorrem os processos reflexivos em sua atuação, conforme apreendidos a partir de relatos de experiências. O método de investigação escolhido foi a fenomenologia, pois oferece os recursos necessários para tal mergulho junto à experiência reflexiva. A amostra intencional foi delineada por PE e Coaches (profissionais de Educação Física que recorrem ao Coaching) em atividade em esportes de alto rendimento, que tenham atuado ou estejam atuando em modalidades esportivas coletivas e/ou individuais. Realizaram-se nove entrevistas (cinco com PE, quatro com Coaches). O acesso ao objeto desse estudo se deu por meio de entrevistas em profundidade e semiestruturadas, orientadas pela escuta suspensiva. As questões disparadoras foram formuladas com base no Procedimento Estruturado de Reflexão adaptado. Para análise das entrevistas, realizou-se uma síntese de cada relato, seguindo-se de cruzamento intencional. Como resultados, percebeu-se que PE e Coaches trazem algumas similaridades no que se refere aos modos de refletir sobre sua prática. No entanto, as experiências que eles fazem desses processos reflexivos é que podem tomar rumos distintos. Os(as) PE amparam-se na regulamentação da profissão e resguardam-se em seus apontamentos, trazendo suas experiências e reflexões sobre os processos vividos. Os(as) Coaches trazem em suas explanações um trabalho coerente, organizado e compatível com o método do Coaching. Problematizar os processos reflexivos desses profissionais permite diferenciar qualitativa e eticamente suas atuações, possibilitando o fomento multiprofissional no esporte.(AU)

The aim of this study consists in phenomenologically identifying and understanding, by the report of Sport Psychologists (SP) and coaches, in their practical experience, how would be the reflexive processes that take place in their performance, as learned from reports of their experiences. The research method chosen was phenomenology, since it offers the necessary resources for such a dive along with the reflective experience. The intentional sample was outlined by SP and coaches (Physical Education professionals who use coaching) active in high performance sports, who have or are working in collective and/or individual sports. Nine interviews were conducted (five with SP, four with coaches). Access to the object of this study took place by in-depth and semi-structured interviews, guided by suspensive listening. The triggering questions were formulated based on the adapted Structured Reflection Procedure. For the analysis of the interviews, a synthesis of each report was carried out, followed by the intentional crossing. As results, it was noticed that SP and coaches bring some similarities regarding the ways of reflecting on their practice. However, their experiences of these reflective processes are that they can take different directions. The SP are based on the regulation of the profession and guard themselves in their notes, bringing their experiences and reflections on the processes experienced. Coaches bring in their explanations a coherent, organized, and compatible work with the coaching method. Problematizing the reflective processes of these professionals allows to differentiate their actuation qualitatively and ethically, making the multiprofessional phenomenon in sport possible.(AU)

El objetivo de este estudio consiste en identificar y comprender fenomenológicamente, a partir de la experiencia práctica de psicólogos del deporte (PD) y coaches, cómo serían los procesos reflexivos que se llevan a cabo en su rendimiento, tal y como se desprende de los informes de experiencias. El método de investigación elegido fue la fenomenología, ya que ofrece los recursos necesarios junto con la experiencia. La muestra intencional fue delineada por PD y coaches (profesionales de la educación física que utilizan el coaching) activos en deportes de alto rendimiento, que tienen o están trabajando en deportes colectivos e/o individuales. Se realizaron nueve entrevistas (cinco con PD, cuatro con coaches). El acceso al objeto de este estudio fue entrevistas en profundidad y semiestructuradas, guiadas por escuchas suspensivas. Las preguntas se formularon desde el procedimiento de reflexión estructurado adaptado. Para el análisis de las entrevistas, se hizo una síntesis de cada informe, seguida del cruce intencional. Como resultados, se notó que los PD y coaches tienen algunas similitudes con respecto a las formas de reflexionar sobre su práctica. Sin embargo, las experiencias que hacen de estos procesos pueden tomar diferentes direcciones. Los(las) PD se basan en la regulación de la profesión y se protegen en sus notas, aportando sus experiencias y reflexiones sobre los procesos vividos. Los(las) coaches plantean en sus explicaciones un trabajo coherente, organizado y compatible con el método de Coaching. Problematizar los procesos reflexivos de estos profesionales permite diferenciar sus acciones de manera cualitativa y ética, además de posibilitar la promoción multiprofesional en el deporte.(AU)

The state mindfulness scale for physical activity: further psychometrics properties / Escala de estado de mindfulness para atividade física: novas propriedades psicométricas / Escala de mindfulness en la actividad física: nuevas propiedades psicométricas

Mindfulness has been defined as attention and awareness to the present with an attitude of openness, non-judgment, and acceptance. It is suggested that mindfulness can positively influence experiences in sports and physical activity, increasing adherence to these activities. This study aimed to examine new psychometric properties of the State Mindfulness Scale for Physical Activity (SMS-PA) using classical and modern testing theories among Brazilian sport and exercise practitioners. Two studies were conducted. In the first, with 617 Brazilian sports practitioners, confirmatory factor analysis supported the bifactor structure of the SMS-PA composed of two specific (mental and body mindfulness) and one general factor (state mindfulness), which did not vary among genders. The Rasch Rating Scale Model (RSM) supported essential one-dimensionality indicated by the general factor with good item fit statistics (infit/outfit 0.62-1.27). The model presented a good level of Rasch reliability (0.85), and the items difficulty estimation provided an understanding of the continuum represented by their content. In the second study, with 249 Brazilian exercise practitioners, the structural equation modeling showed that Body Mindfulness was associated with positive outcomes (positive affect and satisfaction with practice). The mediation analysis showed that people with higher levels of Body mindfulness tend to experience greater levels of Positive Affect and, consequently, greater Satisfaction with exercises. The results suggest that the Brazilian version of the SMS-PA is an appropriate measure of the state of mindfulness.(AU)

Mindfulness pode ser definido como atenção e consciência no momento presente com uma atitude de abertura, não julgamento e aceitação. A literatura sugere que o mindfulness pode influenciar positivamente experiências no esporte e atividade física e pode exercer um papel na adesão a essas atividades. Este estudo teve como objetivo investigar novas propriedades psicométricas da State Mindulness Sacale for Physical Activity (SMS-PA) utilizando as teorias clássicas e modernas dos testes em praticantes de exercício físico e esporte brasileiros. Dois estudos foram conduzidos. No primeiro, com 617 brasileiros praticantes de esporte, a Análise Fatorial Confirmatória (AFC) demonstrou adequação à estrutura bifatorial da SMS-PA composta por dois fatores específicos (mindfulness mental e físico) e um fator geral (estado de mindfulness), que apresentou invariância entre sexos. A Rasch Rating Scale Model (RSM) corroborou a unidimensionalidade essencial indicada pelo fator geral com bons índices de ajustes (infit/outfit 0.62 -1.27). O modelo apresentou bom nível de precisão Rasch (.85), e a estimação de dificuldade dos itens possibilitou compreensão do continuum representado pelo conteúdo dos itens. No segundo estudo, com 249 brasileiros praticantes de esporte, a Modelagem de Equações Estruturais demonstrou que o mindfulness físico esteve associado a afetos positivos e satisfação com a prática. A análise de mediação mostrou que pessoas com níveis altos de mindfulness físico tendem a apresentar níveis mais elevados de afeto positivo e, consequentemente, níveis mais elevados de satisfação com a prática. Os resultados sugerem que a versão brasileira do SMS-PA é uma medida apropriada do estado de mindfulness para atividades físicas.(AU)

La atención plena puede definirse como la atención y la conciencia en el momento presente con una actitud de apertura, no juicio y aceptación. La literatura sugiere que el mindfulness puede influir positivamente en las experiencias en el deporte y en la actividad física, además de desempeñar un papel en la adherencia a estas actividades. Este estudio tuvo como objetivo investigar nuevas propiedades psicométricas de la State Mindfulness Scale for Physical Activity (SMS-PA) utilizando las teorías clásicas y modernas de las pruebas en practicantes de ejercicio físico y de deporte en Brasil. Para ello, se realizaron dos estudios. En el primer, participaron 617 practicantes de deporte brasileños, y el análisis factorial confirmatorio (AFC) demostró adecuación en la estructura bifactorial de la SMS-PA, compuesta por dos factores específicos (mindfulness mental y físico) y un factor general (estado de mindfulness), que mostró invarianza entre sexos. El Rasch Rating Scale Model (RSM) corroboró la unidimensionalidad esencial indicada por el factor general con buenos índices de ajuste (infit/outfit 0,62-1,27). El modelo mostró un buen nivel de precisión de Rasch (.85), y la estimación de la dificultad de los ítems permitió comprender el continuo representado por el contenido de estos. En el segundo estudio, con 249 practicantes de deporte, el modelo de ecuaciones estructurales mostró que el mindfulness físico estaba asociado a resultados positivos (afecto positivo y satisfacción con la práctica). El análisis de mediación reveló que las personas con altos niveles de mindfulness físico tendían a tener mayores niveles de afecto positivo y, en consecuencia, mayores niveles de satisfacción con la práctica. Los resultados sugieren que la versión brasileña de la SMS-PA es una medida adecuada de mindfulness.(AU)

Effect of Eutonia, Holistic Gymnastics, and Pilates on body posture for pre-adolescent girls: Randomized clinical trial.

INTRODUCTION: Postural changes frequently occur in pre-adolescent girls, with sedentary lifestyle with reduced physical activity level as one of the risk factors. OBJECTIVE: To investigate the effects of Eutonia, Holistic Gymnastics, and Pilates on body posture in pre-adolescent girls. METHODS: A randomized prospective quantitative clinical trial was conducted. The study included girls aged 10-13 years and compared the effects of Eutonia, Holistic Gymnastics, and Pilates on body posture. The sample comprised 80 girls divided into three intervention groups as follows: Eutonia group, 26 girls; Holistic Gymnastics group, 27 girls; and Pilates group, 27 girls. Ten sessions of 1 h each were conducted on a weekly basis. Static posture was analyzed using the Postural Analysis Software SAPO; dynamic posture, using the modified Layout for Assessing Dynamic Posture LADy; and lifestyle, using the Body Posture Evaluation Instrument Back PEI questionnaire. The data were statistically analyzed using the analysis of variance (ANOVA) by Kruskal-Wallis' averages test at 5% significance level (p < 0,05). RESULTS: The results showed that the three body movement practices improved the head inclination in the frontal plane (1,49°) and pelvic anteversion in the right (1,9°) and left profiles (2,09°). In addition, 25% of pre-teens started to carry their school bag correctly, improving their posture. CONCLUSION: The body movement practices of Eutonia, Holistic Gymnastics, and Pilates improved head inclination, pelvic anteversion, and the correctness rate of carrying the schoolbag.

Clinical relevance of massage therapy and abdominal hypopressive gymnastics on chronic nonspecific low back pain: a randomized controlled trial.

PURPOSE: To determine the clinical relevance of the effects that Massage-Therapy (MT) and Abdominal-Hypopressive-Gymnastics (AHG) and the combination of both procedures have on the disability, pain intensity, quality of life, and lumbar mobility of patients with chronic nonspecific low back pain (CNSLBP). METHODS: A randomized controlled-trial with parallel-groups, concealed allocation, assessor blinding, and intention-to-treat analysis was carried out. The sample included 60 adults with CNSLBP. The participants received MT (n = 20), AHG (n = 20), or MT + AHG (n = 20). Each group received 8 interventions. RESULTS: The ODI change scores were significantly higher (p < 0.05) in the MT + AHG group than in the other two groups. Significant differences were found in the results of NRS, Schober's test, and SF-12 PCS (p < 0.05) in each group. There were significant differences (p < 0.05) between the values of SF-12 MCS in AHG and MT + AHG groups. CONCLUSIONS: Massage Therapy and Abdominal Hypopressive Gymnastics reduce pain levels, increase the mobility of the lumbar spine, and improve disability and quality of life (PCS) in patients with CNSLBP in the short term. Likewise, AHG and MT + AHG improve quality of life (MCS). The combination of both therapies provides more benefits in terms of lumbar disability in patients with CNSLBP in the short term. This improvement is clinically relevant. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02721914).IMPLICATIONS FOR REHABILITATIONMassage Therapy (MT) and Abdominal Hypopressive Gymnastics (AHG), reduce pain, improve mobility and quality of life, and reduce disability in the short term.These results are clinically relevant.The combination of manual and active therapy (MT + AHG) seems to be more effective and produces clinically relevant changes.

Ginástica holística na educação física escolar: desenvolvimento de uma proposta / Holistic gymnastics in school physical education: development of a proposal

A Ginástica Holística é um método de Educação Somática criado pela alemã Lily Ehrenfried, mas sistematizado após sua chegada à França em 1933. Este método possui cerca de 800 movimentos padronizados, e dentre suas características singulares, citamos: orientações passadas de forma verbal (sem demonstração); sem número de repetições pré-determinadas; e tempo para a percepção do corpo após cada movimento. As ginásticas com componente de conscientização corporal foram incorporadas há pouco tempo nos principais documentos normativos educacionais no Brasil, e sua aplicação parece ser muito pouco realizada. O objetivo da pesquisa foi avaliar o desenvolvimento de um programa de 10 aulas de Ginástica Holística junto à uma turma de 7º ano do Ensino Fundamental de uma escola pública de Campinas/SP. Esta pesquisa do tipo intervenção pedagógica, com abordagem qualitativa, utilizou observações, entrevistas com a professora de Educação Física e dois gestores, e grupos focais com os/as estudantes para o levantamento dos dados, que foram organizados e analisados por meio da triangulação. Segundo os/as estudantes, havia pouca variação em termos dos conteúdos tratados nas aulas de Educação Física, o que pode ter causado certo estranhamento em relação à proposta, como exemplo, eles/as esperarem padrões de movimento para serem imitados. As aulas permitiram ampla exploração corporal associada a noções de cuidado e saúde, sem perder seu componente lúdico e pedagógico. Além de vivenciar um novo conteúdo, a proposta proporcionou aos/às estudantes uma reflexão sobre os significados culturais dos movimentos, estabelecendo uma relação crítica com eles, bem como incentivou relações mais democráticas, favorecendo o diálogo e a participação na construção das aulas. A Ginástica Holística se mostrou uma proposta adequada para ser desenvolvida, tendo boa aceitação por parte dos/as estudantes e da equipe da escola. (AU)

Holistic Gymnastics is a method of Somatic Education created by the german Lily Ehrenfried but systematized after her arrival in France in 1933. This method has about 800 standardized movements, and among its unique characteristics, we mention: instructions given verbally (without demonstration), without a number of predetermined repetitions and time for the perception of the body after each movement. Gymnastics with a body awareness component were recently incorporated into the main educational normative documents in Brazil, and their application seems to be very little performed. The objective of this research was to evaluate the development of a 10-lesson Holistic Gymnastics program in a 7th grade class of a Public Middle School in Campinas/SP. This pedagogical intervention type research, with a qualitative approach, used observations, interviews with the Physical Education teacher and two school coordinators and focus groups with students to survey the data, which were organized and analyzed through triangulation. According to the students, there was little variation in terms of the content treated in Physical Education classes, which may have caused some estrangement in relation to the proposal, such as, for example, they expected movement patterns to be imitated. The classes allowed wide body exploration associated with notions of selfcare and health, without losing its ludic and pedagogical component. In addition to experiencing new content, the proposal provided students with a reflection on the cultural meanings of the movements, establishing a critical relationship with them, as well as encouraging more democratic relationships, favoring dialogue and participation in the construction of classes. Holistic Gymnastics proved to be a suitable proposal to be developed in school, with good acceptance by students and school staff.(AU)

Understanding food choices and eating practices of Brazilian and Spanish athletes in aesthetics and weight class sports

Abstract Aim: This study aimed at understanding determinants of food choices and eating practices of aesthetics and weight class athletes from two countries. Methods: In this qualitative study, through recorded in-depth individual and focal group interviews, gymnasts (n = 16) and martial arts (n = 18) athletes from Brazil and Spain reported their eating practices. Transcripts were analyzed through the Content Analysis method. Results: The main determinants of athletes' eating practices were the quest for a specific body in line with each sports' discipline and cultural food aspects. The everyday eating practices respected the country of origin's food culture; however, some practices, especially aiming at weight loss were similar in both countries and related to the sports discipline. Female Brazilian aesthetics athletes were particularly worried about achieving a thinner body. Martial arts athletes from both countries reported adopting fast weight loss strategies presently or at some point in their sports trajectory. Internal and external pressure to lose weight was a constant factor, especially amongst Brazilians. Conclusions: There is a specific body culture in each sport discipline, which extends beyond country borders. The idealized bodies athletes seek are constructed socially according to their sports. This confers them an identity and promotes beliefs and meanings to foodways. The sports-related eating practices which superimposed national foodways were similar in both countries, suggesting a group identity process, and the existence of a "sports discipline's food culture". Understanding athletes' determinants of food choices and eating practices provide insights to address the gap between nutritional recommendations and eating practices.

Gymnastic Training of Hippotherapy Horses Benefits Gait Quality When Ridden by Riders with Different Body Weights.

The objective was to evaluate the effects of gymnastic training on stride characteristics of walk and trot in therapy horses carrying riders of different weights. Eighteen horses used for therapeutic riding 5 days/week were randomly divided into 2 groups. Nine horses performed gymnastic (GYM) exercises after therapeutic riding on 4 days/week for 3 months, 9 horses did no additional exercises (SED). On days 0 and 90, an inertial sensor mounted to the girth on the ventral midline was used to evaluate stride characteristics when horses were ridden at walk (1.3 m/second) and trot (3.0 m/second) by able-bodied riders representing rider: horse body weight ratios (BWRs) 15%, 20%, and 25%. On day 0, the measured variables did not differ significantly between sedentary (SED) and GYM groups, but on day 90, the following statistically significant results were found: GYM-trained horses had higher regularity for all BWRs at walk and 15% and 20% BWRs at trot. Higher stride symmetry was found in GYM-trained horses carrying 25% BWRs at walk and all rider weights at trot. Dorsoventral displacement was higher in GYM-trained horses when carrying 20% and 25% BWRs at walk and 25% BWRs at trot. Dorsoventral power was lower in SED-trained versus GYM-trained horses carrying 15% BWR at walk and 20% BWR at trot. A more regular and symmetrical stride with a larger range of dorsoventral trunk motion is likely to provide a better therapeutic riding experience.

Categorizing 10 Sports According to Bone and Soft Tissue Profiles in Adolescents.

PURPOSE: Considering the different loading and training characteristics of the sports practiced during growth, it is important to specify and categorize the bone and soft tissue adaptations in adolescent athletes. This study aimed to categorize 10 different loading sports and a nonsport group and identify the differences in bone density and soft tissues. METHODS: The sample included 625 adolescents (10 to 17 yr of age) of 10 sports (soccer, basketball, volleyball, track and field, judo, karate, kung fu, gymnastics, baseball, and swimming) and a nonsport group. Dual-energy x-ray absorptiometry assessed areal bone mineral density (aBMD), bone mineral apparent density (BMAD), and soft tissues (lean soft tissue and fat mass). The results were adjusted for sex, peak height velocity status, lean soft tissue, fat mass, and weekly training volume. RESULTS: The comparisons among groups showed that soccer had the highest whole-body aBMD (mean ± SEM: 1.082 ± 0.007 g·cm) and lower limb aBMD (1.302 ± 0.010 g·cm). Gymnastics presented the highest upper limb aBMD (0.868 ± 0.012 g·cm) and whole-body BMAD (0.094 ± 0.001 g·cm). Swimming presented the lowest aBMD values in all skeletal sites (except at the upper limbs) and whole-body BMAD. The soft tissue comparisons showed that soccer players had the highest lean soft tissue (43.8 ± 0.7 kg). The lowest fat mass was found in gymnasts (8.04 ± 1.0 kg). CONCLUSION: The present study investigated and categorized for the first time 10 different sports according to bone density and soft tissue profiles. Soccer and gymnastics sport groups were found to have the highest bone density in most body segments, and both sports were among the groups with the lowest fat mass.

The effect of four weeks of plyometric training on reactive strength index and leg stiffness is sport dependent.

BACKGROUND: Plyometric exercises are often used to develop lower limb strength and performance-related biomechanics such as leg stiffness. However, the effectiveness of plyometric training may depend on participants' own training and performance demands. The purpose of this study was to examine the effect of plyometric training on Reactive Strength Index (RSI) and leg stiffness (Kleg) on young athletes of different sports. METHODS: Forty eight female athletes (25 Taekwondo (TKD) and 23 rhythmic gymnastics (RG), mean±SD: age: 8.94±2.50 years; mass: 29.73±7.69 kg; height: 138.84±11.90 cm; training experience: 4.62±2.37 years) participated in this study. Participants were randomly assigned to experimental (PT, N.=24) and control (CG, N.=24) groups. The PT group followed a twice-weekly plyometric training program for 4 weeks. Plyometric drills lasted approximately 5-10 s, and at least 90 s rest was allowed after each set. To examine RSI, participants performed trials of five maximal CMJs. Submaximal hopping (20 hops) was performed in order to examine leg stiffness. RESULTS: Significant interaction effect was found for RSI and the post hoc analysis showed that RSI significantly increased by 35% (P=0.017) in RG athletes, whereas a significantly reduction by 28% (P=0.004) was revealed in TKD athletes. The interaction effect between time and group was statistically significant for Kleg (P<0.05) with Kleg significantly increasing by 31% (P=0.008) in TKD athletes, but remaining unchanged (P>0.05) in RG athletes. CONCLUSIONS: The results showed that the effect of a 4-week plyometric training program on RSI and leg stiffness is sport dependent. Further, the applied plyometric program was effective in reducing ground contact time and therefore increasing leg stiffness.

Athletes Play Through Pain-What Does That Mean for Rehabilitation Specialists?

CONTEXT: Pain in sport has been normalized to the point where athletes are expected to ignore pain and remain in the game despite the possible detrimental consequences associated with playing through pain. While rehabilitation specialists may not have an influence on an athlete's competitive nature or the culture of risk they operate in, understanding the consequences of those factors on an athlete's physical well-being is definitely in their area of responsibility. OBJECTIVE: To explore the factors associated with the experiences of subelite athletes who play through pain in gymnastics, rowing, and speed skating. DESIGN: The authors conducted semistructured interviews with subelite athletes, coaches, and rehabilitation specialists. They recruited coach participants through their provincial sport organization. Athletes of the recruited coaches who were recovering from a musculoskeletal injury and training for a major competition were then recruited. They also recruited rehabilitation specialists who were known to treat subelite athletes independently by e-mail. SETTING: An observation session was conducted at the athlete's training facility. Interviews were then conducted either in a room at the university or at a preferred sound-attenuated location suggested by the participant. PARTICIPANTS: The authors studied 5 coaches, 4 subelite athletes, and 3 rehabilitation specialists. INTERVENTIONS: The authors photographed athletes during a practice shortly before an important competition, and we interviewed all the participants after that competition. Our photographs were used during the interview to stimulate discussion. RESULTS: The participant interviews revealed 3 main themes related to playing through pain. They are: Listening to your body, Decision making, and Who decides. CONCLUSION: When subelite athletes, striving to be the best in their sport continue to train with the pain of an injury, performance is affected in the short-term and long-term consequences are also possible. Our study provides some insight into the contrasting forces that athletes balance as they decide to continue or to stop.

Calcium Sulfate/Calcium Phosphate Bone Void Filler in the Treatment of Bilateral Adolescent Unicameral Calcaneal Bone Cysts: 36-Month Follow-Up.

A 36-month follow-up of the management of bilateral adolescent unicameral bone cysts in a high school gymnast treated with a calcium sulfate/calcium phosphate (CSCP) bone void filler (BVF) is presented. The more developed left calcaneal cyst was managed with a traditional, open approach consisting of allogenic bone graft, CSCP BVF mixed with platelet-rich plasma. The less developed right calcaneal cyst was managed with a less used approach, a percutaneous bone cortex incision with only the CSCP BVF. The rationale for the selection between the open and percutaneous approaches, long-term BVF incorporation, and positive patient outcome allowing a quick return to athletics are presented.

[Transcranial electrostimulation and serotonin laser phoresis in the athletes experiencing a combined effect of fatigue and psycho-emotional stress]. / Transkranial'naia élektrostimuliatsiia i lazeroforez serotonina u sportsmenov pri sochetanii utomleniia i psikhoémotsional'nogo stressa.

RATIONALE: At sports submaximal loads accompanied by muscle fatigue due to metabolic transformations, the conditions are created for the development of combined endogenous and exogenous emotional stresses. An important role in the development of stress is played by the state of adaptation mechanisms, in which sintoxic and catatoxic programs are involved, as well as the GABA-dopaminergic system. There is insufficient information on the possibilities for reducing the manifestations of stress. PURPOSE: The objective of the presser study was to estimate the possibilities for the prevention of the development of psycho-emotional stress with the use of transcranial electrostimulation in the combination with serotonin laser phoresis. METHODS: The assessment of the psychological status before and after transcranial electrostimulation in the combination with serotonin laser phoresis was performed in 96 athletes who were engaged in weightlifting and athletic gymnastics, as well as in 37 athletes comprising the control group in the state of sparing rest. Transcranial electrostimulation was carried out during 14 days. The laser phoresis of serotonin was conducted with the application of the Matrix device and transcranial electrostimulation with the use of the Magnon-DKS apparatus. The assessment of the psychological status was carried out based on the Hospital Anxiety and Depression Scale (HADS) and the results of the well-being-activity-mood (WAM) questionnaire and in accordance with the Hildebrandt index, and the Spielberger-Hanin test. RESULTS: The two-week course of exposure to transcranial electrostimulation and serotonin laser phoresis of the patients comprising the main group resulted in a faster stabilization of the psychological status than in the control group. This effect was due to the multi-component involvement of the athletes in the adaptation programs including the management of homeostasis and the influence on the GABA-dopaminergic system via the serotonin and opioidergic mechanisms. CONCLUSION: The results of this study give reason to recommend the proposed method of transcranial electrostimulation and serotonin laser phoresis for the use in sports medicine.

Stage III Kienböck's disease treated with hyperbaric oxygen: the role of an unusual approach to a rare condition.

Kienböck's disease is a rare condition characterised by avascular necrosis of the lunate bone. Its natural history and aetiopathogenesis have not yet been clarified, nor are its triggering factors identified. We present a case of a 17-year-old male gymnast, without relevant medical/family history, with stage IIIA Kienböck's disease diagnosed in 2016. Initially, submitted to conservative treatment that proved to be insufficient. Consequently, surgical treatment was proposed, but refused. The patient instead underwent experimental treatment with hyperbaric oxygen (120 sessions, 100% oxygen at 2.5 atm, for 70 min periods, once daily, five times per week). In April 2018, a favourable clinical and radiological evolution was observed, with an improvement in the patterns of pain, motion and strength and an almost complete involution of the process of aseptic necrosis of the semilunar. To the best of our knowledge, this is the first report of Kienböck's disease treated with hyperbaric oxygen.

Eficacia de la electroestimulación combinada en pacientes con exacerbación aguda de enfermedad pulmonar obstructiva crónica: ensayo clínico aleatorizado / Efficacy of combined electrostimulation in patients with acute exacerbation of COPD: randomised clinical trial

Introducción y objetivo: La disfunción muscular es una afectación muy frecuente en los pacientes con enfermedad pulmonar obstructiva crónica (EPOC), que produce un aumento en la disnea y una incapacidad para la actividad. A pesar de realizarse intervenciones hospitalarias aún no está claro qué tipo de intervención provocará un mejor efecto sobre estos pacientes. Por tanto, el objetivo de este estudio es comparar la eficacia con ejercicios calisténicos de 2 intervenciones de electroestimulación combinada en pacientes hospitalizados por exacerbación de la EPOC (AEEPOC). Pacientes y métodos: Para ello se llevó a cabo un estudio experimental con 39 pacientes aleatorizados en 3 grupos. Un grupo control que recibió un tratamiento médico estándar (oxigenoterapia y farmacoterapia) y 2 grupos que recibieron una intervención de fisioterapia con electroestimulación funcional y con ejercicios calisténicos respectivamente. Las variables principales fueron la capacidad de ejercicio mediante el Five times sit to stand test así como la funcionalidad asociada a la sintomatología, medida con el London Activity of Daily Living Scale. Resultados: Tras comparar los resultados se observó una mejora significativa de la disnea al alta con respecto al ingreso en los 3 grupos. Además, se encontraron diferencias significativas en cuanto a la funcionalidad, la capacidad de ejercicio y la fatiga en los grupos de intervención al alta con respecto al ingreso, siendo estas 2 últimas mejores en el grupo de electroestimulación con ejercicios calisténicos. Conclusión: Un programa de electroestimulación genera mejoras significativas en la capacidad de ejercicio, la funcionalidad y la fatiga en pacientes hospitalizados con AEEPOC

Introduction and objective: Muscle dysfunction is very common in patients with chronic obstructive pulmonary disease (COPD). Muscular strength depletion is a result of numerous hospitalisations and this causes an increase in the symptomatology. Numerous interventions have been used in these patients, but there is no consensus on the best. The main objective of this study is to compare the effectiveness of two physiotherapy interventions during hospitalisation in COPD patients. Patients and methods: In this clinical trial, we included 39 patients who were randomised into three groups. A control group received standard medical treatment (oxygen therapy and pharmacotherapy), and two groups received, in addition to standard medical treatment, a physiotherapy intervention, one with functional electrostimulation and one with calisthenic exercises. The main variables were the ability to exercise using the Five-time sit-to-stand test as well as the functionality associated with symptomatology, as measured by the London Chest Activity of Daily Living Scale. Results: After comparing the results, there was a significant improvement in dyspnea on discharge versus admission in all three groups. In addition, we found significant differences in functionality, exercise capacity, and fatigue in both intervention groups, being better in the electrostimulation with calisthenic exercises group than in the functional group. Conclusion: An electrostimulation treatment improves the exercise capacity, functionality and fatigue in hospitalised AECOPD patients

Back pain prevalence in adolescent athletes.

The research aimed to investigate back pain (BP) prevalence in a large cohort of young athletes with respect to age, gender, and sport discipline. BP (within the last 7 days) was assessed with a face scale (face 1-2 = no pain; face 3-5 = pain) in 2116 athletes (m/f 61%/39%; 13.3 ± 1.7 years; 163.0 ± 11.8 cm; 52.6 ± 13.9 kg; 4.9 ± 2.7 training years; 8.4 ± 5.7 training h/week). Four different sports categories were devised (a: combat sports, b: game sports; c: explosive strength sport; d: endurance sport). Analysis was described descriptively, regarding age, gender, and sport. In addition, 95% confidence intervals (CI) were calculated. About 168 (8%) athletes were allocated into the BP group. About 9% of females and 7% of males reported BP. Athletes, 11-13 years, showed a prevalence of 2-4%; while prevalence increased to 12-20% in 14- to 17-year olds. Considering sport discipline, prevalence ranged from 3% (soccer) to 14% (canoeing). Prevalences in weight lifting, judo, wrestling, rowing, and shooting were ≥10%; in boxing, soccer, handball, cycling, and horse riding, ≤6%. 95% CI ranged between 0.08-0.11. BP exists in adolescent athletes, but is uncommon and shows no gender differences. A prevalence increase after age 14 is obvious. Differentiated prevention programs in daily training routines might address sport discipline-specific BP prevalence.

Attitudes towards nutritional supplement use amongst adult gymnasium users in Johannesburg North

Background: Nutritional supplements refer to a product ingested to increase the nutritional content of a normal diet, to fill a dietary need and/or presumed deficiency. The usage and popularity of nutritional supplements, however, raises concerns from a health benefit and risk perspective. In South Africa, there is currently no adequate regulatory framework of enforcement for nutritional supplement products and undeclared constituents by the statutory body, the Medicines Control Council (MCC). Education awareness programmes by organisations that should take consumer protection and the general public health and wellness as a right, needs to be improved. Objectives: To investigate the attitudes toward nutritional supplements by adult gym users from commercial gymnasiums in the Johannesburg North region of South Africa. Methods: A cross-sectional quantitative design, using a selfadministered questionnaire was applied to 364 recruited study participants who attended commercial gymnasiums in Johannesburg North. Results: One hundred and fifty users (41%) claimed that they 'always' read the information about the nutritional values, benefits, and side effects of the supplements on the labels prior to use. Three hundred and three users (83%) indicated that the number of users of nutritional supplements in gymnasiums is on the increase. Two hundred and seventy-three (75%) of main information sources for nutritional supplements may be found on the internet, while 292 (80%) indicated the need for gymnasiums to provide educational programmes pertaining to nutritional supplement consumption. Conclusion: Gymnasium users are aware of the increase in nutritional supplement use in commercial gymnasiums. Many of the users were unaware of the potential mislabelling and health concerns regarding these supplements. Therefore there is a need for improved nutritional supplement education programmes and diligence at multiple levels

Efeito da Ginástica Holística na postura de meninas de 10 a 12 anos / Effect of Holistic Gymnastics in the posture of girls between 10 and 12 years

Introdução: Alterações posturais são um dos problemas que acometem meninas de 10 a 12 anos, e, um método de intervenção que pode ser utilizado nestes casos é a Ginástica Holística (GH). Objetivo: Avaliar o efeito da GH na postura de meninas saudáveis de 10 a 12 anos. Método: Participaram 43 crianças do sexo feminino divididas em: 21 no grupo controle (GC) e 22 praticantes de Ginástica Holística no grupo experimental (GE), com 9 semanas de prática, uma vez por semana. A postura foi analisada através da fotogrametria (software SAPO). Utilizou-se estatística descritiva e inferencial com nível de significância de p < 0,05. Resultados: Os resultados demonstraram que as participantes do GE apresentaram uma aproximação do padrão normal de verticalidade (p=0.01) e redução significativa na diferença do comprimento dos membros (p=0.02) após a intervenção. Conclusão: A GH mostrou-se um método eficaz na alteração de postura do grupo de meninas estudado.

Introduction: Postural changes are problems that affect girls between 10 and 12 years old, and one method that may be used in these cases is the Holistic Gymnastics (HG). Objective: To evaluate the effects of Holistic Gymnastics on the posture of healthy ten to twelve year old female students. Method: A total of 43 female children were divided into: 21 in the control group (CG) and 22 practitioners of Holistic Gymnastics in experimental group (EG), with 9 weeks of practice once a week. The posture was analyzed using photogrammetry (software SAPO). Descriptive and inferential statistics were used with p <0.05 significance level. Results: Results demonstrate that the participants in the experimental group presented approximation of the verticality pattern (p=0.01) and a significant reduction in the difference of lower limb length (p=0.02), after the intervention. Conclusion: GH was one efficient method in improvement of girls' posture in this group.

Frenkel: ¿un precursor de la neurorrehabilitación? / Frenkel: one of the forerunners of neurorehabilitation?

El término ‘neurorrehabilitación’ es entendido como el proceso destinado a reducir la deficiencia, la limitación de la actividad y la restricción de la participación que padecen las personas como consecuencia de una enfermedad neurológica, y en el que los profesionales involucrados en dicho ámbito tendrán como objetivo la reducción del grado de afectación funcional del paciente. Debido al desconocimiento que existió en relación con la capacidad plástica que presenta el sistema nervioso humano, los orígenes científicos de la rehabilitación neurológica son relativamente recientes, y se sitúan alrededor de la Segunda Guerra Mundial. Sin embargo, existen indicios de que el neurólogo Heinrich Sebastian Frenkel (1860-1931) pudo establecer las bases de la neurorrehabilitación antes de esa época. En relación con los trabajos realizados y publicados por Frenkel, existen referentes históricos que apoyarían la hipótesis de que, considerando sus metodologías de tratamiento empleadas y documentadas, lo que denominó Übungstherapie (gimnasia neurológica) podría considerarse la base de la neurorrehabilitación moderna. Estos conocimientos pudieron haberse tenido en cuenta por multitud de autores que introdujeron dichas experiencias y aprendizajes en los diversos métodos terapéuticos que surgieron con posterioridad, incluso los más novedosos y tecnológicos, si bien las raíces de la neurorrehabilitación aplicada podrían encontrarse a finales del siglo XIX (AU)

Neurorehabilitation is understood as the process intended to reduce the deficiency, limitation of activity and restriction of participation experienced by people as a result of a neurological diseases, and where the professionals involved in this field will aim to reduce the functional involvement degree of the patient. Due to the ignorance existed about the plastic capacity in the nervous system in humans, the scientific origins of neurological rehabilitation is relatively recent, which are located around the Second World War. However, there are signs that the neurologist Heinrich Sebastian Frenkel (1860-1931) was able to establish the basis of neurorehabilitation before that time. There are historical concerning regarding the work conducted and published by Frenkel that would support the hypothesis, based on the characteristics of their treatment employed and documented methodologies, that what he called ‘Übungstherapie’ (neurological gymnastic), it could be considered as the basis of what we consider today as modern neurorehabilitation. This knowledge could have been used by many authors who introduced those experiences and lessons learned to the multiple therapeutic methods that emerged after, even the most innovative and technological, while the roots of neurorehabilitation could be found at the end of the 19th century (AU)

The relationship between yoga involvement, mindfulness and psychological well-being.

OBJECTIVES: The aim of this study was to examine how different levels of yoga involvement are related to different parameters of mental health and illness. DESIGN AND SETTING: A total sample of 455 participants (410 females) were investigated by means of an internet survey. 362 yoga practitioners (327 females) rated their degree of yoga involvement on the Yoga Immersion Scale. A control group was comprised of 93 gymnastics practitioners (83 females). MAIN OUTCOME MEASURES: All participants completed the Multidimensional Inventory for Religious/Spiritual Well-Being, the Freiburger Mindfulness Inventory and the Brief Symptom Inventory for psychiatric symptoms. RESULTS: Highly involved yoga practitioners exhibited a significantly increased amount of mindfulness and religious/spiritual well-being (both p<0.01) and lower psychiatric symptoms such as depression (p<0.01) compared to those who were only marginally/moderately yoga-involved or who were in the gymnastics control group. CONCLUSIONS: In accordance with the literature, yoga practice might have its biggest impact on mental health when it is part of a practitioner's worldview. Further research focusing on the impact of yoga involvement in clinical groups is encouraged.