Effects of dry cupping on pain, function and quality of life in women with knee osteoarthritis: a protocol for a sham-controlled randomised trial.

INTRODUCTION: Knee osteoarthritis (KOA) is the most common cause of pain and disability worldwide. Dry cupping has been used as non-pharmacological approach to control pain and improve physical function. However, there is a lack of high-quality scientific evidence regarding its effects on this condition. This protocol describes a sham-controlled, randomised and simple blind study that aims to evaluate the effect of dry cupping on pain, function and quality of life in women with KOA. METHODS AND ANALYSIS: Sixty-two women diagnosed with KOA, based on American College of Rheumatology clinical criteria, and aged from 50 to 75 years, will be randomly distributed into two groups (31 per group): real and sham dry cupping. Both applications will occur with acrylic cups around the knee. The intervention will last 15 min, two times a week over six consecutive weeks, for a total of 12 sessions. Both groups will be assessed at four different times: before the intervention (T0), after 3 weeks intervention (T3), at the end of the protocol (T6) and 4 weeks after the interventions (follow-up: T10). The primary outcome will be pain intensity (Numerical Pain Rating Scale), and secondary outcomes will be knee-related health status (Western Ontario and McMaster Universities Osteoarthritis Index), functional capacity (8-step stair climb test, 40-metre fast-paced walk test and 30-second chair stand test), quality of life (Short-Form 36) and global perceived effect. ETHICS AND DISSEMINATION: This protocol was approved by the UFRN/FACISA Ethics Committee (number 3.737.688). The study results will be disseminated to the participants and submitted to a peer-reviewed journal and scientific meetings. TRIAL REGISTRATION NUMBER: NCT04331158.

Main types of insoles described in the literature and their applicability for musculoskeletal disorders of the lower limbs: A systematic review of clinical studies.

The objective of this review was to identify the main types of insoles described in the literature that are used to treat musculoskeletal alterations of lower limbs and to analyze the existence of previous evaluation for the prescription of these insoles. To this end, two researchers, independently and blindly, searched the PubMed, SciELO, Bireme, MEDLINE, Lilacs, PEDro, Cochrane Library and Web of Science databases between June and July of 2018, from the free combination of the following descriptors: insoles, foot orthoses, foot, orthoses, musculoskeletal diseases and clinical trial. We included randomized or non-randomized clinical trials in which at least one intervention group used insoles and individuals with some type of musculoskeletal disorder had been sampled. Of the 227 documents identified in date bases, 20 were included in this review. In general, it is suggested to carry out more studies with more precise methods and that include evaluation before the prescription. This is a systematic review of clinical trials registered in PROSPERO (International Prospective Register of Systematic Reviews) under the protocol no. CRD42018099534e.

Dry cupping in the treatment of individuals with non-specific chronic low back pain: a protocol for a placebo-controlled, randomised, double-blind study.

BACKGROUND: Low back pain is a very prevalent condition in the population and cupping therapy has been presented as a frequently used non-pharmacological treatment in this population. However, there is a lack of well-designed studies that evaluate the effects of this technique. This protocol describes a placebo-controlled, randomised, double-blind study that aims to evaluate the effect of dry cupping therapy on pain, physical function, trunk range of motion, quality of life and psychological symptoms in individuals with non-specific chronic low back pain. METHODS AND ANALYSIS: Ninety individuals with chronic non-specific low back pain, aged from 18 to 59 years, will be randomised into two groups: intervention group, which will be submitted to dry cupping therapy application with two suctions; and placebo group which will undergo placebo dry cupping therapy. Both applications will occur bilaterally in parallel to the vertebrae from L1 to L5. The application will be performed once a week for 8 weeks. The volunteers will be evaluated before the treatment (T0), immediately after the first intervention (T1), after 4 weeks of intervention (T4) and after 8 weeks of intervention (T8). The primary outcome will be pain intensity, and secondary outcomes will be physical function, lumbar range of motion, patient expectation, overall perception of effect, quality of life and psychological factors. ETHICS AND DISSEMINATION: This protocol has been approved by the Ethics Committee of FACISA/UFRN (number: 3639814). The results of the study will be disseminated to participants through social networks and will be submitted to a peer-reviewed journal and scientific meetings. TRIAL REGISTRATION NUMBER: NCT03909672.

Assessment of quality of movement during a lateral step-down test: Narrative review.

INTRODUCTION: Altered lower limb movement patterns during weight-bearing activities have been described as risk factors for several injuries. The lateral step-down test (LSD) was developed to be a simple, clinician-friendly tool to facilitate the assessment of lower extremity quality of movement during a functional activity. However, there is still conflicting information across the literature regarding how the LSD should be performed. OBJECTIVE: To critically review the literature regarding the assessment of quality of movement using the LSD and to provide an overview of how this test has been used, describing confounding factors and factors associated with altered movement patterns. METHODS: A literature review was conducted in PubMed/MEDLINE, COCHRANE, PEDro, SciELO and LILACS databases, by two independent reviewers. RESULTS: Sixteen articles met the inclusion criteria. One was a prospective cohort study to identify risk factors for injuries in military recruits. The fifteen remaining were cross-sectional studies involving healthy military recruits, physically active individuals, athletes and/or sedentary subjects, as well as participants with knee and ankle disorders. Worst quality of movement during the LSD has been associated with deficits in hip external rotation and knee extension strength as well as in ankle dorsiflexion range of motion. The reliability of the LSD has been reported to be moderate (κ = 0.59-0.81). CONCLUSIONS: The LSD has adequate reliability and is a simple tool that can be used to quantify lower extremity quality of movement. Future studies should include standardized methods for application, scoring and interpretation of the test, so that confounding factors can be minimized.

Sophrology versus resistance training for treatment of women with fibromyalgia: A randomized controlled trial.

INTRODUCTION: Physical training has been recommended to improve overall well-being in patients with fibromyalgia. Body relaxation exercises also seem to have some beneficial effect, however there is no consensus regarding this modality. OBJECTIVE: Comparing the effectiveness of sophrology and resistance training in improving the pain of women with fibromyalgia. METHOD: A randomized controlled clinical trial with a blind evaluator. Sixty (60) women with a medical diagnosis of fibromyalgia were randomized and included in two groups: sophrology group (SG) who participated in a relaxation program based on sophrology (n = 30), and resistance group (RG) (n = 30) who participated in a resistance training program for biceps, pectoral, triceps, knee extensors, trapezius, knee flexors, hip abductors. Both groups were treated twice a week for 12 weeks and reevaluated every 4 weeks. The assessment instruments used were the Visual Analog Scale for Pain (VAS), the one-repetition maximum test (1 RM), the overall quality of life (SF-36), the 6-min walk test (6MWT), the Timed Up and Go test (TUG) and the Fibromyalgia Impact Questionnaire (FIQ). RESULTS: We found that the RG presented statistically significant decreases in pain (VAS) during the evaluations (p < 0.05) and increased strength of the evaluated muscles (p < 0.05). A statistically significant decrease in pain (p < 0.05) was observed in the SG compared to T0, with no significant differences in muscle strength. Differences between groups were observed, with better indices only for 6MWT and functional capacity domain of the SF36 for the RG (p < 0.05). CONCLUSION: No differences in pain were found between the groups. Resistance training was more effective than sophrology in improving strength and functional capacity of women with fibromyalgia.

Mat Pilates and aquatic aerobic exercises for women with fibromyalgia: a protocol for a randomised controlled blind study.

INTRODUCTION: Physical exercises have been recommended to improve the overall well-being of patients with fibromyalgia, with the main objective of repairing the effects of lack of physical conditioning and of improving the symptoms, especially pain and fatigue. Although widely recommended and widely known, few studies support the use of Pilates as an effective method in improving the symptoms of the disease, comparing it with other well-founded exercise modalities. This protocol was developed to describe the design of a randomised controlled study with a blind evaluator that evaluates the effectiveness of mat Pilates, comparing it with aquatic aerobic exercises, in improving pain in women with fibromyalgia. METHODS: Sixty women aged 18-60 years with a diagnosis of fibromyalgia, with a score of between 3 and 8 points on the Visual Analogue Scale for pain, and who sign the clear and informed consent form will be recruited according to the inclusion criteria. They will be randomised into one of the two intervention groups: (1) Pilates, to perform an exercise programme based on mat Pilates; and (2) aquatic exercise, to participate in a programme of aerobic exercises in the swimming pool. The protocol will correspond to 12 weeks of treatment, with both groups performing the exercises with supervision twice a week. The primary outcome will be pain (Visual Analogue Scale for pain). The secondary outcomes are to include impact related to the disease, functional capacity, sleep quality and overall quality of life. The evaluations will be performed at three points: at baseline and after 6 weeks and 12 weeks of treatment. ETHICS AND DISSEMINATION: This protocol has been approved by the Ethics Committee of FACISA/UFRN (number: 2.116.314). Data collection will begin after approval by the ethics committee. There will be prior contact with the women, at which time all the information about the study and the objectives will be presented, as well as resolution no 466/2012 of the National Health Council of Brazil for the year 2012, which provides guidelines and regulatory standards for research involving human beings. Participants must sign the informed consent form before the study begins. TRIAL REGISTRATION NUMBER: NCT03149198.

Efeito do aquecimento sobre a flexibilidade e o desempenho funcional: ensaio clínico randomizado / Effect of warm-up on flexibility and functional performance: randomized clinical trial / Efecto del calentamiento sobre la flexibilidad y el rendimiento funcional: ensayo clínico aleatorizado

RESUMO Introdução: A atividade física deve ser parte fundamental de programas de promoção da saúde. No entanto, sua realização pode expor o indivíduo a riscos de lesão, o que torna necessária a adoção de medidas preventivas como o aquecimento, com o intuito de minimizar os riscos e/ou contribuir para o melhor desempenho funcional. Objetivo: O propósito deste estudo foi analisar o efeito agudo de diferentes tempos de aquecimento sobre flexibilidade, equilíbrio e desempenho funcional em indivíduos fisicamente ativos. Método: Trinta e dois homens saudáveis que realizavam exercício regularmente pelo menos três vezes por semana foram aleatoriamente incluídos em um de quatro grupos (n = 8): G0 (sem aquecimento), G5 (aquecimento por cinco min.), G10 (aquecimento por dez min.) e G15 (aquecimento por quinze min.). Os indivíduos foram avaliados antes e depois da intervenção nas seguintes variáveis: flexibilidade do reto femoral (RF) e dos isquiotibiais (IT), equilíbrio corporal com olhos abertos e fechados e desempenho funcional por meio dos testes de salto triplo horizontal (STH) e shuttle run (SR). O aquecimento foi realizado numa esteira ergométrica entre 70% e 80% da frequência cardíaca máxima estimada para idade. Resultado: Não houve diferenças significativas na flexibilidade e no equilíbrio nas comparações intra e intergrupos (p > 0,05). Contudo, houve melhora significativa do desempenho funcional somente no G10 na comparação intragrupo para as variáveis STH (de 5,88 ± 0,55 para 6,23 ± 0,66; p = 0,0051) e SR (de 4,72 ± 0,13 para 4,61 ± 0,13; p= 0,0194). Conclusão: O aquecimento durante 10 minutos parece melhorar o desempenho funcional em indivíduos ativos, podendo também ser uma alternativa viável para a prevenção de lesão.

ABSTRACT Introduction: Physical activity should be a fundamental part of health promotion programs. However, its performance can expose the individual to risk of injury, which makes it necessary to adopt preventive measures such as warm-up (WU) in order to minimize risks and/or contribute to better functional performance. Objective: The purpose of this study was to analyze the acute effect of different warm-up times on flexibility, balance, and functional performance in physically active individuals. Method: Thirty two healthy men, who exercise regularly at least three times a week, were randomly assigned to one of four groups (n=8): G0 (without WU), G5 (WU for 5 min), G10 (WU for 10 min), and G15 (WU for 15 min). The subjects were assessed before and after the intervention on the following variables: flexibility of the rectus femoris (RF) and hamstrings (HM) muscles, body balance with open and close eyes and functional performance through triple horizontal jump (THJ) and shuttle run (SR) tests. The WU was carried out on a treadmill between 70% and 80% estimated maximum heart rate for age. Results: There were no significant differences in flexibility and balance in intra and intergroup comparisons (p>0.05). However, there was a significant improvement in functional performance only in G10 in the intragroup comparison for THJ variables (5.88±0.55 to 6.23±0.66; p=0.0051) and SR variables (4.72±0.13 to 4.61±0.13; p=0.0194) variables. Conclusion: Warm-up for 10 minutes seems to improve functional performance in active individuals, and may be a viable alternative for injury preventions.

RESUMEN Introducción: La actividad física debe ser parte fundamental de los programas de promoción de la salud. Sin embargo, su realización puede exponer al individuo a riesgos de lesión, lo que hace necesaria la adopción de medidas preventivas como el calentamiento con el fin de minimizar los riesgos y/o contribuir para el mejor desempeño funcional. Objetivo: El propósito de este estudio fue analizar el efecto agudo de diferentes tiempos de calentamiento sobre flexibilidad, equilibrio y desempeño funcional en individuos físicamente activos. Método: Treinta y dos hombres sanos que hacen ejercicio regularmente por lo menos tres veces por semana fueron incluidos aleatoriamente en uno de cuatro grupos (n = 8): G0 (sin calentamiento), G5 (calentamiento por cinco minutos), G10 (calentamiento por diez minutos) y G15 (calentamiento por quince minutos). Los individuos fueron evaluados antes y después de la intervención en las siguientes variables: flexibilidad del recto femoral (RF) y de los isquiotibiales (IT), equilibrio corporal con ojos abiertos y cerrados y desempeño funcional por medio de las pruebas de salto triple horizontal (STH) y shuttle run (SR). El calentamiento se realizó en una cinta rodante entre el 70% y el 80% de la frecuencia cardiaca máxima estimada para la edad. Resultado: No hubo diferencias significativas en la flexibilidad y el equilibrio en las comparaciones intra e intergrupos (p > 0,05). Sin embargo, hubo una mejora significativa en el desempeño funcional sólo en el G10 en la comparación intragrupo para las variables STH (de 5,88 ± 0,55 a 6,23 ± 0,66, p = 0,0051) y SR (de 4,72 ± 0,13 a 4,61 ± 0,13, p = 0,0194). Conclusión : El calentamiento durante 10 minutos parece mejorar el desempeño funcional en individuos activos, pudiendo también ser una alternativa viable para la prevención de lesión.