The effects of one-time soft tissue therapy on pelvic floor muscle electromyographic signals in women with urinary incontinence: A randomized intervention trial.

AIMS: To investigate the effects of one-time soft tissue therapy (STT) on pelvic floor muscle (PFM) electromyographic signals in women with stress and/or mixed urinary incontinence. METHODS: An intervention study conducted with 63 women with stress and/or mixed urinary incontinence. Participants were randomly assigned to either the one-time STT group (experimental group) or the control group. The same teaching model for voluntary contraction and relaxation of the PFM was used for all participants. Electromyographic signals from the PFM during functional tasks were the primary clinical outcome measures at baseline and immediately after the intervention. Electromyographic signals were analyzed using root mean square amplitude. RESULTS: There was no significant difference between groups in electromyographic PFM signals in prebaseline rest (mean difference: -0.146 [95% confidence interval (CI): -0.44 to 0.148; p = 0.470]), phasic contractions (mean difference: 0.807 [95% CI: 0.123-1.491; p = 0.459]), tonic contractions (mean difference: 1.06 [95% CI: 0.255-1.865; p = 0.302]), endurance contractions (mean difference: 0.896 [95% CI: 0.057-1.735; p = 0.352]) and postbaseline rest (mean difference: -0.123 [95% CI: -0.406 to 0.16; p = 0.591]) immediately after the one-time STT intervention. CONCLUSION: A one-time STT intervention does not appear to effectively alter electromyographic signal of the PFM in women with urinary incontinence. Due to the limitations of the study, further research is needed to confirm these results.

Comparative Efficacy of Ultrasound-Guided Cervical Fascial Infiltration versus Periarticular Administration of Autologous Conditioned Serum (Orthokine) for Neck Pain: A Randomized Controlled Trial Protocol Description.

BACKGROUND Neck pain is a prevalent and burdensome health issue, with autologous conditioned serum (ACS), like Orthokine, being a recognized treatment for musculoskeletal conditions due to its anti-inflammatory effects. However, the optimal ACS administration method for neck pain remains unclear. The existing literature lacks robust evidence, especially for different injection techniques. This study aimed to compare ACS infiltration into cervical fascia with periarticular administration to determine if the former is as effective in alleviating neck pain, offering a novel approach to its management. MATERIAL AND METHODS Our study is designed to be a single-center, prospective, randomized trial involving 100 patients. Group A (n=50) will receive ACS through fascial infiltration at tender points under ultrasound guidance, with 4 doses administered every 3 days. Group B (n=50) will receive ACS injections in the articular column (facet joints) using the same dosing schedule. We will collect data at T0 (before therapy), T1 (6 weeks after therapy), and T2 (12 weeks after therapy), assessing outcomes with the Numerical Pain Scale (NRS), Neck Disability Index (NDI), and Dynamic Proprioception Test (DPT). RESULTS Enrollment begins in August 2023, and the study is set to conclude in July 2024. If data analysis, manuscript preparation, and peer review proceed smoothly, we anticipate publishing the results in late 2024 or early 2025. CONCLUSIONS If fascial infiltration with ACS proves equally effective as the standard periarticular method, it offers promise for patients on long-term anticoagulant treatment. Paravertebral injections in such cases carry a significant risk of bleeding, making ACS infiltration a potentially safer alternative for managing neck pain in these individuals.

Optimal Duration of Cold and Heat Compression for Forearm Muscle Biomechanics in Mixed Martial Arts Athletes: A Comparative Study.

BACKGROUND Cold and heat therapies for recovery in sports are commonly used, including in the mixed martial arts (MMA). The Game Ready (GR) device can be used for local monotherapy with either heat or cold and for contrast therapy. This study aimed to compare the effects of duration of cold and heat compression on biomechanical changes in the forearm muscles of 20 healthy mixed martial arts athletes. MATERIAL AND METHODS Twenty MMA volunteers (26.5±4.5 years old) underwent 3 different phases of the GR: (1) stimulation time 10 min (eGR-10, GR experimental group), (2) 10 min (cGR-10, sham control group) and (3) 20 min (eGR-20, GR experimental group). The following outcomes were assessed: muscle tone (T), stiffness (S), flexibility (E), pressure pain threshold (PPT), microvascular response (PU), and maximum isometric strength (Fmax). All measurements were performed before GR (rest) and after GR stimulation (post). RESULTS Both eGR-10 and eGR-20 significantly improved outcomes T (p<0.001), S (p<0.001), E (p=0.001, and p<0.001, respectively), PPT (p<0.001), PU (p<0.001), and Fmax (p<0.001). Notably, eGR-20 exhibited superior improvements in PU, Fmax, and PPT, with larger effect sizes (p<0.001). While eGR-10 demonstrated more pronounced reductions in T and S (p<0.001), these results underscore the potential for tailored GR therapy durations to optimize specific recovery goals for MMA athletes. CONCLUSIONS GR stimulation affects muscle biomechanical changes, pain threshold, muscle strength, and tissue perfusion. The study results suggest that 10 min of GR stimulation is sufficient to achieve changes that can be used to optimize recovery for MMA athletes.

Jumping Motor Skills in Typically Developing Preschool Children Assessed Using a Battery of Tests.

The preschool period is characterised by the improvement in motor skills. One of the developmental tasks in children is the ability to jump. Jumping plays an important role in the development of leg strength and balance. It is the gateway to more complex movements. In the physiotherapy clinic, we see a lot of difficulties in jumping performance in 5-7-year-old children. The aim of this study is to present the jumping ability, assessed by the Motor Proficiency Test (MOT) and the G-sensor examination of the vertical countermovement jump (CMJ) and countermovement jump with arms thrust (CMJAT) parameters. A total of 47 children (14 boys and 33 girls) were randomly recruited. The mean age was 5.5 years. The mean height was 113 cm and the mean weight was 19.7 kg. The children were divided into two groups according to their results. Children with low basic motor skills have the greatest difficulty with jumping tasks. In the CMJ jump, the take-off force was lower than in the CMJAT (p = 0.04). Most CMJAT parameters correlate with age, weight, and height. Height correlates most with children's jumping performance. This study may be useful for sport educators and developmental researchers. The topic should be further explored and the CMJ and CMJAT parameters may be established as a basis.

Ebbing Strength, Fading Power: Unveiling the Impact of Persistent Fatigue on Muscle Performance in COVID-19 Survivors.

The total number of confirmed cases of COVID-19 caused by SARS-CoV-2 virus infection is over 621 million. Post-COVID-19 syndrome, also known as long COVID or long-haul COVID, refers to a persistent condition where individuals experience symptoms and health issues after the acute phase of COVID-19. The aim of this study was to assess the strength and fatigue of skeletal muscles in people recovered from COVID-19. A total of 94 individuals took part in this cross-sectional study, with 45 participants (referred to as the Post-COVID Cohort, PCC) and 49 healthy age-matched volunteers (Healthy Control Cohort, HCC). This research article uses the direct dynamometry method to provide a detailed analysis of post-COVID survivors' strength and power characteristics. The Biodex System 4 Pro was utilized to evaluate muscle strength characteristics during the fatigue test. The fatigue work in extensors and flexors was significantly higher in the PCC. The PCC also showed significantly less power in both extensors and flexors compared to the HCC. In conclusion, this study provides compelling evidence of the impact of post-COVID-19 fatigue on muscle performance, highlighting the importance of considering these effects in the rehabilitation and care of individuals recovering from the virus. PCC achieved lower muscle strength values than HCC.

Symmetry Function: The Differences between Active and Non-Active Above-the-Knee Amputees.

The number of patients with unilateral above-knee amputation (AKA) due to non-vascular causes has remained stable over the years, at 0.92 per 1000 people per year. Post-AKA individuals are at risk of experiencing a higher incidence of chronic pain. Post rehabilitation, it is estimated that between 16−62% of patients with musculoskeletal disabilities fail to meet the minimum criteria for physical activity in comparison to a healthy population. The current study included 14 participants (11 men and 3 women) with a mean age of 46.1 ± 14.2 years, body height of 1.76 ± 0.09 m, and weight of 79.6 ± 18.3 kg, who were all post-unilateral above-the-knee amputees. Patients in the study were divided into two groups: active (AC) and non-active (NAC). This study was conducted in a certified Laboratory of Biomechanical Analysis using the BTS Smart-E system (BTS Bioengineering). In order to investigate the symmetry function (SF) of gait, the only measurements included were the time series assessment of gait variables defining pelvic and lower limb joint motion and ground reaction forces (GRF). Both groups had an asymmetrical gait pattern with a different magnitude and relative position in the gait cycle, which was revealed by SF. The differences in terms of median, minimum, and maximum were statistically significant (p < 0.05), with SF ranging from −25 to 24% for the AC group and from 43 to 77% (59% on average) for the NAC group. The AC's pattern was more symmetrical compared to the NAC's pattern, especially in the case of pelvic and hip joint motion.

Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee.

BACKGROUND: Above-knee amputations (AKAs) contribute to gait asymmetry. The level of asymmetry is affected by the type of knee prosthetic module. There is limited evidence suggesting that more technically advanced solutions (microprocessor modules; MicPK) are superior to less advanced ones (mechanical modules; MechPK). The study aimed to evaluate the variable range of hip and pelvic joint movements during gait and look for differentiating areas with an increased level of asymmetry of the gait cycle in individuals who underwent an AKA and are equipped with MicPK or MechPK. METHODS: Twenty-eight individuals participated in the study; 14 were assigned to a study group of individuals who underwent a unilateral AKA, and the other 14 were healthy participants as a control group. The movement task was recorded using the optoelectronic SMART-E system following the standard Davis protocol (the Newington model). A new method of quantifying gait symmetry using the symmetry function (SF) is proposed. SF is an integral measure of absolute differences in time-standardized signals between sides throughout the whole cycle of motion variability. RESULTS: In the frontal plane, there were significant differences between groups in the asymmetry of the range of movement in the hip joint of the intact limb. In the middle of the support phase, the intact limb was more adducted in individuals with MicPK and less abducted in people with MechPK (differences in mean 180%, p < 0.000; max 63%, p < 0.000; min 65%, p < 0.000). In the sagittal plane, the range of asymmetry of the flexion and thigh extension of the intact limb was similar to and only slightly different from the physiological gait. In the transverse plane, higher asymmetry values were noted for individuals with MicPK. In the final stage of the swing phase, the thigh was more rotated both externally and internally. The size of the asymmetry, when compared to gait of healthy individuals, reached 50% (differences in mean 115%, p < 0.232; max 62% p < 0.26; min 50, p < 0.154). CONCLUSIONS: In the study group, the assessed ranges of pelvic and thigh movement in the hip joint differed only in the frontal plane. Individuals who underwent a unilateral above-knee amputation may gain less from using MicPK than anticipated.

Gait Parameters in Healthy Preschool and School Children Assessed Using Wireless Inertial Sensor.

BACKGROUND: The objective gait assessment in children has become more popular. Basis parameters for comparison during the examination are advisable. OBJECTIVES: The study aim was to investigate the typical gait parameters of healthy preschool and school children, using a wireless inertial sensor as the reference for atypical gait. The additional aim was to compare the specific gait parameters in the younger and older group of children. METHODS: One hundred and sixty-one children's gait parameters were evaluated by a G-Walk BTS G-SENSOR smart analyzer. The children were walking barefoot, at a self-selected speed, on a five-meter walkway, and they turned around and go back twice. RESULTS: Age significantly influences most of the spatiotemporal parameters. The support phase becomes shorter with age. Accordingly, the swing phase becomes longer with age. The results also show that older children need shorter double support and have longer single support. Moreover, the pelvic tilt symmetry index is higher with increasing age. In each age division, the smallest variation in all gait parameters within the oldest group of examined children was observed. A comparison between the left and right side gait parameters shows the higher difference in boys than in girls. A significant difference was calculated in the pelvic obliquity symmetry index. Girls had significantly more symmetrical obliquity than boys. CONCLUSIONS: the research indicates the basic parameters of typical children's gait, which may be a reference to atypical gait in the case of trauma or disability.

Proprioceptive Neuromuscular Facilitation for Accessory Respiratory Muscles Training in Patients After Ischemic Stroke.

This study focused on how pulmonary function is affected by proprioceptive neuromuscular facilitation (PNF) of accessory respiratory muscles in the chronic post-stroke phase. The study involved patients who had had ischemic stroke 6 months or more before the PNF treatment investigated. The objective was to define the effect of PNF on bioelectrical resting and maximum activity of the accessory muscles. Patients were randomly assigned to PNF treatment and just positioning treatment as a reference for comparison; 30 patients each. Electromyography of accessory muscles was investigated before and after physiotherapeutic treatments. We found that there was a greater reduction in EMG activity in all muscles investigated after PNF compared to positioning treatment alone. A reduction of muscle activity due to PNF concerned both affected and unaffected body side, but it was greater on the affected side. We conclude that a reduction of the accessory respiratory muscle activity due to PNF treatment could be of benefit in chronic stoke patients in that it would help normalize breathing pattern and thereby prevent the development of hypoxia.

Spine pain in the firefighter profession

BACKGROUND: Musculoskeletal disorders mainly affecting the spine constitute one of the major social problems. Frequently, they constitute the cause of prolonged absence at work. Working in a fire brigade is specific because of the physical strain, working time under adverse conditions or stress related to rescue operations. MATERIAL AND METHODS: The study group comprised 61 firefighters, 60 men (98.36%) and 1 woman (1.64%). The age of examined firefighters ranged 20­56 years old. The average age of the examined persons was 33.77 years old and the average working service in a fire brigade was 9.59 years. The following research instruments were applied as the study methods: own survey, the Numerical Rating Scale, the International Physical Activity Questionnaire (IPAQ) ­ long version and the Oswestry Disability Index (ODI) questionnaire. The Pearson correlation coefficient at significance level of p < 0.05 was used for determining the dependencies among the variables. RESULTS: Knowledge of ergonomic lifting and handling principles concerning heavy loads was reported by 84% of the group, the remaining 16% declared ignorance of such rules. The dependence of pain on the length of service of the examined was insignificant and amounted to 0.281 Pearson's r. The results of the ODI questionnaire did not significantly change statistically with age. CONCLUSIONS: The IPAQ confirmed the high level of physical activity of the study population. Even though the study group was small, the results of ODI showed a minor degree of disability. Med Pr 2018;69(4):365-373