Does participation in therapeutic exercise programs after finishing oncology treatment still ensure an adequate health status for long-term breast cancer survivors? A ≥ 5 years follow-up study.

PURPOSE: The aims of this study were to evaluate whether the effects of two therapeutic exercise programs are sustained over time (≥ 5 years) in long-term breast cancer survivors (LTBCS). Second, to determine the influence of the current level of physical activity (PA) performed on cancer-related fatigue (CRF) that these patients may present ≥5 years later. METHODS: A prospective observational study was conducted with a cohort of 80 LTBCS in Granada during 2018. Firstly, considering their participation in one of the programs, they were allocated into two groups: usual care and therapeutic exercise program, to assess CRF, pain and pressure pain sensitivity, muscle strength, functional capacity, and quality of life. Secondly, they were also classified into 3 groups according to current level of weekly PA performed: ≤ 3, 3.1-7.4, and ≥ 7.5 (MET-hour/week) respectively, to assess its impact over CRF. RESULTS: Although the positive effects of the programs are not sustained over time, a trend toward significance can be observed for a greater reduction in overall CRF levels, lower intensity of pain in the affected arm and cervical region, and greater functional capacity and quality of life in the group that underwent therapeutic exercise. Additionally, 66.25% of LTBCS are inactive ≥ 5 years after completion of the program and furthermore, such inactivity is accompanied by higher CRF levels (P .013 to .046). CONCLUSION: The positive effects of therapeutic exercise programs are not maintained over time for LTBCS. Additionally, more than half of these women (66.25%) are inactive ≥ 5 years after completion of the program, this inactivity being accompanied by higher levels of CRF.

Differences in Various Strength Manifestations Between the Flat and Retracted Bench Press Variants: Are They Affected by Subjects' Experience or Strength Levels?

ABSTRACT: Piepoli, A, Miras-Moreno, S, Janicijevic, D, Martínez-Amat, A, and García-Ramos, A. Differences in various strength manifestations between the flat and retracted bench press variants: are they affected by subjects' experience or strength levels? J Strength Cond Res 37(12): 2339-2345, 2023. The objective of this study was to explore the effect of retracting the scapulae during the free-weight bench press (BP) exercise on various strength manifestations and perceptual variables. Twenty-eight recreationally trained male lifters (BP 1-repetition maximum [1RM] = 96.1 ± 20.8 kg) randomly performed in 2 different sessions: the flat BP (scapulae free to move during the movement) and retracted BP (shoulders retracted during the movement). Three strength manifestations were evaluated: (a) explosive strength -mean velocity (MV) achieved against 3 submaximal loads (40, 60, and 80%1RM); (b) maximal strength -1RM; and (c) endurance strength -number of repetitions completed to failure against the 70%1RM. Discomfort and ratings of perceived exertion (RPE) values were also recorded immediately after completing each test. The upward displacement of the barbell was lower for the retracted BP compared with the flat BP at the 3 submaximal loads ( p ≤ 0.024), but no significant differences between the BP variants were observed for the MV at submaximal loads ( p ≥ 0.473), 1RM ( p = 0.147), number of repetitions completed to failure ( p = 0.447), RPE at submaximal loads ( p ≥ 0.363), or discomfort during any test ( p ≥ 0.611). Subjects always demonstrated a greater strength performance with the BP variant most used in their training programs, but the differences between the flat and retracted BP were not affected by subjects' maximal strength values ( p ≥ 0.162). These results suggest that retracting the scapulae during the BP exercise presents minor effects on different strength manifestations and perceptual measures of effort and discomfort.

Time course and predictors of persistent cancer-related fatigue in long-term breast cancer survivors: a prospective observational study.

PURPOSE: The present study investigated whether the level of cancer-related fatigue (CRF) after finishing oncology treatment was related to higher levels of persistent CRF and its relationship with both functional and psychological disturbances. Second, to identify potential predictors of persistent CRF. METHODS: Eighty BC survivors were classified into non-fatigued (≤ 3.9) or fatigued (≥ 4), according to their Piper Fatigue Scale total score after finishing oncology treatment. The time course of fatigue and the impact on its domains, pain, mood state, perceived physical fitness, the level of physical activity, and quality of life were assessed at ≥ 5 years. RESULTS: Women classified as fatigued after finishing oncology treatment had not only a higher prevalence of persistent CRF (41.2%) at the reassessment, but also greater levels of pain (P = .006 to .048) and mood disturbances (P = .007 to .015), and lower levels of physical fitness condition (P = .002 to .039) and quality of life (P < .001 to < .05) over time. Regression analyses revealed that "sadness/depression," "global health status," "physical activity level," and "type of treatment" were significant predictors of persistent CRF (r2 = .692). CONCLUSION: Higher levels of CRF implied greater levels of persistent CRF and a lower functional and psychological profile over time. 69.2% of of persistent CRF was explained.

The Influence of Pilates Exercises on Body Composition, Muscle Strength, and Gait Speed in Community-Dwelling Older Women: A Randomized Controlled Trial.

ABSTRACT: Aibar-Almazán, A, Martínez-Amat, A, Cruz-Díaz, D, Jesús de la Torre-Cruz, M, Jiménez-García, JD, Zagalaz-Anula, N, Redecillas-Peiró, MT, Mendoza-Ladrón de Guevara, N, and Hita-Contreras, F. The influence of Pilates exercises on body composition, muscle strength, and gait speed in community-dwelling older women: a randomized controlled trial. J Strength Cond Res 36(8): 2298-2305, 2022-Population aging is a global phenomenon that has wide-ranging consequences for the health of individuals, including age-related obesity, muscle loss, and a decline in muscle strength and gait speed. These alterations are associated with disability, functional decline, and mortality in older adults. The objective of this study was to analyze the effects of Pilates exercises on body composition, handgrip strength, and physical performance among community-dwelling Spanish women aged 60 and older. A randomized controlled trial of a 12-week Pilates training program was conducted. A total of 109 women were randomly allocated to either a control ( n = 54) or a Pilates ( n = 55) group. Body composition was evaluated by bioelectrical impedance. Body mass index (BMI), percentage of body fat, and height-adjusted skeletal muscle mass index (SMI) were assessed before and immediately after the intervention, as were physical performance, estimated by gait speed (timed up-and-go test), and handgrip strength. Statistically significant improvements ( p < 0.05) were observed both within and between groups for handgrip strength (Cohen's d = 0.40 and 0.52 respectively) and gait speed (Cohen's d = 0.86 and 0.87 respectively). After 12 weeks, BMI significantly decreased (Cohen's d = 0.07) only in the Pilates group. No significant differences were observed regarding SMI. In conclusion, a 12-week Pilates exercise intervention on community dwelling women over 60 years old shows beneficial effects on muscle strength, physical performance, and BMI, but failed to induce any changes on body composition.

Small-sided games in amateur players: rule modification with mini-goals to induce lower external load responses.

The aim of this study was to compare the acute physiological (i.e., heart rate-related variables) and neuromuscular responses (i.e., sprint and jump) and time-motion characteristics (i.e., external load variables) when modifying the game design (possession play vs. mini-goals without a goalkeeper) during 4-a-side in amateur senior football players. Male senior football players (n = 16) performed two formats of small-sided games (SSGs) in two different testing sessions (4-a-side with possession play and mini-goals rule). Differences in time-motion characteristics and physiological parameters of players were measured with the Global Positioning System (GPS), and tested before and after (pre- and post-SSG) for neuromuscular assessment. A repeated measures analysis of variance (ANOVA), with Bonferroni post-hoc test, showed that both SSG formats induced changes in sprint performance (before-after comparison) (p ≤ 0.05). Moreover, the results showed that the variables muscle oxygen saturation, rate of perceived exertion, 85-89% heart rate peak, total distance, total distances at low speed, total distances at high speed, m/min, accelerations at low speed, accelerations of ≥ 2.5 m.s-2, maximal speed, and average speed were statistically significantly different among game conditions. The players' performances are affected by the inclusion of mini-goals during 4 vs. 4 SSGs. The results provide useful information for training and task design that replicate specific physical demands (i.e., accelerations of ≥ 2.5 m.s-2, total distances at high speed or total distances at low speed).

Psychometric Properties of the Spanish Version of the Sarcopenia and Quality of Life, a Quality of Life Questionnaire Specific for Sarcopenia.

The Sarcopenia and Quality of Life questionnaire (SarQol®) is a self-administered multidimensional sarcopenia-specific tool designed for community-dwelling subjects aged 65 years and older. The purpose of the present study was to evaluate the psychometric properties of the Spanish version of the SarQoL®. A total of 252 participants aged ≥ 65 years voluntarily participated in this cross-sectional study. Handgrip strength and bioelectrical impedance analysis were used for sarcopenia screening. Discriminative power, internal consistency, test-retest reliability, and floor and ceiling effects were analyzed. The generic 36-item Short-Form Health Survey (SF-36), the European Quality of Life 5-Dimension-3 Level (EQ-5D-3L), and the Hospital Anxiety and Depression Scale (HADS) were also used for convergent and divergent validity. Significant differences between sarcopenic (n = 66) and non-sarcopenic participants were observed for SarQoL® total score (p = 0.008) and for all domains except D2-locomotion. A high internal consistency of SarQoL® total score (Cronbach's alpha = 0.904) was found, and significant domain-to-total score correlations were obtained (all p < .001). Test-retest data showed excellent reliability for SarQoL® total score (ICC = 0.99; 95%CI 0.98-0.99) and in all dimensions, except for D6-leisure and D7-fears activities (substantial). No floor and ceiling effects were observed for SarQoL® total score. SarQoL® total score showed good and acceptable correlations(p < 0.001) with the selected domains of the SF-36 and EQ-5D-3L which have similar dimensions (convergent validity). Low and non-significant correlations existed with anxiety, depression, and EQ-5D-3L self-care and pain/discomfort domains (divergent validity). The Spanish SarQoL® shows satisfactory general psychometric properties in Spanish-speaking older adults from Spain and is able to discriminate between older adults with and without sarcopenia.

Benefits of adding stretching to a moderate-intensity aerobic exercise programme in women with fibromyalgia: a randomized controlled trial.

OBJECTIVE: To investigate the effects of adding stretching to a moderate-intensity aerobic exercise programme in women with fibromyalgia. DESIGN: Randomized controlled trial. SUBJECTS: Sixty-four female patients who were diagnosed with fibromyalgia syndrome based on the American College of Rheumatology criteria were recruited (mean age: 54.27 ± 6.94 years). INTERVENTIONS: The control group (n = 32) underwent supervised moderate-intensity cycling (50%-70% of the age-predicted maximum heart rate) three times per week for 12 weeks. The experimental group (n = 32) underwent the same exercise programme plus a stretching programme once per week for 12 weeks. MAIN MEASURES: The main measures of this study were sleep quality assessed by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, the impact of fibromyalgia on quality of life assessed by the Fibromyalgia Impact Questionnaire, and pain perception assessed by the visual analogue scale at baseline, after 4 weeks, and after 12 weeks. RESULTS: The experimental group experienced significant improvements at 4-week measure compared with control group: Pittsburgh Sleep Quality Index (P < 0.001); Epworth Sleepiness Scale (P = 0.002); Fibromyalgia Impact Questionnaire (0.93 ± 7.39, P < 0.001); and visual analogue scale (0.52 ± 0.05, P < 0.001). Also at 12-week measure, experimental group experienced significant improvements compared with control group: Pittsburgh Sleep Quality Index (P < 0.001), Epworth Sleepiness Scale (P < 0.001); Fibromyalgia Impact Questionnaire (1.15 ± 9.11, P < 0.001); and visual analogue scale (0.81 ± 0.62, P < 0.001). CONCLUSION: Adding stretching to a moderate-intensity aerobic exercise programme increased sleep quality, decreased the impact of fibromyalgia on the quality of life, and reduced pain compared with just a moderate-intensity aerobic exercise programme in our sample of women with fibromyalgia.

Effects of 12 Weeks of Tai Chi Intervention in Patients With Chronic Ankle Instability: A Randomized Controlled Trial.

CONTEXT: Tai Chi is a physical activity modality which is widely practiced over the world. The effectiveness of Tai Chi on postural control and balance has been described in older population, but until recently there are no studies that include patients with chronic ankle instability. OBJECTIVES: The aim of this study was to evaluate the effectiveness of 12 weeks of Tai Chi intervention on dynamic balance and self-reported instability in patients with chronic ankle instability. STUDY DESIGN: A randomized controlled trial was carried out. SETTING: University physical therapy facility. PARTICIPANTS: Fifty-two participants were allocated to an intervention group (n = 26) based on Tai Chi training or a control group (n = 26) who received no intervention. INTERVENTION: The participants completed 12 weeks of Tai Chi intervention (1 h session/2 times per week) or no intervention in the control group. MAIN OUTCOME MEASURES: Outcome measures included postural control and self-reported instability feeling assessed by the Star Excursion Balance Test and the Cumberland Ankle Instability Tool, respectively. RESULTS: There was observed significant improvement in all Star Excursion Balance Test reach distances (anterior [F = 6.26, P < .01]; posteromedial [F = 9.58, P < .01], and posterolateral [F = 8.42, P < .01]) in the Tai Chi group with no change in the control group (P < .01). The intervention group demonstrated significant improvement on self-reported instability feeling assessed by the Cumberland Ankle Instability Tool questionnaire (F = 21.36, P < .01). CONCLUSION: The obtained results suggested that 12 weeks of Tai Chi intervention have positive effects on postural control and self-reported instability feeling in patients with chronic ankle instability.

Suspension Training HIIT Improves Gait Speed, Strength and Quality of Life in Older Adults.

This study aimed to evaluate the effects of a 12-week high-intensity interval exercise (HIIT) training program involving suspension exercises (TRX) on the muscle strength, body composition, gait speed, and quality of life of older adults. A total of 82 older adults were randomly assigned to 3 groups: a HIIT group (n=28), a continuous intensity training group (MIIT group, n=27), or a control group (CG, n=27). Compared to MIIT and CG, participants of the HIIT group showed significant post-intervention improvements in BMI (p=.002 and p<.001, respectively) and gait speed (p<.001 for both). Handgrip strength increase was also observed after HIIT (p=.002), but no differences were observed with MIIT and CG. Compared with MIIT and control groups, HIIT showed improvements in the SF-36 domains: general health (p<.001 for both) health changes (p<.001 for both), vitality (p=.002 and p=.001 respectively) and physical functioning (p=.036 and p<.001 respectively). Our results suggest that a HIIT training program with TRX have benefits in BMI, handgrip strength, gait speed, and quality of life in older adults.

Risk of Falls in Healthy Older Adults: Benefits of High-Intensity Interval Training Using Lower Body Suspension Exercises.

The objective of this study was to compare the effects of high-intensity interval training (HIIT) and moderate-intensity interval training (MIIT) programs, both with a suspension training system, on several fall risk factors in healthy older adults. A total of 82 participants (68.23 ± 2.97 years) were randomized to HIIT (n = 28), MIIT (n = 27), or control (n = 27) groups. Balance confidence (Activities-specific Balance Confidence Scale), fear of falling (Falls Efficacy Scale-International), dynamic balance (Timed Up and Go test), and gait analysis (OptoGait optical detection system) were assessed. Statistical analysis showed improvements after the intervention in the HIIT group compared with the MIIT and control groups regarding the fear of falling (p < .05 and p < .01, respectively), gait (both ps < .05), and dynamic balance (p < .05 and p < .01, respectively), whereas both HIIT and MIIT groups improved balance confidence compared with the control group (p < .01 and p < .05, respectively). We can conclude that HIIT has significant beneficial effects of fall risk in older adults.

Development of the human shoulder joint during the embryonic and early fetal stages: anatomical considerations for clinical practice.

Although several studies have been published regarding the morphology and anatomical variations of the human shoulder joint, most have dealt with adult individuals. Those looking into the development of the joint have been focused on specific structures or have observed specimens in advanced gestational stages. The goal of this paper is to perform a complete analysis of the embryonic and early fetal development of the elements in the shoulder joint, and to clarify some contradictory data in the literature. In our study, serial sections of 32 human embryos (Carnegie stages 16-23) and 26 fetuses (9-13 weeks) were analyzed. The chondrogenic anlagen of the humerus and the medial border of the scapula can be observed from as early as Carnegie stage 17, whereas that of the rest of the scapula appears at stage 18. The osteogenic process begins in week 10 for the humeral head and week 11 for the scapula. At stage 19 the interzone becomes apparent, which will form the glenohumeral joint. In the next stage the glenohumeral joint will begin delaminating and exhibiting a looser central band. Denser lateral bands will join the humeral head (caput humeri) and the margins of the articular surface of the scapula, thus forming the glenoid labrum, which can be fully appreciated by stage 22. In 24-mm embryos (stage 21) we can observe, for the first time, the long head of the biceps tendon (which is already inserted in the glenoid labrum by week 9), and the intertubercular sulcus, whose depth is apparent since week 12. Regarding ligamentous structures, the coracohumeral ligament is observed at the end of Carnegie stage 23, whereas the primitive glenohumeral ligament already appeared in week 10. The results of this study provide a detailed description of the morphogenesis, origin and chronological order of appearance of the main intrinsic structures of the human shoulder joint during late embryonic and early fetal development. We expect these results to help explain several functional aspects of the shoulder joint, and to clarify some contradictory data in the literature regarding this complex anatomical and biomechanical structure, helping future researchers in their efforts.

The effectiveness of 12 weeks of Pilates intervention on disability, pain and kinesiophobia in patients with chronic low back pain: a randomized controlled trial.

OBJECTIVE: To assess the effectiveness of 12 weeks of Pilates practice on disability, pain and kinesiophobia in patients with chronic non-specific low back pain. DESIGN: This is a randomized controlled trial. SETTING: This study was conducted in the university laboratory. SUBJECTS: A total of 64 participants with chronic non-specific low back pain were included. INTERVENTIONS: Participants were randomly allocated to intervention group consisted in Pilates intervention during 12 weeks ( n = 32) or control group who received no treatment ( n = 32). MAIN MEASURES: Disability, pain and kinesiophobia were assessed by Roland Morris Disability Questionnaire, visual analogue scale and Tampa Scale of Kinesiophobia, respectively. Measurements were performed at baseline, at 6 and 12 weeks after study completion. RESULTS: There were significant differences between groups with observed improvement in Pilates intervention group in all variables after treatment ( P < 0.001). Major changes on disability and kinesiophobia were observed at six weeks of intervention with no significant difference after 12 weeks ( P < 0.001). Mean changes of the intervention group compared with the control group were 4.00 (0.45) on the Roland Morris Disability Questionnaire and 5.50 (0.67) in the Tampa Scale of Kinesiophobia. Pain showed better results at six weeks with a slightly but statistically significant improvement at 12 weeks with Visual Analogue Scale scores of 2.40 (0.26) ( P < 0.001). CONCLUSION: Pilates intervention in patients with chronic non-specific low back pain is effective in the management of disability, pain and kinesiophobia.

Thermographic Assessment of Eccentric Overload Training Within Three Days of a Running Session.

The aim of this study was to analyze the changes in patellar and Achilles tendons between a group trained using eccentric overload and an untrained group within 3 days of a running session. To this end, infrared thermography (IRT) will be used. Twenty healthy male subjects were divided into 2 groups. One group performed a 6-week squat training in the flywheel before the running session. During the running intervention, both groups ran in 3 different days, for 1 hour each, at 80% maximal heart rate. Before, just after, and after 10 minutes of the running intervention, participants were assessed using IRT. Eccentrically trained groups showed a statistically significant difference (analysis of variance, p = 0.0049) expressed as a smaller bilateral increase in temperature in the patellar tendon just before the first running day (right side, 0.11 °C; left side, 0.29 °C). On the other days of running and in the Achilles tendon groups, similar changes were observed: an increase in the temperature after running and no significant difference between contralateral limbs. Our results point at eccentric overload training providing a better adaptation for the first day of running. IRT is an easy-to-apply noninvasive tool to analyze and compare the effects of performance on tendon tissues.

Ultrasound Changes in Achilles Tendon and Gastrocnemius Medialis Muscle on Squat Eccentric Overload and Running Performance.

Sanz-López, F, Berzosa Sánchez, C, Hita-Contreras, F, Cruz-Diaz, D, and Martínez-Amat, A. Ultrasound changes in Achilles tendon and gastrocnemius medialis muscle on squat eccentric overload and running performance. J Strength Cond Res XX(X): 000-000, 2015-Previous studies have proven the adaptation to load in the Achilles tendon and gastrocnemius muscle after different types of exercise, such as running, heel drop training, and a variety of sports. These findings have been applied to improve performance and in the treatment and prevention of overuse injuries. However, the effects that squat performance may have on the Achilles tendon and gastrocnemius muscle are still unknown. Squats are a widely used training exercise that involves calf-muscle activation. Similarly, no reports have been published regarding the adaptation to load of trained and untrained subjects during several consecutive days of running. The purpose of this study was to analyze changes in the Achilles tendon and in the pennation angles of the gastrocnemius medialis after eccentric overload training and within 3 days of running. Twenty healthy males who volunteered for this study were divided into 2 groups. Subjects in the eccentric overload training (ECC) group performed 6 weeks of eccentric overload training (twice weekly, 4 sets of 7 repetitions in a Yoyo squat device) before the running intervention. All participants, ECC and control (CONT) groups, ran on 3 consecutive days. After the eccentric training, an increase in the cross-sectional area of the Achilles tendon and in the pennation angle was observed. As for the running intervention, the behavior of tissues in both groups was similar. These results suggest that eccentric overload training with squats promotes changes in the Achilles tendon and in the pennation angle of the gastrocnemius medialis muscle. Nevertheless, significant changes in the tissue do not appear between the running performance of trained and untrained subjects.

Validation and psychometric properties of the Spanish version of the Quality of Life Scale (QOLS) in patients with fibromyalgia.

Fibromyalgia (FM) is a chronic disease associated with high disability levels, which in turn lead to low quality of life (QOL). The objectives of this study were to translate the Quality of Life Scale (QOLS) into Spanish and to assess its reliability and validity for its use in patients with FM. A total of 140 women are suffering from FM (52.87 ± 9.35 years old). All belonged to an association of FM patients (AFIXA, Jaén, Spain). The Spanish versions of the FM impact questionnaire (FIQ), the SF-36, and Beck's Depression Inventory were used to assess them. The construct's validity was checked by means of exploratory factorial analysis (varimax with Kaiser normalization). Test-retest reliability was assessed through intraclass correlation coefficient (ICC), and convergent validity through Spearman's correlation. Results show that Cronbach's alpha was 0.887, which revealed high internal consistency. The value of ICC for the QOLS total was 0.765 (95 % CI 0.649-0.843, p < 0.001). QOLS presented a significant Spearman's correlation (p < 0.01) with Beck's Inventory, with the physical and mental subtotals of SF-36 and with FIQ. The main component analysis and the varimax rotation revealed the convergence on three factors that account for 54.05 % of variance. Taking into account the severity of the disorder, significant differences (p < 0.05) appeared in QOLS, with moderately afflicted patients getting higher scores than the most severe cases. In conclusion, our study shows that the Spanish version of the QOLS is a reliable instrument, with a good convergent and discriminant construct validity, for measuring the QOL of Spanish FM patients.

Reliability and validity of the Spanish version of the Pittsburgh Sleep Quality Index (PSQI) in patients with fibromyalgia.

Fibromyalgia (FM) is recognized as a common condition, characterized by widespread pain and associated with sleep disturbances and poor-quality sleep. The Pittsburgh Sleep Questionnaire Index (PSQI) is one of the most recommended instruments to measure sleep quality and sleep disorders. The purpose of our study was to translate the questionnaire into Spanish and to assess the psychometric properties of the Spanish version of the PSQI. A total of 138 women with FM belonging to a FM association (AFIXA, Andalusia, Spain) completed the study. Internal consistency and test-retest reliability were analyzed. Factorial analysis was performed for the PSQI components. Convergent validity of the PSQI was evaluated using Spearman's rank correlation coefficient with the Spanish versions of the Fibromyalgia Impact Questionnaire (FIQ) and the health survey short form-36 (SF-36). In our analysis, the Spanish version of the PSQI has shown a good internal consistency of the total score, with a Cronbach's alpha of 0.805, and an acceptable test-retest reliability, with a Spearman's correlation coefficient of 0.773 (p < 0.001), for the total score. A two-factor structure was generated by exploratory factor analysis, with a Cronbach's alpha of 0.866 for factor 1 and of 0.712 for factor 2. In convergent validity analysis, the PSQI total score showed a significant correlation (p < 0.01) with the FIQ total score and with the mental and physical health summaries scores of the SF-36. Our results show that the Spanish version of the PSQI provides a reliable instrument, with a good convergent validity for measuring sleep quality among Spanish FM patients.

Embryonic and early fetal period development and morphogenesis of human craniovertebral junction.

Several studies have focused on the cartilaginous, articular, and ligamentous development of the craniovertebral joint (CVJ), but there are no unifying criteria regarding the origin and morphogenetic timetable of the structures that make up the CVJ. In our study, serial sections of 53 human embryonic (n = 27) and fetal (n = 26) specimens from O'Rahilly stages 17-23 and 9-13 weeks, respectively, have been analyzed. Our results demonstrate that the chondrification of the pars basioccipitalis and exoccipitalis becomes observable at stage 19, and all future bones in the CVJ are in their cartilaginous form except for the future odontoid process. In addition, two chondrification centers appear for the body of the axis. From stage 21, the apical, alar, and transverse atlantal ligaments begin to acquire a ligamentous structure and the odontoid process initiates its chondrogenic phase. Stage 22 witnesses the first signs of the articular cavities of the atlanto-occipital joint, and by stage 23 all joints have cavities except for the transverse-odontoid joint, which will wait until week 9. In week 10, the ossification of the basilar part of the occipital bone begins, followed by the rest of the structures except for the odontoid process, which will start at week 13, thus completing the osteogenesis of all bones in the CVJ. The results of this study could help in establishing the anatomical basis of the normally functioning CVJ and for detecting its related pathologies, abnormalities, and malformations.

Effects of a contrast training program without external load on vertical jump, kicking speed, sprint, and agility of young soccer players.

The purpose of this study was to determine the effects of a 12-week contrast training (CT) program (isometric + plyometric), with no external loads, on the vertical jump, kicking speed, sprinting, and agility skills of young soccer players. Thirty young soccer players (age, 15.9 ± 1.43 years; weight, 65.4 ± 10.84 kg; height, 171.0 ± 0.06 cm) were randomized in a control group (n = 13) and an experimental group (n = 17). The CT program was included in the experimental group's training sessions, who undertook it twice a week as a part of their usual weekly training regime. This program included 3 exercises: 1 isometric and 2 plyometric, without external loads. These exercises progressed in volume throughout the training program. Performance in countermovement jump (CMJ), Balsom agility test (BAT), 5-, 10-, 20-, and 30-m sprint, and soccer kick were assessed before and after the training program. A 2-factor (group and time) analysis of variance revealed significant improvements (p < 0.001) in CMJ, BAT, and kicking speed in the experimental group players. Control group remained unchanged in these variables. Both groups significantly reduced sprint times over 5, 10, 20, and 30 m (p ≤ 0.05). A significant correlation (r = 0.492, p < 0.001) was revealed between ΔBAT and Δaverage kicking speed. Results suggest that a specific CT program without external loads is effective for improving soccer-specific skills such as vertical jump, sprint, agility, and kicking speed in young soccer players.

Association of the weekly practice of guided physical activity with the reduction of falls and symptoms of fibromyalgia in adult women.

The purpose of this study was to evaluate the effects of weekly physical activity on the risk of falls and the impact of fibromyalgia (FM) symptoms on daily function in Spanish women. Fibromyalgia is a common widespread pain condition that has been linked to an increased risk of falling and a low amount of guided physical activity, defined as regular participation in moderate-intensity exercise. Before the development of fall-risk reduction interventions, it is essential to understand the context of falls and fall-related experiences in patients with FM. Ours was a descriptive longitudinal study, wherein 140 women participated, all aged 28-73 years and belonging to AFIXA (Asociación Provincial de Fibromialgia y Síndrome de Fatiga Crónica), the Fibromyalgia Association of Jaén (Andalusia, Spain). The study took place during 2013; data were collected through fall diaries, interviews, and questionnaires. Results showed that weekly physical activity can explain up to 12% of the variance in the fear of falling and 18% of the number of falls per year in patients with FM. However, the weekly physical activity prediction against the perceived impact of FM yielded R values below 10% in the 3 factors and in the total score of the Revised Fibromyalgia Impact Questionnaire (FIQ-R). Inactive women were proven to have a significantly higher number of falls per year than active ones (1.86 ± 1.46 vs. 0.69 ± 0.43, p < 0.001), but their fear of falling was similar (p > 0.05). In addition, physically active women had a significantly lower intensity in the symptoms of their condition (FIQ-R symptoms: 30.87 ± 8.58 vs. 34.78 ± 7.58 arbitrary units [a.u.], p = 0.014), and lower scores in the total score of the FIQ-R (54.33 ± 21.50 vs. 65.19 ± 19.27 a.u., p = 0.004). Results show that, with at least 1 hour per session of guided physical activity, a higher weekly number of sessions reduced the fear of falling in patients with FM and the total number of falls per year, and is associated with less severe symptoms (FIQ-R3).

The association of flexibility, balance, and lumbar strength with balance ability: risk of falls in older adults.

The purpose of the present study was to determine the effects of a proprioceptive training program on older adults, as well as to analyze the association between flexibility, balance and lumbar strength (physical fitness test) with balance ability and fall risk (functional balance tests). This study was a controlled, longitudinal trial with a 12-week follow-up period. Subjects from a population of older adults were allocated to the intervention group (n = 28) or to the usual care (control) group (n = 26). Subjects performed proprioceptive training twice weekly (6 specific exercises with Swiss ball and BOSU). Each session included 50 minutes (10 minutes of warm-up with slow walk, 10 minutes of mobility and stretching exercises, 30 minutes of proprioceptive exercises). The outcome variables were physical fitness (lower-body flexibility, hip-joint mobility, dynamic balance, static balance, and lumbar strength) and functional balance (Berg scale and Tinetti test). The experimental group obtained significantly higher values than the control group in lower-body flexibility, dynamic balance, and lumbar strength (p = 0.019, p < 0.001, and p = 0.034 respectively). Hip-joint mobility, dynamic balance, and lumbar strength were positively associated with balance ability (p < 0.001, p < 0.001, and p = 0.014, respectively) and the prevention of falls (p = 0.001, p < 0.001, and p = 0.017 respectively). These findings suggest that a 12-week proprioception program intervention (twice a week) significantly improves flexibility, balance, and lumbar strength in older adults. Hip-joint mobility, dynamic balance and lumbar strength are positively associated to balance ability and the risk of falls in older adults. This proprioceptive training does not show a significant improvement in hip-joint mobility or static balance. Key pointsA 12-week proprioceptive intervention program (two times per week) significantly improves flexibility, balance, and lumbar strength in older adults.The risk of falls and balance ability are significantly improved after a training program with Bosu and Swiss ball in older adults.An improvement in joint mobility, dynamic balance and lumbar strength is positively associated with balance ability and improved fall risk in older adults.A 12-week proprioceptive intervention program (two times per week) does not show a significant improvement in hip-joint mobility and static balance.