Is pilates better than other exercises at increasing muscle strength? A systematic review.

Our objective was to verify the effectiveness of Pilates method compared against other exercise modalities for muscle strength increase, balance and flexibility. Method: Databases used and its respective results were: CENTRAL (n = 456), CINAHL (n = 291), EMBASE (n = 313), PEDro (n = 176), PUBMED (n = 236), SCIELO (n = 98), SPORTDiscus (n = 197) e Web of Science (n = 150). It included randomized controlled studies using Pilates and others exercise modalities that measured muscle strength. Results: Eleven studies were included for analysis. The mean methodological quality score of these studies, evaluated by the PEDro scale, was 6 ± 1. For the primary outcome, not being observed this difference for dynamic force (SMD = -0.29; 95%IC -0.69; 0.10), isometric (SMD = 0.20; 95%IC -0.06; 0.47) or resistance (SMD = -0.19; 95%IC -0.46; 0.07). For secondary outcomes, there was no difference for balance and flexibility. Conclusion: In conclusion, there is very low to low evidence that there is no difference between Pilates and other exercise modalities for dynamic strength, isometric strength, resistance strength, balance and flexibility.

Long-Term Effects of a Kinematic Bikefitting Method on Pain, Comfort, and Fatigue: A Prospective Cohort Study.

The purpose of this study is to analyze the long-term riders' subjective responses to a standardized bikefitting method on their bicycles. Eighty-six amateur mountain bikers had their riding posture and bicycle components ergonomically adjusted through a 3D kinematic bikefitting method. Validated subjective scales (Feeling, OMNI, and Numerical Rating Pain Scale) were used to assess their overall riding comfort and fatigue along with localized pain for six body parts. Data were collected just before intervention (baseline or pre), immediately after (or post), and 30, 60, 90, and 120 days after the bikefit session. A Student's t-test comparing before bikefit and after 120 days showed significant (p < 0.05) reduction in localized pain for all six body parts and riding comfort along with a large effect size effect (d = 1.18) for riding comfort. Although initially reduced, fatigue scores gradually increased over the months, showing a high correlation (r = 0.946) with increased monthly training volume. In conclusion, overall riding discomfort and pain were significantly decreased after a standardized kinematic bikefit session even after 120 days post intervention. However, fatigue scores began to rise after 30 days, showing a high correlation with increasing monthly training volume.

Validity and reliability of a smartphone-based assessment for anticipatory and compensatory postural adjustments during predictable perturbations.

BACKGROUND: Postural adjustments involve displacements of the center of mass (COM), controlled by the central nervous system (CNS), to maintain equilibrium whilst standing. Postural adjustments can be anticipatory (APAs) or compensatory (CPAs), and are triggered to counteract predictable perturbations. RESEARCH QUESTION: Is the new smartphone application, Momentum, a valid and reliable tool for the assessment of body balance, by measuring APAs and CPAs using accelerometer readings? METHODS: 20 young adults were exposed to external predictable perturbations induced at the shoulder level, whilst standing. COM linear acceleration was recorded by Momentum (extracting data from a smartphone's accelerometer) and a 3D motion capture system. RESULTS: The key results demonstrated a very high, significant correlation (r ≥ 0.7, p < 0.05) between the two device settings in the APA parameters, which obtained r = 0.65, denoting a high correlation. Considering the reliability, variables that are compensatory in nature are presented on a scale of good to excellent in measurement methods, kinematics, and Momentum. However, the anticipatory variables presented excellent reliability only for the kinematics. SIGNIFICANCE: These experiments show that Momentum is a valid method for measuring COM acceleration under predictable perturbations and is reliable for compensatory events.

Validity and Reliability of Smartphone App for Evaluating Postural Adjustments during Step Initiation.

The evaluation of anticipatory postural adjustments (APAs) requires high-cost and complex handling systems, only available at research laboratories. New alternative methods are being developed in this field, on the other hand, to solve this issue and allow applicability in clinic, sport and hospital environments. The objective of this study was to validate an app for mobile devices to measure the APAs during gait initiation by comparing the signals obtained from cell phones using the Momentum app with measurements made by a kinematic system. The center-of-mass accelerations of a total of 20 healthy subjects were measured by the above app, which read the inertial sensors of the smartphones, and by kinematics, with a reflective marker positioned on their lumbar spine. The subjects took a step forward after hearing a command from an experimenter. The variables of the anticipatory phase, prior to the heel-off and the step phase, were measured. In the anticipatory phase, the linear correlation of all variables measured by the two measurement techniques was significant and indicated a high correlation between the devices (APAonset: r = 0.95, p < 0.0001; APAamp: r = 0.71, p = 0.003, and PEAKtime: r = 0.95, p < 0.0001). The linear correlation between the two measurement techniques for the step phase variables measured by ques was also significant (STEPinterval: r = 0.56, p = 0.008; STEPpeak1: r = 0.79, p < 0.0001; and STEPpeak2: r = 0.64, p < 0.0001). The Bland−Altman graphs indicated agreement between instruments with similar behavior as well as subjects within confidence limits and low dispersion. Thus, using the Momentum cell phone application is valid for the assessment of APAs during gait initiation compared to the gold standard instrument (kinematics), proving to be a useful, less complex, and less costly alternative for the assessment of healthy individuals.

Strength Level of Professional Elite Soccer Players after the COVID-19 Lockdown Period: A Retrospective Double-Arm Cohort Study.

BACKGROUND: It is well known that periods of inactivity generate a loss of muscle strength, a fundamental component of sports performance in soccer. However, little information is available on the decrease in strength levels in professional soccer players after the quarantine lockdown that occurred during the COVID-19 pandemic. AIM: To compare the isokinetic peak torque profiles of professional soccer players from different teams before and after the quarantine period generated by COVID-19. METHODS: A retrospective observational study was performed using data collected from two different professional elite-level soccer teams just before and immediately after the COVID-19 quarantine period. One team gave individual instructions to its players for conditioning maintenance at home during the quarantine period, while the other team used regular video calls to maintain the player's conditioning status on home training. The main outcomes were the mean peak torque of knee extensors and flexors, from concentric and eccentric contractions of each playing position. Analysis. A two-way ANOVA analysis was used to compare peak torque before and after the quarantine period and between both teams' strategies, showing a statistically significant reduction in eccentric knee flexor peak torque from the team that did not have remote monitoring. CONCLUSIONS: Remote monitoring programs are recommended so that athletes are less affected by the deleterious effects of confinement.

Association between Concentric and Eccentric Isokinetic Torque and Unilateral Countermovement Jump Variables in Professional Soccer Players.

Isokinetic tests have been highly valuable to athletic analysis, but their cost and technical operation turn them inaccessible. The purpose of this study was to verify the correlation between unilateral countermovement jump variables and isokinetic data. Thirty-two male professional soccer players were subjected to the isokinetic testing of both knee extensors and flexors in concentric and eccentric muscle contractions. They also executed unilateral countermovement vertical jumps (UCMJ) to compare maximum height, ground reaction force, and impulse power with isokinetic peak torque. Data analysis was conducted through Pearson correlation and linear regression. A high correlation was found between dominant unilateral extensor concentric peak torque and the UCMJ maximum height of the dominant leg. The non-dominant leg jump showed a moderate correlation. No other variable showed statistical significance. Linear regression allowed the generation of two formulae to estimate the peak torque from UCMJ for dominant and non-dominant legs. Although few studies were found to compare our results, leading to more studies being needed, a better understanding of the unilateral countermovement jump may be used in the future as a substitute to the expensive and technically demanding isokinetic testing when it is unavailable, allowing the assessment of lower limb physical asymmetries in athletic or rehabilitation environments.

Discomfort, pain and fatigue levels of 160 cyclists after a kinematic bike-fitting method: an experimental study.

OBJECTIVE: To analyse rider's subjective responses after a standardised bicycle ergonomic adjustment method. METHODS: Experimental study of 160 healthy, amateur mountain bikers analysed previously and 30 days after a bike-fitting session. The main outcome measures were subjective comfort level (Feeling Scale, FEEL), fatigue (OMINI Scale) and pain (Visual Analogue Scale, VAS). RESULTS: All variables demonstrated statistical significance between groups pre and post bike-fit session (p<0001). FEEL, OMNI and VAS-knee demonstrated large effect sizes (d=1.30; d=1.39 and d=0.86, respectively). VAS-hands, VAS-neck and VAS-back indicated moderate effect size (d=0.58; d=0.52 and d=0.43, respectively). VAS-groin and VAS-ankle indicated a small size effect (d=0.46 and d=0.43, respectively). CONCLUSIONS: Overall discomfort, fatigue and pain in healthy mountain biker adults improved according to all three scales. The major improvements in pain levels were detected on the knee, hands, back and neck compared with presession values. Groin and ankle pain had smaller improvements but were still significant. Future clinical trials should address the bias effects of this experimental study.

Postural Adjustments and Kinematic Index Finger Features in Frail Older Adults under Different Equilibrium Constraints.

Background: Anticipatory postural adjustments (APAs) are significantly affected by age and may represent restrictions on functional independence. Previous studies in young adults have already highlighted that changing postural stability (i.e., seated vs. upright posture) affects the motor planning and APAs. In frail older adults (FOAs), the effect of these different conditions of postural stability have not yet been established, and the present study aimed to disentangle this issue. Methods: Participants executed an arm-pointing task to reach a diode immediately after it turned on, under different conditions of stability (seated with and without foot support and in an upright posture). A kinematic profile of the index finger and postural electromyographic data were registered in their dominant-side leg muscles: tibialis anterior, soleus, rectus femoris, and semitendinosus. Results: The main finding of this study was that the adopted posture and body stabilization in FOAs did not reflect differences in APAs or kinematic features. In addition, they did not present an optimal APA, since postural muscles are recruited simultaneously with the deltoid. Conclusion: Thus, FOAs seem to use a single non-optimal motor plan to assist with task performance and counterbalance perturbation forces in which they present similar APAs and do not modify their kinematics features under different equilibrium constraints.

Validation of a 3D Camera System for Cycling Analysis.

BACKGROUND: Kinematic analysis aimed toward scientific investigation or professional purposes is commonly unaffordable and complex to use. OBJECTIVE: The purpose of this study was to verify concurrent validation between a cycling-specific 3D camera and the gold-standard 3D general camera systems. METHODS: Overall, 11 healthy amateur male triathletes were filmed riding their bicycles with Vicon 3D cameras and the Retul 3D cameras for bike fitting analysis simultaneously. All 18 kinematic measurements given by the bike fitting system were compared with the same data given by Vicon cameras through Pearson correlation (r), intraclass correlation coefficients (ICC), standard error measurements (SEM), and Bland-Altman (BA) analysis. Confidence intervals of 95% are given. RESULTS: A very high correlation between cameras was found on six of 18 measurements. All other presented a high correlation between cameras (between 0.7 and 0.9). In total, six variables indicate a SEM of less than one degree between systems. Only two variables indicate a SEM higher than two degrees between camera systems. Overall, four measures indicate bias tendency according to BA. CONCLUSIONS: The cycling-specific led-emitting 3D camera system tested revealed a high or very high degree of correlation with the gold-standard 3D camera system used in laboratory motion capture. In total, 14 measurements of this equipment could be used in sports medicine clinical practice and even by researchers of cycling studies.

Strength development according with age and position: a 10-year study of 570 soccer players.

BACKGROUND/AIM: The purpose of this study was to compare the isokinetic peak torque profiles from the quadriceps and hamstrings muscles during concentric and eccentric contractions in elite Brazilian soccer players across different field positions and age categories. Our hypothesis was that soccer players from different field positions are subjected to different ageing-related effects on their isokinetic peak torque. METHODS: This is a retrospective study based on professional elite-level soccer players between the years 2009 and 2019. It included 570 adult males who played for at least 5 years on first or second Brazilian divisions. Playing positions were divided as: goalkeepers, defenders, sidebacks, midfielders and forwards. Age categories were also divided as: G1 (17-20 years old), G2 (21-24 years old), G3 (25-28 years old), G4 (29-32 years old) and G5 (33 years old or more). RESULTS: The results indicate a moderate effect of age (F(4545)=8.197; p<0.001; η2=0.057) and a small effect of playing position (F(4545)=2.993; p<0.05; η2=0.021) on torque of concentric extensors; mainly from midfielders and goalkeepers with 29 years or more. CONCLUSIONS: Soccer players from different field positions are subjected to different ageing related effects on their muscular performance during their career special attention should be given to these players to avoid reduction in physical performance.

Electromyographic activity of the masseter muscle in individuals with group function and canine guidance.

Background. There is no general consensus in restorative dentistry about which lateral guidance should be established. Some studies have shown that canine guidance decreases the tension of masticatory muscles. Others have reported that group function might achieve a better physiologic distribution of occlusal forces. Also, some reports have shown that both guidances are equally acceptable. Despite all discussions, clinical evidence of one guidance being superior to another is limited. Thus, this study aimed to analyze the electromyographic (EMG) activity of masseter muscles in individuals with group function and canine guidance. Methods. Twenty volunteers of both genders, aged 20-25, were divided into two groups: GF (group function guidance, n=10) and CA (canine guidance, n=10). EMG activity of masseters was captured using surface electrodes during habitual maximum intercuspation (HMI) and right and left lateral jaw movements and recorded using EMG amplitude values (RMS - root means square). Student's t-test was used to compare mean RMS values between the groups and lateral movements in each group. Results. During HMI, there was no difference in masseter EMG activity between the groups. Both masseters showed higher activity in group GF only on the right side during lateral movements, while the left masseter exhibited higher activity on the nonworking side in both groups. The activity of both masseters distributed by tooth was higher in group CA. Conclusion. During tooth restorative procedures, any guidance is acceptable considering HMI. However, group function guidance is more favorable during lateral movements due to greater dissipation of occlusal pressures.

Concentric and eccentric isokinetic hamstring injury risk among 582 professional elite soccer players: a 10-years retrospective cohort study.

BACKGROUND/AIM: Different authors have tried to correlate the peak isokinetic torque values with the incidence of soccer match injuries. However, due to the wide variety of assessment testing protocols, such an inference becomes difficult. This study aimed to verify the capacity of an isokinetic test to establish injury risk reference values for hamstring strain injuries. METHODS: A retrospective cohort study based on isokinetic data and clinical records from the last 10 years was conducted in 582 Brazilian elite-professional soccer players, who were subjected to the same isokinetic test protocol, machine, and tester. A Multivariate Logistic Regression Analysis for Complex Data Sampling was used to generate injury risk statistical indexes. RESULTS: Multivariate regression analysis of both legs provided important data to identify the cut-off values of Concentric Peak Torque (181.82 Newton/*metres), Concentric Work (236.23 watts) and Concentric Power (130.11 joules). CONCLUSIONS: The injury risk indexes indicate that an increase of just one Newton unit in CPT (Concentric Peak Torque) and CJ (Concentric Power) above those cut-off values, can reduce the risk of future injuries by 2% and 2.7%, respectively.

Heart rate and lower limb muscle activity on cycle ergometer / Frequência cardíaca e atividade muscular dos membros inferiores em cicloergômetro / Frecuencia cardíaca y actividad muscular de los miembros inferiores en cicloergómetro

ABSTRACT Introduction: Muscle activity in the pedal stroke movement on a cycle ergometer can be measured by surface electromyography, as an effective and improved method for studying muscle action and objectively determining the different action potentials of the muscles involved in specific movements. Heart rate behavior is an important factor during exercise with load. Objective: To identify heart rate behavior and pattern of muscle activity of the rectus femoris and vastus medialis in healthy subjects in the pedaling dynamic at different loads, submaximal test, on an instrumented cycle ergometer. Methods: 20 healthy adults were evaluated. Heart rate measurement was performed, together with electromyographic analysis, in the time domain, of the rectus femoris and vastus medialis muscles during incremental exercise of the lower limbs on the cycle ergometer. Results: Heart rate behavior presented significant difference for p≥0.05 in relation to increased loads. The EMG signal intensity from the vastus medialis muscle (normalized RMS value) in each quadrant of the pedaling cycle showed significant difference for p≥0.05 in relation to quadrants I, II and IV and significant difference for p≥0.05 in relation to quadrants III and IV. In the rectus femoris (RF) muscle, there was significant difference for p≥0.05 in relation to quadrants I, II and IV and significant difference for p≥0.05 in relation to quadrants I, II and III. Conclusion: An increase in heart rate proportional to the increase in load was observed, as well as an increase in the amplitude of the electromyographic signal proportional to the increase in load. It was possible to identify the pattern of muscle activation in the studied quadrants during pedal stroke movements, independent of load. Level of evidence III; Study of non-consecutive patients; without uniform application of the "gold" standard reference.

RESUMO Introdução: A atividade muscular no gesto motor da pedalada no cicloergômetro pode ser mensurada por meio da eletromiografia de superfície. A eletromiografia de superfície tem sido um método efetivo e aprimorado para estudar a ação muscular, determinando com objetividade os diferentes potenciais de ação dos músculos empenhados em movimentos específicos. O comportamento da frequência cardíaca tem relação importante durante o exercício com carga. Objetivo: Identificar o comportamento da frequência cardíaca e o padrão da atividade muscular do reto femoral e vasto medial em indivíduos saudáveis na dinâmica da pedalada em diferentes cargas, teste submáximo, no cicloergômetro instrumentado. Métodos: Foram avaliados 20 adultos saudáveis, realizando-se a mensuração da frequência cardíaca e a análise eletromiográfica no domínio do tempo dos músculos reto femoral e vasto medial durante o exercício incremental dos membros inferiores em cicloergômetro. Resultados: O comportamento da frequência cardíaca apresentou diferença significante para p ≥ 0,05 com relação ao incremento das cargas. A intensidade do sinal EMG do músculo vasto medial (valor RMS normalizado) em cada quadrante do ciclo da pedalada mostrou diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e IV e diferença significativa para p ≥ 0,05 com relação aos quadrantes III e IV. No músculo reto femoral (RF) verificou-se diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e IV e diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e III. Conclusão: Constatou-se aumento da frequência cardíaca proporcional ao incremento das diferentes cargas e também se evidenciou um aumento na amplitude do sinal eletromiográfico proporcional ao incremento da carga. Foi possível identificar o padrão da ativação dos músculos com relação ao ciclo da pedalada nos quadrantes estudados, independentemente do nível da carga. Nível de evidência III; Estudo de pacientes não consecutivos; sem padrão de referência "ouro" aplicado uniformemente.

RESUMEN Introducción: La actividad muscular en el gesto motor de la pedaleada en el cicloergómetro se puede medir por medio de la electromiografía de superficie. La electromiografía de superficie ha sido un método efectivo y mejorado para estudiar la acción muscular, determinando con objetividad los diferentes potenciales de acción de los músculos empeñados en movimientos específicos. El comportamiento de la frecuencia cardíaca tiene relación importante durante el ejercicio con carga. Objetivo: Identificar el comportamiento de la frecuencia cardíaca y el patrón de la actividad muscular del recto femoral y vasto medial en individuos en la dinámica de la pedaleada en el cicloergómetro instrumentado. Métodos: Se evaluaron 20 adultos saludables, realizándose la medición de la frecuencia cardíaca y el análisis electromiográfico en el dominio del tiempo de los músculos recto femoral y vasto medial durante el ejercicio incremental de los miembros inferiores en cicloergómetro. Resultados: El comportamiento de la frecuencia cardíaca presentó una diferencia significativa para p ≥ 0,05 con relación al incremento de las cargas. La intensidad de la señal EMG del músculo vasto medial (valor RMS normalizado) en cada cuadrante del ciclo de la pedaleada mostró diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y IV y diferencia significativa para p ≥ 0,05 con relación a los cuadrantes III y IV. En el músculo recto femoral (RF) se verificó diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y IV, y diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y III. Conclusión: Se constató aumento de la frecuencia cardíaca proporcional al incremento de las diferentes cargas y también se evidenció un aumento en la amplitud de la señal electromiográfica proporcional al incremento de la carga. Fue posible identificar el patrón de la activación de los músculos con relación al ciclo de la pedaleada en los cuadrantes estudiados, independientemente del nivel de la carga. Nivel de evidencia III; Estudio de pacientes no consecutivos; sin patrón de referencia "oro" aplicado uniformemente.

Pattern of respiratory muscle activity during exercise tests in children born prematurely.

INTRODUCTION: Preterm children display only slightly lower exercise capacity than term children do during their development, despite their previous cardiopulmonary impairments. This raises doubts about the role of the respiratory muscles' influence on exercise capacity. This study aimed to compare respiratory muscle activity in preterm and term children using an exercise test. METHODS: This cross-sectional study involved comparison of 35 term children and 39 matched preterm children aged 6-9 years, who were born prematurely with a birth weight <1500 g. An adapted treadmill incremental test was utilized and surface electromyography of the sternocleidomastoid (SCM), upper trapezius (UT), and rectus abdominis (RA) muscles was performed. The root mean square was calculated every minute and compared between and within groups. A Monte Carlo simulation was also applied, and the area under the curve was calculated to evaluate the differences between groups. RESULTS: During the entire exercise, the SCM muscle activity was higher in preterm children with a larger area under the curve than in the term children. There was no difference in the RA and UT muscle activity between groups throughout the test. CONCLUSION: The results suggest a greater contribution of the SCM muscle sin preterm children's performance than in term children's performance during high-intensity exercises. TRIAL REGISTRATION: Brazilian Clinical Trial Registry (ReBec) - RBR-89hr2h.

The walking cane length influences the postural sway of community-dwelling older women.

BACKGROUND: Mobility-related problems in older people may be relieved by the use of walking canes. However, the influence of the cane length on the postural stability of cane users has not been explored. OBJECTIVE: The objective of this study is to examine the influence of a single-point cane with different lengths on the postural sway of regular cane users, older women during two stance positions, with feet parallel and semi-tandem stance. METHODS: Eighteen older women, who used a single-point walking cane for at least 6 months, stood on a force plate with feet parallel or in semitandem position for 40 s. They always used a cane that was adjusted to one of three different lengths resulting from the distance between the wrist crease and the floor, named WF, or this distance plus 7.5 or 10 cm. Amplitude and speed of the centre of pressure (COP) and its components (rambling and trembling) in the anterior-posterior and medial-lateral directions and mean vertical force applied to the cane were compared across cane lengths. RESULTS: The amplitude and velocity of COP, rambling and trembling increased with the cane length. This effect was observed for the anterior-posterior with the feet parallel and in the medial-lateral direction with the semi-tandem position. More force was applied on the shorter cane (WF) in semitandem position. CONCLUSION: Longer canes increased the postural sway in the older women and restricted the body weight loaded on the cane. Improper cane length influences the postural sway particularly in a semitandem stance of regular cane users. This may cause a negative impact on postural stability required in daily life activities. The current findings may contribute to the prescription of this assistive device for older adults.

Lumbar stabilisation exercises versus back endurance-resistance exercise training in athletes with chronic low back pain: protocol of a randomised controlled trial.

BACKGROUND: Chronic low back pain (CLBP) is an important disorder in athletes that may negatively affect their performance in competitions. The literature usually recommends physiotherapy based on exercises for back pain management in athletes. Recent evidence suggests that interventions based on lumbar muscle stabilisation exercises (LMSE) and back endurance-resistance exercises (BERE) may improve back pain and function performance. However, it is still unclear which type of exercise is more effective for the treatment of CLBP in athletes. OBJECTIVE: To compare the efficacy of LMSE versus BERE in athletes with CLBP. DESIGN: The study is a 2-arm, prospectively registered, randomised controlled trial. SETTING: The physical therapy clinical and biomechanics laboratory of the UNOPAR University. PARTICIPANTS: 32 male athletes with CLBP, age between 18 and 40 years old, recruited from the local community. INTERVENTION: An 8-week intervention programme will be carried out with LMSE s versus BERE. MEASUREMENTS: Trunk neuromuscular patterns during balance tasks (unipodal and over a ball) using electromyography and force platform parameters, pain, disability, fear and avoidance will be assessed by a blinded assessor at baseline and at follow-up after 8 weeks of intervention period. LIMITATIONS: The absence of blinding intervention and the exclusion of female athletes, seated sports and swimmers will affect the internal and external validity of the study. CONCLUSIONS: The results of this study will elucidate which of these two interventions promote better results in trunk neuromuscular pattern, back pain and function in male athletes with CLBP.

Effect of Osteopathic Visceral Manipulation on Pain, Cervical Range of Motion, and Upper Trapezius Muscle Activity in Patients with Chronic Nonspecific Neck Pain and Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Pilot Study.

Previous studies have reported that visceral disturbances can lead to increased musculoskeletal tension and pain in structures innervated from the corresponding spinal level through viscerosomatic reflexes. We designed a pilot randomised placebo-controlled study using placebo visceral manipulation as the control to evaluate the effect of osteopathic visceral manipulation (OVM) of the stomach and liver on pain, cervical mobility, and electromyographic activity of the upper trapezius (UT) muscle in individuals with nonspecific neck pain (NS-NP) and functional dyspepsia. Twenty-eight NS-NP patients were randomly assigned into two groups: treated with OVM (OVMG; n = 14) and treated with placebo visceral manipulation (PVMG; n = 14). The effects were evaluated immediately and 7 days after treatment through pain, cervical range, and electromyographic activity of the UT muscle. Significant effects were confirmed immediately after treatment (OVMG and PVMG) for numeric rating scale scores (p < 0.001) and pain area (p < 0.001). Significant increases in EMG amplitude were identified immediately and 7 days after treatment for the OVMG (p < 0.001). No differences were identified between the OVMG and the PVMG for cervical range of motion (p > 0.05). This study demonstrated that a single visceral mobilisation session for the stomach and liver reduces cervical pain and increases the amplitude of the EMG signal of the UT muscle immediately and 7 days after treatment in patients with nonspecific neck pain and functional dyspepsia.

Anticipatory Postural Adjustments and kinematic arm features when postural stability is manipulated.

Beyond the classical paradigm that presents the Anticipatory Postural Adjustments (APAs) as a manner to create forces that counteract disturbances arising from the moving segment during a pointing task, there is a controversial discussion about the role APAs to facilitate the movement and perform a task accurately. In addition, arm kinematics features are classically used to infer the content of motor planning for the execution and the control of arm movements. The present study aimed to disentangle the conflicting role of APAs during an arm-pointing task in which the subjects reach a central diode that suddenly turns on, while their postural stability was manipulated. Three postures were applied: Standing (Up), Sit without feet support (SitUnsup) and Sit with feet support (SitSup). We found that challenging postural stability induced an increase of the reaction time and movement duration (observed for the SitUnsup compared to SitSUp and Up) as well as modified the upper-limb velocity profile. Indeed, a greater max velocity and a shorter deceleration time were observed under the highest stability (SitSup). Thus, these Kinematics features reflect less challenging task and simple motor plan when the body is stabilized. Concerning the APAs, we observed the presence of them independently of the postural stability. Such a result strongly suggests that APAs act to facilitate the limb movement and to counteract perturbation forces. In conclusion, the degree of stability seems particularly tuned to the motor planning of the upper-limb during a pointing task whereas the postural chain (sitting vs. standing) was also determinant for APAs.

Immediate Effect of Acupuncture on Electromyographic Activity of the Upper Trapezius Muscle and Pain in Patients With Nonspecific Neck Pain: A Randomized, Single-Blinded, Sham-Controlled, Crossover Study.

OBJECTIVE: The objective of this study was to assess changes in upper trapezius myoelectric activity and pain in patients with nonspecific neck pain after a single session of acupuncture (ACP). METHODS: A blinded randomized clinical trial was conducted. Fifteen patients with nonspecific neck pain and 15 healthy participants were enrolled in a randomized, single-blinded, crossover study. Each participant was subjected to a single session of ACP and sham acupuncture (SACP). The electromyography (EMG) signal of the upper trapezius muscle was recorded during different step contractions of shoulder elevation force (15%-30% maximal voluntary contraction) before and after ACP treatment. RESULTS: Significant effects were confirmed after the treatment (ACP and SACP) for Numeric Rating Scale scores (F1,28 = 51.61; P < .0001) and pain area (F1,2 = 32.03; P < .0001). Significant decreases in the EMG amplitude were identified for the nonspecific neck pain group (NPG) (F1,112 = 26.82; P < .0001) and the healthy participant group (HPG) (F1,112 = 21.69; P < .0001) after ACP treatment. No differences were identified between the ACP and SACP treatment protocols for Numeric Rating Scale score (NPG: F1,28 = 0.95; P = .33), pain area (NPG: F1,28 = 1.97; P = .17), or EMG amplitude (NPG: F1,112 = 0.47; P = .49; HPG: F1,112 = 0.75; P = .38). CONCLUSION: The effect of ACP at acupoints triple energizer 5 and large intestine 11 triple energizer 5, or in close proximity, contributes to pain relief among patients with nonspecific neck pain. The electromyographic analysis indicated a greater resistance to muscle fatigue and decrease of activity of the upper trapezius muscle among healthy participants and patients with nonspecific neck pain.

Postural control analysis during a standardized kick task in soccer athletes / Análise do controle postural durante tarefa controlada do chute em atletas de futebol / Análisis del control postural durante tarea controlada del tiro en atletas de fútbol

ABSTRACT Introduction: Postural control is a determining factor for functional performance and motor skills during sports activities. Objective: The objective of this study was to investigate postural control during the controlled soccer ball kicking task through a biomechanical analysis system. Methods: The sample consisted of 11 professional male athletes recruited using convenience sampling, with a mean age of 22 years. The athletes performed twenty-five precision kicks at a target, with the ball in vertical motion released by means of a hand-held device synchronized with the computed biomechanical measurements. Marking of the lower limb segments involved in the kick and the ball were analyzed by accelerometry, while postural control measures were quantified by a force platform in three axes of movement. The support leg was investigated in single leg stance during all tests on the force platform. The main variables of postural control calculated by stabilographic analysis and computed during the 25 kicks were: center of pressure (COP) displacement area, velocity and frequency of COP oscillation in the anteroposterior and mediolateral directions. The mean was used for final analysis to determine the differences in the three phases: pre-kick, kick, and post-kick. Results: The results revealed significant differences (p <0.01) between the three phases, with the kick phase presenting higher values of postural COP oscillations than the other phases. The COP area and oscillation velocity were the variables with greatest sensitivity to changes in the kick phase, obtaining an effect size of d = 14 and d = 12, respectively. In clinical terms, the increase in COP values reached 557% between the pre-kick and kick phases; this difference was reduced to 241% when compared to post-kick (i.e., difference between kick and post-kick was 316%). Conclusion . These results have important implications for the perception of postural control responses during soccer ball kicks and consequently, for injury prevention when motor and sensory deficits are diagnosed in soccer players. Level of Evidence III; Study of nonconsecutive patients; without consistently applied reference ''gold'' standard.

RESUMO Introdução: O controle postural é um fator determinante para execução de gestos funcionais e desempenho motor durante as atividades esportivas. Objetivo: O objetivo deste estudo foi de investigar o controle postural durante a tarefa controlada do chute futebolístico por meio de um sistema de análise biomecânica. Métodos: A amostra foi constituída por 11 atletas profissionais do sexo masculino, recrutados por amostragem por conveniência, com média de idade de 22 anos. Os atletas realizaram vinte e cinco chutes de precisão em direção ao alvo, com a bola em movimento vertical lançada por meio de um dispositivo manual sincronizado com as medidas biomecânicas computadas. A marcação dos segmentos de membro inferior envolvidos no chute e a bola foram analisadas por meio da acelerometria, enquanto as medidas de controle postural foram quantificadas por meio de uma plataforma de força em três eixos do movimento. A perna de apoio foi investigada em apoio unipodal durante todos os testes sobre a plataforma de força. As principais variáveis de controle postural calculadas por uma análise estabilográfica e computadas durante os 25 chutes foram área de deslocamento do centro de pressão (COP), velocidade e frequência de oscilação do COP na direção anteroposterior e médio-lateral. A média foi utilizada para análise final para determinar as diferenças nas três fases: pré-chute, chute e pós-chute. Resultados: Os resultados revelaram diferenças significantes (p < 0,01) entre as três fases, sendo que a fase do chute apresentou valores maiores de oscilações posturais do COP do que as demais fases. A área e a velocidade de oscilação do COP foram as variáveis com maior sensibilidade às mudanças na fase do chute, obtendo magnitude de efeito em d = 14 e d = 12, respectivamente. Clinicamente, o aumento foi de 557% entre as fases pré-chute e chute; essa diferença foi reduzida para 241% na comparação com o pós-chute (ou seja, a diferença entre chute e pós-chute foi de 316%). Conclusões: Esses resultados têm implicações importantes para o reconhecimento das respostas de controle postural durante o chute futebolístico e, consequentemente, para prevenção de lesões quando déficits sensório-motores são diagnosticados em atletas de futebol. Nível de Evidência III; Estudo de pacientes não consecutivos; sem padrão de referência "ouro" aplicado uniformemente.

RESUMEN Introducción . El control postural es un factor determinante para la ejecución de gestos funcionales y desempeño motor durante las actividades deportivas. Objetivo: El objetivo de este estudio fue investigar el control postural durante la tarea controlada del tiro futbolístico por medio de un sistema de análisis biomecánico. Métodos: La muestra fue constituida por 11 atletas profesionales del sexo masculino reclutados por muestreo por conveniencia y con promedio de edad de 22 años. Los atletas realizaron veinticinco disparos de precisión en dirección al objetivo, con la pelota en movimiento vertical lanzada por medio de un dispositivo manual sincronizado con las medidas biomecánicas computadas. La marcación de los segmentos de la extremidad inferior involucrados en el tiro y la pelota fueron analizadas mediante acelerometría, mientras que las medidas de control postural fueron cuantificadas por medio de una plataforma de fuerza en tres ejes del movimiento. La pierna de apoyo fue investigada en apoyo unipodal durante todas las pruebas sobre la plataforma de fuerza. Las principales variables de control postural calculadas por un análisis estabilográfico y computadas durante los 25 disparos fueron área de desplazamiento del centro de presión (COP), velocidad y frecuencia de oscilación del COP en la dirección anteroposterior y medio-lateral. El promedio fue utilizado para análisis final para determinar las diferencias en las tres fases: pre-disparo, disparo, y post-disparo. Resultados: Los resultados revelaron diferencias significativas (p < 0,01) entre las tres fases, siendo que la fase del disparo presentó valores mayores de oscilaciones posturales del COP que las demás fases. El área y la velocidad de oscilación del COP fueron las variables con mayor sensibilidad a los cambios en la fase del disparo, obteniendo magnitud de efecto en d = 14 y d = 12, respectivamente. Clínicamente, el aumento fue del 557% entre las fases pre-disparo y disparo; esta diferencia se redujo al 241% en comparación con la fase post-disparo (es decir, la diferencia entre disparo y post-disparo fue de 316%). Conclusiones: Estos resultados tienen implicaciones importantes para el reconocimiento de las respuestas de control postural durante el tiro futbolístico y consecuentemente, para prevención de lesiones cuando se diagnostica déficit sensorio-motor en atletas de fútbol. Nivel de Evidencia III; Estudio de pacientes no consecutivos; sin patrón de referencia "oro" aplicado uniformemente.