Effectiveness of a joint mobilizations protocol for shoulder subacromial pain syndrome: A pilot study.

BACKGROUND: Subacromial pain syndrome (SPS) is the most frequent shoulder pathology. The aims of this prospective randomized study were to evaluate the effects of some specific shoulder joint mobilizations ("spin correction"), and the effectiveness of a rehabilitation program, named Shoulder Global Concept, in SPS patients. METHODS: 45 patients with SPS were randomly assigned to two groups, to benefit from a different first session of mobilizations: the experimental group received all specific mobilizations, while the control group received the same program but without the spin correction mobilizations. The second session was identical for both groups, with all specific mobilizations. Before and after the first two sessions, range of motion (ROM) in flexion, abduction, external and internal rotations, pain and functional status with Constant score and Quick Dash were evaluated. Evaluation was repeated with 24 patients after 11 rehabilitation sessions. Rehabilitation with Shoulder Global Concept included 13 mobilizations aiming at improving the ROM with passive and active-assisted mobilizations, static stretching, and muscle strengthening. RESULTS: All ROM were improved at the end of the first session for both groups, but significantly more in the experimental group for glenohumeral (GH) abduction and external rotation (p < 0.05). Functional scores, pain and strength were significantly improved after 11 rehabilitation sessions with the Shoulder Global Concept. CONCLUSION: This manual therapy method was able to improve shoulder mobility in one session. The additional joint mobilizations (spin correction) specifically increased GH abduction and external rotation. Rehabilitation of SPS with Shoulder Global Concept allowed to improve functional capacity and decrease pain.

Effectiveness of a Functional Rehabilitation Program After Bariatric Surgery: a Pilot Study.

BACKGROUND: Beyond obesity-related comorbidities, overweight patients have a high risk of developing osteoarticular pathologies. Moreover, weight loss following bariatric surgery induces a decrease in fat mass but also in muscle mass, thus affecting the physical capacities of these patients. Functional rehabilitation is a solution to correct these imbalances. The aim of this study was to evaluate the effectiveness of a functional rehabilitation program after bariatric surgery. METHODS: Twenty-three patients with severe obesity (BMI = 37.9 ± 5.7 kg/m2; 41.1 ± 12.9 years) participated in a functional rehabilitation protocol, 2 months after sleeve gastrectomy. Rehabilitation program consisted of 20 sessions of 1h30 (two sessions per week), based on endurance training, muscle strengthening, and proprioception work. An initial and final assessment included bioelectrical impedance measurements, questionnaires, and physical function tests. RESULTS: All impedance parameters were significantly improved in 20 sessions: % excess weight loss (%EWL) from 27.6 ± 9.1 to 51.1 ± 13.4% and % fat-free mass from 52.7 ± 5.6 to 57.6 ± 6.7%. Waist and hip circumferences were significantly reduced in 20 sessions: from 107.4 ± 13.7 to 94.5 ± 12.6 cm and from 120.5 ± 12.4 to 108.7 ± 11.7 cm, respectively (p < 0.001). Physical function tests were significantly improved between the 1st and the 20th sessions (p < 0.001). The cycloergometer stress test progressed from 77.7 ± 24.1 to 93.6 ± 27.2 W, and the sit-to-stand test from 20 ± 5.2 to 24.8 ± 7.6 flexions in 30 s. The Quality Of Life, Obesity and Dietetics (QOLOD) scale increased by 12.6%. CONCLUSIONS: The functional rehabilitation protocol of 20 sessions significantly improved patients' body composition, functional tests, and quality of life. The standardization of tests and sessions allowed to objectively assess progress.

Time course of postactivation potentiation during intermittent submaximal fatiguing contractions in endurance- and power-trained athletes.

This study aimed to measure time course of postactivation potentiation during intermittent submaximal fatiguing isometric contractions in 2 groups of subjects with different physical training history. Fifteen men subjects (8 endurance-trained athletes [END] and 7 power-trained athletes [POW]) performed a 10-minute intermittent (5-second contraction, 5-second rest) knee extension exercise at 50% of their maximal voluntary isometric contraction. Mechanical (peak twitch torque, Pt) and electrophysiological (M-wave) responses following electrical stimulation of the femoral nerve were measured at rest and every 10 s throughout exercise. Vastus lateralis (VL) muscle activity (root mean square, RMS) was recorded during each contraction, and the RMS/M ratio was calculated. A significant increase in Pt (+52%, p < 0.01) was observed in both groups during the first minute of the exercise. Thereafter Pt decreased dramatically (p < 0.05) in POW whereas it remained above baseline values in END until the end of exercise. The VL RMS/M ratio increased from 7 minutes of exercise for the entire population of subjects, but showed a tendency toward greater and earlier increase in POW. Our study showed the effectiveness of an intermittent submaximal preconditioning protocol to induce similar potentiation (5-10 repetitions of 5-second submaximal contraction at 50% MVC of knee-extensors) for 2 groups of trained-individuals with different muscular profiles (END vs. POW). The enhanced fatigue resistance of endurance athletes allows the potentiating effect to prevail longer over the fatigue effect during all the 10-minute exercise. The proposed conditioning protocol (moderate-intensity, short-duration intermittent exercise) as an interesting alternative compared to MVC is adequate to warm all athletes and increase sports performance.

Recurrence quantification analysis of surface electromyographic signal: sensitivity to potentiation and neuromuscular fatigue.

This study aimed to assess the capacity of recurrence quantification analysis (RQA) to detect potentiation and to determine the fatigue components to which RQA is sensitive. Fifteen men were divided in two groups [8 endurance-trained athletes (END) and 7 power-trained athletes (POW)]. They performed a 10-min intermittent (5s contraction, 5s rest) knee extension exercise at 50% of their maximal voluntary isometric contraction. Muscular fatigue and potentiation were evaluated with neurostimulation technique. Mechanical (peak torque, Pt) and electrophysiological (M-wave) responses following electrical stimulation of the femoral nerve were measured at rest and every 10s throughout exercise. Vastus lateralis muscle activity (root mean square, RMS) was recorded during each contraction, and RMS was normalized to M-wave area (RMS/M). During contraction, muscle activity was analyzed with RQA to obtain the percentage of determinism (%Det). At the beginning of exercise, a significant Pt increase (+52%, P<0.001) was observed in both groups, indicating potentiation. At this time, %Det remained constant in both groups, indicating that RQA did not detect potentiation. Thereafter, Pt decreased in POW from 5min 30s of exercise (-30%, P<0.001), reflecting impairment in excitation-contraction coupling, and %Det increased from 3min 30s (P<0.01). In END, Pt remained high and %Det was unchanged. These two results indicated that RQA detected the peripheral component of fatigue. Conversely, RQA did not detect central adaptation to fatigue since %Det remained constant when a significant increase in RMS/M (P<0.01) appeared in END.