The effects of 12 weeks' resistance training on psychological parameters and quality of life in adults with Facioscapulohumeral, Becker, and Limb-girdle dystrophies.

PURPOSE: Investigate the impact of 12-weeks' moderate-intensity resistance training on psychological parameters in ambulatory adults with Facioscapulohumeral, Becker, and Limb-girdle muscular dystrophy. METHODS: Seventeen adults with Facioscapulohumeral (n = 6), Limb-girdle (n = 6; types 2A, 2B, 2L, and 2I), or Becker (n = 5) muscular dystrophy took part. Participants were tested at baseline (PRE), after a 12-week control period (PRE2), and after a 12-week supervised resistance training programme (POST). Training included multi-joint and single-joint resistance exercises. Outcomes from self-report questionnaires were health-related quality of life, depressive symptoms, trait anxiety, self-esteem, and physical self-worth. RESULTS: No difference in outcome measures, except depressive symptoms, was found in the control period (PRE to PRE2). Symptoms of depression were reduced by 9% from PRE to PRE2 (p < 0.05) and by a further 19% from PRE2 to POST (p < 0.05). Other changes from PRE2 to POST were that trait anxiety reduced by 10%, self-esteem increased by 10%, physical self-worth increased by 20%, and quality of life improved in 8 domains (p < 0.05). CONCLUSION: These findings demonstrate the positive impact of moderate-intensity resistance training on psychological health and quality of life in adults with Facioscapulohumeral, Becker, and Limb-girdle muscular dystrophies.Implications for rehabilitationResistance training can have a positive impact on psychological health and quality of life in adults with Facioscapulohumeral, Becker, and Limb-girdle muscular dystrophy.Healthcare professionals should consider including moderate-intensity resistance training within the management and treatment programmes of adults with Facioscapulohumeral, Becker, and Limb-girdle muscular dystrophy.

Psychological parameters impact health-related quality of life in mental and physical domains in adults with muscular dystrophy.

The impacts of potentially treatable psychological parameters on quality of life are relatively unreported in adults with Facioscapulohumeral, Becker and Limb-girdle muscular dystrophy. The purpose of this study was to compare quality of life, psychological parameters, and physical function between adults with muscular dystrophy and controls, and to examine relationships among these parameters in muscular dystrophy. Twenty-one adults with muscular dystrophy (n = 7 Becker, n = 8 Facioscapulohumeral, n = 6 Limb-girdle) and ten age-matched controls participated. Outcome measures were health-related quality of life, depressive symptoms, trait anxiety, self-esteem, physical self-worth and six-minute walk distance. Quality of life scores were lower in the muscular dystrophy groups than the control (p < .05). Depressive symptoms had the greatest association with quality of life in the Mental Health domain (r= -0.89, p < .001). Depressive symptoms also had the most associations with quality of life (7 of 10 domains), followed by trait anxiety (6 of 10 domains), physical self-worth (5 of 10 domains), self-esteem (4 of 10 domains) and six-minute walk distance (3 of 10 domains). Psychological parameters and, to a lesser extent, physical function impact quality of life in muscular dystrophy. This study provides a rationale to include psychological assessment and treatment within muscular dystrophy healthcare.

The Effects of Resistance Exercise Training on Strength and Functional Tasks in Adults With Limb-Girdle, Becker, and Facioscapulohumeral Dystrophies.

Background: The inclusion of resistance training in the treatment and management of muscular dystrophy has previously been discouraged, based on mainly anecdotal evidence. There remains a lack of experimental investigation into resistance training in individuals with muscular dystrophy. The aim of the current study was therefore, to determine the effect of a 12-week resistance training programme on muscle strength and functional tasks in ambulatory adults with muscular dystrophy. Methods: Seventeen ambulatory adults with muscular dystrophy (Facioscapulohumeral muscular dystrophy: n = 6, Limb-Girdle muscular dystrophy: n = 6, Becker muscular dystrophy: n = 5) were recruited for this study. Participants attended three testing sessions: one session at baseline, one session after a 12-week control period and one session after a 12-week resistance training period. Each testing session consisted of measurements of isometric knee extensor and knee flexor maximum voluntary contraction (MVC) torque (Cybex dynamometer). Participants also completed a timed sit-to-stand, a four steps-stair ascent, and a four steps-stair decent. The 12-week resistance training period consisted of two supervised sessions a week. Each training session included a 5-min warm-up, a step-up exercise, free-standing or assisted squats, knee flexion and knee extension exercises, and an additional 6 single-joint exercises specific to each individual's needs. Results: Knee flexor MVC torque increased by 13% after the 12-week resistance training programme (p < 0.05), with no change over the control period. Knee extensor MVC torque did not significantly change after the training programme or the control period. Time taken to complete sit-to-stand, stair ascent and stair descent all decreased (improved) following the 12-week training programme (p < 0.05). Conclusions: A twice-a-week, 12-week, resistance training programme resulted in increased knee flexion strength and improvements in functional tasks in ambulatory adults with muscular dystrophy. This provides support for the inclusion of resistance training in the treatment programmes for these forms of muscular dystrophy.

Establishing the reliability of a novel battery of range of motion tests to enable evidence-based classification in Para Swimming.

OBJECTIVES: To evaluate the reliability of swimming-specific range of movement tests developed in order to permit evidenced-based classification in the sport of para swimming. DESIGN: Test-retest intra- and inter-examiner reliability. SETTING: International Swimming training camps and university exercise science departments. PARTICIPANTS: 42 non-disabled participants (mean age 23.2 years) and 24 Para swimmers (mean age 28.5 years). MAIN OUTCOME MEASURES: Intra- and inter-examiner reliability of a battery of novel active range of motion tests. RESULTS: Good to excellent intra-examiner reliability was found for the majority (32/34) of tests in non-disabled participants (ICC = 0.85-0.98). SEM values ranged from 1.18° to 6.11°. Similarly, good to excellent inter-examiner reliability was found for the majority (35/42) of tests in non-disabled participants (ICC = 0.85-0.98). SEM values range from 0.73° to 6.52°. Para swimmers exhibited significantly reduced range of motion compared to non-disabled participants. CONCLUSIONS: The large majority of ROM tests included in this novel battery were reliable both within and between examiners in non-disabled participants. The tests were found to differentiate between non-disabled participants and Para swimmers with hypertonia or impaired muscle power.

Changes in kinematics and arm-leg coordination during a 100-m breaststroke swim.

The purpose of this study was to compare arm-leg coordination and kinematics during 100 m breaststroke in 26 (8 female; 18 male) specialist breaststroke swimmers. Laps were recorded using three 50-Hz underwater cameras. Heart rate and blood lactate were measured pre- and post-swim. Arm-leg coordination was defined using coordination phases describing continuity between recovery and propulsive phases of upper and lower limbs: coordination phase 1 (time between end of leg kick and start of the arm pull phases); and coordination phase 2 (time between end of arm pull and start of leg kick phases). Duration of stroke phases, coordination phases, swim velocity, stroke length (SL), stroke rate (SR) and stroke index (SI) were analysed during the last three strokes of each lap that were unaffected by turning or finishing. Significant changes in velocity, SI and SL (P < 0.05) were found between laps. Both sexes showed significant increase (P < 0.05) in heart rate and blood lactate pre- to post-swim. Males had significantly (P < 0.01) faster swim velocities resulting from longer SLs (P = 0.016) with no difference in SR (P = 0.064). Sex differences in kinematic parameters can be explained by anthropometric differences providing males with increased propelling efficiency.

Reliability of the elliptical zone method of estimating body segment parameters of swimmers.

Due to the difficulty of measuring forces and torques acting on a swimmer during mid-pool swimming, an inverse dynamics approach is required. Personalised body segment parameter (BSP) data enabling calculation of net forces and torques can be obtained using the elliptical zone method. The purpose of this study was to establish the reliability of estimating BSP data of swimmers by the elliptical zone method with segment outlines being traced manually on a personal computer screen. Five assessors digitised the segment landmarks and traced the body segments from front and side view digital photographs of 11 single arm amputee swimmers. Each swimmer was assessed five times by each of the five assessors. The order was fully randomised. Within assessor variability was less than 5% for the segment centre of mass position of all segments, for segment length except the neck (5.2%), and for segment mass except neck (11.9%), hands (Left: 8.1%; Right: 5.8%) and feet (Left: 7.3%; Right: 7.3%). Analysis of mean variability within and between assessors indicated that between assessor variability was generally as large or larger than within assessor variability. Consequently it is recommended that when seeking personalised BSP data to maximise the accuracy of derived kinetics and sensitivity for longitudinal and bilateral within-subject comparisons the individual should be assessed by the same assessor with mean values obtained from five repeat digitisations. This study established that using the elliptical zone method using E-Zone software is a reliable and convenient way of obtaining personalised BSP data for use in analysis of swimming. Key pointsA unique (not been attempted previously) study of reliability of calculating personalised Body Segment Parameter (BSP) data using the elliptical zone methodEstablishes benchmark data regarding the reliability of BSP data for comparison with emerging technologies for obtaining personalised BSP data non-invasively.Provides a description and guidelines for good practice for maximising the accuracy of derived kinematics and kinetics in swimming.The method of body modelling described can also be applied to studies in other sports and in assessing change in health status related to body shape characteristics for sport and non-sport populations.

Changes in force production and stroke parameters of trained able-bodied and unilateral arm-amputee female swimmers during a 30 s tethered front-crawl swim.

This study examined changes in the propulsive force and stroke parameters of arm-amputee and able-bodied swimmers during tethered swimming. Eighteen well-trained female swimmers (nine unilateral arm amputees and nine able-bodied) were videotaped performing maximal-effort 30 s front-crawl swims, while attached to a load cell mounted on a pool wall. Tether force, stroke rate, stroke phase durations and inter-arm angle were quantified. The able-bodied group produced significantly higher mean and maximum tether forces than the amputee group. The mean of the intra-cyclic force peaks was very similar for both groups. Mean and maximum tether force had significant negative associations with 100 m swim time, for both groups. Both groups exhibited a similar fatigue index (relative decrease in tether force) during the test, but the amputees had a significantly greater stroke rate decline. A significant positive association between stroke rate decline and fatigue index was obtained for the able-bodied group only. Inter-arm angle and relative phase durations did not change significantly during the test for either group, except the recovery phase duration of the arm amputees, which decreased significantly. This study's results can contribute to the development of a more evidence-based classification system for swimmers with a disability.

Influence of swimming speed on inter-arm coordination in competitive unilateral arm amputee front crawl swimmers.

This study examined the effect of swimming speed on inter-arm coordination and the inter-relationships between swimming speed, inter-arm coordination, and other stroke parameters, in a group of competitive unilateral arm amputee front crawl swimmers. Thirteen highly-trained swimmers were filmed underwater during a series of 25-m front crawl trials of increasing speed. Arm coordination for both arms was quantified using an adapted version of the Index of Coordination. Inter-arm coordination of the amputee swimmers did not change as swimming speed was increased up to maximum. Swimmers showed significantly more catch-up coordination of their affected-arm compared to their unaffected-arm. When sprinting, the fastest swimmers used higher stroke frequencies and less catch-up of their affected-arm than the slower swimmers. Unilateral arm-amputees used an asymmetrical strategy for coordinating their affected-arm relative to their unaffected-arm to maintain the stable repetition of their overall arm stroke cycle. When sprinting, the attainment of a high stroke frequency is influenced mainly by the length of time the affected-arm is held in a stationary position in front of the body before pulling. Reducing this time delay appears to be beneficial for successful swimming performance.

Relationships between the front crawl stroke parameters of competitive unilateral arm amputee swimmers, with selected anthropometric characteristics.

The purpose of this study was to determine the relationships between swimming speed (SS), stroke length (SL), and stroke frequency (SF) for competitive single-arm amputee front crawl swimmers and assess their relationships with anthropometric characteristics. Thirteen highly trained swimmers (3 male, 10 female) were filmed underwater from a lateral view during seven increasingly faster 25-m front crawl trials. Increases in SS (above 75% of maximum SS) were achieved by a 5% increase in SF, which coincided with a 2% decrease in SL. At SSmax, interswimmer correlations showed that SF was significantly related to SS (r = .72; p < .01) whereas SL was not. Moderate but nonsignificant correlations suggested that faster swimmers did not necessarily use longer and slower strokes to swim at a common submaximal speed when compared with their slower counterparts. No correlations existed between SL and any anthropometric characteristics. Biacromial breadth, shoulder girth, and upper-arm length all significantly correlated with the SF used at SSmax. These findings imply that as a consequence of being deprived of an important propelling limb, at fast swimming speeds SF is more important than SL in influencing the performance outcome of these single-arm amputee swimmers.

The effect of simple insoles on three-dimensional foot motion during normal walking.

BACKGROUND: The purpose of this study was to establish the effect of simple non moulded flat based insoles on three-dimensional foot motion during normal walking. Excessive foot pronation is considered a major contributing factor to lower limb injuries. Moulded foot orthoses have been shown to decrease maximum foot eversion. Simple insoles are widely used in clinical practice as an alternative to moulded orthoses. However, there has been little research into the kinematic effects of simple insoles. METHODS: All subjects had an inverted rearfoot and forefoot position when the subtalar joint was placed in neutral, which was assessed by a weight bearing goniometer. Rotations of the whole foot about three orthogonal axes relative to the shank were estimated using a five camera motion analysis system. FINDINGS: Biplanar insoles significantly (P < 0.05) reduced maximum eversion by an average of 3.1 degrees when compared to the no insole condition. The cobra insole reduced maximum eversion by an average of 2.1 degrees when compared to the no insole condition. This difference approached statistical significance (P = 0.058). INTERPRETATION: Biplanar and cobra insoles had no significant effect on maximum dorsiflexion, abduction or rate of eversion, when compared to the no insole condition. These results provide some limited support for the use of simple insoles to control for excessive foot pronation during walking.