Acute effects of ipsilateral semitendinosus and gracilis autograft anterior cruciate ligament reconstruction on lower limb muscle activation

There is little information regarding the acute repercussions of anterior cruciate ligament (ACL) reconstruction on muscle activation, especially on the proximal hip muscles. Thus, this study analyzed the acute effects of ACL reconstruction with doubled semitendinosus/gracilis (ST/G) autografts on lower limb muscle activation. Fourteen male recreational athletes that presented a primary unilateral ACL rupture and underwent the ACL reconstruction with an ST/G graft. Surface electromyographic (sEMG) signal were recorded from each participant during the maximal voluntary isometric contraction (MVIC) of the gluteus maximus and gluteus medius, vastus lateralis and vastus medialis, semitendinosus, biceps femoris, and medial gastrocnemius muscles and also during bipodal mini-squatting with open and closed eyes, before surgery and 15 days postoperatively. (sEMG) signal were normalized to isometric peak electromyography. The postoperative assessment showed reduced muscle activation in the gluteus maximus (p = 0.013, d:0.48) in non-operated limb and also in the muscle gluteus medius (p = 0.013, d:0.79), vastus medialis (p = 0.035, d:0.63) semitendinosus (p = 0.001, d:2.46), biceps femoris (p<0.001, d:1.5), and medial gastrocnemius (p = 0.001, d:1.45) during MVIC in the operated limb. The postoperative assessment also revealed alterations in the sEMG activity of the hip and local thigh muscles in the operated and non-operated limbs during mini-squatting with opened eyes and closed eyes (p<0.05). ACL reconstruction surgery with a doubled ST/G autograft may promote immediate changes in lower limb muscle activation of the operated and non-operated limb. (AU)

Effect of two Dynamic Tape™ applications on the electromyographic activity of the gluteus medius and functional performance in women: A randomized, controlled, clinical trial.

INTRODUCTION: Dynamic Tape™ (DT) is a biomechanical tape that is used to directly manage load, modify movement patterns, and assist functioning. However, no studies have evaluated its effectiveness in increasing gluteus medius (GM) muscle activation and improving functional performance. OBJECTIVE: To investigate the effect of two forms of DT applications on the electromyographic (EMG) activity of the GM muscle and lower limb functional performance. METHODS: Thirty-three, healthy, recreationally active women were randomly assigned into two groups: 1) submitted to the DT application on GM muscle that adhered to the stretching method for Kinesio Tape® application (KG, n = 17) and 2) submitted to the DT application on GM muscle that adhered to the stretching method suggested for DT (DG, n = 16). The EMG evaluation of GM was performed at rest, in maximum voluntary isometric contraction, and in the single-leg squat, drop landing, and jump landing + maximum vertical jump tests. Functional performance was evaluated using the triple hop test and the 6-m timed hop test. RESULTS: No significant changes in GM activation or functional performance were found, regardless of the stretching method used. No significant intergroup differences were observed (α = 5%). CONCLUSION: DT did not increase GM activation in functional activities, and it did not improve functional performance in the lower limbs in healthy women, regardless of the form of application used.

Effect of Foot Reflexology on Capillary Blood Glucose, Tissue Temperature, and Plantar Pressure of Individuals With Diabetes Mellitus (Type 2): A Pilot Study.

OBJECTIVE: The purpose of this study was to assess the effect of foot reflexology on capillary blood glucose, feet tissue temperature, and plantar pressure of the feet of individuals with diabetes mellitus (type 2). METHODS: Forty-five individuals with type 2 diabetes mellitus were stratified into 2 groups: treated (n = 21), which received orientation about foot self-care and received 12 foot reflexology sessions; and control (n = 24), which received only orientations about foot self-care. A portable glucose meter, an infrared thermography camera, and a baropodometer evaluated the variables. RESULTS: The data indicate that, after 12 therapy sessions, there were no significant differences between the groups for producing effects on capillary blood glucose, feet tissue temperature, and plantar pressure. CONCLUSION: No significant effect was observed after 12 foot reflexology sessions in the variables that were evaluated.

Reliability of Infrared Thermography Images in the Analysis of the Plantar Surface Temperature in Diabetes Mellitus.

OBJECTIVE: The purpose of this study was to evaluate the intraexaminer and interexaminer reliability of image assessment of infrared thermography of the plantar surface of people with diabetes mellitus. METHODS: Fifty-one participants with diabetes were included. The interexaminer reliability (test) consisted of measuring the temperature of the plantar surface by 2 evaluators who separately performed the analysis of thermographic images. The intraexaminer reliability (retest) consisted of the revaluation of the images by a single evaluator 10 days after the first analysis. RESULTS: The analysis of intrareliability and interreliability indicated excellent levels of correlation (intraclass correlation coefficient >0.75, 95% confidence interval >0.70) in the plantar surface points analyzed. CONCLUSION: Infrared thermography image evaluation identified intrareliability and interreliability for temperature analysis of the plantar surface of people with diabetes mellitus. However, further studies need to be conducted to assess validity and its application in health care.

The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of abdominopelvic training by virtual reality compared to pelvic floor muscle training (PFMT) using a gym ball (a previously tested and efficient protocol) on postmenopausal women's pelvic floor muscle (PFM) strength. METHOD: A randomized controlled trial was conducted with 60 postmenopausal women, randomly allocated into two groups: Abdominopelvic training by virtual reality - APT_VR (n=30) and PFMT using a gym ball - PFMT_GB (n=30). Both types of training were supervised by the same physical therapist, during 10 sessions each, for 30 minutes. The participants' PFM strength was evaluated by digital palpation and vaginal dynamometry, considering three different parameters: maximum strength, average strength and endurance. An intention-to-treat approach was used to analyze the participants according to original groups. RESULTS: No significant between-group differences were observed in most analyzed parameters. The outcome endurance was higher in the APT_VR group (p=0.003; effect size=0.89; mean difference=1.37; 95% CI=0.46 to 2.28). CONCLUSION: Both protocols have improved the overall PFM strength, suggesting that both are equally beneficial and can be used in clinical practice. Muscle endurance was higher in patients who trained using virtual reality.

The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial

ABSTRACT Objective To evaluate the effectiveness of abdominopelvic training by virtual reality compared to pelvic floor muscle training (PFMT) using a gym ball (a previously tested and efficient protocol) on postmenopausal women’s pelvic floor muscle (PFM) strength. Method A randomized controlled trial was conducted with 60 postmenopausal women, randomly allocated into two groups: Abdominopelvic training by virtual reality – APT_VR (n=30) and PFMT using a gym ball – PFMT_GB (n=30). Both types of training were supervised by the same physical therapist, during 10 sessions each, for 30 minutes. The participants’ PFM strength was evaluated by digital palpation and vaginal dynamometry, considering three different parameters: maximum strength, average strength and endurance. An intention-to-treat approach was used to analyze the participants according to original groups. Results No significant between-group differences were observed in most analyzed parameters. The outcome endurance was higher in the APT_VR group (p=0.003; effect size=0.89; mean difference=1.37; 95% CI=0.46 to 2.28). Conclusion Both protocols have improved the overall PFM strength, suggesting that both are equally beneficial and can be used in clinical practice. Muscle endurance was higher in patients who trained using virtual reality.

Postural adjustments in young ballet dancers compared to age matched controls.

OBJECTIVES: The purpose of the study was to use photogrammetry to evaluate the posture of ballet practitioners compared to an age-matched control group. DESIGN: One hundred and eleven 7- to 24-year-old female volunteers were evaluated and were divided into two groups: the ballet practising group (n = 52) and the control group (n = 59), divided into three subgroups according to age and years of ballet experience. RESULTS: Dancers with 1-3 years experience compared to controls of the same age shows alterations in External Rotation Angle (P < 0.05). Dancers 4-9 years experience show alterations in Lumbar Lordosis, Pelvis Tilt Angle and Navicular Angle Right and Left (P < 0.05). Dancers with over 9 years experience show alterations in External Rotation and Navicular Angle Left (P < 0.05). CONCLUSIONS: Research shows there are differences between dancers and controls. In the groups 1-3 years and over 9 years of experience, the External Rotation Angle is greater. In the group 4-9 years of experience the Lumbar Lordosis Angle is greater and Pelvis Tilt, Navicular Angle Left and Right are smaller. In more than 9 years of ballet experience, the Navicular Angle Left is smaller.

Intra and inter-rater reliability study of pelvic floor muscle dynamometric measurements.

OBJECTIVE: The aim of this study was to evaluate the intra and inter-rater reliability of pelvic floor muscle (PFM) dynamometric measurements for maximum and average strengths, as well as endurance. METHOD: A convenience sample of 18 nulliparous women, without any urogynecological complaints, aged between 19 and 31 (mean age of 25.4 ± 3.9) participated in this study. They were evaluated using a pelvic floor dynamometer based on load cell technology. The dynamometric evaluations were repeated in three successive sessions: two on the same day with a rest period of 30 minutes between them, and the third on the following day. All participants were evaluated twice in each session; first by examiner 1 followed by examiner 2. The vaginal dynamometry data were analyzed using three parameters: maximum strength, average strength, and endurance. The Intraclass Correlation Coefficient (ICC) was applied to estimate the PFM dynamometric measurement reliability, considering a good level as being above 0.75. RESULTS: The intra and inter-raters' analyses showed good reliability for maximum strength (ICC(intra-rater1)=0.96, ICC(intra-rater2)=0.95, and ICC(inter-rater)=0.96), average strength (ICC(intra-rater1)=0.96, ICCi(ntra-rater2)=0.94, and ICC(inter-rater)=0.97), and endurance (ICC(intra-rater1)=0.88, ICC(intra-rater2)=0.86, and ICC(inter-rater)=0.92) dynamometric measurements. CONCLUSIONS: The PFM dynamometric measurements showed good intra- and inter-rater reliability for maximum strength, average strength and endurance, which demonstrates that this is a reliable device that can be used in clinical practice.

Virtual reality: a proposal for pelvic floor muscle training.

INTRODUCTION AND HYPOTHESIS: This video's proposal was to present one of the pelvic floor muscle (PFM) training programs, used in our research, that we designed as a virtual reality intervention protocol and investigated its effects on PFM contractility. METHODS: Two clinical, controlled and prospective studies were conducted, one with 19 nulliparous women without urinary symptoms, who were evaluated by both electromyography and digital palpation (DP) and another with 27 postmenopausal women with mixed urinary symptoms (assessed by both ICIQ UI-SF and ICIQ-OAB), evaluated by vaginal dynamometry and DP, with a total of 46 women in both studies. This protocol was designed so that the participant would play a video game, seated on a pressure base platform, while commanding it through her pelvic movements. Using a virtual reality game, five activities were performed during 30 min, twice a week, with a total of 10 sessions. RESULTS: A significant increase in PFM strength was found in both the nulliparous (p = 0.0001) and the postmenopausal (p = 0.0001) groups of women, as ascertained by DP. A significant increase in postmenopausal women's muscle strength and endurance assessed by dynamometry (p = 0.05) and a concomitant decrease in their urinary symptoms, were observed. CONCLUSION: This virtual reality program promoted an increase in PFM contractility and a decrease in postmenopausal urinary symptoms.

Intra and inter-rater reliability study of pelvic floor muscle dynamometric measurements

OBJECTIVE: The aim of this study was to evaluate the intra and inter-rater reliability of pelvic floor muscle (PFM) dynamometric measurements for maximum and average strengths, as well as endurance. METHOD: A convenience sample of 18 nulliparous women, without any urogynecological complaints, aged between 19 and 31 (mean age of 25.4±3.9) participated in this study. They were evaluated using a pelvic floor dynamometer based on load cell technology. The dynamometric evaluations were repeated in three successive sessions: two on the same day with a rest period of 30 minutes between them, and the third on the following day. All participants were evaluated twice in each session; first by examiner 1 followed by examiner 2. The vaginal dynamometry data were analyzed using three parameters: maximum strength, average strength, and endurance. The Intraclass Correlation Coefficient (ICC) was applied to estimate the PFM dynamometric measurement reliability, considering a good level as being above 0.75. RESULTS: The intra and inter-raters' analyses showed good reliability for maximum strength (ICCintra-rater1=0.96, ICCintra-rater2=0.95, and ICCinter-rater=0.96), average strength (ICCintra-rater1=0.96, ICCintra-rater2=0.94, and ICCinter-rater=0.97), and endurance (ICCintra-rater1=0.88, ICCintra-rater2=0.86, and ICCinter-rater=0.92) dynamometric measurements. CONCLUSIONS: The PFM dynamometric measurements showed good intra- and inter-rater reliability for maximum strength, average strength and endurance, which demonstrates that this is a reliable device that can be used in clinical practice. .

Self-care associated with home exercises in patients with type 2 diabetes mellitus.

UNLABELLED: The objective of this study was to verify self-care guidelines together with lower limb home exercises alter ankle and foot plantar pressure and alignment in patient with Type 2 Diabetes Mellitus (DM) measuring health and sociodemographic factors. The health factors analyzed were sensitivity and circulation aspects, risk rating, and neuropathy symptom score, ankle and foot alignment (photogrammetry), plantar pressures, and postural stability (baropodometry) before and after administering these guidelines and home exercises in 97 patients type 2 DM during 10 months. The self-care guidelines and exercises changed the forefoot alignment (Right Foot - Initial vs Final, p = 0.04; Left Foot, P<0.01), the center of the force displacement in the mediolateral (Right Foot - Initial versus Final, p = 0.02; Left Foot, P<0.01), and the anterior-posterior (Right foot - Initial versus Final, p = 0.01) direction, and body balance (Initial versus Final, p = 0.02). There was no change in the remaining assessed parameters. Self-care associated with the guidelines for home exercises for the lower limbs in patients with type 2 DM are effective in maintaining and improving the alignment of the feet, mediolateral stability and prevention of complications. TRIAL REGISTRATION: The Brazilian Clinical Trials Registry RBR-8854CD.

Ectoparasitos em preás (Galea spixii Wagler, 1831) cativos no semiárido do Rio Grande do Norte / Ectoparasites in guinea pigs (Galea spixii Wagler, 1831) in captivity in the semiarid region of Rio Grande do Norte, Brazil

Os roedores silvestres quando criados em cativeiro podem ser acometidos por ectoparasitos que afetam a sua sanidade. Este trabalho objetivou identificar a ectofauna natural do preá Galea spixii criado nas condições de cativeiro no semiárido do Rio Grande do Norte e estudar o comportamento da dinâmica comportamental do ectoparasitismo mais prevalente. Utilizou-se 40 espécimes de spixii cativos do Centro de Multiplicação de Animais Silvestres da Universidade Federal Rural do Semi-Árido. Os exemplares foram anestesiados e examinados para busca de ectoparasitos, durante os meses de março a outubro de 2010. Os preás estudados apresentaram Amblyomma sp., Demodex sp. e Gliricola quadrisetosa. Os dados de frequência de G. quadrisetosa, espécie de maior prevalência, revelaram que a média de piolhos recuperados nas distintas áreas corporais, foi maior para exemplares fêmeas (p=0,0498). O período climático não influenciou na frequência de G. quadrisetosa recuperada dos animais (p>0,05). Da ectofauna identificada em G. spixii, notifica-se Demodex sp. como primeiro registro neste roedor nas condições semiáridas do Brasil. Os dados sugerem que a área corporal e o período não interferiram na infra população de Gliricola quadrisetosa encontrada em Galea spixii.

Wild rodents in captivity can be attacked by ectoparasites which affect their health. This study aimed to identify the natural ectofauna of the guinea pig Galea spixii Wagler, 1831 in captivity in the semiarid region of Rio Grande do Norte and to study the behavioral dynamics of the most prevalent ectoparasitism. Specimens (n=40) of G. spixii in captivity in the Center for Wild Animal Multiplication (Centro de Multiplicação de Animais Silvestres da Universidade Federal Rural do Semi-Árido) were anesthetized from March to October 2010 and examined searching for ectoparasites. The guinea pigs presented Amblyomma sp. (Koch, 1844), Demodex sp. (Owen, 1843) and Gliricola quadrisetosa (Ewing, 1924). The frequency of data of G. quadrisetosa, the most prevalent species in the study, showed that the mean of lice collected in the different body parts was higher in females (p=0,0498). The climatic period did not influence the frequency of G. quadrisetosa collected from the animals (p>0.05). Demodex sp. was the first record of ectofauna identified in G. spixii in semiarid conditions in Brazil. The data indicate that the body surface area and the climatic period did not influence the infra-population of Gliricola quadrisetosa found in Galea spixii.

Morphological effects of resumption of loading after immobilization of skeletal muscles in lengthened position in female rats.

BACKGROUND: In rehabilitation, immobilization of skeletal muscles in the elongated position is performed as a countermeasure in order to reverse the effects of severe muscle shortening and postoperative events. The return to normal functional activities is believed to stimulate mechanotransducers capable of reorganizing the normal muscle cytoarchitecture, but few data describing the histopathological changes relating to these procedures are available in the literature. OBJECTIVES: To assess and quantify histological abnormalities induced by immobilization of the extensor digitorum longus (EDL) muscle in elongation and to compare them with free movement of the animal after this procedure. METHODS: Eighteen female Wistar rats were used, divided into the following groups: Control; Immobilized in plantar flexion (EDL in an elongated position) for 14 days (GI); Immobilized for 14 days and released for 10 days (GIL). EDL fragments were frozen, sectioned and processed through immunohistochemical reactions for collagens I and III and histochemical methods for myofibrillar adenosine triphosphatase using hematoxylin-eosin. RESULTS: GI animals presented slight increases in collagen I and fiber expression in a degenerative/necrotic process, and reductions in the proportion of FT2A fibers and in the diameters of all fiber types, compared with the controls. In GIL, the quantity of collagen I returned to control conditions; the proportion of FT2D decreased; the number of centralized nuclei increased; and the fiber diameter was smaller than in GI. However, FT2B and FT2D expression did not reach the reference values. CONCLUSIONS: The data presented show that the recovery of function over a 10-day period was partially efficient with regard to recuperation of the characteristics of the EDL muscle after the period of immobilization. If the data are extrapolated to physiotherapeutic clinical practice, use of procedures directed towards primary dysfunctions of the muscle may favor a morphofunctional response in the segment and its full recovery.

Efeitos morfológicos do retorno da sobrecarga após imobilização em alongamento de músculo esquelético de ratas / Morphological effects of resumption of loading after immobilization of skeletal muscles in lengthened position in female rats

CONTEXTUALIZAÇÃO: Na reabilitação, a imobilização em alongamento do músculo esquelético é realizada como contramedida para reverter efeitos de encurtamento muscular severo e em eventos pós-cirúrgicos. Acredita-se que o retorno às atividades funcionais normais estimule mecanotransdutores capazes de reorganizar a citoarquitetura normal muscular, porém a descrição das alterações histopatológicas relacionadas a esses procedimentos são escassas na literatura. OBJETIVOS: Avaliar e quantificar anomalias histológicas induzidas pela imobilização em alongamento do músculo EDL (Extensor Digitorum Longus) e confrontá-las com a livre movimentação do animal após esse procedimento. MÉTODOS: Foram utilizadas 18 ratas Wistar, distribuídas nos grupos: controle (GC); imobilizadas em flexão plantar (EDL em posição alongada) por 14 dias (GI); imobilizadas por 14 dias e liberadas por dez dias (GIL). Fragmentos do EDL foram congelados, seccionados e processados com reações imuno-histoquímica para colágenos I e III e histoquímica para Adenosina Trifosfatase Miofibrilar e Hematoxilina-Eosina. RESULTADOS: Os animais do GI apresentaram discreto aumento da expressão de colágeno I e de fibras em processo degenerativo/necrótico, redução da proporção de fibras tipo (FT) 2A e do diâmetro menor de todos os tipos de fibras, quando comparados com os animais do GC. Para o GIL, observou-se retorno da quantidade de colágeno I às condições controle, além de redução na proporção de FT2D, aumento do número de núcleos centralizados e do diâmetro menor das fibras quando comparadas com o GI, porém a expressão de FT2B e FT2D não atingiu os valores de referência. CONCLUSÕES: Os dados apresentados mostram que a retomada da função durante dez dias foi parcialmente eficiente na recuperação das características do músculo EDL após o período de imobilização e que, se extrapolados os dados à clínica fisioterapêutica, a adoção de procedimentos orientados às disfunções primárias do músculo pode favorecer a resposta morfofuncional do segmento e o seu íntegro restabelecimento.

BACKGROUND: In rehabilitation, immobilization of skeletal muscles in the elongated position is performed as a countermeasure in order to reverse the effects of severe muscle shortening and postoperative events. The return to normal functional activities is believed to stimulate mechanotransducers capable of reorganizing the normal muscle cytoarchitecture, but few data describing the histopathological changes relating to these procedures are available in the literature. OBJECTIVES: To assess and quantify histological abnormalities induced by immobilization of the extensor digitorum longus (EDL) muscle in elongation and to compare them with free movement of the animal after this procedure. METHODS: Eighteen female Wistar rats were used, divided into the following groups: Control; Immobilized in plantar flexion (EDL in an elongated position) for 14 days (GI); Immobilized for 14 days and released for 10 days (GIL). EDL fragments were frozen, sectioned and processed through immunohistochemical reactions for collagens I and III and histochemical methods for myofibrillar adenosine triphosphatase using hematoxylin-eosin. RESULTS: GI animals presented slight increases in collagen I and fiber expression in a degenerative/necrotic process, and reductions in the proportion of FT2A fibers and in the diameters of all fiber types, compared with the controls. In GIL, the quantity of collagen I returned to control conditions; the proportion of FT2D decreased; the number of centralized nuclei increased; and the fiber diameter was smaller than in GI. However, FT2B and FT2D expression did not reach the reference values. CONCLUSIONS: The data presented show that the recovery of function over a 10-day period was partially efficient with regard to recuperation of the characteristics of the EDL muscle after the period of immobilization. If the data are extrapolated to physiotherapeutic clinical practice, use of procedures directed towards primary dysfunctions of the muscle may favor a morphofunctional response in the segment and its full recovery.