Perceived social support impacts on exercise adherence in patients with chronic low back pain.

BACKGROUND: Initiating and maintaining physical activity is particularly difficult for at-risk groups such as those with chronic low back pain (LBP). OBJECTIVE: This study aimed to assess whether there is a relationship between perceived social support (e.g., emotional and physical support) in individuals recently discharged from treatment for chronic LBP and the number of exercise sessions and total amount of exercise they perform over a 6-month period. This study also aimed to investigate a possible mediation effect of exercise self-efficacy on the relationship between perceived social support and exercise adherence (number of exercise sessions and total amount of exercise). METHODS: This prognostic study employed a secondary analysis of data collected for The Buddy Study; Data was collected through online weekly diaries over a 6-month period. Poisson regression analyses were used to quantify the relationship between social support at baseline and total number of exercise sessions, and total amount of exercise performed (frequency and duration) in the 6-month follow-up period. Where a relationship was observed, the Stata SEM command was used for the mediation analysis. RESULTS: A positive relationship was found between participants' perceived levels of social support at baseline and the total number of exercise sessions they performed (IRR = 1.56, 95%CI: 1.18 to 2.06) and the total amount of exercise they performed (IRR = 1.57, 95%CI: 1.05 to 2.35) during the 6-month follow-up period. No mediating relationship was found between exercise self-efficacy at 3-months and the total number of exercise sessions performed (ß 3.96, 95% CI: -4.91 to 12.84), or the total amount of exercise performed (ß 243.96, 95% CI: -258.08 to 746.01). CONCLUSION: Social support is potentially an important aspect of exercise adherence, following discharge from treatment, for those with chronic LBP. People's self-efficacy to exercise does not appear to mediate this relationship. Harnessing social support following physiotherapy treatment may increase exercise adherence and may therefore improve long term outcomes for those with chronic LBP.

Health coaching intervention with or without the support of an exercise buddy to increase physical activity of people with chronic low back pain compared to usual care: a feasibility and pilot randomised controlled trial.

BACKGROUND: Exercise buddies (people to exercise together with) might support people with low back pain (LBP) to become active. However, involving buddies in randomised controlled trials (RCT) might challenge recruitment, data collection and follow-up. OBJECTIVES: To explore the feasibility of the intervention, recruitment and data collection approaches and potential effects of a health coaching intervention (focused on physical activity) with or without exercise buddies' support on physical activity of people with chronic LBP versus usual discharge care. DESIGN: Feasibility and pilot RCT. METHODS: Adults (n = 30) discharged from LBP treatment were randomised to the Buddy-Assisted (health coaching intervention with exercise buddy's support), Individual-Only (health coaching only), or usual care groups. Data were collected at baseline, three and six months. The feasibility of trial's procedures was assessed through recruitment rate (acceptable if >70%), data completion rate (acceptable if ≤ 20% missing data), and follow-up rate (successful if ≥ 85%). The intervention's acceptability was assessed via feedback questionnaires. Preliminary effects on physical activity and other outcomes were also explored. RESULTS: Recruitment and baseline data completion were acceptable. However, data collection and follow-up rates post-randomisation were not. 85% of the Buddy-Assisted Group believed the buddies helped them to increase physical activity and would recommend the intervention. 70% of the Individual-Only and Control groups believed exercise buddies would help them to become further active. CONCLUSION: The data collection and follow-up approaches were not successful and need amending before a large-scale RCT. Nonetheless, the buddy-assisted intervention was well-accepted. A future RCT will focus on differences in clinical outcomes. TRIAL REGISTRATION: The study was registered at the Australian New Zealand Clinical Trial Registry (ACTRN12620001118998).

The smallest worthwhile change on function from a self-management intervention for non-persistent low back pain.

PURPOSE: To determine: (1) the smallest change in function patients would need to see following a self-management intervention for low back pain (LBP) to consider it worthwhile; (2) the association between patient-related factors and the magnitude of the smallest worthwhile change. METHODS: A cross-sectional analysis of 212 participants of the TEXT4myBACK randomised trial was conducted. At baseline, participants nominated the smallest change in function (0-30 scale) following a self-management program they would need to reach to consider it worthwhile. A multivariate regression model estimated the effects of demographic, comorbidities, lifestyle and LBP-related factors on the smallest worthwhile change estimates. RESULTS: On average, people with LBP need to experience an improvement of at least 9.4 points (SD: 5.7) in function to consider a self-management intervention worthwhile. Only baseline function severity was significantly associated with the smallest worthwhile estimate (-0.60; 95%CI - 0.76, - 0.44). CONCLUSION: On average, an improvement of 9.4 points (or 31%) in function is considered by people with LBP as the smallest change that makes self-management worthwhile. Those with lower levels of function needed to experience greater improvements.

Usefulness of machine learning softwares to screen titles of systematic reviews: a methodological study.

OBJECTIVE: To investigate the usefulness and performance metrics of three freely-available softwares (Rayyan®, Abstrackr® and Colandr®) for title screening in systematic reviews. STUDY DESIGN AND SETTING: In this methodological study, the usefulness of softwares to screen titles in systematic reviews was investigated by the comparison between the number of titles identified by software-assisted screening and those by manual screening using a previously published systematic review. To test the performance metrics, sensitivity, specificity, false negative rate, proportion missed, workload and timing savings were calculated. A purposely built survey was used to evaluate the rater's experiences regarding the softwares' performances. RESULTS: Rayyan® was the most sensitive software and raters correctly identified 78% of the true positives. All three softwares were specific and raters correctly identified 99% of the true negatives. They also had similar values for precision, proportion missed, workload and timing savings. Rayyan®, Abstrackr® and Colandr® had 21%, 39% and 34% of false negatives rates, respectively. Rayyan presented the best performance (35/40) according to the raters. CONCLUSION: Rayyan®, Abstrackr® and Colandr® are useful tools and provided good metric performance results for systematic title screening. Rayyan® appears to be the best ranked on the quantitative and on the raters' perspective evaluation. The most important finding of this study is that the use of software to screen titles does not remove any title that would meet the inclusion criteria for the final review, being valuable resources to facilitate the screening process.

A qualitative assessment of a text message intervention for people with low back pain.

BACKGROUND: Text messages represent a simple and scalable strategy to provide self-management to people with low back pain (LBP), yet their usefulness is unknown. OBJECTIVE: To assess the usefulness, delivery format, behaviour-change ability and potential for the TEXT4myBACK intervention to be scaled-up. DESIGN: Qualitative study nested within a randomised controlled trial. METHODS: 64 participants of the TEXT4myBACK trial randomised to the intervention arm were invited to participate in online sessions. Participants provided feedback about the text messages received. Online sessions were conducted by two researchers until thematic saturation was achieved. Information was analysed based on framework analysis and thematic data-driven coding. RESULTS: Of the 64 invited, 10 people participated in the sessions and thematic saturation was reached. The following themes were identified: intervention's format, barriers and facilitators for behaviour-change, effectiveness, and implementation into healthcare. The messages were considered useful and their format was well-accepted, whilst some suggested a longer duration. The messages were considered simple to read and understand yet further information about LBP and exercise would be appreciated. Some believed the intervention improved their LBP and others believed its effectiveness would depend on receiver's characteristics. Participants felt the messages helped them to increase physical activity. Provision of information, reminders, and self-awareness were some behaviour-change facilitators. Participants said the intervention could be provided by healthcare professionals either for free or through a small fee. CONCLUSIONS: The TEXT4myBACK intervention was useful and well-accepted. It provided reminders and supported increases in physical activity. Participants provided suggestions for the intervention to be scaled-up.

Poor hamstrings-to-quadriceps torque ratios in male soccer players: weak hamstrings, strong quadriceps, or both?

This study aimed to evaluate the influence of hamstrings and quadriceps strength on the hamstrings-to-quadriceps conventional (H:Qcon) and functional (H:Qfun) ratios in male soccer players. Quadriceps concentric peak torque (PT) and hamstrings concentric and eccentric PT were assessed with isokinetic dynamometry at 60°/s in 101 players (202 legs). The cut-points of 0.50, 0.55 and 0.60 were used to assess muscle imbalance through the H:Qcon ratio, while 0.80, 0.85 and 0.90 were used for H:Qfun ratio. Legs with lower H:Qcon ratio had decreased hamstrings concentric PT (p < 0.01; moderate and large effect sizes) and increased quadriceps concentric PT (p < 0.01; moderate effect sizes) in all cut-points. Legs with lower H:Qfun ratio had decreased hamstrings eccentric PT (p < 0.01; large effect sizes) for all cut-points, and controversial results for quadriceps concentric PT (p < 0.01 only for 0.80 cut-point; small effect sizes). H:Qcon ratio presented only weak correlations with quadriceps (r = -0.37) and hamstrings (r = 0.45) concentric PT, while H:Qfun ratio had a negligible correlation with quadriceps concentric PT (r = -0.30) and a moderate correlation with hamstrings eccentric PT (r = 0.66). In conclusion, our findings support that hamstrings strength deficit is the key factor for low H:Q ratios in male soccer players, especially those with poor H:Qfun ratio.

Relationship between knee extensor and flexor muscle strength and age in professional volleyball players.

We aimed to analyse the relationship of peak torque (PT) of the knee extensors (Ext) and flexors (Fle) with age, and the relationship between conventional ratio and age progression in volleyball players. A total of 41 elite male volleyball players (age: 25.0 ± 6.1 years, body mass: 93.0 ± 9.8 kg, height: 198.0 ± 6.8 cm) were evaluated in a isokinetic dynamometer at speeds of 60, 180 and 300 deg/s, and at dominant (D) and non-dominant (ND) legs. In general, the knee flexor and extensor muscles varied greatly among the athletes (from 81 to 156 N.m for flexors; from 116 to 250 N.m for extensors at 300 deg/s and at dominant side). The mass-specific PT of knee extensors showed strong and negative correlation with ageing at 60 and 180 deg/s (r = -0.52-0.62, p < 0.01). The conventional ratio showed regular and positive relationship at all evaluated velocities (60°.s-1, r = 0.453, p < 0.01; 180°.s-1, r = 0.498, p < 0.01; 300°.s-1, r = 0.316, p = 0.04). The results demonstrated that volleyball players are susceptible to age-related effects on muscular performance during their career; this finding illustrates the importance of adopting training strategies to improve the production of strength in the lower limbs, which is essential for vertical jumps.

Are the Harris Hip Score and the Hip Outcome Score valid patient-reported outcome measures for femoroacetabular impingement syndrome?

BACKGROUND: The International Hip Outcome Tool (iHOT-33) is a reference instrument among the Patient-Reported Outcome Measures (PROMs) to assess people with hip disorders, including femoroacetabular impingement (FAI) syndrome. Older questionnaires such as the Harris Hip Score, or its modified version (mHHS), and the Hip Outcome Score (HOS), through the full version or its subscales (Activities of Daily Living-ADL; and Sports) are still used in the clinical setting and their construct validity is so far underexplored. OBJECTIVE: To assess the construct validity of mHHS and HOS-ADL compared with iHOT-33 by hypothesis testing in a large sample of patients with FAI syndrome. METHODS: This retrospective study was conducted with data records from patients with FAI syndrome seeking care at a private physical therapy clinic between 2013 and 2018. All participants completed the three questionnaires (mHHS, HOS-ADL, and iHOT-33) during the physical therapy initial assessment. RESULTS: From the 523 patients with FAI syndrome found in the clinic's database, 373 were eligible for this study. An acceptable agreement (r>0.70) was found between HOS-ADL and iHOT-33 (r = 0.77, 95%CI: 0.73, 0.81), but not between mHHS and iHOT-33 (r = 0.68, 95%CI: 0.62, 0.73). HOS-ADL score presented an acceptable agreement with iHOT-Symptoms subscale score (r = 0.78, 95%CI: 0.73, 0.81), while mHHS score did not (r = 0.68, 95%CI: 0.62, 0.73). Neither HOS-ADL or mHHS presented an acceptable agreement with iHOT-Sport, iHOT-Job, or iHOT-Social scores. CONCLUSION: The HOS-ADL score, but not mHSS score, is an acceptable measure of health-related quality of life in patients with FAI syndrome.

Use of Online Information in Musculoskeletal Conditions: An Analysis of Google Trends Data.

BACKGROUND/OBJECTIVE: We aimed to investigate the yearly online public interest for gout, low back pain, neck pain, osteoarthritis, and rheumatoid arthritis, the most popular topics searched for these conditions, and the association between the change in their interest over time and the sociodemographic index of the search location. METHODS: We conducted online searches in Google Trends for the aforementioned conditions between 2004 and 2020. The search volumes for each condition (relative to all searches conducted in the period) and the top and rising related queries and topics were downloaded and summarized. RESULTS: There was a rise in the online interest for musculoskeletal conditions between 2008 and 2020, with low back pain (annual percent change, 7.4; 95% confidence interval [CI], 7.1-7.7) and neck pain (annual percent change, 7.2; 95% CI, 6.9-7.5) presenting the highest increases. There was a negative, statistically significant, but small association between change in online interest and the country's sociodemographic index for low back pain (-0.007; 95% CI, -0.011 to-0.003), neck pain (-0.005; 95% CI, 0.009 to -0.001), and rheumatoid arthritis (-0.009; 95% CI, -0.017 to -0.001) between 2013 and 2020. The interest for the cause and symptoms of the selected conditions increased over time, except for gout. The proportion of queries and topics related to treatment of all conditions decreased over time. CONCLUSIONS: The worldwide interest in musculoskeletal conditions increased between 2008 and 2020. The public seems more interested in understanding what musculoskeletal conditions are and less interested in which treatment options are available. The results can guide the development of educational campaigns for musculoskeletal conditions.

TEXT4myBACK - The Development Process of a Self-Management Intervention Delivered Via Text Message for Low Back Pain.

OBJECTIVE: To develop a bank of text messages for a lifestyle-based self-management intervention for people with low back pain (LBP). DESIGN: Iterative development process. SETTING: Community and primary care. PARTICIPANTS: Fifteen researchers, clinicians, and consumer representatives participated in the concept and initial content development phase. Twelve experts (researchers and clinicians) and 12 consumers participated in the experts and consumers review phase. Full study sample of participants was N=39. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We first conducted two 2-hour workshops to identify important domains for people with LBP, sources of content, appropriate volume, and timing of the messages. The messages were then drafted by a team of writers. Second, we invited expert researchers and clinicians to review and score the messages using a 5-item psychometric scale according to (1) the appropriateness of the content and (2) the likelihood of clinical effectiveness and to provide written feedback. Messages scoring ≤8 out of 10 points would be modified accordingly. Consumers were invited to review the messages and score them using a 5-item psychometric scale according to the utility of the content, the understanding of the content, and language acceptability and to provide feedback. Messages scoring ≤12 out of 15 points would be improved. RESULTS: Exercise, education, mood, sleep, use of care, and medication domains were identified and 82 domain-specific evidence-based messages were written. Messages received a mean score of 8.3 out of 10 points by experts. Twenty-nine messages were modified accordingly. The mean score of the messages based on consumers feedback was of 12.5 out of 15 points. Thirty-six messages were improved. CONCLUSIONS: We developed a bank of text messages for an evidence-based self-management intervention using a theory-based, iterative, codesign process with researchers, consumers, and clinicians. This article provides scientific support for future development of text message interventions within the pain field.

TEXT4myBACK: A Text Message Intervention to Improve Function in People With Low Back Pain-Protocol of a Randomized Controlled Trial.

OBJECTIVE: The authors sought to describe the protocol of a randomized controlled trial that will investigate the effects of the TEXT4myBACK self-management text message intervention compared with control in people with low back pain (LBP). METHODS: A single-blind (assessor and statistician), randomized controlled trial with economic analysis and process evaluation will be conducted. A total of 304 people with non-specific LBP of less than 12 weeks will be enrolled and randomly allocated either to TEXT4myBACK intervention or control groups. The TEXT4myBACK intervention group will receive 4 semi-personalized text messages per week providing advice, motivation, and information about LBP, physical activity, sleep, mood, use of care, and medication during 12 weeks. The control group will receive 1 text message with a link to a LBP and diet online information package. Outcomes will be assessed at baseline and 3, 6, and 12 months. The primary outcome will be function assessed with the Patient-Specific Functional Scale. Secondary outcomes will include pain intensity, physical activity participation, sedentary behavior, global impression of change, health-related quality of life, and eHealth literacy. Data on demographic characteristics, smallest worthwhile change (ie, smallest function scored needed to be achieved at the end of the intervention to consider it to be worthwhile), health care utilization, and adverse events (ie, any new health issue that occurs during participation in the study) will be collected. An economic and process evaluation will also be conducted. IMPACT: This study will assess if a self-management text message intervention is effective and cost-effective in improving function of people with LBP. This study can inform clinical practice of a simple, scalable, and affordable intervention for managing LBP.

Measuring adherence to unsupervised, conservative treatment for knee osteoarthritis: A systematic review.

Objective: To describe the measurement of adherence to unsupervised, conservative treatments for knee osteoarthritis (OA), including the methods of adherence measurement, parameters for assessing adherence and any values used to quantify adherence. Methods: A systematic review with search terms related to knee OA, conservative treatments and adherence was conducted. The protocol was registered with the International Prospective Register of Systematic Reviews (registration number CRD42020158188). Seven electronic databases (MEDLINE, AMED, EMBASE, CINAHL, SportDiscus, PsychINFO, PEDro) were searched from inception to February 02, 2021. Studies that included unsupervised, conservative treatment(s) for knee OA measuring adherence were eligible. Studies were independently screened for inclusion by two researchers. Data was extracted by one researcher and verified by a second researcher. Extracted data included: study type, population, type of treatment, adherence measurement methods, time-points, recall, parameters and values used to quantify adherence. Results: Of 5033 references identified, 242 studies comprising of 261 treatments were included in the review. The majority of studies were randomised controlled trials investigating therapeutic exercise (n â€‹= â€‹107, 41.0%). The most common adherence measurement across all treatments was through self-reported diary (n â€‹= â€‹137, 52.5%) and the most common parameter was assessing the frequency of the treatment (n â€‹= â€‹79, 30.3%). Only a small number of studies provided values for quantifying satisfactory adherence (n â€‹= â€‹26, 9.3%). Conclusion: There is a wide variety in the reporting of adherence to conservative treatments for knee OA and standardised methods for measuring and reporting adherence are needed. Developing a tool to measure adherence to conservative treatments for knee OA is a priority.

Family-based Interventions Benefit Individuals With Musculoskeletal Pain in the Short-term but not in the Long-Term: A Systematic Review and Meta-Analysis.

INTRODUCTION: The benefits of family-based interventions for patients with musculoskeletal pain have been previously shown in individual randomized controlled trials (RCTs), but no systematic review has summarized their effects. MATERIALS AND METHODS: A systematic review was conducted to assess the effectiveness of family-based interventions on clinical and biopsychosocial outcomes in people with musculoskeletal pain (PROSPERO CRD42018118442). Meta-analyses were performed for the outcomes of pain intensity, disability, mood, self-efficacy, and marital adjustment. RESULTS: Of 1223 records identified, 18 reports representing 15 RCTs were included in the qualitative review and 10 in the meta-analyses. Family-based interventions were more effective to reduce pain (mean difference [MD], -3.55/100; 95% confidence intreval [CI], -4.03 to -3.06) and disability (MD, -1.51/100; 95% CI, -1.98 to -1.05) than individual-focused interventions at short-term, but not at mid term or long term. There were no effects on other outcomes. Family-based interventions were more effective to reduce pain (MD, -6.05/100; 95% CI, -6.78 to -5.33) compared with usual care only at short-term. No effects were found on disability and other outcomes. DISCUSSION: There is moderate-quality evidence that family-based interventions result in small, significantly better pain and disability outcomes in the short-term compared with individual-focused interventions in patients with musculoskeletal pain. Based on low-quality evidence, family-based interventions result in small improvements on pain in the short-term compared with usual care. Future studies should review the content and optimize the mechanisms underpinning family-based interventions in musculoskeletal pain so that the approach could be further tested in adequately powered RCTs.

Effects of long-term concurrent training to failure or not in muscle power output, muscle quality and cardiometabolic risk factors in older men: A secondary analysis of a randomized clinical trial.

This study investigated the effects of concurrent training performed either with repetitions to failure or not to failure in muscle power, muscle quality (MQ), peak oxygen uptake (VO2peak), and visceral fat in older men. This is an ancillary analysis of a randomized controlled trial. 36 older men (mean age ± SD; 67.1 ± 5.1 years) were randomized into three groups: one performing repetitions to failure (RFG, n = 13), another performing repetitions not to failure and 50% of the repetitions of the RFG (NFG, n = 12), and third performing repetitions not to failure with equal training volume of the RFG (ENFG, n = 11). The training was performed twice a week for 20 weeks at intensities ranging from 65 to 80% of maximal strength. In each session, the individuals started with strengthening exercises and then performed aerobic exercise (i.e., walking) on a treadmill. The primary endpoint was change from baseline to post-20 wk of absolute and relative muscle power output during squat and countermovement jump, ultrasound measurements for MQ using quadriceps echo intensity, and visceral fat thickness, as well as their VO2peak through a maximal incremental test on a treadmill. All training groups improved similarly and significantly jump height (ranging from 9 to 16%) and all their muscle power outcomes (mean change ranging from 2 to 7%) (P < .001). In addition, all groups significantly decreased visceral fat thickness (ranging from -11 to -21%) (P < .001), and significantly increased VO2peak (ranging from 4 to 8%) (P < .01), with no differences between groups. No changes were observed in the MQ outcomes. Concurrent training performed using repetitions to failure or not to failure promoted similar gains in the muscle power output, aerobic capacity, and visceral fat in healthy older men.

Effect of Weekly Training Frequency With the Nordic Hamstring Exercise on Muscle-Strain Risk Factors in Football Players: A Randomized Trial.

PURPOSE: To examine the differences between performing Nordic hamstring exercises once or twice a week on hamstring eccentric strength and other muscle-strain risk factors in high-level football players. METHODS: In this randomized trial, 32 football players (18-23 y old) completed an 8-week Nordic hamstring exercise training program in 1 of 2 experimental groups: group 1 (once a week; n = 15) and group 2 (twice a week; n = 17). Knee-flexor/extensor peak torques and biceps femoris long-head muscle architecture were assessed through isokinetic dynamometry and ultrasonography, respectively, before and after the training programs. Analysis of covariance, effect sizes (ESs), and t tests for percentage change were used to assess the effect of the 2 interventions on the outcome measures. RESULTS: Group 2 demonstrated higher hamstring concentric peak torque than group 1 posttraining (155-164 vs 149-158 N·m; P = .043; ES = 0.27), although there was also a statistical trend for higher hamstring eccentric peak torque (212-234 vs 198-221 N·m; P = .098; ES = 0.37), hamstring-to-quadriceps conventional ratio (0.56-0.59 vs 0.54-0.57; P = .089; ES = 0.31), and hamstring-to-quadriceps functional ratio (0.76-0.84 vs 0.71-0.79; P = .076; ES = 0.50). No between-groups differences were found for muscle thickness (P = .864; ES = 0.12), pennation angle (P = .289; ES = 0.18), fascicle length (P = .406; ES = 0.03), and quadriceps concentric peak torque (P = .340; ES = 0.02). CONCLUSION: Only the Nordic hamstring exercise training program performed twice a week strengthened the hamstrings of high-level football players, while similar changes in muscle architecture occurred with both once- and twice-weekly sessions.

Effects of using text message interventions for the management of musculoskeletal pain: a systematic review.

Musculoskeletal pain is the greatest cause of disability worldwide. Owing to its increasing prevalence and burden, the importance of affordable treatments has been highlighted. Text message interventions are accessible, low cost, and effective in promoting healthy behaviour and managing chronic diseases. However, little is known about their role in musculoskeletal pain. This systematic review was conducted to appraise the literature on the effects of text messages (as an intervention or a component of an intervention) compared with any control on pain and function in people with musculoskeletal pain (PROSPERO: CRD42018117371). MEDLINE, EMBASE, CINAHL, Cochrane, and PEDro databases were searched from inception to April 2020. Keywords relating to musculoskeletal pain, text messages, and randomised controlled trials were combined. Methodological quality was assessed using the PEDro score. Of the 12,022 studies identified, 11 were included, with a mean PEDro score of 5.4/10 points (SD 1.3). Pooled analyses were not performed because of heterogeneity of interventions and clinical characteristics. When text messages were added to and compared with usual care, some positive effects were found only on treatment adherence. Although small and inconsistent, some positive effects were reported for pain intensity, function, care-seeking behaviour, adherence, and quality of life when text messages were added to multicomponent interventions. Moreover, text message and telephone counselling interventions had similar effects on function. Overall included studies were of limited methodological quality and heterogeneous. However, our results indicate potential benefits of text messages in the treatment of musculoskeletal pain, which need to be confirmed in future trials.

Correction to: Are the ergogenic effects of photobiomodulation therapy age-dependent? A randomized double-blinded placebo-controlled trial.

The author name Bruno Menfridini Baroni was incorrectly captured in the original article. The correct author name is Bruno Manfredini Baroni. The original article has been corrected.

Prevalence of Hamstring Strain Injury Risk Factors in Professional and Under-20 Male Football (Soccer) Players.

CONTEXT: Hamstring strain injury (HSI) is the most prevalent injury in football (soccer), and a few intrinsic factors have been associated with higher injury rates. OBJECTIVE: To describe the prevalence of the main intrinsic risk factors for HSI in professional and under-20 football players. DESIGN: Cross-sectional study. SETTING: Physiotherapy laboratory, Federal University of Health Sciences of Porto Alegre (Brazil). PARTICIPANTS: A total of 101 football players (52 professional and 49 under-20 players). INTERVENTION: An evidence-based testing protocol for screening HSI risk factors. MAIN OUTCOME MEASURES: Anamnesis, ultrasonography of the hamstrings, passive straight-leg raise test, Functional Movement Screen, and isokinetic dynamometry were performed. Eleven HSI risk factors for each leg were assessed, besides the player's age as a systemic risk factor. Reports were delivered to the coaching staff. RESULTS: Professionals had greater prevalence of HSI history compared with under-20 players (40% vs 18%). No between-group differences were found for the other screening tests. Altogether, 30% of players had already sustained at least one HSI; 58% had a history of injuries in adjacent regions; 49% had short biceps femoris fascicles; 66% and 21% had poor passive and active flexibility, respectively; 42% and 29% had deficits in functional movements and core stability, respectively; 7% and 26% presented bilateral imbalance for hamstring concentric and eccentric strength, respectively; 87% and 94% obtained low values for hamstring-to-quadriceps conventional and functional ratios, respectively. Two-thirds of players had 3 to 5 risk factors per leg. None of the players was fully free of HSI risk factors. CONCLUSION: Most football players present multiple risk factors for sustaining an HSI. Hamstring weakness is the most prevalent risk factor, but the teams should also be aware of deficits in flexibility, core stability, functional movements, and hamstring fascicle length.

Concurrent training performed with and without repetitions to failure in older men: A randomized clinical trial.

This study compared the effects of 20 weeks of concurrent training with and without repetitions to failure on neuromuscular and functional adaptations in older men. METHODS: Thirty-six older men (67.1 ± 5.1 years) were randomized into three groups: one performing repetitions to failure (RFG, n = 13), another performing repetitions not to failure and 50% of the repetitions of the RFG (NFG, n = 12), and a third performing repetitions not to failure with equal training volume of the RFG (ENFG, n = 11). Training was performed twice a week for 20 weeks at intensities ranging from 65% to 80% of maximal strength. In each session, the individuals started with strengthening exercises and then performed aerobic exercise on a treadmill. Before and after the intervention, individuals were assessed for their one repetition maximum (1RM) for leg press (LP) and knee extension (KE) exercises, knee extensors' isometric peak torque (PTiso ), and rate of torque development (RTD) at 50 ms, 100 ms, and 250 ms, muscle thickness of the quadriceps, as well as functional performance on sit-to-stand, and timed up and go tests. RESULTS: After training, there were significant (P < 0.001) increases in the LP and KE 1RM, PTiso , and RTD outcomes in all groups. Also, there were significant increases in muscle thickness of the quadriceps and in the sit-to-stand test (P < 0.05) in all groups. No significant differences were observed between groups in any outcome. CONCLUSION: Concurrent training using repetitions to concentric failure did not promote additional benefits for neuromuscular function, muscle thickness, or functional capacity of older individuals.