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1.
J Frailty Aging ; 9(1): 23-29, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32150210

RESUMEN

BACKGROUND: Stride-to-stride fluctuations, or gait variability, can be captured easily using body worn inertial sensors. Previously, sensor-measured gait variability has been found to be associated with fall risk and central nervous changes. However, further research is needed to clarify the clinical relevance of this method. OBJECTIVES: In this study, we look at how gait variability is associated with muscle strength, measured two years earlier. DESIGN, SETTING AND PARTICIPANTS: This is study of longitudinal associations. Participants were community-dwelling volunteers between 70-81 years. MEASUREMENTS: Participants were tested while walking with a single sensor at their lower back, and they walked back and forth over a distance of 6.5 meters under four conditions: at preferred speed, at fast speed, with an added cognitive task, and while walking across an uneven surface. Gait variability in the anteroposterior (AP), mediolateral (ML) and vertical (V) directions was identified. A muscle strength score was composed by transforming hand grip strength, isometric knee extension strength and the 30 second chair rise-test to z-scores and adding them. RESULTS: 56 individuals were analysed (mean age at baseline 75.8 (SD 3.43), 60 percent women). In a backwards regression method using age, gender and baseline walking speed as covariates, muscle strength predicted gait variability after two years for AP variability during preferred speed (Beta= .314, p=.025) and uneven surface walking (Beta=.326, p=.018). Further, muscle strength was associated with ML variability during preferred speed (Beta=.364, p=.048) and fast speed (Beta=.419, p=.042), and V variability during preferred speed (Beta=.402, p=.002), fast speed (Beta=.394, p=.004) and uneven surface walking (Beta=.369, p=.004). CONCLUSIONS: Sensor-measured gait variability tended to be associated with muscle strength measured two years earlier. This finding could emphasize the relevance of this relatively novel measure of gait in older adults for both research and clinical practice.


Asunto(s)
Marcha/fisiología , Fuerza Muscular , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Vida Independiente , Masculino
2.
J Frailty Aging ; 9(1): 30-36, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32150211

RESUMEN

BACKGROUND: The mobility of older adults is limited by the compounding effects of vascular health conditions, or vascular risk burden. However, little is known about the role of neuromuscular attributes among those in which vascular risk burden contributes to mobility limitations. OBJECTIVE: We investigated (1) the relationship between the absence/presence of type 2 diabetes, hypertension, and/or obesity and mobility measures and neuromuscular attributes, and (2) whether the association between vascular risk burden and mobility is mediated by lower limb neuromuscular attributes. DESIGN: Cross-sectional analysis of baseline data from 430 older adults within the Boston RISE Study. MEASUREMENTS: Measures of mobility were the Short Physical Performance Battery, habitual gait speed, and functional mobility as measured by the Late Life Function Instrument. We also evaluated lower limb neuromuscular attributes, namely leg strength, leg velocity, trunk extensor muscle endurance, knee and ankle range of motion, and sensory loss. RESULTS: Participants self-reported the presence of None (n=93), One (n=179), Two (n=114), or Three (n=44) of the following conditions: diabetes, hypertension, and obesity. Multivariable regression models indicated that those with a greater vascular risk burden had worse performance on the Short Physical Performance Battery (p=0.01), slower gait speed (p=0.0003) and lower Basic and Advanced Late Life Function Instrument scores (p<0.003). These associations were independent of multiple covariates. Vascular risk burden was also found to be negatively associated with leg strength (p=0.0002) and knee flexion range of motion (p<0.0001) and an associated non-significant trend was observed with leg velocity (p=0.06). In addition, the association between vascular risk burden and mobility outcomes were found to be partially mediated by leg strength, leg velocity, and knee flexion range of motion. CONCLUSIONS: Among older adults with vascular risk burden and mobility problems, neuromuscular impairments in attributes such as leg strength, leg velocity, and knee range of motion may need to be treatment priorities.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Hipertensión/epidemiología , Limitación de la Movilidad , Fuerza Muscular/fisiología , Obesidad/epidemiología , Anciano , Estudios Transversales , Humanos , Articulación de la Rodilla/fisiología , Pierna/fisiología , Rango del Movimiento Articular/fisiología , Factores de Riesgo
3.
J Frailty Aging ; 9(1): 37-43, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32150212

RESUMEN

BACKGROUND: Sarcopenic obesity (SO) is associated with poorer physical performance in the elderly and will increase in relevance with population ageing and the obesity epidemic. The lack of a consensus definition for SO has resulted in variability in its reported prevalence, poor inter-definitional agreement, and disagreement on its impact on physical performance, impeding further development in the field. While sarcopenia definitions have been compared, the impact of obesity definitions in SO has been less well-studied. OBJECTIVES: To compare 3 widely-adopted definitions of obesity in terms of SO prevalence, inter-definitional agreement, and association with muscle function. DESIGN: Cross-sectional. SETTING: GERILABS study, Singapore Participants: 200 community-dwelling, functionally-independent older adults. MEASUREMENTS: We utilized three commonly-used definitions of obesity: body mass index (BMI), waist circumference (WC) and DXA-derived fat mass percentage (FM%). Sarcopenia was defined using Asian Working Group for Sarcopenia criteria. For muscle function, we assessed handgrip strength, gait speed and Short Physical Performance Battery (SPPB). Subjects were classified into 4 body composition phenotypes (normal, obese, sarcopenic and SO), and outcomes were compared between groups. RESULTS: The prevalence rate for SO was lowest for BMI (0.5%) compared to FM% (10.0%) and WC (10.5%). Inter-definitional agreement was lowest between BMI and WC (κ=0.364), and at best moderate between FM% and WC (κ=0.583). SO performed the worst amongst body composition phenotypes in handgrip strength, gait speed and SPPB (all p<0.01) only when defined using WC. In regression analyses, SO was associated with decreased SPPB scores (ß=-0.261, p=0.001) only for the WC definition. CONCLUSION: There is large variation in the prevalence of SO across different obesity definitions, with low-to-moderate agreement between them. Our results corroborate recent evidence that WC, and thus central obesity, is best associated with poorer muscle function in SO. Thus, WC should be further explored in defining obesity for accurate and early characterization of SO among older adults in Asian populations.


Asunto(s)
Obesidad , Sarcopenia , Terminología como Asunto , Anciano , Estudios Transversales , Humanos , Fuerza Muscular/fisiología , Obesidad/epidemiología , Obesidad/fisiopatología , Prevalencia , Reproducibilidad de los Resultados , Sarcopenia/epidemiología , Sarcopenia/fisiopatología
4.
J Frailty Aging ; 9(1): 57-63, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32150215

RESUMEN

BACKGROUND: Human aging is characterized by a chronic, low-grade inflammation suspected to contribute to reductions in skeletal muscle size, strength, and function. Inflammatory cytokines, such as interleukin-6 (IL-6), may play a role in the reduced skeletal muscle adaptive response seen in older individuals. OBJECTIVES: To investigate relationships between circulating IL-6, skeletal muscle health and exercise adaptation in mobility-limited older adults. DESIGN: Randomized controlled trial. SETTING: Exercise laboratory on the Health Sciences campus of an urban university. PARTICIPANTS: 99 mobility-limited (Short Physical Performance Battery (SPPB) ≤9) older adults. INTERVENTION: 6-month structured physical activity with or without a protein and vitamin D nutritional supplement. MEASUREMENTS: Circulating IL-6, skeletal muscle size, composition (percent normal density muscle tissue), strength, power, and specific force (strength/CSA) as well as physical function (gait speed, stair climb time, SPPB-score) were measured pre- and post-intervention. RESULTS: At baseline, Spearman's correlations demonstrated an inverse relationship (P<0.05) between circulating IL-6 and thigh muscle composition (r = -0.201), strength (r = -0.311), power (r = -0.210), and specific force (r = -0.248), and positive association between IL-6 and stair climb time (r = 0.256; P<0.05). Although the training program did not affect circulating IL-6 levels (P=0.69), reductions in IL-6 were associated with gait speed improvements (r = -0.487; P<0.05) in "higher" IL-6 individuals (>1.36 pg/ml). Moreover, baseline IL-6 was inversely associated (P<0.05) with gains in appendicular lean mass and improvements in SPPB score (r = -0.211 and -0.237, respectively). CONCLUSIONS: These findings implicate age-related increases in circulating IL-6 as an important contributor to declines in skeletal muscle strength, quality, function, and training-mediated adaptation. Given the pervasive nature of inflammation among older adults, novel therapeutic strategies to reduce IL-6 as a means of preserving skeletal muscle health are enticing.


Asunto(s)
Ejercicio/fisiología , Interleucina-6/sangre , Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Anciano , Humanos , Limitación de la Movilidad
6.
Medicine (Baltimore) ; 99(6): e19050, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028421

RESUMEN

The relationship between maximal muscle strength (MMS) and bone mineral density (BMD) in males remains unclear. Therefore, the aim of this cross-sectional study was to investigate the association of MMS, using 3 fundamental compound exercises, and body composition with BMD in Chinese male adults. One hundred forty-seven Chinese male adults aged 20 to 47 years were recruited. Total and regional BMD and body composition were measured using dual-energy X-ray absorptiometry. Measurements of MMS included bench press, deadlift, and squat 1-repetition maximum (1RM). Bench press, deadlift, squat 1RM, fat mass (FM), and lean mass (LM) had a significant positive association with BMD. Intriguingly, squat 1RM was found to have a stronger association than bench press or deadlift 1RM, whereas bench press 1RM was found as the strongest determinant of BMD at the forearm sites. Furthermore, LM was found to be stronger related with BMD than FM. Our findings identify LM, FM and MMS are positively associated with BMD and squat may serve as a simple, most efficient strategy to optimize peak total body BMD, while bench press fit best for forearm BMD. Our results validate the benefits of MMS training in males and underscores site-specific effects on BMD levels. These findings emphasize the need for prospective studies to investigate the maximum therapeutic potential and sex specific modifiers of MMS training.


Asunto(s)
Composición Corporal , Densidad Ósea , Fuerza Muscular , Adulto , Composición Corporal/fisiología , Densidad Ósea/fisiología , China , Estudios Transversales , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular/fisiología , Adulto Joven
7.
J Sports Sci ; 38(6): 597-606, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32005085

RESUMEN

When new protocols are developed, there is a requirement to investigate test-retest reliability of measures for valid use and interpretation of data in research and practice. Therefore, the aim of this investigation was to determine the inter-day reliability of the cable put and seated rotation assessment protocols. On three occasions, nine resistance-trained men performed cable puts and cable rotations at different loads between 6 and 42 kg on a commercially available cable cross over machine. Load stack movement was recorded using a PT5A linear position transducer from which all kinematic and kinetic variables were calculated. Reliability was excellent for peak velocity and displacement based on intraclass correlation coefficient (ICC) and coefficient of variation (CV) across the majority of loads and movements (cable put: ICC = 0.92 to 0.99, CV = 3.1% to 8.6%; cable seated rotation: ICC = 0.76 to 0.99, CV = -1.7% to 16.1%). However, kinetic variables demonstrated inadequate reliability across the majority of days, loads and movements (ICC = 0.70, CV >10%). It was concluded that peak velocity is a reliable kinematic measure to assess muscular capability from cable put and seated rotation protocols; however, kinetic measures are too variable to provide reliable outputs across testing occasions.


Asunto(s)
Prueba de Esfuerzo/métodos , Atletismo/fisiología , Adulto , Fenómenos Biomecánicos , Humanos , Cinética , Masculino , Fuerza Muscular/fisiología , Reproducibilidad de los Resultados , Entrenamiento de Resistencia , Rotación , Adulto Joven
8.
Medicine (Baltimore) ; 99(5): e18544, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32000363

RESUMEN

Most research on sedentary lifestyle has focused on pain and disability, while neuromuscular outcomes (postural control and strength) have received less attention. The objective of the study was to determine whether low level of physical activity is negatively associated with measures of lower body muscular strength and postural control in individuals with and without non-specific chronic low back pain (NSCLBP).Twenty-four subjects with NSCLBP (28.8 ±â€Š5.9 years) and 24 age, gender, and body mass index matched healthy controls participated in the study. Subjects were sub-classified into 4 subgroups based on their physical activity level: Non-active NSCLBP; Active NSCLBP; Non-active healthy control; and Active healthy control. Each subgroup consisted of 12 subjects. Peak force of hip muscles strength was assessed using a handheld dynamometer. Postural control was assessed using computerized posturography and the Y Balance Test.There was no significant group by physical activity interaction for strength and static and dynamic postural control, except for static control during left single leg stance with eyes closed (P = .029). However, there was a significant difference in strength and postural control by physical activity (P < .05). Postural control and peak force of hip muscles strength were significantly associated with physical activity (r ranged from 0.50 to 0.66, P < .001 and r ranged from 0.40 to 0.59, P < .05, respectively).Postural control and hip strength were independently related to physical activity behavior. A sedentary behavior may be an important risk factor for impaired postural control and hip muscles strength, and that physical fitness is vital to neuromuscular outcomes.


Asunto(s)
Dolor Crónico/fisiopatología , Ejercicio , Articulación de la Cadera/fisiopatología , Dolor de la Región Lumbar/fisiopatología , Fuerza Muscular , Músculo Esquelético/fisiopatología , Balance Postural , Adulto , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducta Sedentaria
9.
Unfallchirurg ; 123(3): 176-179, 2020 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-32030479

RESUMEN

BACKGROUND: Training under conditions of blood flow restriction (BFR) has recently been advocated as an option for alternative training in athletes. OBJECTIVE: Does BFR make sense in athlete training? MATERIAL AND METHODS: An overview of the currently available literature is given. RESULTS: The use of BFR appears to be a possibility to achieve muscle hypertrophy and an increase in muscular strength and can also improve parameters of cardiocirculatory function. CONCLUSION: Various approaches for implementation of BFR in athletes can be found in the literature. These approaches differ in the frequency, force used, duration and finally type of implementation of BFR itself. Clear recommendations for training cannot be given to date and the individual weighing up of possibilities and supervised implementation of BFR in athlete training by the trainer are still necessary.


Asunto(s)
Flujo Sanguíneo Regional , Entrenamiento de Resistencia , Deportes , Humanos , Fuerza Muscular , Músculo Esquelético
10.
PLoS One ; 15(1): e0219954, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31990914

RESUMEN

A new methodology was developed to quickly generate whole body models with detailed neck musculoskeletal architecture that are properly scaled in terms of anthropometry and muscle strength. This method was implemented in an anthropometric model generation software that allows users to interactively generate any new male or female musculoskeletal models with adjustment of anthropometric parameters (such as height, weight, neck circumference, and neck length) without the need of subject-specific motion capture or medical images. 50th percentile male and female models were developed based on the 2012 US Army Anthropometric Survey (ANSUR II) database and optimized with a novel bilevel optimization method to have strengths comparable to experimentally measured values in the literature. Other percentile models (ranging from the 1st to 99th percentile) were generated based on anthropometric scaling of the 50th percentile models and compared. The resultant models are reasonably accurate in terms of both musculoskeletal geometry and neck strength, demonstrating the effectiveness of the developed methodology for interactive neck model generation with anthropometric scaling.


Asunto(s)
Antropometría/métodos , Modelos Anatómicos , Sistema Musculoesquelético/anatomía & histología , Cuello/anatomía & histología , Adulto , Estatura , Peso Corporal , Femenino , Humanos , Contracción Isométrica/fisiología , Masculino , Fuerza Muscular/fisiología , Cuello/fisiología , Programas Informáticos
11.
Ann Hematol ; 99(3): 635-648, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31970448

RESUMEN

Patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) experience a considerable decline in physical and psycho-social capacity. Since whole body vibration (WBV) is known to efficiently stimulate the neuromuscular system and enhance cardiorespiratory fitness and muscle strength in frail individuals, we hypothesized that WBV would maintain various physical and psychological capacities in patients during alloHCT. Seventy-one patients were randomly allocated to either an intervention group (IG) doing WBV or an active control group (CG) doing mobilization exercises five times per week. We determined peak oxygen consumption (VO2peak) and maximum power, maximum strength, functional performance, body composition, quality of life (QoL), and fatigue. Tests were carried out before conditioning therapy, at hospital discharge and at day ± 180 (follow-up). As 18 patients did not participate in post-intervention assessment and follow-up data from 9 patients was not collectible, per-protocol (PP) analysis of 44 patients is presented. During hospitalization, WBV maintained maximum strength, height, and power output during jumping, as well as reported QoL, physical functioning, and fatigue level compared with mobilization. At follow-up, relative VO2peak (p = 0.035) and maximum power (p = 0.011), time and power performing chair-rising test (p = 0.022; p = 0.009), and reported physical functioning (p = 0.035) significantly increased in the IG, while fatigue decreased (p = 0.005). CG's body cell mass and phase angle had significantly decreased at follow-up (p = 0.002; p = 0.004). Thus, WBV might maintain maximum strength, functional performance, QoL, and fatigue during alloHCT, while cardiorespiratory fitness might benefit from accelerated recovery afterwards.


Asunto(s)
Composición Corporal , Trasplante de Células Madre Hematopoyéticas , Fuerza Muscular , Acondicionamiento Físico Humano , Calidad de Vida , Vibración , Adulto , Anciano , Aloinjertos , Femenino , Humanos , Masculino , Persona de Mediana Edad
12.
Int Heart J ; 61(1): 96-102, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31956152

RESUMEN

Heart failure (HF) is associated with aberrant skeletal muscle impairments, which are closely linked to the severity of HF. A low level of brain-derived neurotrophic factor (BDNF), a myokine produced in the skeletal muscle, is known to be involved in reduced exercise capacity and poor prognosis in HF. However, little is known about the factors or conditions of skeletal muscle associated with BDNF levels. We investigated the association between serum BDNF levels and the skeletal muscle mass and function in HF patients (n = 60, 63 ± 13 years) and age-matched controls (n = 29, 61 ± 16 years). The serum BDNF level was significantly lower in the HF patients compared to the controls (24.9 ± 0.9 versus 28.6 ± 1.3, P = 0.021). In a univariate analysis, BDNF was significantly correlated with the peak oxygen uptake, estimated glomerular filtration rate, 10-m gait speed, and muscle strength, but not with the body mass index or lean mass in the HF group. A multiple linear regression analysis revealed that BDNF was independently associated with muscle strength (ß-coefficient = 2.80, 95%CI: 1.89-11.8, P = 0.008). Serum BDNF levels were associated with exercise capacity and skeletal muscle function, but not with muscle mass. These novel findings may suggest that BDNF production is controlled by muscle function and activity and consequently regulates exercise capacity, highlighting the importance of adequate training regarding skeletal muscle in HF patients.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/sangre , Insuficiencia Cardíaca/fisiopatología , Músculo Esquelético/fisiopatología , Anciano , Índice de Masa Corporal , Estudios de Casos y Controles , Ejercicio/fisiología , Femenino , Barrera de Filtración Glomerular , Insuficiencia Cardíaca/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular , Análisis de Regresión
13.
Medicine (Baltimore) ; 99(2): e18609, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914039

RESUMEN

BACKGROUND: Cerebral palsy (CP) is a common disability in children featured with pathological gait and limb function limitation due to muscle weakness. Improving limb function and quality of life is currently considered to be highlighted. Physiotherapy is a chief component of rehabilitation for children with CP, correcting gait and improve walking capacity through muscle strength training. Standard rehabilitation programs for CP have not been determined. Core stability training (CST), which coordinates limb balance via trunk control, is widely used in sports competition. And it is gradually introduced into the rehabilitation of children with cerebral palsy with a positive impact on the patients' gait performance. By screening published literatures, this study aims to conduct a meta-analysis to systematically evaluate the effectiveness and safety of CST in gait of children with CP. METHODS: Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on CST in the treatment of children with CP were searched from 6 databases. Moreover, the reference lists of conference papers and included literatures will be manually searched to avoid omissions. Literature screening and data extraction were performed independently by 2 researchers. RCTs carry out the risk of bias analysis evaluation from seven aspects through the Cochrane Collaboration's risk of bias tool. Fixed or random effect model will be performed to analyze the outcomes. When higher heterogeneity occurs (I > 50%), the sensitivity or subgroup analysis will also be conducted to find potential factors. And the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is used for assessing the quality of evidence. RESULTS: The study will evaluate the effect of CST on gait of children with CP from multiple outcomes, including walking speed, endurance, stride length, and safety. CONCLUSION: Based on evidence-based medicine, the conclusion of this study can demonstrate the effectiveness and safety of CST in gait correction for children with CP. PROSPERO REGISTRATION NUMBER: PROSPERO CRD 42019134094.


Asunto(s)
Parálisis Cerebral/rehabilitación , Terapia por Ejercicio/métodos , Fenómenos Biomecánicos , Niño , Ensayos Clínicos como Asunto , Femenino , Humanos , Masculino , Metiltiouracilo , Fuerza Muscular , Proyectos de Investigación
14.
Medicine (Baltimore) ; 99(2): e18716, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914084

RESUMEN

BACKGROUND: Rotator cuff disease (RCD) consists of subacromial impingement syndrome, rotator cuff tendinopathy or tendinitis, partial or full rotator cuff tear, calcific tendinitis, and subacromial bursitis. Acupuncture has been suggested as a meaningful nonsurgical intervention for managing shoulder pain and dysfunction. However, previous reviews have not completely addressed the role of acupuncture in the management of RCDs. The objective of this systematic review is to evaluate the effectiveness and safety of acupuncture for managing symptoms in patients with RCD. METHODS: We will search the following databases from their inception to November 30, 2019: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine (AMED), Physiotherapy Evidence Database (PEDro), 3 Chinese databases (China Academic Journal Full-text Database (CAJ), China Doctoral Dissertations Full-text database and China Masters' Thesis Full-text Database), 6 Korean databases (Korean studies Information Service System (KISS), National Digital Science Library (NDSL), Research Information Sharing Service (RISS), Korean Medical Database (KMBASE), Korea Institute of Science and Technology Information (KISTI), Oriental Medicine Advanced Searching Integrated System (OASIS)), and 3 trial registries (ClinicalTrials.gov, International Standard Randomized Controlled Trials Number (ISRCTN) Registry, WHO International Clinical Trials Registry Platform (ICTRP)). We will include randomized controlled trials of acupuncture for RCD. There will be no restrictions related to setting or location. The primary outcome is pain intensity and shoulder dysfunction measured on validated scales within 12 weeks. Quality assessment will be performed using the Cochrane risk of bias tool. Dichotomous outcomes will be presented as risk ratios (RR), and continuous outcomes will be presented as weighted or standardized mean differences (SMD). Each outcome will be calculated with 95% confidence intervals. DISCUSSION: The updated evidence that would be provided by this review will offer useful information for patients and practitioners, and also have implications for future studies and the development of clinical practice guidelines of RCD.Registration: Open Science Framework (OSF) Preregistration. 2019, December 5. osf.io/n2e6t.


Asunto(s)
Terapia por Acupuntura/métodos , Manguito de los Rotadores , Síndrome de Abducción Dolorosa del Hombro/terapia , Dolor de Hombro/terapia , Tendinopatía/terapia , Terapia por Acupuntura/efectos adversos , Humanos , Fuerza Muscular , Ensayos Clínicos Controlados Aleatorios como Asunto , Rango del Movimiento Articular , Proyectos de Investigación , Evaluación de Capacidad de Trabajo
15.
Int J Sports Med ; 41(2): 82-88, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31902128

RESUMEN

Sex differences exist in vascular responses to blood pressure perturbations, such as resistance exercise. Increases in aortic stiffness following acute resistance exercise appear different between sexes, with attenuated increases in females vs. males. Whether sex differences exist in carotid stiffness, following resistance exercise is unknown. This study sought to examine sex differences in carotid stiffness, aortic stiffness, and hemodynamics following acute resistance exercise. Thirty-five participants (18 male) completed 3 sets of 10 repetitions of maximal isokinetic knee extension/flexion. Aortic stiffness and hemodynamics were estimated using an automated oscillometric blood pressure monitor at baseline, 5- and 30-min post-exercise. Carotid stiffness was assessed by ß-stiffness index, pressure-strain elastic modulus and arterial compliance using ultrasonography. Resistance exercise increased aortic stiffness, mean and systolic pressure at 5-min (p<0.01), and pressure-strain elastic modulus at 5-min in both sexes (p<0.05). Arterial compliance decreased at 5- and 30-min post exercise in both sexes (p<0.01). No interaction effects were detected in carotid stiffness, aortic stiffness, and hemodynamics, indicating similar vascular responses between sexes. Our findings indicate that the large arteries appear to stiffen similarly following resistance exercise in males and females when presented with similar blood pressure responses.


Asunto(s)
Arterias Carótidas/fisiología , Entrenamiento de Resistencia , Rigidez Vascular/fisiología , Adulto , Presión Sanguínea/fisiología , Composición Corporal , Módulo de Elasticidad/fisiología , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Rodilla/fisiología , Masculino , Fuerza Muscular/fisiología , Factores Sexuales , Adulto Joven
16.
Sports Health ; 12(2): 124-131, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31916920

RESUMEN

CONTEXT: Recent studies examining return to sport after traumatic shoulder instability suggest faster return-to-sport time lines after bony stabilization when compared with soft tissue stabilization. The purpose of the current study was to define variability across online Latarjet rehabilitation protocols and to compare Latarjet with Bankart repair rehabilitation time lines. EVIDENCE ACQUISITION: Online searches were utilized to identify publicly available rehabilitation protocols from Accreditation Council for Graduate Medical Education (ACGME)-accredited academic orthopaedic surgery programs. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 3. RESULTS: Of the 183 ACGME-accredited orthopaedic programs reviewed, 14 institutions (7.65%) had publicly available rehabilitation protocols. A web-based search yielded 17 additional protocols from private sports medicine practices. Of the 31 protocols included, 31 (100%) recommended postoperative sling use and 26 (84%) recommended elbow, wrist, and hand range of motion exercises. Full passive forward flexion goals averaged 3.22 ± 2.38 weeks postoperatively, active range of motion began on average at 5.22 ± 1.28 weeks, and normal scapulothoracic motion by 9.26 ± 4.8 weeks postoperatively. Twenty (65%) protocols provided specific recommendations for return to nonoverhead sport-specific activities, beginning at an average of 17 ± 2.8 weeks postoperatively. This was compared with overhead sports or throwing activities, for which 18 (58%) of protocols recommended beginning at a similar average of 17.1 ± 3.3 weeks. CONCLUSION: Similar to Bankart repair protocols, Latarjet rehabilitation protocols contain a high degree of variability with regard to exercises and motion goal recommendations. However, many milestones and start dates occur earlier in Latarjet protocols when compared with Bankart-specific protocols. Consequently, variability in the timing of rehabilitation goals may contribute to earlier return to play metrics identified in the broader literature for the Latarjet procedure when compared with arthroscopic Bankart repair. STRENGTH OF RECOMMENDATION TAXONOMY (SORT): Level C.


Asunto(s)
Artroscopía/rehabilitación , Lesiones de Bankart/cirugía , Terapia por Ejercicio/métodos , Inestabilidad de la Articulación/cirugía , Luxación del Hombro/cirugía , Artroscopía/métodos , Protocolos Clínicos , Ambulación Precoz , Humanos , Fuerza Muscular/fisiología , Rango del Movimiento Articular , Entrenamiento de Resistencia , Restricción Física , Volver al Deporte , Factores de Tiempo
17.
Artículo en Inglés | MEDLINE | ID: mdl-31948000

RESUMEN

Vibration rolling (VR) has emerged as a self-myofascial release (SMR) tool to aid exercise performance when warming up. However, the benefits of VR on exercise performance when combined with dynamic muscle contraction are unclear. The purpose of this study was to investigate the immediate effects of the combination of VR with dynamic muscle contraction (DVR), VR, and static stretching (SS) during warm-up on range of motion (ROM), proprioception, muscle strength of the ankle, and agility in young adults. In this crossover design study, 20 recreationally active adults without musculoskeletal disorders completed three test sessions in a randomized order, with 48 h of rest between each session. Participants completed one warm-up intervention and its measurements on the same day; different warm-up interventions and measurements were performed on each of the three days. The measurements included ankle dorsiflexion and plantarflexion ROM, ankle joint proprioception, muscle strength, and agility. After DVR and VR intervention, ankle dorsiflexion ROM (both DVR and VR, p < 0.001), plantarflexion ROM (both DVR and VR, p < 0.001), plantar flexor muscle strength (DVR, p = 0.007; VR, p < 0.001), and agility (DVR, p = 0.016; VR, p = 0.007) significantly improved; after SS intervention, ankle dorsiflexion and plantar flexion ROM (dorsiflexion, p < 0.001; plantar flexion, p = 0.009) significantly improved, but muscle strength and agility were not enhanced. Compared with SS, DVR and VR significantly improved ankle plantar flexor muscle strength (p = 0.008 and p = 0.001, respectively). Furthermore, DVR significantly improved ankle dorsiflexion compared with VR (p < 0.001) and SS (p < 0.001). In conclusion, either DVR, VR, or SS increased ankle ROM, but only DVR and VR increased muscle strength and agility. In addition, DVR produced considerable increases in ankle dorsiflexion. These findings may have implications for warm-up prescription and implementation in both rehabilitative and athletic practice settings.


Asunto(s)
Tobillo/fisiología , Contracción Muscular , Fuerza Muscular , Propiocepción , Rango del Movimiento Articular , Vibración/uso terapéutico , Ejercicio de Calentamiento , Adulto , Articulación del Tobillo , Estudios Cruzados , Humanos , Masculino , Músculo Esquelético/fisiología , Taiwán , Adulto Joven
18.
Sports Health ; 12(1): 80-87, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31710819

RESUMEN

BACKGROUND: The prevalence of musculoskeletal (MSK) conditions is increasing, and although current guidelines for physical activity attempt to combat this, many fail to achieve the recommended targets. The present study sought to investigate whether regular tennis participation is more effective at enhancing MSK function than meeting the current international physical activity guidelines. HYPOTHESIS: Tennis players will display significantly enhanced MSK function when compared with age-matched healthy active nonplayers. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: Ninety participants (age range, 18-65 years) took part in this study; there were 43 tennis players (18 men, 25 women) and 47 nonplayers (26 men, 21 women). MSK function was assessed by cluster analysis of 3 factors: (1) electromyographic fatigability of prime movers during handgrip, knee extension, and knee flexion; (2) isometric strength in the aforementioned movements; and (3) body composition measured by bioelectrical impedance analysis. Maximal oxygen uptake was also assessed to characterize cardiorespiratory fitness. RESULTS: Tennis players displayed significantly greater upper body MSK function than nonplayers when cluster scores of body fat percentage, handgrip strength, and flexor carpi radialis fatigue were compared by analysis of covariance, using age as a covariate (tennis players, 0.33 ± 1.93 vs nonplayers, -0.26 ± 1.66; P < 0.05). Similarly, tennis players also demonstrated greater lower extremity function in a cluster of body fat percentage, knee extension strength, and rectus femoris fatigue (tennis players, 0.17 ± 1.76 vs nonplayers, -0.16 ± 1.70; P < 0.05). CONCLUSION: The present study offers support for improved MSK functionality in tennis players when compared with age-matched healthy active nonplayers. This may be due to the hybrid high-intensity interval training nature of tennis. CLINICAL RELEVANCE: The findings suggest tennis is an excellent activity mode to promote MSK health and should therefore be more frequently recommended as a viable alternative to existing physical activity guidelines.


Asunto(s)
Músculo Esquelético/fisiología , Tenis/fisiología , Adolescente , Adulto , Anciano , Composición Corporal , Capacidad Cardiovascular/fisiología , Análisis por Conglomerados , Estudios Transversales , Femenino , Fuerza de la Mano , Humanos , Rodilla/fisiología , Masculino , Persona de Mediana Edad , Fatiga Muscular/fisiología , Fuerza Muscular/fisiología , Consumo de Oxígeno/fisiología , Adulto Joven
19.
J Stroke Cerebrovasc Dis ; 29(1): 104478, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31704124

RESUMEN

BACKGROUND AND PURPOSE: Vision, Aphasia, Neglect (VAN) is a large vessel occlusion (LVO) screening tool that was initially tested in a small study where emergency department (ED) nurses were trained to perform VAN assessment on stroke code patients. We aimed to validate the VAN assessment in a larger inpatient dataset. METHODS: We utilized a large dataset and used National Institute of Health Stroke Scale (NIHSS) performed by physicians to extrapolate VAN. VAN was compared to NIHSS greater than or equal to 6 and established prehospital LVO screening tools including Rapid Arterial Occlusion Evaluation scale (RACE), Field Assessment Stroke Triage for Emergency Destination (FAST-ED), and Cincinnati Pre-hospital Stroke Scale (CPSS). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under receiver operating characteristics curve was calculated to estimate the predictive value of LVO. RESULTS: VAN was comparable in sensitivity (79% versus 80%) and NPV (88% versus 87%) to NIHSS greater than or equal to 6. It was superior in specificity (69% versus 57%), PPV (53% versus 46%) and accuracy to NIHSS greater than or equal to 6 (72% versus 64%) with significant receiver operating curve (.74 versus .69, P = .02). VAN also had comparable area under the curve when compared to RACE, FAST-ED, and CPSS however slightly lower accuracy (69%-73%) compared to RACE (76%), FAST-ED (77%), and CPSS (75%). VAN had the highest NPV among all screening assessments (88%). CONCLUSIONS: VAN is a simple screening tool that can identify LVOs with adequate accuracy in hospital setting. Future studies need to be conducted in prehospital setting to validate its utility to detect LVOs in the field.


Asunto(s)
Afasia/diagnóstico , Isquemia Encefálica/diagnóstico , Técnicas de Apoyo para la Decisión , Evaluación de la Discapacidad , Debilidad Muscular/diagnóstico , Músculo Esquelético/inervación , Accidente Cerebrovascular/diagnóstico , Visión Ocular , Anciano , Anciano de 80 o más Años , Afasia/fisiopatología , Afasia/psicología , Isquemia Encefálica/fisiopatología , Isquemia Encefálica/psicología , Bases de Datos Factuales , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular , Debilidad Muscular/fisiopatología , Debilidad Muscular/psicología , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/psicología , Extremidad Superior
20.
Br J Sports Med ; 54(3): 183-187, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31704697

RESUMEN

OBJECTIVE: We performed a randomised controlled trial (RCT) in patients undergoing ACL reconstruction (ACLR) using either quadriceps tendon graft (QT) or semitendinosus/gracilis hamstring (STG) graft. We compared subjective outcome (primary outcome) and knee stability, donor site morbidity and function (secondary outcomes). METHODS: From 2013 to 2015, we included 99 adults with isolated ACL injuries in the RCT. Fifty patients were randomised to QT grafts and 49 to STG grafts and followed for 2 years. Patient evaluated outcomes were performed by subjective International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Kujala and Tegner activity scores. Knee laxity was measured with a KT-1000 arthrometer. Donor site morbidity was evaluated by the 'donor site-related functional problems following ACLR score'. One-leg hop test tested limp strength symmetry. RESULTS: At 2-year follow-up, there was no difference between the two graft groups regarding subjective patient outcome, knee stability and reoperations. Also, at 2 years, donor site symptoms were present in 27% of patients in the QT group and 50% of patients in the STG group. The donor site morbidity score was 14 and 22 for the QT and STG, respectively. Hop test demonstrated lower limp symmetry for QT graft than STG graft of 91% and 97% respectively. CONCLUSION: QT graft for ACLR did not result in inferior subjective outcome compared with STG graft. However, QT graft was associated with lower donor site morbidity than STG grafts but resulted in more quadriceps muscle strength deficiency than hamstring grafts. Both graft types had similar knee stability outcome. TRIAL REGISTRATION NUMBER: NCT02173483.


Asunto(s)
Reconstrucción del Ligamento Cruzado Anterior/métodos , Músculos Isquiotibiales , Músculo Cuádriceps , Tendones/trasplante , Adulto , Lesiones del Ligamento Cruzado Anterior/rehabilitación , Lesiones del Ligamento Cruzado Anterior/cirugía , Prueba de Esfuerzo , Femenino , Humanos , Inestabilidad de la Articulación , Masculino , Fuerza Muscular , Estudios Prospectivos , Reoperación , Resultado del Tratamiento , Adulto Joven
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