Absolute Reliability and Concurrent Validity of Hand-Held Dynamometry in Shoulder Rotator Strength Assessment: Systematic Review and Meta-Analysis.

The purpose of this study is to establish the absolute reliability between hand-held dynamometers (HHDs) and concurrent validity between HHDs and isokinetic dynamometers (IDs) in shoulder rotator strength assessment. The Medline, CINAHL, and Central databases were searched for relevant studies up to July 2020. Absolute reliability was determined by test-retest studies presenting standard error of measurement (SEM%) and/or minimal detectable change (MDC%) expressed as percentage of the mean. Studies considering intra-class correlation coefficient (ICC) between IDs and HHDs were considered for concurrent validity. The risk of bias and the methodological quality were evaluated according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Thirteen studies were included in the meta-analysis. Shoulder internal rotator strength assessment MDC% was 0.78%, 95% confidence interval (CI) -5.21 to 3.66, while shoulder external rotators MDC% was 3.29%, CI -2.69 to 9.27. ICC between devices was 0.94, CI (0.91 to 0.96) for shoulder internal rotators and 0.92, IC (0.88 to 0.97) for shoulder external rotators. Very high correlation was found for shoulder rotator torque assessment between HHDs and IDs. The COSMIN checklist classified the selected studies as adequate and inadequate.

Reliability of Low-Cost Near-Infrared Spectroscopy in the Determination of Muscular Oxygen Saturation and Hemoglobin Concentration during Rest, Isometric and Dynamic Strength Activity.

BACKGROUND: The objective of this study was to establish the reliability of the Humon Hex near-infrared reflectance spectroscopy (NIRS) in determining muscle oxygen saturation (SmO2) and hemoglobin concentration (Hgb) at rest and during isometric and dynamic strength exercises using a functional electromechanical dynamometer (FEMD). METHODS: The SmO2 and Hgb values of sixteen healthy adults (mean ± standard deviation (SD): Age = 36.1 ± 6.4 years) were recorded at rest and during isometry (8 s), dynamic strength I (initial load of 40% of the average isometric load, with 2 kg increments until muscle failure) and dynamic strength II (same as I, but with an initial load of 40% of the maximum isometric load) activity. To evaluate the reliability in the determination of SmO2 and Hgb of this device, intraclass correlation coefficient (ICC), standard error of measurement (SEM) and coefficient of variation (CV) were obtained. RESULTS: The main results obtained are SmO2 at rest (CV = 5.76%, SEM = 3.81, ICC = 0.90), isometric strength (CV = 3.03%, SEM = 2.08, ICC = 0.92), dynamic strength I (CV = 10.6, SEM = 7.17, ICC = 0.22) and dynamic strength II (CV = 9.69, SEM = 6.75, ICC = 0.32); Hgb at rest (CV = 1.97%, SEM = 0.24, ICC = 0.65), isometric strength (CV = 0.98%, SEM = 0.12, ICC = 0.96), dynamic strength I (CV = 3.25, SEM = 0.40, ICC = 0.54) and dynamic strength II (CV = 2.74, SEM = 0.34, ICC = 0.65). CONCLUSIONS: The study shows that Humon Hex is a reliable device to obtain SmO2 and Hgb data in healthy adult subjects at rest and during isometric strength, providing precision for measurements made with this device.

Behavior of the muscle quality index and isometric strength in elderly women.

This study aimed (I) to compare the muscle quality index (MQI) and the isometric hip strength between younger and older women, and (II) to determine the relationship of the MQI with the sit-to-stand test (STS) and isometric hip strength in younger and older women. Twenty-eight elderly women (age= 66.2 ± 5.6 years) and twenty younger women (21.2 ± 2.2 years) participated in the study. The following dependent variables were measured: MQI, STS, body composition, and the peak isometric strength of the hip (PF) which was also normalized using three different methods (PF/Body Mass, PF/Fat-Free Mass, and PF/Body Mass0,335). Older women presented a lower PF in hip flexion, extension and external rotation regardless of the method of normalization (p < 0.001), but the PF of hip abductors and internal rotators was higher for older women (p < 0.05). No significant differences were found in the MQI between older and younger women (p = 0.443). The MQI was negatively correlated with the time in the STS in older women (r = -0.706, p < 0.001) and younger women (r = -0.729, p < 0.001), while the correlations of MQI with isometric hip strength were weaker in older women (r range: -0.082 - 0.556) and younger women (r range: -0.020 - 0.309). MQI is a clinical and practical tool to assess the muscular power of the lower extremities.

[Colleges of royal physicians and isolation hospitals to control public hygiene in Chile from 1879 to 1920]. / Protomedicatos y lazaretos como instituciones de control de la higiene pública en Chile entre 1879 y 1920.

This article investigates the emergence of two institutions for the control of public hygiene in Chile between 1879 and 1920: colleges of royal physicians and isolation hospitals using the case of smallpox in La Araucanía, a region located in the South of Chile. We cover the characteristics and context of these institutions that allowed the State of Chile to address the problems of public hygiene and to prompt health professionals to professionalize the practice of medicine. The liberal positivist state of the late nineteenth century understood that the issue of hygiene was not only a matter of individual responsibility but had a social, public, and environmental dimension. People practiced hygiene alongside the existence of hygienic and anti-hygienic environments. Therefore, hygiene, the royal colleges of physicians, health records, isolation hospitals, doctors, and vaccinators are studied. All of these components of the health care system of the time were in permanent tension with the central government authorities due to the insufficient resources provided by the state for the care of infected patients with smallpox. The study follows a qualitative methodology with a descriptive historiographic design. We used archival primary and secondary sources available in Chile and Germany. The results show that the presence of smallpox appeared ferociously in South-Central Chile in the second half of the 19th century and remained in La Araucanía until the first half of the 20th century. The extent to which smallpox spread, spawning fear and insecurity in people of different social classes, had as one of its leading causes the precarious conditions of health and hygiene of the population.

El presente artículo indaga la aparición de dos instituciones de control de la higiene pública en Chile entre los años 1879 y 1920: los protomedicatos y lazaretos. El objeto de estudio utiliza como caso la presencia de la viruela en La Araucanía. Se abordan las características y contexto que adquirió la instalación de estos dispositivos que permitieron al Estado de Chile operacionalizar el asunto de la higiene pública, lo que interpeló a los profesionales de la salud para avanzar a mayores niveles de perfeccionamiento del ejercicio profesional de la medicina. El Estado liberal positivista de fines de siglo XIX comprendió que el tema de la higiene no era solamente una cuestión de responsabilidad individual, sino que tenía una dimensión social, pública y medio ambiental. No sólo había personas que eran higiénicas, sino también ambientes higiénicos y antihigiénicos. Por tanto, se estudia la higiene, el tribunal del protomedicato, la hoja sanitaria, lazaretos, médicos y vacunadores; quienes estuvieron en permanente tensión con las autoridades del gobierno central debido a los insuficientes recursos proporcionados por el Estado para la atención de los enfermos contagiados con viruela. El estudio se orienta desde una metodología cualitativa con un diseño historiográfico con alcances descriptivos densos. Se han utilizado fuentes primarias y secundarias disponibles en archivos en Chile y Alemania. Los resultados evidencian que la presencia de viruela apareció violentamente en el centro sur de Chile en la segunda mitad del siglo XIX y permaneció en la Araucanía hasta la primera mitad del siglo XX. La violencia con que se desarrolló la viruela generó miedo e incertidumbre afectando a personas de diferentes clases sociales, y tuvo como una de sus causas principales las precarias condiciones de salubridad de la población.

Punción seca y cambios en la actividad muscular en sujetos con puntos gatillo miofasciales: serie de casos / Dry needling and changes in muscular activity in subjects with myphastial trigger points: case series

Introducción: Los puntos gatillo miofasciales (PGM) son una causa importante de dolor musculoesquelético que se defi nen como un dolor localizado, expresado en una banda de fibra muscular tensa, hiperirritable, que puede ser referido a zonas distantes. Objetivo: Describir el efecto inmediato de la punción seca (PS) sobre la actividad muscular y la intensidad de dolor en sujetos con puntos gatillo miofasciales en el trapecio superior. Métodos: Se seleccionó una muestra de 36 participantes con diagnóstico PGM latentes. Se les realizó una intervención con punción seca y se midieron las variables de dolor con EVA y actividad muscular del trapecio superior con electromiografía antes y después de la intervención en un gesto de alcance anterior. Resultados: Posterior a la aplicación de PS, la actividad muscular disminuyó en un 4,53 % (p = 0,002), el dolor en un 1,53 cm (p = 0,000). Conclusión: La aplicación PS tiene un efecto inmediato en la disminución de la actividad muscular y el dolor en PGM latente en el trapecio superior durante un alcance funcional anterior

Introduction: Myofascial trigger points (MTP) are an important cause of musculoskeletal pain and are defi ned as localized pain, expressed in a band of hyperirritable tense muscle fiber that can be referred to distant areas. Objective: To describe the immediate effect of dry needling (DN) on muscle activity and pain intensity in subjects with myofascial trigger points in the upper trapezius. Methods: A sample of 36 participants with latent PGM diagnosis was selected. They underwent an intervention with dry puncture and the variables of pain with VAS and muscular activity of the upper trapezius were measured before and after the intervention in a gesture of anterior reach. Results: After the application of DN, muscle activity decreased by 4.53 % (p = 0.002), pain by 1.53 cm (p = 0.000). Conclusion: The DN application has an immediate effect on the decreased muscle activity and pain in latent PGM in the upper trapezius during a previous functional range

Una visión compleja sobre la etiología de las enfermedades / A complex perspective on the etiology of diseases

Resumen A pesar de que el objetivo de las investigaciones en ciencias médicas es alcanzar un mayor conocimiento de cómo el cuerpo y su funcionamiento se relacionan con los patrones disfuncionales y cómo estos generan patologías, la mayoría de los esfuerzos se centran en preguntas usando datos cada vez más detallados. Sin embargo, podría ser posible abordar con éxito a los usuarios mediante una mirada más amplia de mecanismos corporales desde una perspectiva global y pensando en cómo las disfunciones o patologías pueden influir desencadenando otros problemas. El cuerpo se puede entender como un sistema o una red compleja en la que los patrones disfuncionales surgen de la interacción entre múltiples niveles físicos y funcionales. El logro de un mayor progreso con los usuarios dependerá, en lo fundamental, de las propiedades y relaciones de las patologías, disfunciones y herramientas que están disponibles o se deban desarrollar con el fin de estudiar los mecanismos de patología-disfunción.

Abstract Although the goal of medical research is to understand better how the body and its functioning relate to dysfunctional patterns and how they generate pathologies, most current efforts focus on small questions using increasingly detailed data. However, it might be possible to successfully approach patients by taking a broader look at body mechanisms, from a global perspective, and thinking about how dysfunctions or pathologies can trigger other problems. The body can be understood as a complex system or network in which dysfunctional patterns arise from the interaction between multiple physical and functional levels. Achieving greater progress with patients will depend, fundamentally, on the properties and relationships of pathologies, dysfunctions and tools that are available or should be developed in order to study pathology-dysfunction mechanisms.

Methods of evaluating the force-velocity profile through the vertical jump in athletes: a systematic review / Métodos de evaluación del perfil fuerza-velocidad a través del salto vertical en deportistas: una revisión sistemática

Introduction: In the world of sport, the ability of humans to develop maximum muscular power (Pmax) is directly related to performance and sporting success. For this, the measurement of the force- velocity profile (F-v) plays a key role in the evaluation of the athlete. At present, there are different methodologies and technologies to assess this profile, with sprint and vertical jump being the most used forms. The objective of this review is to identify and analyze different methods and tools for assessing F-v profile through the vertical jump. Methods: A search was carried out on the following databases, PubMed, SPORTDiscus, and Web of Science, of papers published between January 2010 and August 2017. The search terms were as follows: strength, speed, profile, vertical jump, squat jump (SJ), countermovement jump (CMJ), sports, strength training, resistance training, and all possible combinations of the above. Methodological quality was assessed using the PEDro scale. Results: Nine out of a total of 254 articles met the criteria for inclusion: six of them evaluated the F-v profile using a force platform, while three used the photocell system. Analysis of their evaluation methods revealed that of the six studies using the force platform, one used the SJ as an assessment measure, two used the CMJ and three used both methods; all three studies using the photocell system used the SJ as the method of assessment. Conclusion: The instruments most often used to evaluate the F-v profile are the force platform and the photocell system. Nevertheless, other new and interesting technologies exist that are capable of evaluating the vertical jump. for example, through mobile applications

Introducción: En el mundo del deporte, la capacidad que tiene el ser humano para desarrollar la máxima potencia muscular (Pmáx) está directamente relacionada con el rendimiento y éxito deportivo. Para ello, la medición del perfil fuerza velocidad (F-v) cumple un rol clave dentro de la evaluación del deportista. En la actualidad existen diversas metodologías y tecnologías para valorar este perfil, siendo el sprint y el salto vertical las formas más utilizadas. El objetivo de esta revisión es identificar y analizar diferentes métodos e instrumentos de evaluación del perfil F-v a través del salto vertical. Método: La búsqueda se realizó en las siguientes bases de datos: PubMed, SportDiscus y Web of Science, entre enero del 2010 hasta agosto del 2017. Los términos de búsqueda fueron los siguientes; Fuerza, velocidad, perfil, salto vertical, Squat Jump (SJ), Countermovement Jump (CMJ), deportes, entrenamiento de fuerza, entrenamiento de resistencia y sus posibles combinaciones. La calidad metodológica fue evaluada a través de la escala PEDro. Resultados: Nueve de los 254 artículos encontrados cumplieron con los criterios de inclusión al estudio, de los cuales, 6 evaluaron el perfil F-v a través de una plataforma de fuerza y 3 mediante el sistema de fotocélulas. En el análisis de los métodos de evaluación, de los 6 estudios que evaluaron el perfil F-v con plataforma de fuerza, uno lo hizo a través del SJ, dos a través del CMJ y tres utilizaron ambos métodos, mientras que de los tres estudios que valoraron el perfil F-v con el sistema de fotocélulas, todos usaron el SJ como método de evaluación. Conclusión: Los instrumentos más utilizados para la evaluación del perfil F-v son; Plataforma de fuerza y fotocélulas, sin embargo, existen nuevas tecnologías capaces de evaluar el salto vertical, por ejemplo, a través de aplicaciones móviles

Efectividad de ejercicios submaximales versus protocolo convencional en el rango de movimiento glenohumeral tras reparación artroscópica del supraespinoso / Effectiveness of submaximal exercise versus conventional protocol on range of movement glenohumeral after arthroscopic repair of supraspinatus

OBJETIVO: Determinar si la aplicación precoz de un programa de ejercicios submaximal, disminuye el dolor y aumenta el rango de movimiento glenohumeral en comparación a un protocolo convencional, en sujetos sometidos a artroscopia del supraespinoso. MATERIAL Y MÉTODO: El presente estudio corresponde a un diseño casi experimental, longitudinal y prospectivo. La muestra contó con 30 sujetos, con un promedio de edad de 52,8 años. Los sujetos se dividieron aleatoriamente por sorteo simple. Un grupo recibió un protocolo de ejercicios submaximales de forma precoz, y el otro, péndulo de Codman. Las variables analizadas fueron: dolor y rango de movimiento glenohumeral. RESULTADOS: Ambos grupos mostraron diferencias estadísticamente significativas al término de las intervenciones para todas las variables (p < 0,05). Al comparar la efectividad entre ambos tratamientos, la rehabilitación submaximal precoz mostró una disminución del dolor y un aumento en la rotación externa glenohumeral estadísticamente significativa en comparación con el tratamiento con péndulo de Codman (p = 0,004 p = 0,001 respectivamente). DISCUSIÓN: Estudios hechos han establecido un margen seguro para la activación del manguito rotador, menor al 20% de la contracción voluntaria máxima para tendones reparados mediante cirugía. Nuestros resultados arrojan que este protocolo de ejercicios que cumple con esos niveles de activación aplicados de forma precoz, muestran beneficios sobre el rango y el dolor. CONCLUSIONES: La aplicación de un programa de ejercicio submaximal de forma precoz, podría disminuir el dolor y aumentar los rangos de flexión, abducción y rotación externa glenohumeral, disminuyendo las complicaciones de la inmovilización.

OBJECTIVE: Determine if the application of an early submaximal exercise program reduces pain and increases the glenohumeral joint range of motion in comparison to a conventional protocol, in subjects with supraspinatus arthroscopic surgery. METHOD: The present study corresponds to a prospective quasi-experimental longitudinal design study. The sample was formed by 30 subjects, with a mean aged of 52,8 years old. The subjects were randomly divided by a simple draw. One of the groups received the early submaximal exercise protocol, and the other the Codman pendulum exercises. The analyzed variables were; pain, glenohumeral range of motion. RESULTS: Both groups showed significant statistical differences for all variables at the end of the intervention (p < 0.05). When the effectiveness of both treatments were compared, the early submaximal rehabilitation showed a significant statistical difference in pain decreased, and an increased in glenohumeral external rotation, in comparison to the Codman pendulum treatment plan (p = 0.004 and p = 0.001 respectively). DISCUSSION: Studies have established a secure margin for the rotator cuff activation of less than 20% of maximal voluntary contraction for the surgery repaired tendons. Our results show that this exercise protocol complies with these levels of activation when applied in an early stage, show benefits in range of motion and pain. CONCLUSSIONS: The application on an early submaximal exercise program might decrease pain and increased glenohumeral flexion, abduction and external rotation range of motion, decreasing the complication due to immobilization.