The effects of physical activity tele-counseling intervention on physical activity, functional performance, and quality of life in post-COVID-19 conditions: a randomized controlled trial.

BACKGROUND: This study aims to investigate the effectiveness of tele-counseling to promote physical activity in COVID-19 survivors at the persistent phase. METHODS: Twenty-eight participants who suffered from COVID-19 were randomly assigned to intervention and control groups. Physical activity counseling was applied according to the transtheoretical model to the intervention group during 20 sessions. Second assessments were performed 6 weeks after the intervention. The physical activity, functional performance (4-meter gait speed; 4-MGS and 5-repetition Sit-To-Stand; STS test), exercise behavioral change and processes, quality of life, fatigue, mental health, severity of symptoms, and dyspnea were evaluated in groups. RESULTS: The baseline demographic and clinical outcomes were similar (p > 0.05) except for physical role limitations and general health perceptions in groups. Five-repetition STS, 4-MGS, activity dyspnea, step counts, sitting time, physical role limitations, Exercise Processes of Change Scale (EPCS) total, and behavioral processes scores except for self-liberation significantly improved in the counseling group. Five-repetition STS, 4-MGS improved while dramatic relief, self reevaluation, self-liberation, and EPCS total scores deteriorated in the control group. CONCLUSIONS: The tele-counseling intervention contributes to improving physical activity, functional performance, behavioral change, quality of life, and decreasing common problems related to COVID-19. The results of the tele-counseling intervention are promising in post-COVID-19 conditions. TRIAL REGISTRATION (CLINICALTRIALS.GOV): Registration ID: NCT04853966.

Profile of Ankle Isokinetic Strength and Proprioception in Elite Female Handball Players / Perfil de Fuerza Isokinética del Tobillo y Propiocepción en Jugadoras de Balonmano de Élite

SUMMARY: The evaluation of the invertor and evertor muscle strength and proprioception are important in terms of determining the risk of injury in handball players. The aim of this study was to determine the isokinetic strength and proprioception profile of the ankle invertor and evertor muscles of elite female handball players. Fifteen elite female handball players were included. Ankle invertor and evertor muscle strength and proprioception were evaluated using the isokinetic system. The isokinetic strength test was performed in concentric mode at 30°/s (5 repetitions) and 120°/s (10 repetitions). Proprioception sense was evaluated as active joint position sense. There was no statistically significant difference between the dominant and nondominant sides in terms of invertor and evertor muscle strength, evertor/invertor (Ever/Inver) ratio, and active joint position sense at both angular speeds (p>0.05). The Ever/Inver ratio on both sides was lower than normal values. It was concluded that the female handball players showed bilateral symmetry in the invertor and evertor muscles. However, the fact that the Ever/Inver strength ratio was lower than normal values on both sides suggested that caution should be exercised in terms of risks such as ankle sprain or chronic ankle instability. Pre-season evaluations should be made and it would be beneficial to add strengthening exercises to related muscle groups in training programs to normalize the unilateral ratios in these athletes.

La evaluación de la fuerza muscular inversora y eversora y la propiocepción son importantes para determinar el riesgo de lesión en los jugadores de balonmano. El objetivo de este estudio fue determinar la fuerza isocinética y el perfil de propiocepción de los músculos inversores y eversores del tobillo de jugadoras de balonmano de élite. Se incluyeron 15 jugadoras de élite de balonmano. La fuerza muscular inversora y eversora del tobillo y la propiocepción se evaluaron mediante el sistema isocinético. El test de fuerza isocinética se realizó en modo concéntrico a 30º/s (5 repeticiones) y 120º/s (10 repeticiones). El sentido de propiocepción se evaluó como sentido activo de posición articular. No hubo diferencias estadísticamente significativas entre los lados dominante y no dominante en términos de fuerza muscular inversora y eversora, relación eversor/inversor (Ever/ Inver) y sentido activo de la posición de la articulación en ambas velocidades angulares (p>0.05). La relación Ever/Inver en ambos lados fue inferior a los valores normales. Se concluyó que las jugadoras de balonmano presentaron simetría bilateral en los músculos inversores y eversores. Sin embargo, el hecho de que la relación de fuerza Ever/Inver fuera inferior a los valores normales en ambos lados sugirió que se debe tener precaución en términos de riesgos como el esguince de tobillo o la inestabilidad crónica de tobillo. Se deben realizar evaluaciones de pretemporada y sería beneficioso agregar ejercicios de fortalecimiento a los grupos musculares relacionados en los programas de entrenamiento para normalizar las proporciones unilaterales en estas atletas.

Respiratory muscle strength in volleyball players suffered from COVID-19.

BACKGROUND: Symptoms related to Coronavirus-19 disease (COVID-19) and quarantine measures have caused pulmonary function abnormality and impaired respiratory mechanics. However, no studies are evaluating pulmonary functions and respiratory muscle strength in female volleyball players according to COVID-19 status in the pandemic. AIMS: This study aims to compare pulmonary functions and respiratory muscle strength in female players with and without COVID-19. METHODS: Seventeen players (23.47 ± 5.89 years) who were recovered from COVID-19 and 25 female volleyball players (20.48 ± 5.05 years) who were not infected by SARS-CoV-2 were included in the study. Maximal inspiratory and expiratory pressure, pulmonary functions, body composition, symptom severity, and perceptions of performance were evaluated. RESULTS: Measured and predicted percent maximal inspiratory pressure and measured maximal expiratory pressure values of COVID-19 players were statistically significantly lower than non-COVID-19 players (p < 0.05). Dynamic lung volumes were similar in groups (p > 0.05). CONCLUSIONS: Inspiratory and expiratory muscle strength in COVID-19 players were more affected compared with non-COVID-19 players. Pulmonary functions were mostly preserved in COVID-19 players. Respiratory muscle weakening can affect the performance of female players. Therefore, respiratory muscle strength training could be suggested in female players with COVID-19 to increase respiratory muscle strength and prevent deterioration in performance. TRIAL REGISTRATION (CLINICALTRIALS.GOV): Registration ID: NCT04789512.

An online pilates exercise program is effective on proprioception and core muscle endurance in a randomized controlled trial.

BACKGROUND: Proprioception is important for stability of body segments, postural control, and functionality. However, there are no studies in literature showing effects of online Pilates exercises that create proprioceptive inputs on vertebra on trunk proprioception. AIMS: This study aims to reveal effect of online Pilates exercises conducted on trunk proprioception and core muscle endurance in healthy individuals. METHODS: We included thirty-three healthy individuals between ages of 18 and 25 in study. Individuals were randomly divided into two groups. There were 17 individuals in Pilates group (PG), and 16 individuals in control group (CG). The PG was given online Pilates exercises by the physiotherapist in groups 3 days a week for 6 weeks, 1 h a day. There was no exercise program recommended for individuals in CG. We evaluated trunk proprioception with an inclinometer, core muscle endurance with three core endurance tests created by McGill, and prone bridge tests. All evaluations completed just before start of study and 2 days after 6-week training. RESULTS: Two groups had similar demographic characteristics, and there was no difference between baseline measurements (p > 0.05). While improvement observed in PG in trunk proprioception and all of core muscle endurance tests (p < 0.05), no statistically significant difference reported in CG (p > 0.05). CONCLUSIONS: We revealed that online Pilates exercises performed at mat level for 6 weeks in healthy individuals had positive effects on trunk proprioception and core muscle endurance with this study. Contribution of Pilates exercises to development of both muscular endurance and proprioceptive senses, even if performed at a distance, is important.

Muscle Activation Differences During Eccentric Hamstring Exercises.

BACKGROUND: The hamstring muscles play a critical role in the prevention of lower limb injuries. However, it is still unclear which exercises are more effective in terms of muscle activation. HYPOTHESIS: In healthy individuals, there are differences between muscular activations of the biceps femoris (BF), semitendinosus (ST), and semimembranosus (SM) muscles during eccentric hamstring exercises. STUDY DESIGN: Cross-sectional. LEVEL OF EVIDENCE: Level 2. METHODS: A total of 31 healthy participants (18 male; mean age, 22.5 years; SD, 3.1) were included in this study. The maximum voluntary isometric contraction of the hamstring muscles was measured using an isokinetic dynamometer. The participants were asked to perform one of the following exercises randomly (3 repetitions each): stiff-leg deadlift (SLDL), unilateral stiff-leg deadlift (USLDL), Nordic hamstring exercise (NHE), and ball leg curl (BLC). Activation of the BF, ST, and SM muscles was measured using surface electromyography during the exercises. In the statistical analysis of this study, factorial analysis of variance was used to compare the effects of each exercise on the muscle groups and to analyze which exercise type was more effective for each muscle group. RESULTS: The NHE led to higher muscle activation than the other exercises (P < 0.001). When exercise type and muscle interaction were examined, SM activation was lower than BF (P = 0.04) and ST (P = 0.001) during NHE (P < 0.05). The highest level of muscular activation was recorded during the NHE in both male and female participants. CONCLUSION: The NHE may be the most effective exercise for the hamstring muscles as it leads to greater muscle activation. SLDL, USLDL, and BLC exercises may be preferred at the beginning of strength training programs since they lead to lower muscular activation compared with the NHE. CLINICAL RELEVANCE: To select the optimum hamstring exercise, it is important to know the activation levels of the hamstring muscles during different eccentric exercises.

The acute effects of two different rigid taping methods in patients with hallux valgus deformity.

BACKGROUND: Hallux valgus (HV) is one of the most common deformities of the foot, and it causes great difficulties for the patients. OBJECTIVE: We aimed to investigate the effects of different rigid taping techniques on HV angle, foot motor performance, balance and walking parameters. METHODS: Twenty-two voluntary individuals (12 males, 10 females) with flexible HV deformities between 18 and 35 years of age were included in the study. All measurements were done before and after placebo, athletic and Mulligan tapings were applied. After a three-day interval, new taping was applied on the same subject. HV angle was measured by goniometer. Foot motor performance (single leg heel rise test), balance (unilateral stance, limits of stability, sensory integration of balance) and temporospatial parameters of gait (step length, stride length, step width, foot angle and cadence) were evaluated. RESULTS: HV angles were reduced in all taping groups (p< 0.05). The Mulligan taping method was the most effective method in reducing HV angle. Foot motor performance was not affected by any type of taping (p> 0.05). Athletic taping increased step length and step width but reduced foot angle and cadence. The Mulligan taping increased cadence and reduced foot angle (p< 0.01). Both taping methods did not affect the postural stability and fall risk (p> 0.05). Stability limits were increased in Mulligan taping group (p< 0.05). CONCLUSION: It can be concluded that Mulligan taping method may be an alternative treatment method for HV rehabilitation especially as it increased the limits of stability and maintaining the balance. Mulligan method is more effective than athletic taping in terms of reducing instant HV angle.

The effects of acute L-carnitine supplementation on endurance performance of athletes.

This study examined the effect of acute L-carnitine loading on the endurance performance of footballers. Measurements were performed on 26 candidate professional footballers who volunteered to take part in the study. Athletes were given a glass of fruit juice 1 hour before applying L-carnitine with the double-blind method. Then, 12 participants were given 3 g of L-carnitine (LK-3) and the remaining 14 were given 4 g (LK-4). Athletes began the exercise test at a running speed of 8 km·h and then continued at 10 km·h. The speed was increased 1 km·h every 3 minutes, and the test continued until the subject chose to quit. Heart rate was registered using a portable telemetric heart rate monitor during the test. Blood samples were taken from the earlobes of the footballers both before the test and before the speed increase (during the 1-minute interval), and the lactate (La) concentration was measured electroenzymatically. The test was repeated after 1 week as a group of placebos (P-3 and P-4). The result showed that the running speeds corresponding to specific La concentrations were increased, and La and heart rate responses to the running speeds were decreased in both supplemented groups compared with placebos (p ≤ 0.05). A significant reduction in heart rate was found in LK-4 and P-4 (p ≤ 0.05). When the Borg responses to the running speeds were analyzed, a significant difference was found in both supplemented groups (p ≤ 0.05). The results show that 3 or 4 g of L-carnitine taken before physical exercise prolonged exhaustion.

Malpractice leading to secondary lymphedema after radical mastectomy: case report.

BACKGROUND: With this case report we want to demonstrate the results of chemotherapy application to the mastectomized side in a patient who had undergone radical mastectomy. CASE REPORT: A patient who was accidentally given chemotherapy on the mastectomized side (PCMS) and a control patient who received chemotherapy on the non-affected side (PCNS) were included in this study. Edema, pain, muscle strength, and shoulder mobility were evaluated. The results of the 2 patients were compared. After chemotherapy, PCMS experienced edema and pain in the affected arm compared to PCNS. Increased circumference measurement, and decreased shoulder mobility and muscle strength were observed in PCMS. CONCLUSION: It was suggested that chemotherapy application on the mastectomized side triggered lymphedema. Our findings on the subject revealed that education of health care professionals and patients alike is very important.

Effects of acute L-carnitine intake on metabolic and blood lactate levels of elite badminton players.

OBJECTIVES: Purpose of this study is to research the effects of acute L-Carnitine intake on badminton players' metabolic and blood lactate values. DESIGN: A total of 16 Turkish national badminton players (8 male, 8 female) were voluntarily participated into study. MaxVO2, MET, energy consumption, HR (heart rate), VE (minute ventilation), R (respiratory exchange ratio), AT (anaerobic threshold), oxygen pulse and blood lactate (LA) of subjects were measured by Sensormedics VmaxST and Accutrend Lactate Analyzer. The participants were subjected to the test protocol twice before and after 2g of L-Carnitine intake. The data were evaluated by the use of SPSS 13.0 for Windows. RESULTS: No significant differences were found between 1st. (without L-Carnitine intake) and 2nd. (with L-Carnitine intake) measurements of female participants as regards to all measured parameters. There was a significant difference in EMHR (exercise maximum heart rate) of males between two measurements (p<0.05). However the differences in other parameters were not significant. AT values of female subjects were not significant difference (p>0.05). Respiratory exchange ratio of males was significantly different at anaerobic threshold (p<0.05). CONCLUSION: Results of this study show that L-carnitine intake one hour prior to the exercise has no effect on the metabolic and blood lactate values of badminton players.