Statistical Parametric Mapping to detect the effects of the secondary jump direction on landing kinematics.

Anterior cruciate ligament (ACL) injuries in sports often occur with non-contact mechanisms, such as landing and cutting. Previous studies explored the ACL injury biomechanical risk factors through drop-jumps combined with secondary jumps. This study aimed to investigate the effect of the secondary jump direction on first landing kinematic temporal series. Fifty-seven participants (29 males, 28 females) performed three single-leg drop-jumps followed by secondary jumps in vertical (single-planar), 45°-medial and 45°-lateral direction (multi-planar). Lower limb and trunk landing kinematics was recorded using a 9-camera motion capture system and analysed with a One-way ANOVA through Statistical Parametric Mapping (SPM), from initial contact to maximum knee flexion. All variables were affected by the secondary jump direction, except trunk rotation. In sagittal plane, kinematic main differences were found between single- and multi-planar tasks. The latter elicited higher trunk, hip, and knee flexion. Frontal plane kinematics was more influenced by medio-lateral components of secondary jumps. Our results could underline how a single task may be insufficient for ACL injury risk assessment. Single- and multi-planar tasks including a secondary jump should be considered for more comprehensive evaluations in prevention and rehabilitation programs, but caution should be used when comparing results of studies adopting different tasks.

Soccer and volleyball players do not land differently: implications for anterior cruciate ligament injury risk.

BACKGROUND: Non-contact anterior cruciate ligament injuries are common in soccer and volleyball, occurring during changes of direction and landings. This study aimed to investigate kinematic differences between soccer and volleyball players in single-planar and multiplanar landing tasks, simulating sport-specific injury mechanisms. Since the anterior cruciate ligament injury rate in soccer is higher than in volleyball, we hypothesized that volleyball players would adopt safer landing strategies, especially in single-planar landing tasks. METHODS: Twenty-two soccer and 19 volleyball players performed single-leg drop landing, drop jump in vertical, 45°-medial and 45°-lateral directions. Box height and jump length were adapted to the subject's height and performance level, respectively. A 9-camera motion capture system provided lower limb kinematics. Two mixed multivariate analyses of covariance (sport, task, sex as covariate) were used to compare soccer and volleyball players' initial contact and peak kinematics (α=0.05). RESULTS: Task had significant effects on lower limb initial contact and peak angles, as expected. Sport and task × sport interaction had no significant effects on kinematics. CONCLUSIONS: Soccer and volleyball players' landing strategies were thus similar in each task, in opposition to initial hypotheses. We might speculate that the higher anterior cruciate ligament injury rate in soccer may be more related to non-predictable factors than the isolated landing kinematics.

Customized Landing Task for ACL Injury Risk Assessment: Kinematic Sex-Related Differences.

BACKGROUND: Women present a higher anterior cruciate ligament (ACL) injury rate than men, suggesting sex-related biomechanical differences. Task characteristics are often fixed for both sexes, possibly affecting the perceived difficulty. We investigated kinematic sex differences across landing tasks for ACL injury risk assessment, adjusted to participants' anthropometrics/performance, and whether different tasks affect kinematic sex comparisons. HYPOTHESIS: Female subjects would exhibit motion patterns more associated with ACL injury risk, and sex-related differences may depend on task type. STUDY DESIGN: Descriptive laboratory study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 27 female and 29 male amateur players (18-30 years) executed horizontal hop, drop jump (DJ), and DJ followed by vertical or forward jump (length, proportional to maximal forward jump; box, 20% participant's height). An optoelectronic system provided lower limb kinematics at initial contact and peaks until maximum knee flexion (KF), analyzed separately by multivariate analysis of variance (MANOVA) (α = 0.05). RESULTS: At initial contact, the interaction term had significant effects on hip adduction (P < 0.01) and knee abduction (KAb) (P = 0.04); female participants demonstrated higher KAb (P < 0.01) and knee internal rotation (P = 0.05). For peaks analysis, the interaction term had no significant effects on any individual variable, although significant in MANOVA; female participants had higher KAb (P = 0.01) and lower KF (P = 0.04). Task type affected hip flexion and knee angles in both analyses. CONCLUSION: All variables in which significant sex-related differences were found are potential ACL injury risk factors, and all findings indicate that the analyzed female sample exhibited higher injury-related patterns. Although customized, male and female participants showed different landing strategies depending on the task. CLINICAL RELEVANCE: The findings underline how female participants adopted potentially harmful kinematics while executing customized landing tasks (adjusted by subject's anthropometrics/performance), which may enhance risk of ACL injury.

COVID-19 in older adult residents in nursing homes: factors associated with mortality and impact on functional capacity.

Objective: To verify if the functional capacity prior to COVID-19 infection was different between Survivor and Non-survivor older adults. Also, to verify the effect of the isolation period after COVID-19 infection on the functional capacity of the Survivors residing in nursing homes. Materials and methods: Older adults residing in nursing homes were evaluated 30 days before the COVID-19 outbreak at the site for (i) general health characteristics (obtained from medical records); (ii) gait speed, handgrip strength and 30-s sit-to-stand; (iii) sarcopenia and (iv) estimated muscle mass. Comparisons were made between Survivors and Non-survivors of COVID-19. After the isolation, the Survivors performed the assessments again. Results: Twenty-one (81 ± 9.3 years) participants tested positive for COVID-19 and participated in the study, 12 survivors. No difference was observed between Survivors and Non-survivors in any of the outcomes evaluated. However, a moderate effect size was observed for handgrip strength, with lower values for the Non-survivors group (- 16%; d = 0.53). The isolation period reduced the number of sit-to-stand repetitions with moderate effect size in the Survivors (p = 0.046, gav = 0.66). Conclusion: Although the null hypothesis analysis did not find significant differences between the groups, the effect size suggests that older adults residing in nursing homes who died from COVID-19 had lower handgrip strength. In the survivors, the isolation period after COVID-19 infection only negatively impacted the sit-to-stand performance.

Are proximal and distal neuromuscular parameters able to predict hip and knee frontal plane kinematics during single-leg landing?

OBJECTIVE: To determine if proximal and distal neuromuscular parameters (EMG amplitude and median frequency - MDF) can predict frontal plane kinematics during single-leg landing. STUDY DESIGN: Cross sectional study. SETTING: Laboratory. PARTICIPANTS: Fifteen participants (7 female) performed six single-leg landings with measures of frontal plane kinematics and EMG obtained 230 ms after first foot contact, totalizing 90 landings. MAIN OUTCOME MEASURES: (i) 2D hip adduction [hip ADD] and knee frontal plane projection angle [knee FPPA]; (ii) EMG amplitude and MDF of gluteus medius [GMed], tensor fascia latae [TFL], peroneus longus [PL] and tibialis anterior [TA]. RESULTS: We observed that MDF of TA was a significant predictor of hip ADD (p = 0.037; ß = -0.049 Hz; R2c = 0.30). Also, MDF of PL was significant predictor of knee FPPA (p = 0.043; ß = 0.042 Hz; R2c = 0.37). Hip muscles and EMG amplitude parameters were not considered predictors of frontal plane kinematics. CONCLUSION: The firing frequency of ankle muscles predicted the variance of hip and knee frontal plane kinematics during single-leg landing.

Association Between Success and Unsuccess Rates on Technical Skills and Physical Qualities in Rugby Players.

Purpose: Although physical and technical performance are both fundamental in rugby union teams, the association between these variables in sub-elite players is limited. This study investigated the association between the rate of success and unsuccess in technical skills throughout a season with physical quality variables in sub-elite rugby players. Methods: Twenty-five sub-elite rugby union players (age: 26.4 ± 3.8 years; body mass: 99.68 ± 14.34 kg; height: 1.81 ± 0.07 m) completed the following assessments: (i) broad jump; (ii) 10- and 30-meters sprint speed; (iii) 5-10-5 test; (iv) 1 RM of bench press, chin-up and squat and (v) Yo-Yo fitness test. The rate of success and unsuccess in tackles, attacking rucks and carries were measured during a season. Results: We found that: (i) higher success rates in carries were associated with faster speeds and greater broad jump distance; (ii) higher unsuccess rates in tackles were associated with lower 1 RM chin-up. When controlling for playing position, (iii) higher success rates in carries were associated with 30-meters speed and broad jump distance; (iv) higher success rates in tackles were associated with higher 1 RM chin-up; and (v) higher unsuccess rates in tackles were associated with lower 1 RM chin-up. Conclusions: Success and unsuccess rates in attacking rucks and success in carries were not associated with physical qualities. Therefore, training programs that improve speed, lower limb power and upper limb maximal strength should receive greater attention when seeking to achieve greater success in trying to break the opponent's defensive line and stop the ball carrier.

Foot dominance and ball approach angle affect whole-body instep kick kinematics in soccer players.

Past investigations provided limited information regarding instep kicking kinematics in soccer. It is unclear how foot dominance and ball approach angle impact whole-body kinematics and consequently the ball velocity. We aimed to analyse the effects of the ball approach angle and the foot used on the whole-body kinematics of soccer players performing an instep kick. Twenty-four soccer players performed maximal instep kicks, using the dominant and non-dominant feet, with the ball stationary or rolling from four different directions. Whole-body motion was recorded during the kicking action and kinematic time-series were extracted and resampled to 200 points equally divided into kicking and follow-through phases. 1-D statistical parametric mapping two-way ANOVA tested for the effect of ball condition and foot dominance. Ball approach angle affected most of the swinging and support limb variables and some upper body variables. Performance-related variables such as CoM, foot, and shank velocities were reduced when the ball approached posteriorly. The linear and angular velocities of the swinging limb, and CoM vertical position, were higher when kicking with dominant foot. Based on these findings, as a practical implication, coaches should vary ball approach angles and the foot used during kicking drills to improve technical effectiveness in various situations.

The influence of task type and movement speed on lower limb kinematics during single-leg tasks.

BACKGROUND: Single-leg squats and step-downs are commonly used to assess kinematic variables that may be linked to injuries. Task type and movement speed may influence the outcomes of interest because of different balance requirements. RESEARCH QUESTION: What is the influence of task type and movement speed on lower limb kinematics? METHODS: This is a cross-sectional within-subjects study where 22 physically active females performed three single-leg functional tasks (Squat, Anterior step-down, and Lateral step-down) at three movement speeds (slow [5 s], fast [2 s], and self-selected), while three-dimensional kinematic variables were recorded. Displacement values from the initial position in single-leg support until 60° or peak knee flexion were calculated. Two-way repeated measures ANOVA was used to compare tasks and speeds, and Cohen's d effect size (ES) was calculated for significant pairwise comparisons. RESULTS: At 60°, lateral step-down presented the greatest hip adduction (large ES) and internal rotation (small ES). The anterior step-down had the lowest knee abduction displacement while the squat had the greatest (small to medium ES). At peak knee flexion, values increased but differences between tasks followed a similar pattern. Slow speed induced smaller displacement angles at the knee and hip (trivial to small ES). SIGNIFICANCE: When knee abduction is the variable of interest, the SLS may be the best test since it elicits the greatest displacement, but when evaluating hip motion, SDLAT might be best. Knee abduction and internal rotation were lowest in the slow condition, suggesting that faster speed may be more appropriate to detect abnormal movement patterns. However, the small difference in absolute values (i.e., degrees of movement) may indicate that the differences are not clinically significant, particularly for speed comparisons. Researchers and clinicians should take this into consideration when choosing the most appropriate task and the instruction to give during its execution.

Hip abduction machine is better than free weights to target the gluteus medius while minimizing tensor fascia latae activation.

INTRODUCTION: Changes in the lower extremities' biomechanics are associated with gluteus medius (GMed) weakness and increased tensor fascia latae (TFL) activation. OBJECTIVE: To determine which exercises produce greater GMed activity while minimizing TFL activation during the concentric and eccentric phases of three single-joint strengthening exercises. DESIGN: Controlled laboratory study. SETTING: Laboratory. PARTICIPANTS: Eleven males (age: 29.18 ± 4.51 years; body mass: 84.01 ± 14.48 kg; height: 1.74 ± 0.07 m; body fat: 16.34 ± 3.33%). MAIN OUTCOME MEASURES: GMed and TFL activation and activation ratio while performing ten maximal repetitions of three exercises: side-lying hip abduction (SLHA); clamshell (CLAM) and hip abductor machine (HAM). RESULTS: GMed activation was greater than TFL in all exercises in both concentric and eccentric phases. There were no differences in GMed activation between the three exercises in both phases. TFL activation was greater in SLHA compared to HAM and CLAM during both phases. In both concentric and eccentric phases, GMed:TFL ratio was greater in HAM compared to CLAM and SLHA. CONCLUSIONS: GMed had increased activation compared to TFL in all analyzed exercises. Considering GMed:TFL ratio, if the goal is to preferentially activate GMed while minimizing TFL activation, the hip abductor machine seems to be the best exercise.

Lower limbs muscle activation during instep kick in soccer: effects of dominance and ball condition.

Muscle activation has been studied in soccer players kicking stationary balls with the dominant foot. This study evaluated swinging and support limb muscle activation during the instep kick using different feet and ball approach conditions.Vastus medialis (VM), biceps femoris (BF), gastrocnemius medialis (GM) and tibialis anterior (TA) activations were evaluated during maximal instep kicks with both feet and the ball in five conditions (n = 18): stationary (STAT), approaching anteriorly (ANT), posteriorly (POST), laterally (LAT) and medially (MED). A repeated-measures two-way ANOVA compared activations between feet and ball conditions throughout the kicking (0-100%) and follow-through phases (101-200%). Close to ball contact (81-124%), non-dominant support GM had greater activation than the dominant one. The LAT and MED conditions differed within the cycle in the swinging VM (0-21%; 191-200%), BF (13-70%; 121-161%), GM (22-82%; 121-143%) and TA (0-32%; 55-97%; 186-200%) and in support VM (0-81%), BF (6-24%; 121-161%) and GM (24-87%). Players require greater support GM activation to stabilize the ankle during non-dominant kicks. Muscle activation differences between LAT and MED indicate that the kicking strategies are altered when kicking balls approaching from different directions.

Physical and performance indicators between backs and forwards in a subelite Rugby Union Team.

BACKGROUND: Backs and forwards have different physical and performance demands in Rugby Union, which are well documented in elite teams. However, in subelite teams, this comparison is scarce. The aim of study was to compare physical and performance indicators during matches in backs and forwards from a subelite Rugby Union Team. METHODS: Twenty-five professional rugby athletes (backs, N.=12; forwards, N.=13) from a subelite team were evaluated for: 1) body mass and height; 2) sprinting speed of 10 meters; 3) sprint momentum; 4) 1RM of bench press, chin-up and squat exercises; and 5) yo-yo fitness test. Performance indicators during matches (number of passes, carries, tackles, attacking rucks and ball possessions) were evaluated. A Student's t-test was used to compare variable between positions. RESULTS: We found that forwards are taller (P=0.01), heavier (P<0.001), have stronger upper limbs (P=0.02), perform more tackles (P<0.001) and participate in more attacking rucks (P<0.001), while backs are faster (P=0.005), have higher sprint momentum (P<0.001), aerobic power (P=0.01) and have more ball possessions (P=0.02). CONCLUSIONS: This study demonstrated that backs and forwards from a subelite national team have different physical characteristics and perform different actions during the matches.

Moderate intensity cycling is better than running on recovery of eccentric exercise-induced muscle damage.

OBJECTIVE: To compare the effects of moderate intensity running and cycling on markers of exercise-induced muscle damage in men. STUDY DESIGN: Randomized controlled trial. SETTING: Laboratory. PARTICIPANTS: Thirty volunteers were randomized in three groups [running (RG; n = 10), cycling (CG; n = 10) and control (CON; n = 10)] and were evaluated at baseline, post 24, 48 and 72 h of knee extensors' muscle damage protocol. CON performed passive recovery, while RG and CG performed active recovery immediately after the protocol, as well as 24 h and 48 h afterwards. MAIN OUTCOMES: (i) maximal voluntary isometric contraction (MVIC); (ii) delayed-onset muscle soreness (DOMS); (iii) plasma creatine kinase (CK) and lactate dehydrogenase (LDH) levels. RESULTS: No group-by-time interaction was found in any outcome evaluated (p > 0.05). All groups presented decreases in MVIC and increases in DOMS (p < 0.001), without differences in CK and LDH. Compared with CON, exercise groups presented likely beneficial effects for LDH, while only CG had a likely beneficial effect for DOMS. Lastly, CG presented likely/very likely beneficial effects for MVIC and DOMS compared to RG. CONCLUSION: Although the null hypothesis analysis did not find differences, the magnitude-based inference analysis suggested that moderate intensity cycling have likely beneficial effects on knee extensor muscle recovery after eccentric exercise protocol.

Influence of Pulse Waveform and Frequency on Evoked Torque, Stimulation Efficiency, and Discomfort in Healthy Subjects.

OBJECTIVE: The aim of the study was to determine the influence of neuromuscular electrical stimulation pulse waveform and frequency on evoked torque, stimulation efficiency, and discomfort at two neuromuscular electrical stimulation levels. DESIGN: This is a repeated measures study. The quadriceps muscle of 24 healthy men was stimulated at submaximal (neuromuscular electrical stimulationsub) and maximal (neuromuscular electrical stimulationmax) levels using two pulse waveforms (symmetrical, asymmetrical) and three pulse frequencies (60, 80, 100 Hz). Repeated measures analysis of variance and effect sizes were used to verify the effect of pulse waveform and pulse frequency on stimulation efficiency (evoked torque/current intensity) and discomfort and to assess the magnitude of the differences, respectively. RESULTS: Stimulation efficiency was higher for symmetrical (neuromuscular electrical stimulationsub = 0.88 ± 0.21 Nm/mA; neuromuscular electrical stimulationmax = 1.27 ± 0.46 Nm/mA) compared with asymmetrical (neuromuscular electrical stimulationsub = 0.77 ± 0.21 Nm/mA; neuromuscular electrical stimulationmax = 1.02 ± 0.34 Nm/mA; P ≤ 0.001; effect size = 0.56-0.66) but did not significantly differ between frequencies (P = 0.17). At both neuromuscular electrical stimulation levels, there were no statistically significant differences in discomfort between pulse waveforms or frequencies. CONCLUSIONS: The higher stimulation efficiency of symmetrical pulses suggests that this waveform would be preferred to asymmetrical pulses in clinical practice. Stimulation frequencies between 60 and 100 Hz can be used interchangeably because of similar efficiency and discomfort.

Core muscles thickness is not associated with knee frontal plane projection angle during single-leg squat in healthy people.

BACKGROUND: Core muscles play an important role in lower limb stability and alignment, with their weakness being associated with poor alignment and, consequently, with injuries. Despite muscle structure being critical to muscle strength production, we did not find studies associating the morphology of the core muscles and lower limb alignment during functional tasks. RESEARCH QUESTION: Is there association between thickness of core muscles (external oblique - EO, internal oblique - IO, transversus abdominis - TrA and gluteus medius - GMed) and lower limb alignment during the single-leg squat in healthy subjects? METHODS: Forty-six healthy participants (27 male and 19 female) performed the following evaluations: (i) measurements of muscle thickness of the EO, IO, TrA and GMed using ultrasound and (ii) measurements of lower limb alignment using the knee frontal plane projection angle (FPPA) during the single-leg squat. A Spearman rank correlation coefficient (rs) was performed between the thickness of selected core muscles (OE, OI, TrA and GMed) and the knee FPPA. In addition, a partial correlation (r) was performed, using sex, physical activity level and body mass index as control variables. RESULTS: We did not observe significant correlations between the knee FPPA and the thickness of the EO (rs = 0.194; p = 0.197), IO (rs = 0.182; p = 0.225), TrA (rs = 0.073; p = 0.627) and GMed (rs = -0.092; p = 0.542). When controlling for sex, physical activity level and body mass index, similar results were observed [EO (r = 0.157; p = 0.316), IO (r = 0.261; p = 0.092), TrA (r = 0.030; p = 0.850) and GMed (r = -0.144; p = 0.356)] SIGNIFICANCE: Our results demonstrated that core muscles' thickness is not associated with lower limb alignment during the single-leg squat in healthy people.

Echo intensity reliability between two rectus femoris probe sites.

INTRODUCTION: The ultrasound technique has been extensively used to measure echo intensity, with the goal of measuring muscle quality, muscle damage, or to detect neuromuscular disorders. However, it is not clear how reliable the technique is when comparing different days, raters, and analysts, or if the reliability is affected by the muscle site where the image is obtained from. The goal of this study was to compare the intra-rater, inter-rater, and inter-analyst reliability of ultrasound measurements obtained from two different sites at the rectus femoris muscle. METHODS: Muscle echo intensity was quantified from ultrasound images acquired at 50% [RF50] and at 70% [RF70] of the thigh length in 32 healthy subjects. RESULTS: Echo intensity values were higher (p = 0.0001) at RF50 (61.08 ± 12.04) compared to RF70 (57.32 ± 12.58). Reliability was high in both RF50 and RF70 for all comparisons: intra-rater (ICC = 0.89 and 0.94), inter-rater (ICC = 0.89 and 0.89), and inter-analyst (ICC = 0.98 and 0.99), respectively. However, there were differences (p < 0.05) between raters and analysts when obtaining/analyzing echo intensity values in both rectus femoris sites. CONCLUSIONS: The differences in echo intensity values between positions suggest that rectus femoris's structure is not homogeneous, and therefore measurements from different muscle regions should not be used interchangeably. Both sites showed a high reliability, meaning that the measure is accurate if performed by the same experienced rater in different days, if performed by different experienced raters in the same day, and if analyzed by different well-trained analysts, regardless of the evaluated muscle site.

Blood protein adsorption on sulfonated chitosan and κ-carrageenan films.

Many strategies have been reported to improve compatibility of biopolymers using chemical and physical modifications. One possibility is the introduction of sulfonate groups (R-SO3(-)) in the chitosan chain. Another biopolymer with similar characteristics to those of heparin is κ-carrageenan. This study proposed to investigate the application of these two polymers, based on their potential for globular protein adsorption (BSA and fibrinogen). Polymeric films of chitosan and κ-carrageenan were prepared; all films were characterized by elemental analyses, FTIR, XPS and SEM. Characterization techniques showed that the chitosan chain was modified and confirmed the existence of sulfonate groups, as well as in the κ-carrageenan chain, indicating surfaces with similar chemical properties to those of heparin. The effect of charge density was observed for each adsorption condition (BSA at pH 5.0 and 7.4). A more pronounced adsorption rate was observed at pH 5.0 than at pH 7.4 and equilibrium adsorption was achieved, in both cases, after approximately 20 min. The equilibrium data indicate a lower adsorption rate for the sulfonated chitosan film, in comparison to the other films. These results confirm the potential of modified chitosan for use in applications in which globular protein adsorption should be avoided.

Análise do traçado cefalométrico segundo rocabado antes e após o uso do protocolo básico do método equilibrador neuromuscular / Analysis of cephalometric dash according to rocabado before and after the use of a basic protocol

As disfunções crânio-cérvico-mandibulares e seus sinais e sintomas são comuns nos relatos dos pacientes que buscam por tratamento especializado; elas podem ser avaliadas através da cefalometria, a qual também pode ser utilizada como forma de comparação após um tratamento. O Método de Equilíbrio Neuromuscular (ENM) é uma forma de tratamento global que não gera estresse ao paciente, onde é possível eliminar bloqueios estruturais cuja origem são as dores articulares. O objetivo desse trabalho foi verificar a eficácia do protocolo básico do ENM em funcionários de uma clínica com disfunções crânio-cérvico-mandibulares utilizando como evidências radiológicas o traçado cefalométrico de Rocabado. A amostra foi composta de 8 indivíduos, sendo sete do sexo feminino e um do sexo masculino, com faixa etária entre 24 e 54 anos, que apresentaram queixas ou sintomas de dor ou disfunção crânio-cérvico-mandibular por pelo menos 3 meses e evidências radiológicas através do traçado cefalométrico de Rocabado. O tratamento foi realizado através do protocolo básico do Método Equilibrador Neuromuscular (ENM), que consistiu de seis sessões, sendo distribuídas em três na primeira semana, duas na segunda semana e uma na terceira semana. Após a finalização do tratamento, os indivíduos realizaram novamente o exame radiológico. Foi considerado como nível de significância 5% (p≤0,05) e calculado o grau de probabilidade de significância para as variáveis do estudo. Não houve mudança estatisticamente significante nos traçados cefalométricos analisados, concluindo-se que, para maior efetividade no tratamento, é necessária a inclusão de outras técnicas fi sioterápicas ao ENM.

The craniomandibular disorders and their signs and symptoms are common in the reports of the patients that seek for specialized treatment; they can be analyzed through the cephalometry, which can be also utilized as a comparison way after a treatment. The Balance Neuromuscular Method (ENM) is a way of global treatment that doesnot generate stress to the patient, where it is possible to eliminate structural blocks whose origin are the articular pains. The objective of this study was to verify the efi cacy of the ENM basic protocol in workers with craniomandibular disorders using as radiological evidences the cephalometric tracing of Rocabado. The sample was composed by 8 individuals, with 24 to 54 years that presented complaints or symptoms of pain or craniomandibular disorder for at least 3 months and radiological evidences through the cephalometric tracing of Rocabado. The treatment was realized throughthe ENM basic protocol that was 6 sessions, being distributed in 3 sessions at the fi rst week, 2 sessions at the second week and 1 session at the third week. After the fi nalization of the treatment, the individuals realized the radiological examination again. It was considered as level of signifi cance p value < 0,05 and calculated the odds ratio to the variables of the study. There was not a changing statiscally signifi cant at the cephalometric tracings analyzed, concluding that, for a major effectiveness in the treatment, it is necessary the inclusion of others physiotherapy techniques.