Hypoxic peripheral chemoreflex stimulation-dependent cardiorespiratory coupling is decreased in swimmer athletes.

Swimmer athletes showed a decreased ventilatory response and reduced sympathetic activation during peripheral hypoxic chemoreflex stimulation. Based on these observations, we hypothesized that swimmers develop a diminished cardiorespiratory coupling due to their decreased hypoxic peripheral response. To resolve this hypothesis, we conducted a study using coherence time-varying analysis to assess the cardiorespiratory coupling in swimmer athletes. We recruited 12 trained swimmers and 12 control subjects for our research. We employed wavelet time-varying spectral coherence analysis to examine the relationship between the respiratory frequency (Rf ) and the heart rate (HR) time series during normoxia and acute chemoreflex activation induced by five consecutive inhalations of 100% N2 . Comparing swimmers to control subjects, we observed a significant reduction in the hypoxic ventilatory responses to N2 in swimmers (0.012 ± 0.001 vs. 0.015 ± 0.001 ΔVE /ΔVO2 , and 0.365 ± 0.266 vs. 1.430 ± 0.961 ΔVE /ΔVCO2 /ΔSpO2 , both p < 0.001, swimmers vs. control, respectively). Furthermore, the coherence at the LF cutoff during hypoxia was significantly lower in swimmers compared to control subjects (20.118 ± 3.502 vs. 24.935 ± 3.832 area under curve [AUC], p < 0.012, respectively). Our findings strongly indicate that due to their diminished chemoreflex control, swimmers exhibited a substantial decrease in cardiorespiratory coupling during hypoxic stimulation.

Effects of dominance and vision on unipedal balance tests in futsal players using a triaxial accelerometer.

Optimal postural control improves performance and reduces the risk of injury in futsal. In this context, wearable accelerometers may detect velocity changes of the centre of mass during a task, enabling the analysis of postural control in different environments. This work aimed to determine the influence of vision and dominance on unipodal static postural balance in non-professional athletes. Twenty-four university male futsal players performed a unipodal balance test to assess their body sway using a triaxial accelerometer. To assess dominance, the preferred limb for kicking the ball was considered, while vision was manipulated by asking participants to close their eyes during the test. Root mean square (RMS) and sample entropy (SaEn) of centre of mass variables were analysed. For statistical analysis, a multivariate analysis of variance model was used. Our results suggest an effect of vision, but not of dominance nor the interaction between vision and limb dominance. Specifically, a higher-acceleration RMS in the mediolateral axis was observed, as well as an increased SaEn in the three axes. To conclude, unipodal postural demand in futsal players under visual input suppression was not influenced by their limb dominancy.

Intra- and inter-rater reliability in ultrasonographic measurements of coracohumeral distance.

BACKGROUND: Ultrasonography (US) is a widely used diagnostic tool in physical therapy. One of the US variables often utilized to quantify the dimensions of the subacromial space and its association with shoulder pathology is the coracohumeral distance (CHD), however, this measurement presents diverse evidence in terms of reliability. OBJECTIVES: To assess the intra- and inter-rater reliability of both expert and non-expert raters when measuring CHD through US in asymptomatic subjects. Additionally, we determined the effect of rater experience and measurement conditions on the recording of CHD. METHODS: CHD of 15 individuals were recorded from US images of the glenohumeral joint of both upper extremities in three different positions. An expert and a non-expert rater in US usage recorded three CHD measurements, after a randomization procedure. To determine intra- and inter-rater reliability, the interclass correlation coefficient (ICC) and a multivariate variance model for the effects of rater experience, joint position and time of measure were used. Standard Error of Measurement and Minimal Detectable Change was also estimated for CHD measurements. RESULTS: Intra-rater reliability ranged 0.970 to 0.998) and Inter-rater reliability ranged 0.48 to 0.876). Joint position (F2;55 = 38.308; p < 0.001; ηp2 = 0.582) and measurement time (F2;55 = 6.019; p = 0.004; ηp2 = 0.180) effect was observed on CHD. CONCLUSION: Excellent intra- and poor to moderate inter-rater reliability between expert and non-expert clinicians was determined, the latter being influenced by the position of the glenohumeral joint position at the time of US recording and the time of recording the measurement.

Enseñanza de deportes de Colaboración y Oposición: Análisis comparativo entre Metodologías comprensivas y modelo tradicional

El propósito del estudio fue determinar el efecto que produce la aplicación de una unidad de enseñanza de los deportes de colaboración y oposición diseñada en base a dos propuestas del modelo pedagógico comprensivo: el Teaching Games for Understanding y la Didáctica Cognitiva, en comparación a un modelo tradicional de enseñanza. La muestra estuvo conformada por alumnos(as) de 5° a 8° básicos (12 a 14 años). Mediante metodología observacional, fueron evaluadas las principales acciones de juego eficientes en las dimensiones de ataque y defensa, en momentos de test y retest, a un grupo control (GC) y otro experimental (GE). El análisis de varianza (MANOVA) y las comparaciones por pares con corrección de Bonferroni aplicadas con un alfa de 0.05, evidenciaron diferencias significativas entre ambos grupos, de las acciones motoras de lanzamiento en zona eficaz (GE: 74,3% GC: -16,7%) y Pase simple (GE: -27,1% - GC: -3,1%). Mientras que, mediante el análisis descriptivo de las tasas de ocurrencia, se encontraron diferencias de las acciones motoras de Anticipación (GE:211,1% - GC:20%), marcación eficiente (GE: 330,8% - GC: -7,1%) y desmarcación (GE: 400% - GC: 0%). Los hallazgos de ambos análisis muestran que la aplicación de metodologías comprensivas en la enseñanza de los deportes de colaboración y oposición en el contexto de educación física escolar, mejoran la calidad de las acciones de juego, en comparación a un modelo tradicional de enseñanza.

The purpose of the study was to determine the effect produced by the application of a teaching unit for collaborative and oppositional sports designed on the basis of two proposals of the comprehensive pedagogical model: Teaching Games for Understanding and Cognitive Didactics, compared to a traditional teaching model. The sample consisted of students from 5th to 8th grade (12 to 14 years old). By means of observational methodology, the main efficient game actions in the dimensions of attack and defense were evaluated, in test and retest moments, to a control group (CG) and an experimental group (EG). The analysis of variance (MANOVA) and pairwise comparisons with Bonferroni correction applied with an alpha of 0. 05, showed significant differences between both groups in the motor actions of throwing in the effective zone (EG: 74.3% - CG: -16.7%) and simple passing (EG: -27.1% - CG: -3.1%), while descriptive analysis of the occurrence rates showed differences in the anticipation motor actions (EG: 211.1% - CG: 20%), efficient tackling (EG: 330.8% - CG: -7.1%) and untacking (EG: 400% - CG: 0%). The findings of both analyses show that the application of comprehensive methodologies in the teaching of collaborative and oppositional sports in the context of school physical education improves the quality of the game actions, compared to a traditional teaching model.

O objetivo do estudo foi determinar o efeito produzido pela aplicação de uma unidade de ensino de esportes colaborativos e opostos projetada com base em 2 propostas do modelo pedagógico integral: Jogos de ensino para a compreensão e didática cognitiva, em comparação com um modelo de ensino tradicional. A amostra foi composta por alunos da 5ª à 8ª série (12 a 14 anos). Por meio de metodologia observacional, foram avaliadas as principais ações de jogo eficientes nas dimensões de ataque e defesa, nos momentos de teste e reteste, em um grupo controle (GC) e um grupo experimental (GE). A análise de variância (MANOVA) e as comparações por pares com correção de Bonferroni aplicada com alfa de 0,05, mostraram diferenças significativas entre ambos os grupos, das ações motoras de lançamento na zona efetiva (GE: 74,3% GC: -16,7% ) e passe simples (GE: -27,1% - GC: -3,1%). Já pela análise descritiva das taxas de ocorrência, foram encontradas diferenças nas ações motoras de Antecipação (GE: 211,1% - GC: 20%), marcação eficiente (GE: 330,8% - GC: -7,1%) e desmarcação (GE: 400% - GC: 0%). Os resultados de ambas as análises mostram que a aplicação de metodologias abrangentes no ensino de esportes colaborativos e de oposição no contexto da educação física escolar melhora a qualidade das ações de jogo, em comparação com um modelo de ensino tradicional.

Postural performance assessment in aging people with diabetes and diabetic peripheral neuropathy using a Wii balance board.

PURPOSE: To determine the effect of sensory perturbations on static postural control in older people with type 2 diabetes mellitus by comparing postural outcomes of people with and without diabetic neuropathy using a Wii Balance Board (WBB). MATERIALS AND METHODS: Static postural balance assessments were performed in 31 participants: nine with type 2 diabetes mellitus; 12 with diabetic neuropathy; and 10 non-diabetic controls. Participants stood on the WBB under sensory perturbations (visual and proprioceptive). Body balance was analysed using centre of pressure ellipse area, mean velocity, and sample entropy. The effects of within-participant factors, sensory perturbations and the between-participants factor 'group' on outcomes were analysed using a multivariate analysis of variance model. RESULTS: Type 2 diabetes mellitus participants with and without neuropathy showed altered postural performance under sensory perturbations compared to non-diabetic participants. Moreover, participants with diabetic neuropathy showed impaired postural performance when one perceptual system was disturbed. Finally, participants with type 2 diabetes mellitus without neuropathy decreased their postural performance when both sensory disturbances were present. CONCLUSIONS: The Wii Balance Board can be a useful alternative for balance impairment screening related to diabetic neuropathy and contribute as an affordable source of insight in early interventions in integral diabetes care.Implications to rehabilitationOlder people with diabetic peripheral neuropathy depend on visual and somatosensory cues to keep their static postural balance.Static balance assessment using the Wii Balance Board allows the identification of alterations in postural performance in participants with diabetes.This low-cost method used can be considered as a complement to integral diabetes care.

Identifying neuropathies through time series analysis of postural tests.

BACKGROUND: In physical therapy, postural tests are frequently used to diagnose neuropathies, particularly in diabetic individuals. This study aims to develop a method based on the analysis of time series that allows discriminating between healthy and diabetic subjects with or without a neuropathic condition. RESEARCH QUESTION: Do features obtained from time series corresponding to postural tests allow us to reliably discriminate between healthy, diabetic and neuropathic patients? METHODS: In this study, 32 people participated in the healthy, diabetic, and neuropathic categories (11, 9, and 12, respectively). The data was collected by positioning each participant on a Wii Balanced Board platform, under 8 different conditions. The analyzed time series are sensed by devices that capture variations in the subject's center of pressure when subjected to a test on different conditions over a short period of time. The method proposed considers statistical techniques used for characterizing the time series combined with machine learning techniques to classify the individual's profile into one of the three categories mentioned. The classification is supported by an underlying probabilistic model, based on the characteristics of the time series, generating average curves for each class, which are then used by the classification methods. RESULTS: The empirical results include classification models for each class, obtaining a performance (F-score) over 98%. In addition, other models considering the particular conditions to which the subject is exposed during the test are developed, revealing that the conditions of eyes open and eyes closed show the highest levels of discrimination to classify participants into one of the three class categories. SIGNIFICANCE: These results suggest a test protocol simplification and, at the same time, that the proposed method based on the analysis of the time series associated with the test used is highly predictive and may reliably complement or substitute a questionnaire-based diagnosis.

Variability in Normalization Methods of Surface Electromyography Signals in Eccentric Hamstring Contraction.

CONTEXT: In human movement analysis, normalization of a surface electromyography signal is a crucial step; therefore, parameter selection for this procedure must be adequately justified. The aim of this research was to determine the variability of electromyography signals in eccentric hamstring contraction under different normalization parameters. DESIGN: Cross-sectional study. METHODS: Nine university rugby players (age 21.50 [3.61] y; body mass index 21.50 [4.95]) and no history of recent hamstring injury. Values from maximum voluntary isometric contraction protocol and task related (ie, Nordic hamstring exercise) were used for surface electromyography signal normalization. Intersubject and intrasubject variation coefficients were used for normalization method variability and for signal reproducibility, respectively. RESULTS: Intrasubject variation coefficient value indicates acceptable reproducibility of surface electromyography (less than 12%) for all normalization procedures. Lower values of intersubject variation coefficient value were achieved for normalization procedures using task-related values. CONCLUSION: Parameters extracted from task execution provided less variability for surface electromyography amplitude normalization in eccentric hamstring muscle contractions.

Role of active joint position sense on the upper extremity functional performance tests in college volleyball players.

Background: It has been well established that proprioception plays a decisive role in shoulder stability and sport performance. Notwithstanding, there is a lack of clear association between active joint position sense (AJPS) and the performance of upper-extremity functional performance tests. The aim of this study was to determine whether the AJPS of the shoulder complex is associated with the performance of college volleyball players with the following functional tests: Y-Balance Test-Upper Quarter (YBT-UQ), Closed Kinetic Chain Upper-Extremity Stability Test (CKCUEST), and Seated Medicine Ball Throw (SMBT). The secondary aim was to investigate whether the magnitude of the proprioception error through the AJPS had the ability to act as a predictor for functional test scores. Methods: Cross-sectional study with a convenience sampling. Healthy college volleyball players (≥12 h of training/week), 30 males and 22 females, between 18 and 26 years of age were included. AJPS of the shoulder (90° of flexion (90°Flex), 90° of internal rotation at 90° of abduction (90°IR/ABD), 90° of external rotation at 90° of abduction (90°ER/ABD)) and three upper-extremity functional performance tests (YBT-UQ, CKCUEST and SMBT) were assessed. A Pearson's test and a stepwise multiple linear regression analysis were used to determine possible associations and relationships between outcome measures, respectively. Results: The analysis revealed that AJPS at 90°IR/ABD and 90°ER/ABD were the only proprioceptive variables with an association to the YBT-UQ and SMBT. Despite these relationships, only the AJPS at 90°IR/ABD was associated with the performance of the YBT-UQ in; superolateral direction (ß = -0.7; 95% CI [-1.3 to 0.1]; p = 0.025); inferolateral direction (ß = -1.5; 95% CI [-2.1 to -0.8]; p = 0.001); and composite score (ß = -0.8; 95% CI [-1.3 to -0.3]; p = 0.002). From these, AJPS at 90°IR/ABD mainly explained the variability of YBT-UQ (inferolateral direction) performance (R2 = 0.32; %R2 = 0.32). Our findings allow for a possible expanded role for proprioception as a contributing factor in upper limb motor control during functional movements. Further research is required to explore and distinguish the associations between proprioception, motor control and sport performance involving the upper limbs.

Inter-rater reliability of scapular dyskinesis classification in overhead athletes by entry-level physical therapy students.

BACKGROUND: Scapular dyskinesis (SD) is a dysfunction associated with shoulder pathologies in overhead athletes and its classification is highly complex, especially in entry-level physical therapy students. OBJECTIVE: This research aimed to determine the effect of a video training method on inter-rater reliability of physical therapy entry-level students with no clinical experience while performing SD ratings under 4-type, severity, and 'yes or no' criteria in overhead athletes. METHODS: A total of 49 overhead athletes were evaluated by video recordings in posterior view of lifting tasks. Two entry-level students without clinical experience performed SD classifications according to previously mentioned criteria on both scapula in two separate sessions, with 1 week of difference. Data analysis was conducted based on the kappa coefficient (k) and its confidence intervals (CI). RESULTS: The 'yes or no' criteria present better results than the 4-type and severity criteria. In addition, a better inter-rater agreement is evidenced in the second measurement compared to the first one. Furthermore, the k coefficients reach values like those achieved by experienced evaluators. CONCLUSION: Video training settings for scapular dyskinesis rating in entry-level physical therapist students with no clinical experience allows better inter-rater reliability values.

Implementación de rehabilitación remota en artrosis bilateral de cadera / Implementation of Remote Rehabilitation in Bilateral Hip Osteoarthritis

Introducción: La pandemia causada por el COVID-19 obligó a cambiar la modalidad en la cual se llevan cabo los procesos de rehabilitación -de presencial a remoto- incluso la de aquellos tratamientos ya planificados. Objetivos: Implementar la telerehabilitación y documentar si el cambio de modalidad basada en el ejercicio terapéutico tiene efectos en los resultados de la intervención. Presentación del caso: Se presenta el caso de una paciente con osteoartritis bilateral de cadera cuya intervención de terapia física tuvo que ser modificada a una modalidad remota, debido a la pandemia por COVID-19. Conclusiones: La modalidad remota adoptada no afectó la recuperación funcional establecida en las primeras etapas. Se recomienda utilizar evaluaciones funcionales, así como considerar las condiciones en el hogar requeridas para la continuidad de las intervenciones(AU)

Introduction: The pandemic caused by COVID-19 forced to change the modality in the rehabilitation processes -from face-to-face to remote- including that of those already planned treatments. Objectives: To implement remote rehabilitation and to set down whether the change of modality based on therapeutic exercise impacts on the results of the intervention. Case report: The case of a patient with bilateral hip osteoarthritis is reported here. Her physical therapy intervention had to be modified to a remote modality, due to the COVID-19 pandemic. Conclusions: The remote modality adopted did not affect the functional recovery established in the early stages. It is recommended to use functional evaluations, as well as to consider the required conditions at home to continue the interventions(AU)

In vivo effects of two shoulder girdle motor control exercises on acromiohumeral and coracohumeral distances in healthy men.

INTRODUCTION: Altered motor control and proprioceptive deficits are associated with kinematics dysfunctions and may cause alterations in subacromial space (SAS) that could lead to shoulder pathologies. Dimensions of the subacromial space, as well as interventions aimed at its normal restitution, can be explored by ultrasound (US). OBJECTIVE: To describe the effect of two shoulder girdle motor control exercises with cognitive training strategies on SAS dimensions, measured with US. METHODS: Cognitive movement control strategies, with visual and haptic feedback were applied on 21 healthy participants. SAS dimensions were measured through in vivo variations of acromiohumeral (AHD) and coracohumeral distances (CHD) using US. RESULTS: Our results show that as exercise repetitions are performed, an increasing trend in both measures can be observed, being wider for AHD (i.e. humeral head descent exercise) than CHD (i.e. scapular retraction exercise). CONCLUSION: Specific cognitive and motor control exercises improve congruence joint and centering of the humeral head.

In vivo measurements of glenohumeral distraction technique performed in three different joint positions.

Introduction: Distraction techniques are an important part of the manual approach in the glenohumeral joint; however, there is controversy regarding the initial joint position to maximize separation of joint surfaces.Objective: To identify, through an in vivo exploration, the behavior of the coracohumeral distance (CHD) during the application of a short lever arm grade III distraction technique on the humeral head, executed in three different glenohumeral positions (zero position (P0), rest position (RP) and 90º abduction position with maximum external rotation (ABD+ER)).Methods: 15 participants were selected. A physical therapist executed grade III distraction techniques in described joint positions. Ultrasound was used to visualize the differences in CHD. Statistical analysis included interclass correlation coefficients (ICC) and repeated measurements of ANOVA.Results: The range of ICC values was 0.740 and 0.948. The differences in CHD were 5.74 ± 0.51 mm, 3.97 ± 0.24 mm, and 0.64 ± 0.02 mm, for P0, RP and ABD+ER during application of distraction technique, respectively. There were differences between P0 and RP with ABD+ER (P < 0.001), and no differences between P0 and RP.Conclusion: Initial joint position of application influences the separation of the articular surfaces, being wider in the zero and rest positions.