Determination of Five Sit-to-Stand Test Performance at Discharge of Stroke Patients.

The early identification of performance in the five-repetition sit-to-stand test (5-STS) at discharge in stroke patients could be of interest because it can determine independence for community-based activities. This study aimed to determine whether the initial measurement of the 5-STS test can be a determinant of the performance level prediction and amount of change in the 5-STS test at discharge in stroke patients. A prospective cohort study was conducted with a sample of 56 patients aged ≤60 d post-stroke. The 5-STS test results, as well as changes in patient condition, were measured at admission (T0) to an outpatient rehabilitation program, after the first month (T1), and at discharge (T2). The mean age was 62.7 (SD = 13.0), 58.9% of the subjects were male, and 75% had suffered an ischemic stroke. A multivariate linear regression model using the 5-STS test at T0 explained 57.7% of the variance in the performance at discharge. Using the 5-STS at T1 increased the variance to 75.5% (p < 0.001). Only the time from stroke onset at T0 significantly contributed to the two models. The measurement of the 5-STS at T0 and the amount of change in its performance at T2 explained 60.2% (p < 0.001) of the variance, while reassessment at T1 explained only 19.3% (p < 0.001). The level of patient performance on the 5-STS test at discharge, as well as any potential change, can be predicted by the admission measure of 5-STS in stroke patients.

Responsiveness of monopodal postural stability tests in recreational athletes.

Background: Stabilometry, the modified Star Excursion Balance Test (mSEBT) or the Emery balance test (EBT) are reported in the literature to reflect changes after an intervention in monopodal postural stability. Even so, the responsiveness of those tests has not been evaluated after an instability training programme or analysed using multiple statistical indicators of responsiveness. The main aim of this study was to analyse the responsiveness of the stabilometry, mSEBT or EBT. Methods: Thirty healthy recreational athletes performed a 4-week programme with three weekly sessions of instability training of the dominant lower limb and were evaluated using stabilometry, mSEBT, and EBT tests. Responsiveness was quantified based on internal and external responsiveness. Results: EBT and all parameters in mSEBT for the dominant lower limb showed large internal responsiveness (SRM > 0.8). Furthermore, mSEBT values for the non-dominant lower limb (except anterior displacement) also experienced significant changes with an associated large internal responsiveness. None of the stabilometry platform parameters showed a significant change after the intervention. The ability of the EBT to discriminate between the dominant and non-dominant lower limb (i.e., trained vs untrained, respectively) was generally acceptable (AUCs = 0.708). However, none of the parameters of the mSEBT test showed an acceptable AUC. Conclusions: EBT showed a positive responsiveness after instability training compared to mSEBT, which only showed internal responsiveness, or stabilometry platform measures, whose none of the parameters could identify these changes.

Accuracy of Two Continuous Glucose Monitoring Devices During Aerobic and High-Intensity Interval Training in Individuals with Type 1 Diabetes.

BBACKGROUND: This study aimed to evaluate the accuracy of Dexcom G6 (DG6) and FreeStyle Libre-2 (FSL2) during aerobic training and HIIT in individuals with type 1 diabetes (T1D). METHODS: Twenty-six males (mean age 29.3 ± 6.3 years and mean duration of diabetes 14.9 ± 6.1 years) participated in this study. Interstitial glucose levels were measured using DG6 and FSL2, while plasma glucose levels were measured every 10 min using YSI 2500 as the reference for glucose measurements in this study. The measurements began 20 min before the start of exercise and continued for 20 min after exercise. Seven measurements were taken for each subject and exercise. RESULTS: Both DG6 and FSL2 devices showed significant differences compared to YSI glucose data for both aerobic and HIIT exercises. Continuous glucose monitoring (CGM) devices exhibited superior performance during HIIT than aerobic training, with DG6 showing a mean absolute relative difference (MARD) of 14.03% versus 31.98%, respectively. In the comparison between the two devices, FSL2 demonstrated significantly higher effectiveness in aerobic training, yet its performance was inferior to DG6 during HIIT. According to the 40/40 criteria, both sensors performed similarly, with marks over 93% for all ranges and both exercises, and above 99% for HIIT and in the >180 mg/dL range, which is in accordance with FDA guidelines. CONCLUSIONS: The findings suggest that the accuracy of DG6 and FSL2 deteriorates during and immediately after exercise, but remains acceptable for both devices during HIIT. However, accuracy is compromised with DG6 during aerobic exercise. This study is the first to compare the accuracy of two CGMs, DG6 and FSL2, during two exercise modalities, using plasma glucose YSI measurements as the gold standard for comparisons.

Development and validity of the expectations of physiotherapists questionnaire on practice management software.

Background: Despite the growing trend in the use of digital technologies in physiotherapy, the overall adoption of both, practice management software (PMS) and electronic health records in physiotherapy clinics has been low and slow over time. In order to learn what factors determine the adoption of these technologies by physiotherapists, there is a need to examine the expectations of physiotherapists (EPs) on specific software attributes. The main aims of this study were to develop a questionnaire to measure and describe the EPs towards PMS. The knowledge of these EPs will be useful to guide PMS design in order to improve physiotherapists' satisfaction. Methods: Instrument development study with validity and reliability testing. The development of this questionnaire was conducted in three phases: identification of attributes to be explored, development of the items, pilot study, and psychometric testing. The questionnaire was distributed to chartered physiotherapists. A total of 272 participants completed the questionnaire. Results: A series of analysis were conducted to assess item reduction, factor structure of the questionnaire and metric properties of multi-item scales. From the initial 43 attributes, the final version of the questionnaire consisted of 26 items on EPs, grouped in nine scales and two areas (clinical care and administrative activities). As a result, all scores had strong item-scale correlations, excellent item scaling success, and good internal consistency (Cronbach alpha coefficients of >.7). Our study also showed that current EPs were high towards most of the items, only two scales concentrated most of the attributes with the least expectations (monitoring quality of care and digital health interventions). Our study included physiotherapists with and without experience with PMS, and it showed that both groups had a similar pattern of expectations. Our study provides a valuable questionnaire of EP on PMS attributes for clinical care and administrative activities and shows a detailed development process.

Knowledge and Attitudes towards Patient Safety among Students in Physical Therapy in Spain: A Longitudinal Study.

(1) Background: Patient safety is a discipline of health care management aiming to prevent and reduce errors and harm to patients. The assessment of knowledge and attitudes on patient safety among students in physical therapy is still scarce; no studies have yet explored the changes that internship periods may produce. Objectives: 1. to determine the attitudes and knowledge of students in physical therapy with respect to patient safety in a Spanish University; and 2. to explore changes following a practical internship period. (2) Methods: Longitudinal study. Data from the Attitudes to Patient Safety Questionnaire III (APSQ-III) before and after the internship period were obtained from an initial sample of 125 students and average positive response rates were compared. (3) Results: "Team functioning", "Importance of patient safety in the curriculum", and "Error inevitability" displayed the highest scores, in accordance with the current literature. After the internship period, the dimensions "Patient safety training received" (p = 0.001), "Error reporting confidence" (p = 0.044), and "Professional incompetence as an error cause" (p = 0.027) showed significant changes. (4) Conclusions: The current study, highlighting areas of strengths and weaknesses in the knowledge and attitudes of students in physical therapy towards patient safety, may be a foundation to adopt tailored programs to enhance students' competencies in patient safety.

Effects of core training on trunk function, balance, and gait in stroke patients: A systematic review and meta-analysis of randomised controlled trials.

OBJECTIVE: The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) includes determining the effects of core training alone or combined with conventional therapy on trunk function, balance, and gait in stroke patients; analysing these effects considering the stroke stage and the core training type; establishing the methodological quality of the studies published to date; and knowing the best dosage and type of exercise these aspects. DATA SOURCE: Cochrane Library, Medline, Web of Science, Scopus, and Science Direct were searched from inception to January 2022. REVIEW METHOD: A review and meta-analysis of RCTs about core intervention effects on trunk function, balance, and gait in stroke patients was carried out following the Preferred Items for Reporting in Systematic Review and Meta-Analyses guidelines. The Cochrane Collaboration tool was used to assess the risk of bias and internal validity of the included studies. RESULTS: Twenty-nine studies were included (1030 stroke patients). The mean age of the participants was 58.46 ± 9.89 years, and the average time since the stroke incident was 308.64 ± 175.52 days. The meta-analysis results showed significant improvements in core interventions for trunk function (P ≤ 0.008) and balance (P < 0.00001) but not for gait performance (P = 0.11 in chronic and P = 0.06 in pooled cases). In relation to the differential meta-analysis between training performed on stable and unstable surfaces, no significant differences were found in trunk function (P = 0.06) or balance measures (P = 0.05). CONCLUSION: Core training improves trunk function and balance in acute and chronic patients, but no changes were found in gait performance.

Differences in lower limb muscle activation between global and selective instability devices in single-leg stance in healthy active subjects.

Background: Balance and strength training are frequent strategies to address lower limb injuries, including ankle injuries, which are usually performed in single-leg stance on global instability devices, producing generalized muscular activation of the lower limb. In this context, new specific instability devices arise from the need to selectively work the ankle, specifically the peroneus longus. This study aimed to compare the EMG muscle activation of the peroneus longus, as well as other lower limbs muscles, in a single-leg stance on different balance training devices (BOSU, wobble board, power board, and Blackboard) in standing or squatting positions. Methods: Twenty healthy recreationally trained subjects participated in the study. Subjects performed three repetitions of 15 s (one for familiarization and two for measurement) in standing and squatting positions on the floor, BOSU, wobble board, power board, and Blackboard. Surface electromyography (EMG) was used to record activity of the peroneus longus, soleus, gastrocnemius medialis, tibialis anterior, rectus femoris, and gluteus maximus. Results: The main outcome was that no differences were found for the peroneus longus normalized EMG, neither between devices (p = 0.09) nor between conditions (p = 0.11), nor in the interaction between them (p = 0.16). For the normalized EMG of the other muscles, there were multiple differences between devices and conditions. Of the devices studied, the Blackboard was the one that implied a lower activation of the lower limb muscles and a lower degree of instability, activating the peroneus longus similarly to global instability devices. The BOSU and wobble board achieved high levels of EMG muscle activation for most muscles of the lower limbs. Therefore, they should be considered as potential devices for work in highly unstable conditions or when high activation levels are sought.

Comparison of Electromyographic Activity During Hip Extension Exercises Under Gravitational or Inertial Loading Conditions.

BACKGROUND: Hamstring injury prevention programs include strengthening, especially eccentric exercises using both gravitational and inertial loading. Inertial exercises are characterized by eccentric contractions of high intensity and velocity. This study aimed to analyze the muscular activation of the biceps femoris (BF), semitendinosus (ST), gluteus maximus (GM), and gracilis (GC) muscles during hip extension (HE) exercises performed under both gravitational and inertial loading conditions. HYPOTHESIS: Inertial training would generate a greater activation of HE muscles than gravitational training. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 4. METHODS: Fifteen resistance-trained men performed the unilateral straight knee bridge (SKB), 45° of HE, and stiff-leg deadlift (SDL) exercises under gravitational and inertial loading conditions. Concentric and eccentric phases were identified with a linear encoder. Differences between load types, exercises, and their interaction were examined to establish the electromyographic (EMG) activity of each muscle and BF/ST ratio. RESULTS: In the concentric phase, inertial loading showed a higher normalized EMG than gravitational loading for BF, ST, and GM. SKB and HE activated BF and ST between 9.6% and 24.3% more than SDL. In the eccentric phase, the inertial modality achieved greater GM activation than the gravitational form (18.1%). BF activation was increased with HE and SKB as compared with SDL (24.4% and 16.4%, respectively), while ST activation was likewise enhanced with HE as compared with SDL (15.1%). CONCLUSION: Inertial training is more effective than gravitational training for the concentric activation of the hamstring muscles while SDL showed lower hamstring activation than HE and SKB. Therefore, HE and SKB with inertial loading should be taken into account in hamstring training programs. CLINICAL RELEVANCE: Inertial training is more effective than gravitational training for the concentric activation of the hamstring muscles. HE and SKB with inertial loading should be taken into account in hamstring training programs.

Prognostic value of balance performance for improvements of community ambulation among stroke patients: a cohort study.

BACKGROUND: Despite the positive impact of improving the level of community ambulation among stroke patients, little prognostic research has focused on this indicator. AIM: To investigate the prognostic value of the side-by-side, semi-tandem, and tandem standing balance positions and the five-sit-stand (5STS) test for discriminating patients undergoing physical rehabilitation who improve level of functional ambulation and predicting transition time. DESIGN: A cohort study with assessments repeated monthly until discharge for classifying patients in a community ambulation class. SETTING: A neurological rehabilitation unit of a hospital in Spain. POPULATION: A consecutive sample of 109 stroke patients (68.5±12.0 years) was screened and included within four months post stroke. Of them no one refused, 3 died, and 5 were lost earlier to transition or discharge. METHODS: Balance tests, the 5STS and gait speed were measured at the center at baseline and monthly until discharge. Transition from household or limited community ambulation to a higher ambulatory capacity or class. Area under the curve (AUC) were used to compare discriminative abilities of the tests and Cox regression analysis to evaluate the association between the tests and time of transition. RESULTS: For household non-ambulators, the semi-tandem was the best discriminative test (AUC=0.850) and the three balance tests showed an association with time to transition. Among the limited community ambulators, the 5STS test also revealed discriminative ability (AUC: 0.822 [0.63-1.00]), with a good prognostic cut-off (14.8 seconds) and association with time to transition (Hazard Ratio: 1.22; 95%CI: 1.05-1.43). CONCLUSIONS: Semi-tandem and the 5STS tests can discriminate patients who improve level of functional ambulation and predict transition times within three months in non-ambulators and limited community ambulation patients, respectively. CLINICAL REHABILITATION IMPACT: The semi-tandem and the 5STS tests can be performed easily in clinical settings to predict improvement of functional ambulation level in patients following stroke.

Analysis of Compliance with Time under Tension and Force during Strengthening Exercises with Elastic Bands.

Quantifying training variables of a physical exercise modality is essential for an appropriate dosage. In training with elastic bands, time under tension (TUT) and force represent the duration and intensity of this force-training modality. The aims of this study were to evaluate the degree of compliance to TUT prescription for three different scenarios of two exercises and the comparison of the force values obtained versus the estimate values. A total of 29 healthy volunteers were evaluated in a clinical environment under controlled conditions in 3 different scenarios (different velocities or ROMs) of both shoulder abduction and knee extension in 2 sets of 10 repetitions per scenario within a single session. Concentric and isometric phases showed a higher degree of compliance for their TUTs than the eccentric phase TUTs for all scenarios of both exercises, whereas the degree of compliance was higher for the total TUT than for the phases' TUTs. Additionally, the eccentric phase showed a general tendency to develop for longer time periods than prescribed, whilst the fast scenario showed a higher degree of compliance for isometric phase TUTs and total TUTs than the extant two scenarios in both exercises. On the other hand, the force of the elastic bands tends to be overestimated according to the estimates of the manufacturers. These findings, both those related to the degree of compliance with TUTs and the force analysis, can be used by physiotherapists and other exercise professionals as a reference to achieve a good dosage of routine exercises with elastic bands.

Influence of rigid taping on the acromiohumeral distance in healthy recreational weightlifters.

BACKGROUND: Subacromial pain syndrome is one of the most frequent injuries in overhead athletes, and it takes place when the acromiohumeral distance (AHD) is narrowed. Conservative treatment is the first approach to this syndrome, being shoulder taping one of the most used techniques. Although there are quite a few studies that analyse the effect of taping on the AHD, most of them do not include sham tapings. This study aimed to examine if the Relocation of the humeral head (RHH) taping produced an increase in the AHD in healthy recreationally weightlifter males, quantifying the change that may be due to a placebo effect. METHODS: The design of this study was a two-group pretest-posttest, in which eighteen healthy recreationally weightlifter males were measured. in a laboratory of the University of Valencia. RHH using rigid or sham taping was randomly applied to the participants. The AHD was measured and registered before and after the application of the taping for both groups by a blinded examiner using ultrasound. RESULTS: There were no significant differences between pre and post measures in the sham group (p = 0.51). The experimental group showed a significant AHD increase of 9.2% (10.75 ± 1.89 vs 11.74 ± 1.82, respectively, with p < 0.001). Significant differences in the effects of each taping on the AHD were found between groups (p < 0.001). The results of this study indicate that the RHH rigid taping increases the AHD in the shoulders of recreationally weightlifters, dismissing the possibility of a placebo effect of the taping.

Intra- and Inter-Rater Reliability of Strength Measurements Using a Pull Hand-Held Dynamometer Fixed to the Examiner's Body and Comparison with Push Dynamometry.

Hand held dynamometers (HHDs) are the most used method to measure strength in clinical sitting. There are two methods to realize the assessment: pull and push. The purpose of the present study was to evaluate the intra- and inter-rater reliability of a new measurement modality for pull HHD and to compare the inter-rater reliability and agreement of the measurements. Forty healthy subjects were evaluated by two assessors with different body composition and manual strength. Fifteen isometric tests were performed in two sessions with a one-week interval between them. Reliability was examined using the intra-class correlation (ICC) and the standard error of measurement (SEM). Agreement between raters was examined using paired t-tests. Intra- and inter-rater reliability for the tests performed with the pull HHD showed excellent values, with ICCs ranging from 0.991 to 0.998. For tests with values higher than 200 N, push HHD showed greater differences between raters than pull HHD. Pull HHD attached to the examiner's body is a method with excellent reliability to measure isometric strength and showed better agreement between examiners, especially for those tests that showed high levels of strength. Pull HHD is a new alternative to perform isometric tests with less rater dependence.

Validity and reliability of the DiCI for the measurement of shoulder flexion and abduction strength in asymptomatic and symptomatic subjects.

BACKGROUND: A higher risk of shoulder injury in the athletic and non-athletic population is frequently associated with strength deficits. Therefore, shoulder strength assessment can be clinically useful to identify and to quantify the magnitude of strength deficit. Thus, the aim of this study was to evaluate the validity and reliability of a DiCI (a new hand-held dynamometer) for the measurement of shoulder flexion and abduction strength in asymptomatic and symptomatic subjects. METHODS: Forty-three recreational athletes (29 males and 14 females; age: 22.1 ± 0.47 years; body mass: 68.7 ± 13.1 kg; height = 173.3 ± 9.7 cm) and 40 symptomatic subjects (28 males and 12 females; age: 49.9 ± 8.1 years; body mass: 70.6 ± 14.3 kg; height = 171.7 ± 9.0 cm) completed shoulder flexion and abduction strength tests in two identical sessions one-week apart. Both types of movement were evaluated at 45º and 90º. RESULTS: Relative reliability analysis showed excellent intra-class correlation coefficients (ICC) for all evaluated movements (ICC range = 0.90 to 0.99). Absolute reliability analysis showed a standard error of measurement (SEM) ranging from 1.36% to 2.25%, and minimal detectable change (MDC) ranging from 3.93% to 6.25%. In conclusion, the DiCI is a valid and reliable device for assessing shoulder strength both in recreational athletes and in subjects with restricted mobility and loss of strength.

Epidemiology of Injuries in First Division Spanish Women's Soccer Players.

The epidemiology of injuries in female soccer has been studied extensively in several national leagues. Even so, data on the first division Spanish league are limited. The objective of this study was to describe the epidemiology of the first division of the Spanish Women's Soccer League and to analyze data in relation to game position, circumstance, or the moment of injury. Fifteen teams and 123 players participated in the study. Players' characteristics and their injuries (location, type, diagnosis, circumstance, and moment) were collected. Injuries were described by their frequencies (number and percentage) and incidence rates (IR) with 95% confidence intervals (CIs). Lower limb injuries accounted for 86.8% of total injuries. Anterior cruciate ligament (ACL) and meniscus injuries occurred in totality in non-contact circumstance (0.35/1000 h; 95% CI, 0.18 to 0.62 and 0.23/1000 h; 95% CI, 0.10 to 0.45, respectively). Match injury IRs (19.02/1000 h; 95% CI, 14.89 to 23.97) were significantly higher than training (1.70/1000 h; 95% CI, 1.27 to 2.22). As a conclusion, structures such as the ACL or meniscus are most commonly injured in the non-contact circumstance in the first division of the Spanish Women's Soccer League. In addition, match situations involve a greater risk of injury than training, increasing the risk to the ankle and knee injuries as the season progresses.

Validity and reliability of Veloflex to measure active cervical range of motion in asymptomatic and symptomatic subjects.

BACKGROUND: Neck pain has a high annual incidence and decreases the cervical active range of motion (ROM). Clinicians use various methods to evaluate cervical range of motion (CROM) that some of them have also been proposed to give instant feedback. Accordingly, this study aimed to examine the validity and reliability of Veloflex (VF) to measure the CROM by comparison with the cervical range of motion (CROM) device, and to examine their test-retest reliability. METHODS: Thirty-eight healthy and 20 symptomatic participants were evaluated. Cervical flexion-extension, side bending, and rotations were tested in two sessions, first by the CROM and VF and in the second only with the VF. To evaluate the concurrent validity and agreement between CROM and VF, Pearson correlation coefficient (r) and Bland-Altmann plots were used. Reliability were evaluated using intra-class correlation (ICC), standard error of measurement (SEM) and minimal detectable change (MDC). RESULTS: CROM and VF showed excellent correlation for all movements (r > 0.960). Both devices provided small mean 'bias' (≤1.29%) in all movements regarding CROM measures. The intra-rater and inter-rater reliability of the VF was excellent (ICC > 0.98). SEMs ranging from 0.72% to 2.38% and the MDC ranging from 1.22° to 2.60° in all participants. The results support the validity and reliability of VF to measure CROM. For its use, with a basic training is enough to get reliable measurements.

Sex Differences and Patterns of Muscle Stiffness in the Knee Flexor and Extensor Musculature Through Analysis of Isolated Bellies.

ABSTRACT: Martín-San Agustín, R, Benítez-Martínez, JC, Medina-Mirapeix, F, and Casaña-Granell, J. Sex differences and patterns of muscle stiffness in the knee flexor and extensor musculature through analysis of isolated bellies. J Strength Cond Res 35(4): 1044-1049, 2021-Muscle stiffness (MS) is one of the key factors in joint control. The purpose of this study was to determine sex differences in the MS of 5 isolated muscle bellies (biceps femoris [BF], semitendinosus [ST], rectus femoris [RF], vastus medialis [VM], and vastus lateralis [VL]) and in the pattern of differences among their respective MS. Twenty female and 20 male recreational athletes participated. Muscle stiffness was measured by tensiomyography using maximum radial deformation (Dm) as an indirect indicator of MS. Sex differences were observed only in the Dm of RF (mean difference = 2.07 mm, p < 0.05) when values were adjusted by body mass and stature. Males and females showed a similar pattern in the Dm between the muscle bellies: within the hamstrings, ST had a significantly higher Dm than BF in females (3.02 mm) and males (4.28 mm); within the quadriceps, RF also had a significantly higher value than VL and VM in females (6.50 and 7.38 mm, respectively) and males (4.87 and 4.82 mm, respectively). Sex differences in patterns were found between BF and the vastus muscles: the BF of females had a significantly higher Dm than VL (3.78 mm) and VM (4.51 mm), but this was not observed in males. Differences may imply different involvement of the bellies in countering the movements of the lower extremities. Our results can help to direct exercises to improve the MS in certain muscular bellies.

Validity of an inertial system for measuring velocity, force, and power during hamstring exercises performed on a flywheel resistance training device.

BACKGROUND: Inertial hamstring exercises promote functional changes leading to lower rates of hamstring injuries. However, variable training measurement systems have not been specifically validated for hamstring exercises. Accordingly, this study aimed to evaluate the validity of the Inertial Measurement System (IMS) to measure the velocity, force, and power during the performance of different hamstring exercises on a flywheel resistance training device. METHODS: Fifteen males (average age: 22.4 ± 2.5 years; body mass: 77.3 ± 9.8 kg; height: 179.5 ± 7.4 cm; weekly physical activity: 434.0 ± 169.2 min; years of strength training: 4.3 ± 2.2 years) performed the bilateral stiff-leg deadlift (SDL), 45° hip extension (HE), and unilateral straight knee bridge (SKB) in two sessions (familiarization and evaluation) with a 1-week interval between them. The velocity, force, and power (average and peak values) in the concentric and eccentric phases for each of the exercises were recorded simultaneously with IMS and MuscleLab. RESULTS: Consistency between IMS and MuscleLab was good to excellent for all variables, with r ranges from 0.824 to 0.966 in SDL, from 0.822 to 0.971 in HE, and from 0.806 to 0.969 in SKB. Acceptable levels of agreement between devices were observed in general for all exercises, the "bias" ranging from 1.1% to 13.2%. Although MuscleLab showed higher values than IMS for peak velocity, force and power values, the effect size was only relevant for 5 of the 36 parameters. IMS is a new and valid system to monitor inertial hamstring exercises on a new flywheel device. In this way, IMS could have potential practical applications for any professional or athlete who wants to monitor inertial hamstring exercises.

Stability and Predictors of Poor 6-min Walking Test Performance over 2 Years in Patients with COPD.

Poor performance in the 6-min walk test (6MWT < 350 m) is an important prognostic indicator of mortality and risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Little is known about the stability of this state over time and what factors might predict a poor 6MWT performance. To determine the stability of 6MWT performance over a 2-year period in COPD patients participating in annual medical follow-up visits, and to assess the ability of several clinical, pulmonary, and non-pulmonary factors to predict poor 6MWT performance, we prospectively included 137 patients with stable COPD (mean age, 66.9 ± 8.3 years). The 6MWT was scored at baseline and 2-year follow-up. To evaluate clinical, pulmonary, and non-pulmonary variables as potential predictors of poor 6MWT performance, we used multiple logistic regression models adjusted for age, sex, weight, height, and 6MWT performance at baseline. Poor 6MWT performance was stable over 2 years for 67.4% of patients. Predictors of poor 6MWT performance included a five-repetition sit-to-stand test score ≤2 (OR, 3.01; 95% CI, 1.22-7.42), the percentage of mobility activities with limitations (OR, 1.03; 95% CI, 1.00-1.07), and poor 6MWT performance at baseline (OR, 4.64; 95% CI, 1.88-11.43). Poor 6MWT performance status was stable for the majority of COPD patients. Lower scores on the five-repetition sit-to-stand test and a higher number of mobility activities with limitations were relevant predictors of poor 6MWT performance over 2 years. Prognostic models based on these non-pulmonary factors can provide non-inferior discriminative ability in comparison with prognostic models based on only pulmonary factors.

Tensiomyographical responsiveness to peripheral fatigue in quadriceps femoris.

BACKGROUND: Fatigue influences athletic performance and can also increase the risk of injury in sports, and most of the methods to evaluate it require an additional voluntary effort. Tensiomyography (TMG), which uses electrical stimulation and a displacement sensor to evaluate muscle contraction properties of one or more muscle bellies, has emerged as a technique that can assess the presence of peripheral and central fatigue without requiring additional voluntary efforts. However, the evaluation of the TMG's ability to detect fatigue is limited, both at the level of muscle bellies and statistical methods. Thus, the aim of the present study was twofold: (i) to examine and compare the tensiomyographical responsiveness to quadriceps femoris (QF) fatigue by multiple statistical methods and (ii) to analyze sex differences in the variation produced by fatigue in TMG parameters. METHODS: Thirty-nine recreational athletes participated (19 males/20 females; aged 22 ± 2 years). TMG parameters of QF bellies and maximal voluntary isometric contraction (MVIC) were measured before and after a fatigue protocol. TMG parameters used were maximum radial deformation (Dm), contraction time between 10-90% of the Dm (Tc), contraction velocity between 10-90% (Vc) and of the first 10% (V10) of the Dm. Internal responsiveness of TMG to fatigue was analyzed by paired t-test and standardized response mean (SRM). External responsiveness was examined by correlations, regression models, and receiver operating characteristic (ROC) curves. RESULTS: All TMG parameters, except for Tc of rectus femoris and vastus medialis, showed large internal responsiveness. In adjusted regression models by sex, only Dm and V10 of rectus femoris were statistically associated (p < 0.05) with b coefficients of 0.40 and 0.43, respectively. r2 explained the 22% of the total variance. In addition, these parameters could discriminate between QF with and without fatigue. CONCLUSION: Since the QF is the main strength contributor during multiple physical activities, clinicians and trainers will be able to discriminate the presence of fatigue and the magnitude of changes in the QF strength by TMG evaluation.

Effect of different ergonomic supports on muscle activity of dentists during posterior composite restoration.

BACKGROUND: The aim of this study was to evaluate the effect of different ergonomic supports on the muscle activity of two trunk muscles while a group of dentists performed a common dental procedure on a phantom head, divided into three tasks. METHODS: A one-way repeated measures study (ANOVA) was conducted on a group of 36 dentists. The middle trapezius and lumbar erector spinae muscles were measured with and without the use of different ergonomic supports (ergonomic stool, magnification lenses and both) using a portable surface electromyography (sEMG) device. Intraclass correlation coefficients (ICCs) and the absolute standard error of measurement (SEM) were used to establish the reliability of the baseline measures without ergonomic supports. RESULTS: The sEMG showed excellent ICCs (ranging from 0.92 to 0.99) and SEM. Bonferroni post hoc tests showed differences between the three ergonomic supports (p < 0.001) in both muscles studied. The lowest muscle activity measurement occurred with the isolated used of magnification lenses. The use of the ergonomic stool increased the muscle activity of the middle trapezius and lumbar erector spinae muscles to a greater extent than the magnification lenses. The combination of the ergonomic stool and the magnification lenses produced a different effect on each muscle.