Effectiveness of therapeutic ultrasound on reducing pain intensity and functional disability in patients with plantar fasciitis: a systematic review of randomised controlled trials.

Background: Ultrasound therapy is one of the preferred conservative treatments for patients with plantar fasciitis. This study aims to evaluate the effectiveness of therapeutic ultrasound in decreasing pain intensity and improving functional disability in patients with plantar fasciitis. Methods: Five randomised control trials (RCT) were selected based on an electronic search in PubMed, Trip Database and PEDro. To be included in the systematic review, the study should be an RCT which investigated the effectiveness of therapeutic ultrasound conducted in patients with plantar fasciitis with pain intensity and functional disability as outcome measures. Only studies published in peer-reviewed journals written in the English language were included. The quality of the selected studies was measured by the PEDro scale. Results: All the included studies showed that ultrasound therapy is beneficial in reducing pain score and improving functional disability, except one study did not recommend using ultrasound therapy for plantar fasciitis. Moreover, regarding another outcome measure, two studies found that ultrasound therapy reduces thickness and tenderness in plantar fasciitis and improves static and dynamic balance. Conclusion: After reviewing the five studies, this systematic review support using ultrasound therapy to decrease pain and improve functional disability in patients with plantar fasciitis. Study Registration: https://osf.io/xftzy/.

Effect of Whole-Body Vibration Exercise on Pain, Disability, Balance, Proprioception, Functional Performance and Quality of Life in People with Non-Specific Chronic Low Back Pain: A Systematic Review and Meta-Analysis.

Background: Non-specific chronic low back pain (NSCLBP) presents significant treatment challenges due to its multifactorial nature. Whole-body vibration exercise (WBVE) has emerged as a potential therapeutic modality, offering benefits across various domains, including pain reduction, improved balance, and enhanced quality of life (QoL). The aim of this present systematic review and meta-analysis is to evaluate the effects of WBVE on pain, disability, balance, proprioception, functional performance, and QoL in individuals with NSCLBP. Methods: We comprehensively searched PubMed, Web of Science, Scopus, and CENTRAL databases from October 2023 to January 2024, including RCTs with a PEDro score of ≥5 for high-quality evidence. Outcome measures included pain intensity, Oswestry Disability Index (ODI) score, Roland-Morris Disability Questionnaire (RMDQ) score, balance, proprioception, functional performance (through a progressive iso-inertial lifting evaluation), and QoL (SF-36) in NSCLBP patients. The risk of bias was assessed using ROB-2, and the certainty of evidence for each outcome indicator was analyzed using GRADE. A meta-analysis was conducted using standardized mean differences (SMD) and mean differences (MD) for continuous outcomes. Results: Ten randomized controlled trials fulfilled the inclusion criteria for the systematic review, and nine were suitable for the meta-analysis. The qualitative synthesis revealed WBVE is effective in improving pain, disability, balance, proprioception, and functional performance and QoL. Further, the results of the quantitative review demonstrated WBVE significantly reduced pain [visual analogue scale: SMD = -0.81, 95% CI (-1.11, -0.50), I2 = 0%, p < 0.01], disability [ODI: MD = -3.78, 95% CI (-5.27, -2.29), I2 = 24%, p < 0.01]; RMDQ: MD = -1.43, 95% CI (-2.04, -0.82), I2 = 51%, p < 0.01], balance [SMD = -0.28, 95% CI (-0.52, -0.05), I2 = 0%, p = 0.02], and proprioception [SMD = -4.20, 95% CI (-7.50, -0.89), I2 = 99%, p = 0.01]. Conclusions: This review and meta-analysis indicate that WBVE significantly improves pain, disability, balance and proprioception in individuals with non-specific chronic low back pain. These findings suggest potential benefits of incorporating WBVE into the management strategies for NSCLBP.

Effects of physical interventions on pain and disability in chronic low back pain with pronated feet: a systematic review and meta-analysis.

BACKGROUND: A link between pronated feet (PF) and chronic low back pain (CLBP) has been reported in the literature. However, physical interventions (PI) like physiotherapy and orthotics mainly target the lower back, neglecting the broader biomechanical impacts of PF that affect the feet, ankles, and overall posture. Currently, there is a lack of comprehensive meta-analyses or systematic reviews on this subject. OBJECTIVES: This systematic review with a meta-analysis aimed to evaluate the effects of PI on pain and disability in patients having CLBP with PF. METHODS: From inception until October 15, 2023, Medline/PubMed, Web of Science, and Scopus databases were searched using the desired keywords for randomized control trials (RCTs). The quality of the RCTs was evaluated using the PEDro scale and risk of bias tool. RESULTS: Four studies involving 268 patients were identified, two compared custom-made foot orthoses to non-biomechanical foot insoles, while the other two used exercises. The meta-analysis included four studies for pain and three for disability. The results showed a significant change in pain [-2.43 (95% CI -2.73 to -2.13, p < .001)] and disability of -6.69 (95% CI -8.04 to -5.33, p < .001)]. CONCLUSIONS: This systematic review and meta-analysis of four RCTs elucidates that PI, specifically targeting PF, significantly alleviate pain and reduce disability in patients having CLBP with PF. These findings advocate for integrating foot-based PI within the treatment protocols for patients suffering from CLBP accompanied by PF.

Correlation between hip muscle strength and the lower quarter Y-balance test in athletes following anterior cruciate ligament reconstruction.

INTRODUCTION: The lower quarter Y-balance test (YBT-LQ), which measures dynamic postural control, has been reported to be predictive of lower limb injuries in athletes. It requires subjects to control their body while maintaining a single-leg stance, which necessitates sufficient strength of the hip muscles to maintain stability. The purpose of the study was to investigate the correlation between the performance of the YBT-LQ and the hip abductor or extensor muscle strength in athletes following anterior cruciate ligament reconstruction surgery (ACLR). METHODS: Fifteen athletes with post-ACLR participated in this cross-sectional study. The participants completed the YBT-LQ, followed by isokinetic measurement of the hip abductor and extensor muscles of both the legs. The peak and average torque of the hip abductor and extensor muscles were tallied with the composite score of the YBT-LQ for each limb. RESULTS: No correlation was found between the strength of the hip muscles and the YBT-LQ composite score in both injured and non-injured limbs at all velocities except for the eccentric hip abductor and concentric hip extensor torques. The eccentric hip abductor average torque is strongly associated with the YBT-LQ (r = 0.663, p = 0.010) at a speed of 180°/s. The concentric hip extensor peak torque was weakly correlated with balance (r = 0.540, p = 0.046) at a speed of 180°/s. CONCLUSION: Our study demonstrated a positive correlation between the YBT-LQ and eccentric hip abduction and concentric hip extension at higher velocities. This shows the importance of implementing velocity-oriented rehabilitation in an athletic population following ACLR.

The effectiveness of the Copenhagen adduction exercise on improving eccentric hip adduction strength among soccer players with groin injury: a randomized controlled trial.

INTRODUCTION: Groin injuries are common in soccer players and often involve adductor muscle strains. The Copenhagen Adduction Exercise (CAE) is a targeted intervention whose effectiveness in rehabilitation for these injuries warrants investigation. OBJECTIVE: To investigate the impact of a rehabilitation program, which includes the CAE, on eccentric hip adduction (EHAD) strength, hip joint range of motion (ROM), self-reported disability, and pain among soccer players with adductor-related groin pain. It was hypothesized that the addition of CAE to the rehabilitation program would yield greater improvements. METHODS: Employing a randomized controlled trial with a two-group parallel design, thirty male soccer players with a mean age of 26.4 ± 3.9 years were randomized into an intervention group (IG) including CAE (n = 15) and a control group (CG) without CAE (n = 15), based on a power analysis to ensure 80% power to detect significant differences. Both groups engaged in their respective rehabilitation programs twice a week for eight weeks. The primary outcome measured was EHAD strength, while secondary outcomes included hip joint ROM, self-reported disability measured by the Copenhagen Hip and Groin Outcome Score (HAGOS), and pain levels. RESULTS: Significant improvements within groups were observed across all measures (p < 0.001). The IG demonstrated a greater increase in EHAD strength (Mean Difference [MD] = 0.49 Nm/kg, 95% Confidence Interval [CI] [0.31, 0.66]), a more pronounced reduction in pain (MD = -1.60, 95% CI [-2.18, -1.02]), and betterment in all HAGOS subscale scores compared to the CG. There were no significant between-group differences in hip joint ROM. CONCLUSION: Incorporating the CAE into rehabilitation programs significantly improves EHAD strength, decreases pain scores, and reduces self-reported disability in soccer players with adductor-related groin pain. REGISTRATION: ClinicalTrials.gov identifier: NCT05589623.

Effects of hip abductor with external rotator strengthening versus proprioceptive training on pain and functions in patients with patellofemoral pain syndrome: A randomized controlled trial.

BACKGROUND: Strengthening the hip muscles, particularly the abductors and rotators, has been reported beneficial for treating Patellofemoral pain syndrome (PFPS). Proprioceptive training (PT) is also shown to improve musculoskeletal pain and function in PFPS. The most appropriate treatment from these 2 is unclear. This study aimed to compare the effects of hip abductors and external rotator strengthening exercises along with conventional physical therapy (CPT) vs the proprioceptive training of the knee along with CPT in patients with PFPS. METHODS: Forty-five participants were divided into 3 groups, experimental group 1 (EG 1), experimental group 2 (EG 2), and control group (CG), with fifteen participants in each group. EG 1 received hip abductor and external rotator strengthening exercises in addition to CPT. EG 2 received proprioceptive training and CPT. CG received CPT alone. Intervention programs lasted for 4 weeks. The pain was measured by Kujala Anterior Knee Pain Scale (AKPS). The study was registered retrospectively in the protocol registration and results system (clinicaltrials.gov, ID: NCT05698797 on 26/01/2023). RESULTS: AKPS scores significantly (P < .001) improved in all 3 groups. A significant (P < .05) difference was also observed between all 3 groups. The greatest improvement was observed in EG 1, followed by EG 2 and CG. CONCLUSION: The addition of hip abductor and external rotator strengthening exercises to a 4-week CPT program showed a more significant improvement in AKPS scores than the addition of proprioceptive training in patients with PFPS.

Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: A randomized controlled trial.

PURPOSE: The present study aims to investigate the combined effect of slow breathing exercise (SBE) and progressive muscle relaxation (PMR) technique on blood pressure (BP), heart rate (HR), respiratory rate (RR), and anxiety in patients diagnosed with essential hypertension. TRIAL DESIGN: This study was based on a 4-arm parallel-group, randomized control design. METHODS: Sixty-four participants diagnosed with essential hypertension were randomly allocated into SBE, PMR, SBE-PMR, and Control groups, with 16 subjects each. All 3 groups received different treatments according to their name; however, the Control group received no treatment. Systolic and diastolic BP (SBP and DBP), HR, RR, and anxiety were all evaluated as the study outcomes using a digital sphygmomanometer and perceived stress scale (PSS) at baseline (pretest), 2nd week and 4th weeks post-intervention. A repeated measure analysis of variance test assessed intra-group comparison (overall) analyses across multiple time points. Bonferroni multiple comparison tests were used to analyze the mean differences between the groups. The confidence interval was kept at 95% for all the statistical analyses, that is, P < .05 is considered significant. RESULTS: There was a significant change in the HR (F = 239.04, P = .0001), RR (F = 167.74, P = .0001), SBP (F = 266.64, P = .0001), DSP (F = 279.80, P = .0001), and PSS (F = 473.42, P = .0001) as an outcome of baseline measurements versus (vs) the following weeks. There were significant (F = 48.57, P = .001) differences among different training on HR. The SBE vs SBE-PMR showed an insignificant difference (F = 48.54, P = 1.000). The RR showed significant differences (F = 32.05, 0.0001) between the SBE vs PMR, SBE vs Control, PMR vs Control, and SBE-PMR vs Control groups and insignificant differences for the SBE vs SBE-PMR and PMR vs SBE-PMR groups. The SBE vs SBE-PMR groups showed insignificant differences for DPP and SBP. However, PSS showed significant differences (F = 67.12, P = .0001) among the intervention groups except for the PMR and SBE-PMR groups. CONCLUSIONS: The combined interventions of SBEs and progressive muscle relaxation techniques can effectively reduce the heart rate, respiratory rate, BP, and anxiety in essential hypertensive patients compared to both techniques when given alone.

A comparison of the range of motion and dynamic stability of the ankle joint of athletes with an ankle sprain as compared to healthy controls: A cross-sectional study.

Background: Ankle sprains are the most common lower-leg musculoskeletal injuries, frequently occurring among athletes and other physical activity individuals. The objective of this study was to compare the ankle range of motion and dynamic stability of healthy and injured athletes for their dominant and nondominant legs. Methods: A cross-sectional study design was selected to investigate this study with 32 male soccer players with average age: 22.6 ± 3.3 years, weight: 69.6 ± 5.7 kg, height: 176.8 ± 5.32 cm, with a history of a lateral ankle sprain on the dominant leg for the past 2 years. Ankle range of motion was determined using dorsiflexion and plantar flexion by a goniometer. The dynamic stability was determined using the SWAY medical system. An independent t-test was used to study the differences between healthy and injured groups and between dominant and nondominant legs for dynamic stability, dorsiflexion, and plantar flexion range. Results: There were higher significant differences for dynamic stability in healthy participants than in injured participants for their dominant (P = 0.001) and nondominant (P = 0.001) legs. There were significant differences in dynamic stability in the dominant and nondominant leg (healthy [P = 0.033] and injured [P = 0.000] participants). The dominant leg shows higher dynamic stability in healthy group, whereas nondominant leg shows higher dynamic stability in the injured group. Conclusion: The study found significant differences between the injured and sound legs. The injured dominant and nondominant leg revealed a striking disparity in the ankle range of motion. Therefore, the study demonstrated that ankle sprain causes due to less stability of the ankle joint, which limits ankle movements.

Arthroscopic debridement of the ankle in synovitis.

Inflammation and hypertrophy of the ankle joint's synovial lining can occur due to various causes. Chronic pain and degenerative changes may be due to synovitis causing clinical manifestations through traction on the joint capsule. The failure of conservative treatment for at least six months indicates arthroscopic debridement, which can provide significant pain relief without the morbidity of extensive surgical exposures. This study was therefore conducted to establish the functional results of arthroscopic debridement of the ankle joint in synovitis. Fifteen patients with chronic ankle pain who had not responded to conservative treatment for approximately six months were included in the study. Arthroscopic debridement was performed using a shaver blade, followed by a postoperative ankle physiotherapy regimen. Patients were assessed preoperatively and postoperatively using the AOFAS, FADI, and VAS scores, with a mean follow-up period of 26 months. There was a significant improvement in the final clinical outcomes of the patients. The post-operative VAS score improved to 2.20±0.56 (2-4) (p-value=0.001), the AOFAS score was 86±8.25 (65-98) (p-value-0.001), and the FADI Score was 86.93±7.35(70-96) (p-value=0.001). Thirteen patients (86.67%) achieved outstanding or good results, while two had fair results, according to Meislin's criterion. One patient reported a superficial wound infection, which subsided with antibiotic therapy. The study findings indicate that arthroscopic ankle debridement is an efficient method to treat persistent ankle discomfort induced by synovitis, and it has a low postsurgical complications rate, quicker recovery, and less joint stiffness.

Effect of different coronary artery revascularization procedures on cognition: A systematic review.

Coronary revascularization interventions have been associated with post-intervention cognitive decline. Hence, this systematic review aims to compare the long-term effects of different coronary revascularization interventions on cognition. The Cochrane Library and MEDLINE databases were searched for articles published between January 2009 and January 2023. Articles on clinical trials and cohort studies that compared at least two different interventions with a minimum three months follow up were included to evaluate the consequences of different intervention techniques on cognition. Each selected study was evaluated using a revised tool to assess the risk of bias in randomized trials (RoB 2), and Risk of Bias In Non-Randomized Studies - of Interventions(ROBINS-1) was used for evaluating non-randomized studies. Five eligible studies, with four different comparisons, were included. Out of these studies, three RCTs and two cohort studies were included A participants gone through different procedures; on-pump and off-pump coronary artery bypass grafting (CABG), Percutaneous coronary intervention (PCI conventional cardiopulmonary bypass (CCPB), the miniaturized cardiopulmonary bypass (MCPB) and endoscopic coronary artery bypass grafting (Endo-CABG). These comparisons showed that different interventions have different effects on cognition; however, there is no solid evidence of correlations between them. Thus, the results of this review suggest that there should be greater focus on comparing interventions and that a reasonable follow-up duration should be set to avoid the influence of confounders. There is also a need to determine the effect of long-term cognitive decline while reducing interference by other variables.

Exploring variations in gait patterns and joint motion characteristics in school-aged children across different walking speeds: a comprehensive motion analysis study.

This study aimed to investigate differences in gait patterns among individuals with different walking speeds and identify the range of motion (ROM) and angular velocity for various joints during gait. Forty-five schoolchildren were randomly selected for this study. To capture their walking patterns, two FDR-AX700 4K HDR camcorders were positioned to observe the predetermined walkway. Each participant completed a 5-meter walk at various speeds, including slow, normal, and fast, while maintaining a straight stride. There were significantly higher ROM and angular velocity (p<0.05) at the hip, knee, and ankle joints across most stages of walking at a faster speed compared to slow and normal speeds. At the same time, the angular velocity was significantly higher at the hip joint during hip extension terminal stance at normal speed compared to slow and fast speeds (p<0.05, ƞ2 =0.74). Similarly, the ROM of knee flexion swing, ankle plantar flexion loading response, and ankle dorsiflexion midswing angular velocity were significantly higher during normal walking speed (p<0.05). Conversely, slow-speed walking showed significantly higher ROM at knee extension terminal swing (ƞ2=0.52) and ankle dorsiflexion terminal stance (ƞ2=0.78) (p<0.05). The results indicate that individuals with different walking speeds exhibit significant differences in gait patterns. Slower walking speeds resulted in lower gait velocity and different joint motions compared to faster walking speeds.

Analysis of the kinematic variables that predict jump serve efficacy among volleyball players.

In volleyball, a strong correlation exists between the proper application of kinematics factors and the serve results. Therefore, this study compared the kinematics parameters of the volleyball jump serve among different functional classes and established an appropriate multilinear regression model of performance. This correlational observational study involved thirty male collegiate volleyball players categorized into under twenty-three (U-23) men, under twenty-one (U-21) junior men, and under nineteen (U-19) youth boys. Data acquisition entailed the utilization of synchronized cameras to capture the volleyball serves meticulously, while subsequent data analysis was conducted through the implementation of silicon coach-pro 8 motion analysis software. Analysis of variance and multiple linear regressions were performed to analyze data, with a predetermined significance level of P < .05. Jump serve analysis showed significant mean differences in selected major kinematic variables among all 3 classes (U-23 men, U-21 junior men, and U-19 youth boys). U-23 men Model-3, which includes 3 independent variables (approach velocity [AV], shoulder extension angles during the cocking phase, and center of gravity [CG] height), predicted velocity with an R-square of 1.00, indicating that the selected independent variable caused 100% variation in ball velocity (BV), whereas models 1 and 2 showed 99% variation in BV, respectively. The U-21 Junior men Model-2, which includes 2 independent variables (height of CG and shoulder extension angles during the cocking phase), predicted velocity with an R-square of 9.80, indicating that the selected independent variable caused a 98% variation in BV. In contrast, model 1 showed a 94% variation in BV, respectively. U-19 youth boys Model-1, which includes one independent variable (AV), predicted velocity with an R-square of 0.89, indicating that the selected independent variable caused 89% variation in BV. The jump serve exhibits similar biomechanical characteristics across different classes. However, the major independent variables of the jump serve: U-23 men were AV, shoulder extension angles at cocking phase (SEACP), the height of CG, U-21 junior men were SEACP and height of CG, and U-19 youth boys were SEACP and height of CG AV showed significant with the dependent variable (BV).

Examining gender differences in gait parameters between non-smoker and smoker participants.

Smoking is one of the predictors of decreased cardiopulmonary endurance. Gait disturbance may be due to many reasons, including cardiovascular endurance. This study aimed to determine differences in gait parameters between non-smoker and smoker participants. A cross-sectional design was employed, involving thirty non-smokers and thirty-seven smokers as participants. Detailed interviews were conducted to gather information on smoking habits, status, and history. Gait parameters were measured using a high-quality 3D accelerometer, 3D gyroscope, and barometric pressure sensors (Physilog4 from GaitUp). Anthropometric characteristics were described, and mean values with standard deviations (SD) were calculated. An independent two-tailed t-test was conducted to compare gait parameters between non-smokers and smokers, with statistical significance set at p<0.05. The analysis revealed significant differences in various gait parameters between non-smokers and smokers. Specifically, significant differences were found in cadence (t=9.95, p=0.001), stride length (t=6.85, p=0.001), stride velocity (t=-6.58, p=0.001), stance (t=2.02, p=0.001), swing (t=3.46, p=0.001), foot flat (t=-8.94, p=0.001), pushing (t=3.53, p=0.001), and double support (t=-13.35, p=0.001). However, no significant difference was found between non-smokers and smokers in the loading phase (t=-1.57, p= 0.121). There were significant differences in general and temporal gait parameters between smokers and non-smokers. Gait parameters provide valuable insights for evaluating functional performance and providing objective and quantitative data to assess gait disorders. Future studies should include longitudinal studies with large sample sizes to explore the effects of potential confounders on gait parameters.

Effects of modified sleeper stretch and modified cross-body stretch on upper limb functions and shoulder ROM in tennis players: a randomized trial.

Tennis players often experience posterior shoulder pain due to restricted internal rotation (IR) range of motion (ROM) of the glenohumeral joint. No research has compared the effects of modified sleeper stretch (MSS) versus modified cross-body stretch (MCBS) on tennis players' upper limb functions and IR ROM. The study aimed to compare the efficacy of modified sleeper and cross-body adduction stretch in improving shoulder IR ROM and upper limb functions in tennis players. Thirty male lawn tennis players (aged 20 to 35 years) with more than 15° glenohumeral IR deficiency on the dominant side compared to the non-dominant side were recruited and divided into two groups: Modified sleeper stretch group (MSSG) and modified cross-body stretch group (MCBSG). MSSG received MSS, and MCBSG received MCBS, 3-5 repetitions once daily for 4 weeks. Upper limb functions were measured using the Disability of the Arm, Shoulder, and Hand (DASH) scale, and the IR ROM of the shoulder joint was measured using a universal goniometer. Both groups observed significant (p < 0.05) DASH scores and IR ROM improvements. DASH scores decreased by 85% in MSSG and 79.60% in MCBSG. IR ROM increased by 94.64% in MSSG and 89.52% in MCBSG. No significant differences (p > 0.05) were found in post-intervention DASH scores and IR ROM values between both groups. MSS and MCBS improved upper limb functions and IR ROM of the shoulder joint in the selected sample population of lawn tennis players. No difference was observed between both stretching techniques in improving upper limb functions and IR ROM of the shoulder joint.

Effects of an aerobic training program on liver functions in male athletes: a randomized controlled trial.

The optimal functioning of the liver is essential for athletic performance. It is necessary to maintain the liver's enzymes at an optimal level so that liver cells can be protected from inflammation or damage. This study investigated the effects of a 12-week aerobic exercise program on the liver function of adult athletes. A pretest-posttest experimental design was used. A total of thirty healthy male athletes (football players) aged 21 to 24 years were recruited for this study and randomly and equally divided into the experimental group (EG) and control group (CG). The CG did not participate in any special activities. The EG performed an aerobic training program consisting of several exercises for 12 weeks. Evaluation of all participants in both groups was carried out before and after the intervention by measuring the blood levels of Alkaline phosphate, AST/SGOT, ALT/SGPT, Bilirubin Total/indirect/direct, Albumin, Globulin, and Total protein using the standard methods by collecting blood samples. There was a significant decrease (p < 0.05) in Bilirubin and globulin levels in the EG after 12 weeks of aerobic training sessions. However, there was no significant difference in alkaline phosphate, AST/SGOT, ALT/SGPT Total protein, and Albumin (p > 0.05) between both groups post-treatment. The 12 weeks of aerobic training used in the study can potentially improve the liver function of adult athletes.

Immediate and Long-Term Effectiveness of Proprioceptive Neuromuscular Facilitation and Static Stretching on Joint Range of Motion, Flexibility, and Electromyographic Activity of Knee Muscles in Older Adults.

Introduction and Objective: Previously, various stretching techniques were compared to study their effects on the different physiological parameters of hamstring muscles in the elderly population. There is no research that compares the immediate and long-term effects of proprioceptive neuromuscular facilitation-contract-relax (PNF-CR) and static stretching (SS) techniques on knee range of motion (ROM), hamstring flexibility, and knee flexor muscle EMG activity in the elderly. This study intends to compare the same. Methods: A total of 30 males aged 55-75 years were randomly assigned into the PNF-CR group (n = 10), SS group (n = 10), and control group (n = 10). The PNF-CR group received four trials of the contract-relax technique, the SS group received passive stretching of an 80 s duration by the therapist, and the control group received no intervention. A total of 12 sessions were given during the four-week period. Knee range of motion, electromyographic activity of the biceps femoris, and the sit-and-reach test were taken for the dominant side thrice: pre-intervention, immediately after stretching, and after the training period. Results: A statistically significant difference was observed in the maximum voluntary isometric contraction (MVIC) of biceps femoris between the PNF and the control groups (p = 0.01) after four weeks of intervention. The knee ROM and hamstring flexibility for the PNF group showed significant improvement immediately post-test (p = 0.01) and after four weeks of training (p = 0.07 and p = 0.001). SS showed significant results for both ROM and flexibility after four weeks of intervention (p = 0.001), and significant immediate post-test improvements were seen for ROM only (p = 0.007). Conclusions: PNF stretching has an immediate, as well as long-term, effect on knee ROM and hamstring flexibility, whereas it has only a long-term effect on muscle electromyographic activity. SS has an immediate, as well as long-term, effect on knee ROM and only a long-term effect on hamstring flexibility, without any immediate or long-term effects on muscle electromyographic activity.

Dry needling in the management of tendinopathy: A systematic review of randomized control trials.

INTRODUCTION: The objective of the study is to evaluate the best available evidence on the effectiveness of DN in the management of tendinopathy. METHODS: Seven randomized control trials were selected following an electronic search in PubMed, Web of Science, Scopus, and SPORTDiscus databases. To be included in the current systematic review, the study had to be an RCT conducted on human participants, which investigated the effect of the DN technique on the management of tendinopathies. Only studies in the English language published in peer-reviewed journals between 1999 and 2020 were included. The methodological quality of the studies was assessed using the PEDro scale. RESULTS: The PEDro score of the studies ranged from 5 to 9 with a mean score of 6.7 ± 1.2 (mean ± SD). A total of 357 participants were enrolled in the seven included studies, which were on greater trochanteric pain syndrome, lateral epicondylitis, supraspinatus tendinopathy and Achilles tendinopathy. DN was compared with various interventions, including platelet-rich plasma injection, autologous blood injection and non-steroidal anti-inflammatory medication. All the selected studies reported a significant positive effect of DN on pain intensity and other outcome measures, such as patient-specific functional score, disability index, range of motion and health-related quality of life. CONCLUSION: The results indicate that DN appears to be as effective as other treatment methods at relieving pain and other symptoms of tendinopathy immediately after treatment and up to 6 months. DN can be considered among the many options available for the management of tendinopathy.

Effects of an incentive spirometer versus a threshold inspiratory muscle trainer on lung functions in Parkinson's disease patients: a randomized trial.

Upper airway obstruction, reduced maximal expiratory and inspiratory flows, reduced lung volumes, abnormal ventilatory control, and diaphragmatic dyskinesias are reported in patients with Parkinson's disease (PD). Inspiratory muscle training (IMT) has been reported to be effective in improving respiratory functions; however, no studies have compared the effects of the incentive spirometer (IS) with the threshold inspiratory muscle trainer (TIMT) in patients with PD. The study aimed to compare the effects of IS and TIMT on maximum inspiratory pressure (MIP), 6-min walk distance (6-MWD), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow rate (PEFR) in patients with stage 1-3 according to the Hoehn and Yahr scale. 18 patients were randomly assigned to two groups, i.e., incentive spirometer (IS) and threshold inspiratory muscle trainer (TIMT) group. The IS group received IMT with volume-based IS, and the TIMT group received IMT with TIMT. MIP, 6-MWD, FVC, FEV1, and PEFR were measured before and after six weeks of training. In IS group: A significant increase (p < 0.05) was observed in MIP and 6-MWD by 18.13 and 5%, respectively. In the TIMT group: A significant increase (p < 0.05) was observed in MIP and 6-MWD by 30.15 and 8.94%, respectively. Both groups observed no significant difference (p > 0.05) in FVC, FEV1, and PEFR. When the two groups were compared, a greater increase (p < 0.05) was observed in the MIP and 6-MWD in the TIMT group compared to IS group. IMT with IS or TIMT for six weeks effectively increased MIP and 6-MWD in patients with stage 1-3 (Hoehn and Yahr scale) of PD. No improvement was observed in FVC, FEV1, or PEFR with any of the techniques. TIMT is more effective than IS in improving MIP and 6-MWD.

Correlation of ankle dorsiflexion range of motion with lower-limb kinetic chain function and hop test performance in healthy male recreational athletes.

Background: The study aims to identify the correlation of ankle dorsiflexion range-of-motion (ADROM) (with its related gastrocnemius and soleus extensibility) with lower-limb kinetic chain function and hop test performance in young healthy recreational athletes. Methods: Twenty-one young male healthy recreational athletes were tested for ADROM, gastrocnemius and soleus extensibility, lower-limb kinetic chain function with the closed kinetic chain lower extremity stability test (CKCLEST) and hop test performance with the single-leg hop for distance test (SHDT) and side hop test (SHT). Results: There was a positive significant (rho = 0.514, 95% CI [0.092-0.779], P < 0.01) correlation between the dominant lower-limb weight-bearing/closed-chain ADROM (that represented the soleus extensibility) and the CKCLEST. There were no significant correlations between the study performance-based tests and open-chain ADROM (P > 0.05). Conclusion: The CKCLEST is positively and significantly correlated with SHT and weight-bearing ADROM with knee flexion (and its related soleus extensibility) which suggests comparability among them. Open-chain ADROM has a negligible and non-significant correlation with the readings of this study performance-based tests suggesting that it is probably not an essential construct of their execution. To the best of our knowledge, this study is the first to investigate these correlations.

Effects of circadian rhythm on anaerobic performance and blood lactate level: a systematic review.

PURPOSE: Circadian rhythm affects maximal short-term performance, and it is an important determinant of the training component. This review aimed to summarise the influence of circadian rhythm on peak and mean power output of muscle, fatigue index, and blood lactate levels. METHODS: English language articles were searched through the following databases: PubMed, Web of Science, Science Direct, and Google Scholar, and pertinent randomized control trials were scrutinized. RESULTS: The search revealed 17,481 articles, and 29 were included in this systematic review based on inclusion and exclusion criteria. Randomized control trials were selected, and the methodological validity of articles was evaluated using the 'Cochrane risk of bias tool'. Findings suggest that outcome variables muscle peak power output (p < 0.0001, Z = 7.22, I2 = 57.42, SMD = - 0.91, 95% confidence interval CI = - 1.16, - 0.67), muscle mean power output (p < 0.0001, Z = 5.66, I2 = 83.85, SMD = - 0.75, 95% CI = - 1.01, - 0.49), and fatigue index (p = 0.02, Z = 2.41, I2 = 2.49, SMD = - 0.39, 95% CI = - 0.72, - 0.07) were higher in the evening while the level of blood lactate was higher in the morning (p = 0.79, Z = 0.27, I2 = 0.73, SMD = - 0.05, 95% CI = - 0.46, - 0.35). CONCLUSION: The results show that diurnal variation affects both peak and mean power output of muscle as well as fatigue index. However, there is no remarkable effect of circadian rhythm on blood lactate level. A major factor attributed to this finding was the variation in the training experience of participants. For an effective training prescription, it is very important to consider the effect of the biological clock on muscle power output since anaerobic exercise performance is discernibly influenced by the time of the day.