Maximal aerobic exercise and acute visual performance in females: Implications for concussion side-line testing.

PURPOSE: Many sports-related concussion (SRC) outcomes can be prevented by removing affected athletes and allowing return after full recovery. Diagnosing concussions on the side-line is challenging, as tools often rely on visual performance assessment. Since acute exercise can affect vision, it is vital to determine if exercise can mask potential brain injury if visual performance assessments are used. The aim of this study was to determine the effect of a single bout of maximal aerobic exercise on acute visual performance. METHODS: Eighty previously sedentary females were randomly assigned to an experimental group (N = 40) or control group (N = 40) and completed an identical visual task test battery. Two weeks later, participants returned to participate in the test battery, with the experimental group doing so immediately following a maximal treadmill exercise protocol. RESULTS: Significant (P < 0.05) improvements were found in accommodation facility, saccadic eye movement, speed of recognition, peripheral awareness, and hand-eye coordination (P < 0.001 for all), but not in visual memory (P = 0.556). All visual tasks, barring visual memory, loaded onto a single factor and approximated the root mean square error of approximation (RMSEA) threshold value (RMSEA = 0.112 [90 %CI: 0.047-0.182]), and a significant large main effect was found on all factors as a universal visual task performance (P < 0.001; d = 1.01). CONCLUSION: This study shows that exercise can affect performance across multiple, but not all, visual tasks and should be utilised with caution in comprehensive side-line SRC assessments. Visual memory may be more stable to the effects of acute exercise and be considered for inclusion in side-line SRC assessments.

Four-year longitudinal associations of physical activity, waist circumference, and blood pressure in UK adolescents.

BACKGROUND: This study assessed the specific influence of physical activity (PA) and waist circumference (WC) on the 4-year growth trajectory of blood pressure in UK high-school students. METHODS: Four-year longitudinal monitoring of 1501 adolescents was conducted as part of the EoEHHS. Measurements were taken in Grades (G)7, 9, and 11. RESULTS: Systolic (SBP) and diastolic blood pressure (DBP) increased over the 4-year period (SBP G7 114.6 ± 8.9 mmHg, G9 118.1 ± 9.7 mmHg, G11 122.8 ± 7.8 mmHg; DBP G7 66.7 ± 6.6 mmHg, G9 68.0 ± 6.4 mmHg, G11 70.0 ± 5.2 mmHg). Baseline WC predicted baseline and growth in SBP, but the strongest contribution to SBP came from changes in WC (ß = 0.084, p = 0.002). Baseline PAQ-A score (ß = -0.822, p = 0.020) and changes in PAQ-A score (ß = -0.650, p = 0.019) were associated with smaller increases in DBP over the 4-year measurement period. CONCLUSIONS: Baseline and change in WC predicted the growth trajectory of SBP, while baseline and change in PA predicted the growth trajectory of DBP. PA and WC have a prognostic value in predicting changes in blood pressure in adolescents. Increasing PA during adolescence could slow the rise in DBP over time. This is meaningful for future hypertension and CVD risk reduction into adulthood. IMPACT: Hypertension in adolescents is a growing health problem that is often overlooked. Baseline and changes in waist circumference over a 4-year period predicted development of systolic blood pressure, while baseline and changes in physical activity predicted development of diastolic blood pressure. Physical activity and waist circumference have a prognostic value in predicting changes in blood pressure in adolescents and could be valuable in planning programmes to prevent hypertension in similar communities and reduce the risk of future adult hypertension.

Implementation of a Community-Based Mind-Body (Tae-Bo) Physical Activity Programme on Health-Related Physical Fitness in Rural Black Overweight and Obese Women with Manifest Risk Factors for Multimorbidity.

Non-communicable diseases (NCDs) are the leading cause of death globally, particularly impacting low- and middle-income countries and rural dwellers. Therefore, this programme aimed to investigate if a community-based mind-body PA programme implemented in a low-resource setting could improve health-related physical fitness outcomes. Black overweight or obese adult women (25 ± 4.7 years) with a body mass index (BMI) > 25 kg·m-2 recruited from a rural settlement in South Africa with manifest risk factors for multimorbidity were assigned to a 10-week waiting-to-treat non-exercising control group (n = 65) or a community-based mind-body programme (n = 60) consisting of 45-60 min, thrice-weekly Tae-Bo. The intervention resulted in significant (p ≤ 0.05) improvements in body weight (p = 0.043), BMI (p = 0.037), and waist (p = 0.031) and hip circumferences (p = 0.040). Flexibility was found to be significantly increased at mid- and post-programme (p = 0.033 and p = 0.025, respectively) as was static balance (mid: p = 0.022; post: p = 0.019), hand grip strength (mid: p = 0.034; post: p = 0.029), sit-up performance (mid: p = 0.021; post: p = 0.018), and cardiorespiratory endurance (mid: p = 0.017; post: p = 0.011). No significant change was found in sum of skinfolds following the programme (p = 0.057). Such a community-based mind-body programme presents an opportunity to level health inequalities and positively improve health-related physical fitness in low-resource communities irrespective of the underlying barriers to participation.

Effects of a maximal cycling all-out anaerobic test on visual performance.

CLINICAL RELEVANCE: All-out exercise may not impair all central nervous system processes, such as those related to visual-motor abilities, and may actually prove stimulatory to such tasks allowing athletes and sports conditioning specialists to develop strategies to take advantage of/mitigate the effects of such exercise on athletic performance. BACKGROUND: Despite research indicating that visual-motor abilities play a critical role in athletic performance, research has primarily focused on the effect of all-out exercise on processes along the motor pathway, such as resultant force production or simple cognitive tasks. Such research has neglected to investigate the effect of all-out exercise on visual tasks. When investigations on visual tasks are forthcoming, they focus on prolonged aerobic exercise, which is not the primary metabolic pathway for all, or even the majority of sports. METHODS: Sixty untrained males (experimental group; N = 30, control group; N = 30) completed a standardised six-item baseline sports vision test battery and one week later, the experimental participants returned to undertake a 30-second Wingate anaerobic test (30-WAnT) immediately followed by the same test battery. RESULTS: Significant (P < 0.05) improvements were found in accommodation facility, saccadic eye movement, speed of recognition, peripheral awareness and hand-eye coordination (P < 0.001 for all), but not visual memory (P = 0.242) following the 30-WAnT. CONCLUSIONS: Although the mechanisms underlying these improvements in visual task performance have not yet been studied, this study suggests that simple anaerobic all-out exercise does not cause central- or brain-based fatigue impairing the oculomotor system but may rather provide "excitability" of the underlying motor cortex, motoneurons and/or corticofugal connections utilised in visual task response. It appears that the sweeping improvements in visual task performance elucidate the need for an intense anaerobic warm-up when training visual skills and when visual skills form an integral part of athletic performance.

A randomised controlled trial of 1- versus 2-day per week formats of Nordic hamstring training on explosive athletic tasks in prepubertal soccer players.

This randomised controlled trial examined the effect of volume-equated programmes of Nordic hamstring exercise (NHE) training, executed at frequencies of 1- or 2-days per week, on explosive athletic tasks (30 m sprint, 15 m manoeuvrability and standing long jump [SLJ]) in male youth soccer players (mean age: 10.3 ± 0.5 years). Players were divided into an experimental group (n = 31) which was further subdivided into 1-day (n = 16) and 2-days (n = 15) per week training conditions, and a control group (n = 14). There were significant group-by-time interactions for 30-m sprint (p < 0.001, d = 0.6), SLJ (p = 0.001, d = 1.27) and 15 m manoeuvrability (p < 0.001, d = 0.61). The experimental group demonstrated small to moderate effect sizes in 30-m sprint (d = 0.42, p = 0.077), SLJ (d = 0.97, p < 0.001) and 15 m manoeuvrability (d = 0.61, p < 0.001). The control group showed small significant performance decrements or no change in these variables. There were no significant differences between the 1-day and 2-day training groups. In two of the three tests (30 m sprint, SLJ) the 2-day group demonstrated larger effect sizes. The NHE enhances explosive athletic task performance in prepubertal youth soccer players and there may be only small advantages to spreading training over two days instead of one.

A review of the essential visual skills required for soccer: Beyond 20-20 optometry.

In ball sports such as soccer, the visual system is critical in guiding a player's search for crucial information that underpins skillful behavior, which requires the incorporation of all of the relevant information in the environment in order to make successful decisions under pressure. However, vision in sport, and focusing on the specific visual skills required to be successful in a particular sport has largely been a practice ignored by experts and coaches as being an essential component of athletic performance. This is the first attempt to summarize and compile the necessary visual skills for soccer. This review's evidence suggests that, while current research still tends to focus on visual skills as a whole, there is a need to streamline this focus to the necessities of a particular sport. Furthermore, in identifying the visual skills essential for soccer, it allows for the effective training and testing of these skills, as well as for talent identification.

A systematic review with meta-analysis on balance, fatigue, and motor function following aquatic therapy in patients with multiple sclerosis.

OBJECTIVE: In this systematic review and meta-analysis, we aimed to evaluate the impact of long-term aquatic exercise training on balance, fatigue, and motor function. METHODS: Scopus, PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Ovid Medline, EBSCO Cumulative Index to Nursing, and Allied Health Literature were searched on April 19, 2021. The search included randomized and non-randomized controlled trials, case-control studies, case series, and case reports. Two independent reviewers reviewed titles and abstracts to determine which studies satisfied the eligibility criteria. Two reviewers independently surveyed the full texts and conducted the study selection, data extraction, and quality assessment. Data synthesis was applied to summarize information from included studies. Meta-analysis was performed using RevMan 5. RESULTS: From 170 studies that were identified in the initial search, 16 trials (794 participants) satisfied the eligibility criteria. Aquatic therapy had a positive effect on fatigue compared to control group based on Modified Fatigue Impact Scale (MFIS) in physical (SMD, -1.29; 95% CI, [(-1.65) - (-0.93)]; I2=88%) cognitive (SMD, -0.75; 95% CI, [(-1.08)-(- 0.43)]; I2=78%), and psychological (SMD, -1.25; 95% CI, [(-1.59) - (-0.90)]; I2=79%) domains, and Fatigue Severity Scale (FSS) (SMD, -0.53; 95% CI, [(-0.86) - (-0.20)]; I2=57%). In addition, aquatic therapy improved balance based on the Berg Balance Scale (BBS) compared to the control group (SMD, 1.19; 95% CI, [(0.62)-(1.76)]; I2=11%) CONCLUSIONS: Aquatic therapy has positive effects on fatigue and balance. Further research is needed to confirm the clinical utility of aquatic therapy for multiple sclerosis patients in the long term.

Effects of dry needling and exercise therapy on post-stroke spasticity and motor function- protocol of randomized clinical trial.

Background: Spasticity is one of the most common problems after the first stroke. Dry needling (DN) has been presented as a new therapeutic approach used by physiotherapists for the management of post-stroke spasticity. This study aimed to determine whether the addition of exercise therapy to the DN results in better outcomes in wrist flexors spasticity, motor neuron excitability, motor function and range of motion (ROM) in patients with chronic stroke. Methods: We will use a single-blind randomized controlled trial (RCT) in accordance with the CONSORT guidelines. A total of 24 patients with stroke will be included from the University Rehabilitation Clinics. The outcome measures will include Modified Modified Ashworth Scale, Hmax/Mmax ratio, H-reflex latency, Action Research Arm Test, Fugl-Meyer Assessment, and wrist extension active and passive range of motion. Patients in the DN and exercise therapy group will undergo 4 sessions of deep DN in flexor carpi radialis and flexor carpi ulnaris muscles on the affected upper limb and exercise therapy. Participants in the DN group will only receive DN for target muscles. Clinical and neurophysiological tests will be performed at baseline, after four therapy sessions, and at three weeks' follow-up. Discussion: This study will provide evidence for additional effects of exercise therapy to DN in comparison to DN alone on wrist flexors spasticity, motor neuron excitability, upper-limb motor function, and ROM in patients with chronic stroke.

German volume training for health promotion: Acute vasopressor, pulmonary and metabolic responses.

Resistance training (RT) is increasingly recommended for incorporation into comprehensive fitness or "exercise as medicine" programs. However, the acute effects of RT, and especially its different sub-types, and how they impact health outcomes are not fully investigated. This study evaluated German Volume Training (GVT) ("10 set × 10 rep scheme") for its efficacy for its use in health settings. This study utilized a randomized crossover design with subjects serving as their own controls to establish baseline values. Subjects were blinded to the study hypothesis. Subjects performed a single session of GVT or no exercise, in a randomised order separated by a 1-week washout period. Outcomes were assessed before and immediately post-exercise. GVT significantly (p < 0.05) decreased systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP), but increased heart rate (HR), rate pressure product (RPP) and rating of perceived exertion (RPE). No changes were found in the measured spirometry parameters. Increases were observed in carbon dioxide production (VCO2) and minute ventilation (VE), but not respiratory exchange ratio. Post hoc analysis demonstrated that post-GVT values were significantly lower for SBP (p = 0.017; d = 1.00), DBP (p = 0.013; d = 0.90), MAP (p = 0.024; d = 1.06), and VCO2 (p = 0.009; d = -1.32), and significantly higher for RPP (p = 0.001; d = -3.11), RPE (p = 0.001; d = -14.14), and HR (p = 0.001; d = -3.00). This study indicates that acute GVT promotes post-exercise hypotension and is of sufficient intensity to increase both objective HR and subjective RPE intensities appropriately for use in a variety of health promotion settings.

Effects of aquatic therapy on balance in older adults: a systematic review and meta-analysis.

PURPOSE: Balance is a key component of movement for daily activities, especially in older adults. Previous studies examining aquatic therapy as an effective way for improving balance have yielded inconsistent findings. The current systematic review and meta-analysis investigated the effectiveness of aquatic therapy on balance among older adults. METHODS: Sources include Cochrane Central Register of Controlled Trials, Medline, ISI Web of Science, EBSCO, Embase, Cumulative Index to Nursing and Allied Health Literature, and Scopus. Randomized controlled or cross-over trials published by Feb 2020 were included following pre-determined search and selection criteria. Data extraction was performed by two researchers independently using a pre-determined data extraction form. Methodological quality was assessed by two reviewers using the PEDro scale which was used to rate trials according to criteria such as concealed allocation, blinding, and intention-to-treat analysis. Furthermore, meta-analysis was conducted where possible. This review was registered at PROSPERO CRD42018118382. RESULTS: Fifteen trials with 385 healthy participants aged 50 or over were included. Results showed that aquatic therapy had a significant effect on dynamic balance (SMD, - 1.13; 95% CI, [- 1.45 to (- 0.82)]; I2 = 77%). The analysis indicated that aquatic therapy improved balance ability compared to controls. CONCLUSIONS: Aquatic therapy has a positive impact on dynamic balance in older adults. However, further high-quality and appropriately powered studies are required to confirm this assertion.

How much water is in a mouthful, and how many mouthfuls should I drink? A laboratory exercise to help students understand developing a hydration plan.

Preventing impairments in athletic performance is an important concept for students that are preparing for careers that involve working with athletes. Gaining hands on, laboratory-based experience in measuring exercise induced dehydration can help students understand how to help athletes prevent dehydration induced impairment in performance. This article describes a laboratory exercise for junior and senior students in a sports nutrition class, in which the students measure changes in body mass (as a measure of dehydration) due to 40 min of moderate-intensity exercise and 40 min of vigorous-intensity exercise. The students also measure how much water is in a mouthful from a sports bottle and from a drinking fountain. The students then calculate how many mouthfuls are necessary to replace exercise induced fluid losses. This laboratory exercise has been well received by students and has improved performance on the test regarding hydration.

Establishing a proof of concept for the effects of low-carbohydrate, high-fat diet (LCHFD) and physical activity on body composition in type 2 diabetes.

Overweight and obesity are both a risk factor for developing and exacerbating type 2 diabetes (T2D). While the most common diet used to treat overweight and obesity focus on high-carbohydrate, low-fat, energy deficit diets, recently, low-carbohydrate, high-fat diets (LCHFD) have become popular in targeting obesity. This proof-of-concept study attempted to determine if an LCHFD could improve body composition variables, or if a concurrent treatment of LCHFD and physical activity would create an interference effect in individuals with T2D. Overweight and obese with T2D (n = 39) were assigned into either a 16-week combined physical activity and LCHFD group (ConG), LCHFD-only group (DieG) or control group (NonG). No statistically significant (p > 0.01) changes were found in body mass in the ConG (2.0%, F = 0.039, P = 0.846) and DieG (2.5%, F = 0.188, P = 0.669); for body mass index in the ConG (2.2%, F = 0.046, P = 0.832) and DieG (2.3%, F = 0.098, P = 0.758.); and waist-to-hip ratio in the ConG (0%, F = 0.002, P = 0.968) and DieG (0%, F = 0.023, P = 0.882). However, clinically significant changes were observed in HbA1c in the ConG male group (23% decrease); percentage body fat for the ConG (16.7%, F = 1.682, P = 0.208, g = 0.534) and DieG (13.0%, F = 0.638, P = 0435, g = 0.361); for waist circumferences in the ConG (5.4%, F = 0.686, P = 0.416, g = 0.341) and DieG (6.3%, F = 1.327, P = 0.264, g = 0.520); and for hip circumference in the ConG (5.8%, F = 0.993, P = 0.329, g = 0.410) and DieG (7.0%, F = 2.668, P = 0.119, g = 0.737). Results indicate that moderate clinically significant changes in body composition are achievable with LCHFD and/or daily walking in obese adults living with T2D. However, more robust research is required to determine the effects of LCHFD, with or without concurrent physical activity, on obesity and other diabetic complication markers.

Differences in visio-spatial expertise between 1st division rugby players and non-athletes.

The present study aimed to compare the visual expertise of non-athletes (n = 40; 19-35 years old; age: 22.13 ± 2.37 years) to amateur, non-professional South-African Rugby Union (SARU) first-division club rugby players (n = 40; 19-35 years old; age: 23.88 ± 4.36 years; training age mean: 9.0 ± 1.5 years). Research suggests that athletes have enhanced visio-spatial expertise in comparison to non-athletes. However, conflicting research suggests that this is not always the case as non-athletes possess similar visio-spatial expertise in certain visual skills. Participants underwent an optometric assessment after which the following 6 visio-spatial intelligence (VSI) components were measured; accommodation facility, saccadic eye movement, speed of recognition, peripheral awareness, visual memory and hand-eye coordination using the following tests; hart near far rock, saccadic eye movement, evasion, accumulator, flash memory and ball wall toss tests. Results indicated that first-division rugby players performed significantly better (p ≤ 0.05) in five of the six tests performed, except for visual memory (p = 0.893). While this study substantiates the notion that athletes, in this case first-division rugby players, performs significantly better in most VSI components, this is not the case for all, as with visual memory in this study. To more accurately distinguish between athletes and non-athletes, research should move away from tests that focus on basic visual function and develop sport specific testing methods that can be used by a variety of sports.

Role of Spasticity Severity in the Balance of Post-stroke Patients.

Background: Lower limb spasticity after stroke is common that can affect the balance, increase the risk of falling, and reduces the quality of life. Objective: First, evaluate the effects of spasticity severity of ankle plantar flexors on balance of patients after stroke. Second, to determine the relationship between the spasticity severity with ankle proprioception, passive ankle dorsiflexion range of motion (ROM), and balance confidence. Methods: Twenty-eight patients with stroke based on the Modified Modified Ashworth Scale (MMAS) were divided into two groups: High Spasticity Group (HSG) (MMAS > 2) (n = 14) or a Low Spasticity Group (LSG) (MMAS ≤ 2) (n = 14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway of both affected and non-affected limbs under the eyes open and eyes closed conditions, timed up and go (TUG) test, passive ankle dorsiflexion ROM, and ankle joint proprioception were measured. Results: The ankle joint proprioception was significantly better in the LSG compared to the HSG (p = 0.01). No significant differences were found between the LSG and HSG on all other outcome measures. There were no significant relationships between the spasticity severity and passive ankle dorsiflexion ROM, and balance confidence. Conclusion: The severity of ankle plantar flexor spasticity had no effects on balance of patients with stroke. However, the ankle joint proprioception was better in patients with low spasticity. Our findings suggest that the balance is affected regardless of the severity of the ankle plantar flexor spasticity in this group of participants with stroke.

Effect of Ankle Plantar Flexor Spasticity Level on Balance in Patients With Stroke: Protocol for a Cross-Sectional Study.

BACKGROUND: The lower limb spasticity after stroke can affect the balance and gait of patients with stroke. OBJECTIVE: The aim of this study is to assess the effects of ankle plantar flexor spasticity level on balance in patients with stroke. METHODS: Patients with stroke were recruited from neurology and physiotherapy clinics in Tehran, Iran. Based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS), the eligible patients with stroke were divided into 2 groups: high spasticity (MMAS score≥2) and low spasticity (MMAS score<2). The primary outcome measures were the MMAS scores, Activities-Specific Balance Confidence questionnaire scores, eyes-open and eyes-closed posturography measures, and Timed Up and Go test results. The secondary outcome measures were the ankle passive range of motion and ankle joint proprioception. The t test, mixed model univariate analysis of variance, and Spearman rank correlation were used for statistical analysis. RESULTS: Data collection and statistical analysis are complete. The interpretation of results is underway. We expect the results to be published in winter 2020. CONCLUSIONS: We believe that patients with high ankle plantar flexor spasticity after stroke will demonstrate greater balance dysfunction, which will worsen with impaired proprioception, passive range of motion, and eyes closed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/16045.

Effect of combined aquatic and cognitive training on quality of life, fall self-efficacy, and motor performance in aged with varying cognitive status: a proof-of-concept study.

With the increasing number of aged individuals, research pertaining to their cognitive functions and physical-motor has become exponentially imperative. The purpose of the study was to investigate the effect com-bined aquatic and cognitive training on quality of life (QoL), fall self-effi-cacy and motor performance (static and dynamic balance) in aged with varying cognitive status levels. Thirty participants were assigned to a high cognitive status group (n=10), low cognitive status group (n=10), or nonintervention control group (n=10). Participants completed a 6-week motor-cognitive training regime with increasing intensity. QoL, fall self-efficacy, static balance, and dynamic balance were assessed. Preliminary results suggest proof-of-concept significant (P<0.05) im-provements were found in both the high and low cognitive status groups for static and dynamic balance and fall self-efficacy. However, QoL was only found to be significantly improved in the low cognitive status group. Aqua training along with cognitive training can effectively be used to prevent falls in the elderly and to improve their physical-motor perfor-mance. However, when attempting to improve QoL, the cognitive status of the individual should be considered.

The impact of modified exercise and relaxation therapy on chronic lower back pain in office workers: a randomized clinical trial.

This study aimed to evaluate the effectiveness of a modified package of exercise therapy combined with relaxation on pain intensity, range of motion (ROM), anxiety, and quality of life (QoL) in office workers with chronic lower back pain. In this clinical trial, 72 office workers aged 20 to 50 years with chronic low back pain were randomized to one of four groups including; group 1, exercise therapy; group 2, psychotherapy (relaxation therapy); group 3, modified protocol (exercise therapy followed by relaxation therapy); group 4, control group (no intervention). Participants exercised 3 times weekly for 6 weeks for 40-45 min of exercise/relaxation. Pain intensity, ROM, anxiety, and QoL were evaluated at baseline, 6 weeks, and 12 weeks after the end of the intervention. Results showed significant decreases in pain intensity and anxiety in the three experimental groups compared to the control group. The three intervention groups indicated a significant decrease in pain intensity and anxiety after 6 and 12 weeks. ROM significantly improved in the exercise therapy and the modified protocol over time (after 6 and 12 weeks). A significant difference in QoL was found between the groups, with the greatest improvement found in the psychotherapy and modified protocol groups. This therapeutic package (including exercise movements and psychological interventions) was found to have a superior effect on pain intensity, ROM, anxiety, and QoL after 6 and 12 weeks compared to other interventions (only exercise and psychotherapy).

Changes in chronic neck pain following the introduction of a visco-elastic polyurethane foam pillow and/or chiropractic treatment.

BACKGROUND: Sleep ergonomics are increasingly prescribed as an adjunct treatment to chronic neck pain. Postulated benefits to maintaining the ideal sleeping posture are improved tissue repair in and around the facet joints, decrease in tension of associated musculature and better quality sleep. AIM: The purpose of this study was to determine if the inclusion of a visco-elastic polyurethane (VEP) pillow could benefit the chiropractic treatment of chronic neck pain. SETTING: The study took place at a chiropractic training clinic in Johannesburg. METHOD: Participants were randomly assigned to either a chiropractic treatment only group (CHI) (n = 15) or a chiropractic treatment with a VEP pillow group (CHI+P) (n = 15). Both groups underwent six chiropractic treatments spaced at 3-4-day intervals and the CHI+P were provided with a VEP pillow. Baseline and post-test measurements consisted of the initial Numerical Pain Rating Scale (NRS) and the Vernon-Mior Neck Pain and Disability Index (NDI). RESULTS: Both the CHI and CHI+P groups significantly (p ≤ 0.05) improved their NRS (p = 0.001 for both groups) and NDI (p = 0.001 and p = 0.000, respectively) scores. Furthermore, post hoc analysis indicated a significant difference at post-test between the two groups for NRS (p = 0.015), but not for NDI (p = 0.195). The CHI+P demonstrated an improved minimum clinically important difference (MCID) (43% vs. 73% for NRS and 59% vs. 71% for the NDI). CONCLUSION: Findings of this study suggest that a VEP pillow could be included as an adjunct management tool to chiropractic treatment of chronic neck pain.

Cycling training and functional electrical stimulation for post-stroke patients / Treinamento de ciclismo e estimulação elétrica funcional para pacientes pós acidente vascular cerebral / Entrenamiento de ciclismo y estimulación eléctrica funcional para pacientes post ataque vascular cerebal

ABSTRACT Introducion: Stroke is one of the leading causes of morbidity and mortality in adults worldwide. The prevalence of stroke in developing countries such as South Africa and Iran is growing, especially in an increasingly younger population. In Iran, the annual stroke incidence ranges from 23 to 103 per 100,000 inhabitants, with the rate being higher in those aged 15-45 years. Problematically, almost 50% of stroke patients face difficulties in performing activities of daily living, hence the importance of functional rehabilitation. These factors necessitate cost-effective solutions in developing countries, where there is insufficient research focused on practical solutions for treatment/rehabilitation. Objective: We hypothesize that while progressive cycling training would activate cortical regions and that cycling speed feedback could lead to additional cortical activations and resultant improvements in cycling performance, combined cycling training and functional electrical stimulation would result in superior improvements in cycling performance, aerobic capacity, and functional performance in post-stroke patients. Conclusions: Ultimately, we expect this hypothesis to provide a useful framework for facilitating combined cycling and functional electrical stimulation rehabilitation research in post-stroke patient populations. Level of Evidence V; Expert opinion.

RESUMO Introdução: Acidente vascular Cerebral é uma das principais causas de morbidade e mortalidade em adultos ao redor do mundo. A prevalência de AVC em países em desenvolvimento, como África do Sul e Irã, tem aumentado principalmente na população cada vez mais jovem. No Irã, a incidência anual de AVC varia de 23 a 103 em cada 100000 habitantes, com aumento da taxa entre 15-45 anos. Problematicamente, quase 50% dos pacientes que sofreram AVC tem dificuldade de praticar atividades cotidianas, por isso a importância da reabilitação funcional. Esses fatores exigem a necessidade de soluções econômicas nos países em desenvolvimento, onde há pesquisas insuficientes que focam em soluções práticas para o tratamento/reabilitação. Objetivo: nossa hipótese é que o treinamento ciclístico progressivo pode ativar regiões corticais e a resposta da velocidade do ciclismo levaria a ativação corticais adicionais e melhorias resultantes no desempenho do ciclismo, treinamento combinado de ciclismo e estimulação elétrica funcional resultariam em melhorias superiores no desempenho do ciclismo, na capacidade aeróbica e no desempenho funcional em pacientes pós-AVC. Conclusão: Por fim, nós esperamos que essa hipótese providencie uma estrutura útil para facilitar a pesquisa em treinamento combinado de ciclismo e reabilitação em estimulação elétrica funcional em pacientes pós-AVC. Nível de Evidência V; Opinião do especialista.

RESUMEN Introducción: El accidente cerebro-vascular es una de las principales causas de morbilidad y mortalidad en adultos en todo el mundo. La prevalencia de accidente cerebro-vascular en países en desarrollo, como Sudáfrica e Irán, está en aumento, especialmente en una población cada vez más joven. En Irán, la incidencia anual de ataque varía de 23 a 103 por 100000 habitantes, y la tasa es más alta en personas de 15 a 45 años. El problema radica en que casi el 50% de los pacientes que sufrieron un accidente cerebro-vascular tienen dificultad para realizar actividades de la vida diaria. De ahí la importancia de la rehabilitación funcional. Estos factores requieren la necesidad de soluciones rentables en los países en desarrollo, donde no hay suficiente investigación que se centre en soluciones prácticas para el tratamiento/rehabilitación. Objetivos: Nuestra hipótesis es que, mientras el entrenamiento de ciclismo progresivo activaría las regiones corticales y que la retroalimentación de la velocidad de ciclismo podría conducir a activaciones corticales adicionales y mejoras resultantes en el rendimiento del ciclismo, el entrenamiento combinado de ciclismo y estimulación eléctrica funcional daría como resultado mejoras superiores en rendimiento de ciclismo, capacidad aeróbica y rendimiento funcional en pacientes post-ataque. Conclusiones: En última instancia, esperamos que esta hipótesis proporcione un marco útil para facilitar el ciclo combinado y la investigación de rehabilitación de estimulación eléctrica funcional en poblaciones de pacientes post-ataque. Nivel de Evidencia V; Opinión del especialista.

Salivary Testosterone and Cortisol Concentrations, and Psychological Overtraining Scores as Indicators of Overtraining Syndromes among Elite Soccer Players / Concentraciones salivales de testosterona y cortisol. Puntuaciones de sobreentrenamiento como indicadores de síndrome de sobreentrenamiento entre jugadores de fútbol de élite

Overreaching (short-term overtraining) and overtraining syndrome (OTS) are caused by a chronic imbalance between training and recovery and can lead to prolonged fatigue and decrements in athletic performance. Though research on OTS has increased greatly over the last decade, there is still a lack of consensus about its etiology and a precise diagnosis of its occurrence. The purpose of the study was to examine the relationship between psychological scores and OTS markers in elite soccer players. Three samples of unstimulated saliva (2 ml) were taken on rest days (8:00 am, 11:00 am, and 5:00 pm) from 30 elite male soccer players (age: 24.1±3.8 years (mean±SD)) and analyzed for cortisol and testosterone. They were also asked to complete the Societe Francaise de Medecine du Sport (SFMS) overtraining questionnaire. Results of zero-order correlation indicated that the SFMS overtraining scores had a significant positive correlation with cortisol concentrations at 8:00 am (r = 0.66; p<0.001), 11:00 am (r = 0.62; p<0.001), and 5:00 pm (r = 0.40; p< 0.05), mean cortisol concentrations of the entire day (r = 0.60; p<0.001). Psychological overtraining scores were also positively correlated with testosterone concentrations at 8:00 am (r = 0.39; p=0.015) and 5:00 pm (r = 0.37; p< 0.05), but negatively correlated with the T/C ratio at 8:00 am (r = -0.38; p=0.020). It should be concluded that the SFMS overtraining questionnaire may be considered as a cost-effective and useful tool for monitoring (and thus preventing) overtraining in soccer players

La sobre-solicitación (o sobre-entrenamiento a corto plazo) y el síndrome de sobre-entrenamiento (SSL) están causados por un desequilibrio crónico entre entrenamiento y recuperación, pudiendo conducir a situaciones de fatiga prolongada y a disminuciones en el rendimiento deportivo. Pese al gran incremento experimentado por la investigación en SSL durante la última década, no existe aún consenso acerca de su etiología ni tampoco un criterio diagnóstico preciso que permita detectar su presencia. El objetivo del presente estudio fue examinar la relación entre las puntuaciones obtenidas en un test de carácter psicológico y marcadores fisiológicos de SSE en futbolistas de elite. Se analizaron los niveles de cortisol y testosterona presentes en tres muestras de saliva no estimuladas (2 mi) obtenidas en días de descanso (8:00 am, 11:00 am, and 5:00 pm) en 30 futbolistas de élite masculinos (edad: 24.1±3.8 años (media±DT)). Adicionalmente, los participantes completaron el Cuestionario de Sobre-entrenamiento de la Sociedad Francesa de Medicina del Deporte (SFMD). Los resultados de las correlaciones de orden cero indicaron que las puntuaciones de sobre-entrenamiento del cuestionario SFMD se correlacionaban de forma positiva y estadísticamente significativa tanto con las concentraciones de cortisol a las 8:00 am (r = 0.66; p<0.001), 11:00 am (r = 0.62; p<0.001), y 5:00 pm (r = 0.40; p< 0.05), como con la concentración media a lo largo del día (r = 0.60; p<0.001). Además, las puntuaciones de sobre-entrenamiento psicológico estuvieron positivamente correlacionadas con las concentraciones de testosterona a las 8:00 am (r = 0.39; p=0.015) y 5:00 pm (r = 0.37; 100 p< 0.05), pero negativamente correlacionadas con la relación T/C a las 8:00 am (r = -0.38; p=0.020). Puede concluirse que el cuestionario de sobre-entrenamiento de la SFMD podría ser una alternativa asequible y útil en el control (y por tanto prevención) del sobre-entrenamiento en futbolistas