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1.
PLoS One ; 15(4): e0231663, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32298326

RESUMO

BACKGROUND: Having a physically active lifestyle after cancer diagnosis is beneficial for health, and this needs to be continued into survivorship to optimize long-term benefits. We found that patients, who participated in an 18-week exercise intervention, reported significant higher physical activity (PA) levels 4 years after participation in a randomized controlled trial of supervised exercise delivered during chemotherapy (PACT study). This study aimed to identify social-ecological correlates of PA levels in breast and colon cancer survivors 4 years after participation in the PACT study. METHODS: Self-reported PA levels and potential correlates (e.g. physical fitness, fatigue, exercise history, and built environment) were assessed in 127 breast and colon cancer survivors shortly after diagnosis (baseline), post-intervention and 4 years later. Multivariable linear regression analyses were performed to identify social-ecological correlates of PA 4 years post-baseline. RESULTS: The final model revealed that lower baseline physical fatigue (ß = -0.25, 95% CI -0.26; -0.24) and higher baseline total PA (0.06, 95% CI, 0.03; 0.10) were correlated with higher total PA levels 4 years post-baseline. Higher baseline leisure and sport PA (0.02, 95% CI 0.01; 0.03), more recreational facilities within a buffer of 1 km (4.05, 95% CI = 1.28; 6.83), lower physical fatigue at 4-year follow-up (-8.07, 95% CI -14.00; -2.13), and having a positive change in physical fatigue during the intervention period (0.04, 95% CI 0.001; 0.07) were correlates of sport and leisure PA levels 4 years post-baseline. CONCLUSIONS: This study suggests that baseline and 4-year post-baseline physical fatigue, and past exercise behaviour, were significant correlates of PA 4 years after participation in an exercise trial. Additionally, this study suggests that the built environment should be taken into account when promoting PA. Understanding of socio-ecological correlates of PA can provide insights into how future exercise interventions should be designed to promote long-term exercise behaviour. TRIAL REGISTRATION: Current Controlled Trials ISRCTN43801571, Dutch Trial Register NTR2138. Trial registered on 9 December 2009, http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2138.

2.
Int J Sports Physiol Perform ; : 1-15, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31810063

RESUMO

BACKGROUND: Plyometric training is a specific form of strength training that is used to improve the physical performance of athletes. An overview of the effects of plyometric training on soccer-specific outcomes in adult male soccer players is not available yet. PURPOSE: To systematically review and meta-analyze the effects of plyometric training on soccer-specific outcome measures in adult male soccer players and to identify which programs are most effective. METHODS: PubMed, Embase/Medline, Cochrane, PEDro, and Scopus were searched. Extensive quality and risk of bias assessments were performed using the Cochrane ROBINS 2.0 for randomized trials. A random effects meta-analysis was performed using Cochrane Review Manager 5.3. RESULTS: Seventeen randomized trials were included in the meta-analysis. The impact of plyometric training on strength, jump height, sprint speed, agility, and endurance was assessed. Only jump height, 20-m sprint speed, and endurance were significantly improved by plyometric training in soccer players. Results of the risk of bias assessment of the included studies resulted in overall scores of some concerns for risk of bias and high risk of bias. CONCLUSION: This review and meta-analysis showed that plyometric training improved jump height, 20-m sprint speed, and endurance, but not strength, sprint speed over other distances, or agility in male adult soccer players. However, the low quality of the included studies and substantial heterogeneity means that results need to be interpreted with caution. Future high-quality research should indicate whether or not plyometric training can be used to improve soccer-specific outcomes and thereby enhance performance.

3.
BMJ Open Sport Exerc Med ; 5(1): e000532, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31191976

RESUMO

Objectives: To assess the outcome of conservative treatment for chronic exertional compartment syndrome (CECS) as it relates to the reduction in surgical fasciotomy and return to active duty in a military population. Methods: Historic cohort. From 2015 to 2018, 75 surgically eligible patients with pressure-positive anterior CECS (Group 1), or with positive pressures and associated medial tibial stress syndrome (Group 2), underwent a conservative treatment programme emphasising gait retraining of running and marching. Treatment success was defined as return to duty, without surgery. Fifty patients from 2015 to 2017 were surveyed to assess mid-term outcomes. Results: The average duration of conservative treatment was 144.9 (±59.6) days. Initially, 65% (49/75) were able to return to duty; 28% (21/75) were referred for surgery and 7% (5/75) left the armed forces. There was no difference in outcomes between Group 1 and Group 2. Survey response rate, on average after 742 days (SD 267, range 381-1256), was 84% (42/50); 57% (24/42) had continued duty, without surgery; of them, 43% were at the same military specialty, 57% in a physically less demanding job. Conclusion: A conservative treatment programme for anterior CECS was able to return 65 % of patients to active duty, without surgery. At 2 years, the success rate decreased slightly, but remained positive at 57%. In this high-risk group, initiating a conservative treatment protocol with an emphasis on gait retraining can significantly reduce the need for surgical fasciotomy. For those that fail conservative treatment, surgical release may still be indicated.

4.
J Orthop Sports Phys Ther ; 49(7): 518-528, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31213161

RESUMO

OBJECTIVE: To describe the incidence, prevalence, and impact of running-related injuries (RRIs) and illness symptoms in half marathon and marathon runners during the 16-week period before the Utrecht Marathon. METHODS: In this prospective cohort study, we used the Oslo Sports Trauma Research Center questionnaire to register RRIs and illness symptoms every 2 weeks during the 16-week study period. When an injury or illness occurred, questions were added regarding its nature. We calculated the incidence proportion (the number of new cases divided by the number of runners at risk) and the period prevalence (the number of existing and new cases within a 2-week period, divided by the total number of runners at risk during that period). RESULTS: Of the 161 included runners, 9 out of 10 reported an RRI or illness symptom at some time during the study period. In any 2-week period, 5.6% to 14.8% of the runners reported a new RRI, and 6.3% to 13.8% of the runners reported a new illness symptom. The prevalence of RRIs ranged from 29.2% to 43.5%, and the prevalence of illness symptoms ranged from 28.3% to 71.2%. The most prevalent RRIs were in the lower leg (prevalence range, 5.4%-12.3%) and knee (prevalence range, 2.7%-9.3%). The most prevalent illness symptoms were rhinorrhea/sneezing (prevalence range, 3.9%-12.7%) and coughing (prevalence range, 3.9%-11.9%). The incidence and prevalence of illness symptoms peaked at the same time as the influenza-like illness epidemic of the winter of 2015-2016. CONCLUSION: Nine out of every 10 runners reported an RRI or illness symptom in the lead-up to a half or full marathon. In any 2-week period, up to 1 in 7 runners reported a new RRI or illness symptom. LEVEL OF EVIDENCE: 2b. J Orthop Sports Phys Ther 2019;49(7):518-528. doi:10.2519/jospt.2019.8473.

5.
Front Psychiatry ; 10: 87, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30873051

RESUMO

Introduction: The aim of this study was to objectively assess time spent in physical activity (PA) and sedentary behavior (SB) in patients with schizophrenia compared to healthy controls matched for age, gender and socioeconomic status. Associations between both PA and cardiorespiratory fitness (CRF) and mental and physical health parameters in patients with schizophrenia were examined. Materials and Methods: Moderate and vigorous PA (MVPA), moderate PA, vigorous PA, total and active energy expenditure (TEE and AEE), number of steps, lying down and sleeping time was assessed with SenseWear Pro-2 body monitoring system for three 24-h bouts in patients with schizophrenia (n = 63) and matched healthy controls (n = 55). Severity of symptoms (Positive and Negative Syndrome Scale and Montgomery and Åsberg Depression Rating Scale), CRF (peak oxygen uptake, VO2peak), body mass index (BMI), and metabolic syndrome were assessed. Results: Patients with schizophrenia performed less MVPA and moderate activity had lower TEE and AEE, spent more time per day lying down and sleeping, and had poorer CRF compared to healthy controls. The amount of MVPA, but especially CRF was associated with severity of negative symptoms in patients with schizophrenia. Only CRF was associated with BMI. Discussion: The current data offer further evidence for interventions aiming to increase physical activity and decrease sedentary behavior. Given strong associations of CRF with both negative symptoms and BMI, treatment aimed at CRF-improvement may prove to be effective.

6.
J Neuroeng Rehabil ; 16(1): 9, 2019 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-30642361

RESUMO

BACKGROUND: Even though typically developing youth are already at risk for physical inactivity, youth with spina bifida may be even at higher risk as a consequence of their reduced mobility. No objective data is available for youth with spina bifida who use a manual wheelchair, so the seriousness of the problem is unknown. The purpose of this observational study was to quantify physical activity in wheelchair-using youth with spina bifida and evaluate the intensity of activities. METHODS: Fifty-three children and adolescents (5-19 years) with spina bifida who use a manual wheelchair for daily life, long distances or sports were included. To assess time spent in several types of activities VitaMove data of 34 participants were used and were presented as time spent sedentary and time spent physically active. This was compared to reference data of typically developing youth. To assess time spent in several intensities Actiheart data of 36 participants were used. The intensities were categorized according to the American College of Sports Medicine, ranging from very light intensity to near to maximal intensity. Data of 25 participants were used to combine type of activity and intensity. RESULTS: Children and adolescents with spina bifida who use a manual wheelchair were more sedentary (94.3% versus 78.0% per 24 h, p < 0.000) and less physically active (5.0% versus 12.2% per 24 h, p < 0.000) compared to typically developing peers. Physical activity during weekend days was worse compared to school days; 19% met the Guidelines of Physical Activity during school days and 8% during weekend days. The intensities per activity varied extensively between participants. CONCLUSIONS: Children and adolescents with spina bifida who use a manual wheelchair are less physically active and more sedentary than typically developing youth. The physical activity levels on school days seem to be more favorable than the physical activity levels on a weekend day. The low levels of physical activity need our attention in pediatric rehabilitation practice. The different intensities during activities indicate the importance of individually tailored assessments and interventions.


Assuntos
Crianças com Deficiência/estatística & dados numéricos , Exercício Físico , Disrafismo Espinal , Cadeiras de Rodas , Adolescente , Criança , Feminino , Humanos , Masculino
7.
J Sci Med Sport ; 22(3): 259-263, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30268637

RESUMO

OBJECTIVES: To investigate the prognosis and possible prognostic factors of running-related injuries (RRIs) in novice runners. DESIGN: Prospective cohort study. METHODS: Participants of Start to Run, a 6-weeks course for novice runners in The Netherlands, were asked to participate in this study. Before the start of the course a baseline questionnaire, on demographics, physical activity and perceived health, was sent to runners willing to participate. The 26- or 52-weeks follow-up questionnaires assessed information on RRIs and their duration. Only participants that sustained a RRI during follow-up were included in the analyses. An injury duration of 10weeks or shorter was regarded as a relatively good prognosis, while an injury duration of more than 10weeks was defined as a poor prognosis. To determine the associations between baseline characteristics and injury prognosis and between injury location and injury prognosis, multivariable logistic regression analyses were performed. RESULTS: 347 participants (48.8%) sustained an RRI during follow-up. The RRIs had an overall median duration of eight weeks (range: 1-52weeks). Participants with a previous RRI were more likely to have a poor prognosis (OR 2.31; 95%CI 1.12-4.79), while a calf injury showed a trend towards an association with a relatively good prognosis (OR 0.49; 95%CI 0.22-1.11). CONCLUSIONS: The duration of RRIs in novice runners is relatively long, with only calf injuries being associated with a good prognosis. This emphasizes the need of injury prevention measures in novice runners and adequate support during and after an RRI, especially in runners with a previous injury.


Assuntos
Traumatismos em Atletas/diagnóstico , Corrida/lesões , Adulto , Feminino , Humanos , Traumatismos da Perna/diagnóstico , Masculino , Pessoa de Meia-Idade , Países Baixos , Prognóstico , Estudos Prospectivos , Inquéritos e Questionários
8.
J Sci Med Sport ; 22(1): 106-111, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29934211

RESUMO

OBJECTIVES: To determine the proportion of participants of a running program for novice runners that discontinued running and investigate the main reasons to discontinue and characteristics associated with discontinuation. DESIGN: Prospective cohort study. METHODS: The study included 774 participants of Start to Run, a 6-week running program for novice runners. Before the start of the program, participants filled-in a baseline questionnaire to collect information on demographics, physical activity and perceived health. The 26-weeks follow-up questionnaire was used to obtain information on the continuation of running (yes/no) and main reasons for discontinuation. To determine predictors for discontinuation of running, multivariable logistic regression was performed. RESULTS: Within 26 weeks after the start of the 6-week running program, 29.5% of the novice runners (n=225) had stopped running. The main reason for discontinuation was a running-related injury (n=108, 48%). Being female (OR 1.74; 95% CI 1.13-2.68), being unsure about the continuation of running after the program (OR 2.06; 95% CI 1.31-3.24) and (almost) no alcohol use (OR 1.62; 95%CI 1.11-2.37) were associated with a higher chance of discontinuation of running. Previous running experience less than one year previously (OR 0.46; 95% CI 0.26-0.83) and a higher score on the RAND-36 subscale physical functioning (OR 0.98; 95% CI 0.96-0.99) were associated with a lower chance of discontinuation. CONCLUSIONS: In this group of novice runners, almost one-third stopped running within six months. A running-related injury was the main reason to stop running. Women with a low perceived physical functioning and without running experience were prone to discontinue running.


Assuntos
Motivação , Corrida/psicologia , Adulto , Traumatismos em Atletas/psicologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Aptidão Física , Estudos Prospectivos , Corrida/lesões , Inquéritos e Questionários
9.
Scand J Med Sci Sports ; 29(4): 515-523, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30536639

RESUMO

BACKGROUND: Although the Nordic Hamstring Exercise (NHE) prevents hamstring injury in soccer players effectively, the annual incidence of these injuries still increases. This may be because of poor long-term compliance with the program. Furthermore, the timing and amplitude of gluteal and core muscle activation seem to play an important role in hamstring injury prevention, the NHE program was not designed to improve activation of these muscles. Therefore, we propose plyometric training as an alternative to reduce hamstring injuries in soccer players. PURPOSE: To determine the preventive effect of the Bounding Exercise Program (BEP) on hamstring injury incidence and severity in adult male amateur soccer players. STUDY DESIGN: A cluster-Randomized Controlled Trial. METHODS: Thirty-two soccer teams competing in the first-class amateur league were cluster-randomized into the intervention or control group. Both groups were instructed to perform their regular training program, and the intervention group additionally performed BEP. Information about player characteristics was gathered at baseline and exposure, hamstring injuries and BEP compliance were weekly registered during one season (2016-2017). RESULTS: The data of 400 players were analyzed. In total, 57 players sustained 65 hamstring injuries. The injury incidence was 1.12/1000 hours in the intervention group and 1.39/1000 hours in the control group. There were no statistically significant differences in hamstring injury incidence (OR = 0.89, 95% CI 0.46-1.75) or severity between the groups (P > 0.48). CONCLUSION: In this large cluster-randomized controlled trial, no evidence was found for plyometric training in its current form to reduce hamstring injuries in amateur soccer players.


Assuntos
Músculos Isquiossurais/lesões , Traumatismos da Perna/prevenção & controle , Exercício Pliométrico , Lesões dos Tecidos Moles/prevenção & controle , Adolescente , Adulto , Atletas , Humanos , Masculino , Futebol , Adulto Jovem
10.
Pediatr Phys Ther ; 31(1): 84-93, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30507854

RESUMO

PURPOSE: To investigate the effects of high-intensity interval training (HIT) on physical fitness and cardiometabolic health in youth with physical disabilities. METHODS: For this quasi-experimental study 70 participants were recruited from schools for special education and divided into runners and users of wheelchairs. HIT was performed for 8 weeks, twice a week, containing 30 seconds all-out exercises. RESULTS: Exercise adherence was 84.5%. Following HIT, there were improvements in anaerobic performance, agility, aerobic performance, and systolic and diastolic blood pressure. There were no changes in peak oxygen uptake ((Equation is included in full-text article.)O2peak), arterial stiffness, body composition, lipid profile, and fasting glucose. CONCLUSIONS: Both anaerobic and aerobic performance improved after HIT, with no changes in (Equation is included in full-text article.)O2peak. There were no effects on cardiometabolic health, except for a decrease in blood pressure.


Assuntos
Crianças com Deficiência/reabilitação , Treinamento Intervalado de Alta Intensidade , Aptidão Física/fisiologia , Adolescente , Pressão Sanguínea , Composição Corporal , Criança , Deambulação com Auxílio/fisiologia , Teste de Esforço , Terapia por Exercício , Feminino , Humanos , Masculino , Limitação da Mobilidade , Consumo de Oxigênio , Corrida/fisiologia , Adulto Jovem
11.
Int J Behav Nutr Phys Act ; 15(1): 58, 2018 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-29940977

RESUMO

BACKGROUND: The objective of this study was to derive evidence-based physical activity guidelines for the general Dutch population. METHODS: Two systematic reviews were conducted of English language meta-analyses in PubMed summarizing separately randomized controlled trials and prospective cohort studies on the relation between physical activity and sedentary behaviour on the one hand and the risk of all-cause mortality and incidence of 15 major chronic diseases and conditions on the other hand. Other outcome measures were risk factors for cardiovascular disease and type 2 diabetes, physical functioning, and fitness. On the basis of these reviews, an expert committee derived physical activity guidelines. In deriving the guidelines, the committee first selected only experimental and observational prospective findings with a strong level of evidence and then integrated both lines of evidence. RESULTS: The evidence found for beneficial effects on a large number of the outcome measures was sufficiently strong to draw up guidelines to increase physical activity and reduce sedentary behaviour, respectively. At the same time, the current evidence did not provide a sufficient basis for quantifying how much physical activity is minimally needed to achieve beneficial health effects, or at what amount sedentary behaviour becomes detrimental. A general tenet was that at every level of current activity, further increases in physical activity provide additional health benefits, with relatively larger effects among those who are currently not active or active only at light intensity. Three specific guidelines on (1) moderate- and vigorous-intensity physical activity, (2) bone- and muscle-strengthening activities, and (3) sedentary behaviour were formulated separately for adults and children. CONCLUSIONS: There is an unabated need for evidence-based physical activity guidelines that can guide public health policies. Research in which physical activity is measured both objectively (quantity) and subjectively (type and quality) is needed to provide better estimates of the type and actual amount of physical activity required for health.


Assuntos
Exercício Físico , Promoção da Saúde , Guias de Prática Clínica como Assunto , Adulto , Criança , Humanos , Países Baixos
13.
Sports Med ; 48(3): 705-723, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29249084

RESUMO

BACKGROUND: Midportion Achilles tendinopathy (AT) can cause long-term absence from sports participation, and shows high recurrence rates. It is important that the decision to return to sport (RTS) is made carefully, based on sharply delimited criteria. Lack of a well-defined definition and criteria hampers the decision to RTS among athletes with AT, and impedes comparison of RTS rates between different studies. OBJECTIVE: The aim of this study was to systematically review the literature for definitions of, and criteria for, RTS in AT research. STUDY DESIGN: Qualitative systematic review. METHODS: The PubMed, EMBASE, Cochrane, CINAHL, PEDro, and Scopus electronic databases were searched for articles that reported on the effect of a physiotherapeutic intervention for midportion AT. Article selection was independently performed by two researchers. Qualitative content analysis was used to analyze the included studies and extract definitions of, and criteria for, RTS. RESULTS: Thirty-five studies were included in the content analysis, showing large variety in both the definitions and criteria. Thirty-two studies reported a definition of RTS, but only 19 studies described the criteria for RTS. The content analysis revealed that 'reaching pre-injury activity/sports level, with the ability to perform training and matches without limitations', 'absence of pain', and 'recovery' were the main content categories used to define RTS. Regarding the criteria for RTS, eight different content categories were defined: (1) 'level of pain'; (2) 'level of functional recovery'; (3) 'recovery of muscle strength'; (4) 'recovery of range of motion'; (5) 'level of endurance of the involved limb'; (6) 'medical advice'; (7) 'psychosocial factors'; and (8) 'anatomical/physiological properties of the musculotendinous complex'. Many criteria were not clearly operationalized and lacked specific information. CONCLUSIONS: This systematic review shows that RTS may be defined according to the pre-injury level of sports (including both training and matches), but also with terms related to the absence of pain and recovery. Multiple criteria for RTS were found, which were all related to level of pain, level of functional recovery, muscular strength, range of motion, endurance, medical advice, psychosocial factors, or anatomical/physiological properties of the Achilles tendon. For most of the criteria we identified, no clear operationalization was given, which limits their validity and practical usability. Further research on how RTS after midportion AT should be defined, and which criteria should be used, is warranted. PROSPERO REGISTRATION NUMBER: CRD42017062518.


Assuntos
Tendão do Calcâneo/lesões , Traumatismos em Atletas/fisiopatologia , Volta ao Esporte , Tendinopatia/cirurgia , Tenotomia/métodos , Tendão do Calcâneo/cirurgia , Atletas , Humanos , Força Muscular/fisiologia , Recuperação de Função Fisiológica , Fatores de Tempo , Resultado do Tratamento
14.
Phys Ther ; 97(10): 1020-1029, 2017 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-29029556

RESUMO

Background: Testing aerobic fitness in youth is important because of expected relationships with health. Objective: The purpose of the study was to estimate the validity and reliability of the Shuttle Ride Test in youth who have spina bifida and use a wheelchair for mobility and sport. Design: Ths study is a validity and reliability study. Methods: The Shuttle Ride Test, Graded Wheelchair Propulsion Test, and skill-related fitness tests were administered to 33 participants for the validity study (age = 14.5 ± 3.1 y) and to 28 participants for the reliability study (age = 14.7 ± 3.3 y). Results: No significant differences were found between the Graded Wheelchair Propulsion Test and the Shuttle Ride Test for most cardiorespiratory responses. Correlations between the Graded Wheelchair Propulsion Test and the Shuttle Ride Test were moderate to high (r = .55-.97). The variance in peak oxygen uptake (VO2peak) could be predicted for 77% of the participants by height, number of shuttles completed, and weight, with large prediction intervals. High correlations were found between number of shuttles completed and skill-related fitness tests (CI = .73 to -.92). Intraclass correlation coefficients were high (.77-.98), with a smallest detectable change of 1.5 for number of shuttles completed and with coefficients of variation of 6.2% and 6.4% for absolute VO2peak and relative VO2peak, respectively. Conclusions: When measuring VO2peak directly by using a mobile gas analysis system, the Shuttle Ride Test is highly valid for testing VO2peak in youth who have spina bifida and use a wheelchair for mobility and sport. The outcome measure of number of shuttles represents aerobic fitness and is also highly correlated with both anaerobic performance and agility. It is not possible to predict VO2peak accurately by using the number of shuttles completed. Moreover, the Shuttle Ride Test is highly reliable in youth with spina bifida, with a good smallest detectable change for the number of shuttles completed.


Assuntos
Teste de Esforço/métodos , Consumo de Oxigênio/fisiologia , Aptidão Física/fisiologia , Disrafismo Espinal/fisiopatologia , Cadeiras de Rodas , Adolescente , Limiar Anaeróbio/fisiologia , Criança , Teste de Esforço/estatística & dados numéricos , Feminino , Humanos , Masculino , Países Baixos , Reprodutibilidade dos Testes , Respiração , Taxa Respiratória/fisiologia , Esportes , Transportes
15.
Alzheimers Dement (N Y) ; 3(2): 157-165, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29067325

RESUMO

There is evidence for a beneficial effect of aerobic exercise on cognition, but underlying mechanisms are unclear. In this study, we test the hypothesis that aerobic exercise increases cerebral blood flow (CBF) in patients with vascular cognitive impairment (VCI). This study is a multicenter single-blind randomized controlled trial among 80 patients with VCI. Most important inclusion criteria are a diagnosis of VCI with Mini-Mental State Examination ≥22 and Clinical Dementia Rating ≤0.5. Participants are randomized into an aerobic exercise group or a control group. The aerobic exercise program aims to improve cardiorespiratory fitness and takes 14 weeks, with a frequency of three times a week. Participants are provided with a bicycle ergometer at home. The control group receives two information meetings. Primary outcome measure is change in CBF. We expect this study to provide insight into the potential mechanism by which aerobic exercise improves hemodynamic status.

16.
BMC Musculoskelet Disord ; 18(1): 296, 2017 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-28693535

RESUMO

BACKGROUND: Midportion Achilles tendinopathy (AT) is a common overuse injury, usually requiring several months of rehabilitation. Exercise therapy of the ankle plantar flexors (i.e. tendon loading) is considered crucial during conservative rehabilitation. Alfredson's isolated eccentric and Silbernagel's combined concentric-eccentric exercise programs have both shown beneficial results, but it is unknown whether any of these programs is superior for use in clinical practice. Therefore, the primary objective of this study is to compare the effectiveness of both programs on clinical symptoms. Secondary objectives are to compare the effectiveness of both programs on quality of life and functional outcome measures, to investigate the prognostic value of baseline characteristics, to investigate differences in cost-effectiveness. METHODS/DESIGN: Eighty-six recreational athletes (21-60 years of age) with unilateral chronic midportion AT (i.e. ≥ 3 months) will be included in this multicenter assessor blinded randomized controlled trial. They will be randomly allocated to either a group performing the Alfredson isolated eccentric training program (n = 43), or a group performing the Silbernagel combined concentric-eccentric program (n = 43). In the Alfredson group, participants will perform eccentric heel-drops on their injured side, twice daily for 12 weeks, whereas in the Silbernagel group, participants perform various concentric-eccentric heel-raise exercises, once daily for 12 weeks. Primary outcome measure will be the Victorian Institute of Sport Assessment - Achilles (VISA-A) questionnaire. Secondary outcomes will be a visual analogue scale (VAS) for pain during daily activities and sports, duration of morning stiffness, global perceived effect, the 12-item Short Form Health Survey and the Euroqol instrument, and functional performance measured with the heel-raise test and the countermovement jump. Additionally, alongside the RCT, a cost-effectiveness analysis will be performed. Assessments will be performed at baseline and after 12, 26, and 52 weeks. DISCUSSION: This study is the first to directly compare the Alfredson and the Silbernagel exercise program in a randomized trial. The results can further enlarge the evidence base for choosing the most appropriate exercise program for patients with midportion AT. TRIAL REGISTRATION: Dutch Trial register: NTR5638 . Date of registration: 7 January 2016.


Assuntos
Tendão do Calcâneo/patologia , Traumatismos em Atletas/reabilitação , Terapia por Exercício/métodos , Tendinopatia/reabilitação , Adulto , Traumatismos em Atletas/diagnóstico , Doença Crônica , Terapia por Exercício/normas , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Tendinopatia/diagnóstico , Resultado do Tratamento , Adulto Jovem
17.
Patient Educ Couns ; 100(12): 2218-2230, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28662874

RESUMO

OBJECTIVE: To provide an evidence-based overview of the effectiveness of e-coaching as a cardiac rehabilitation program (CRP). METHODS: Pubmed, Embase, PEDro and CINAHL were searched to identify relevant RCTs. The e-coaching programs were divided into basic or complex depending on their content. Two reviewers independently assessed the methodological quality and extracted the data. A best-evidence synthesis was used to summarize the results. RESULTS: 19 RCTs were included. Detailed descriptions of the e-coaching programs were lacking. Complex e-coaching was more effective than usual-care for physical capacity (moderate evidence for short-, and mid-term; strong evidence for long-term), for clinical status (limited evidence for short- and mid-term; moderate evidence for the long-term), and for psychosocial health (moderate evidence for short-term; strong evidence for mid-, and long-term). For basic e-coaching only limited or no evidence for effectiveness was found. CONCLUSION: Promising results were found for the effectiveness of complex e-coaching as a CRP to improve a patients' physical capacity, clinical status and psychosocial health. PRACTICE IMPLICATIONS: The content of the e-coaching programs were not clearly described. This makes it difficult to identify which components of e-coaching are most effective and should be further developed to deliver the most optimal care for cardiac rehabilitation patients.


Assuntos
Reabilitação Cardíaca/tendências , Promoção da Saúde/métodos , Autocuidado , Análise Custo-Benefício , Humanos
18.
Am J Sports Med ; 45(2): 286-293, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28146401

RESUMO

BACKGROUND: Although it has been suggested that generalized joint hypermobility (GJH) is a risk factor for injury in soccer players, it remains unclear whether this applies to elite female soccer players. PURPOSE: To investigate whether GJH is a risk factor for injury in elite female soccer players. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Elite female soccer players in the Netherlands were screened at the start of the 2014-2015 competitive season. GJH was assessed using the Beighton score. Soccer injuries and soccer exposure were registered throughout the entire season. Poisson regression was performed to calculate incidence risk ratios (IRRs) using different cutoff points of the Beighton score (≥3, ≥4, and ≥5) to indicate GJH. RESULTS: Of the 114 players included in the study, 20 were classified as hypermobile (Beighton score ≥4). The mean (±SD) injury incidence per player was 8.40 ± 9.17 injuries/1000 hours of soccer, with no significant difference between hypermobile and nonhypermobile players. GJH was not a risk factor for injuries when using Beighton score cutoff points of ≥3 (IRR = 1.06 [95% CI, 0.74-1.50]; P = .762), ≥4 (IRR = 1.10 [95% CI, 0.72-1.68]; P = .662), or ≥5 (IRR = 1.15 [95% CI, 0.68-1.95]; P = .602). Similarly, GJH was not a significant risk factor for thigh, knee, or ankle injuries evaluated separately. CONCLUSION: This study indicates that GJH is not a risk factor for injuries in elite female soccer players, irrespective of Beighton score cutoff point. Hypermobile players at this elite level might have improved their active stability and/or used braces to compensate for joint laxity.


Assuntos
Traumatismos em Atletas/epidemiologia , Instabilidade Articular/epidemiologia , Futebol/lesões , Adolescente , Adulto , Traumatismos em Atletas/etiologia , Feminino , Humanos , Incidência , Instabilidade Articular/complicações , Países Baixos/epidemiologia , Razão de Chances , Distribuição de Poisson , Estudos Prospectivos , Fatores de Risco , Futebol/estatística & dados numéricos , Adulto Jovem
19.
Clin J Sport Med ; 27(2): 89-96, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27347857

RESUMO

OBJECTIVE: To evaluate the effectiveness of a combined treatment of focused shockwave therapy (ESWT) and eccentric training compared with sham-shockwave therapy (placebo) and eccentric training in participants with patellar tendinopathy (PT) after 24 weeks. DESIGN: Randomized controlled trial. SETTING: Sports medicine departments of a university hospital and a general hospital in the Netherlands. PARTICIPANTS: Fifty-two physically active male and female participants with a clinical diagnosis of PT (mean age: 28.6 years; range, 18-45) were randomly allocated to the ESWT (n = 22) or sham shockwave (n = 30). INTERVENTIONS: Extracorporeal shockwave therapy and sham shockwave were applied in 3 sessions at 1-week intervals with a piezoelectric device. All participants were instructed to perform eccentric exercises (3 sets of 15 repetitions twice a day) for 3 months on a decline board at home. MAIN OUTCOME MEASURES: The Victorian Institute of Sport Assessment-Patella (VISA-P) scores (primary), pain scores during functional knee loading tests, and Likert score (secondary) were registered at baseline and at 6, 12, and 24 weeks after the start with the ESWT or sham-shockwave treatment. RESULTS: No significant differences for the primary and secondary outcome measures were found between the groups. In the ESWT/eccentric group, the VISA-P increased from 54.5 ± 15.4 to 70.9 ± 17.8, whereas the VISA-P in the sham-shockwave/eccentric group increased from 58.9 ± 14.6 to 78.2 ± 15.8 (between-group change in VISA-P at 24 weeks -4.8; 95% confidence interval, -12.7 to 3.0, P = 0.150). CONCLUSIONS: This study showed no additional effect of 3 sessions ESWT in participants with PT treated with eccentric exercises. The results should be interpreted with caution because of small sample size and considerable loss to follow-up, particularly in the ESWT group.


Assuntos
Ondas de Choque de Alta Energia/uso terapêutico , Ligamento Patelar/efeitos da radiação , Tendinopatia/terapia , Adolescente , Adulto , Método Duplo-Cego , Terapia por Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
20.
Am J Sports Med ; 45(1): 121-126, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27582278

RESUMO

BACKGROUND: In soccer, although hamstring flexibility is thought to play a major role in preventing hamstring injuries, the relationship between hamstring flexibility and hamstring injuries remains unclear. PURPOSE: To investigate the relationship between hamstring flexibility and hamstring injuries in male amateur soccer players. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: This study included 450 male first-class amateur soccer players (mean age, 24.5 years). Hamstring flexibility was measured by performing the sit-and-reach test (SRT). The relationship between hamstring flexibility and the occurrence of hamstring injuries in the following year, while adjusting for the possible confounding effects of age and previous hamstring injuries, was determined with a multivariate logistic regression analysis. RESULTS: Of the 450 soccer players, 21.8% reported a hamstring injury in the previous year. The mean (±SD) baseline score for the SRT was 21.2 ± 9.2 cm. During the 1-year follow-up period, 23 participants (5.1%) suffered a hamstring injury. In the multivariate analysis, while adjusting for age and previous injuries, no significant relationship was found between hamstring flexibility and hamstring injuries ( P = .493). CONCLUSION: In this group of soccer players, hamstring flexibility (measured with the SRT) was not related to hamstring injuries. Age and previous hamstring injuries as possible confounders did not appear to influence this relationship. Other etiological factors need to be examined to further elucidate the mechanism of hamstring injuries.


Assuntos
Músculos Isquiossurais/lesões , Músculos Isquiossurais/fisiologia , Futebol/lesões , Adulto , Estudos de Casos e Controles , Tendões dos Músculos Isquiotibiais/lesões , Tendões dos Músculos Isquiotibiais/fisiologia , Humanos , Masculino , Países Baixos , Estudos Prospectivos , Adulto Jovem
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