Impact of airflow on body cooling in exercise: an exploratory study / Impacto del flujo de aire en el enfriamiento del cuerpo en el ejercicio: un estudio exploratorio

Objective: To analyze the body heat dissipation by thermography during indoor running treadmill with different airflowconditions.Materials and method: Nine male participants (23.0±2.5 years old) underwent three 45-minute moderate-intensity runningsessions (60-70% reserve heart rate) on a treadmill. At each session, a different experimental condition was applied in a cros-sover design: without airflow (NF), and with low (LF) and high airflow (HF) generated by a fun. Thermograms were obtainedwith a thermal camera before exercise, during (every 10 minutes), and after exercise. Skin temperature (Tsk) was measuredon regions of interest of the upper body: pectoral, brachial biceps, and upper back. A repeated measures ANOVA was usedto compare Tsk over time and between conditions, considering p<0.05 as statistically significant.Results: In pectoral and brachial biceps, LF and HF conditions provided greater reductions in Tsk at all moments when com-pared to the NF (p<0.05). There was a higher reduction in Tsk to the HF vs LF in biceps at 30, 40, and 45 min during exercise(p<0.05). In the upper back, Tsk remained below baseline at all moments during exercise only in the HF condition (p<0.05).In NF and LF conditions, Tsk returned to baseline at 30 min during exercise (p>0.05).Conclusion: The frontal wind flow enhances body heat dissipation during moderate-intensity running in the pectoral, brachialbiceps, and upper back, with a direct relationship of flow speed and Tsk reduction during exercise.(AU)

Objetivo: Analizar el disipación del calor corporal mediante termografía en ejercicio de carrera en tapiz con diferentescondiciones de flujo de aire.Material y método: Nueve hombres (23,0±2,5 años) se sometieron a tres sesiones de 45 minutos de carrera de intensidadmoderada (60-70% frecuencia cardíaca de reserva) en tapiz, bajo tres condiciones diferentes en un diseño cruzado: sin flujo deaire (NF) y con flujo de aire bajo (LF) y alto (HF) generado por un ventilador. Los termogramas se obtuvieron con una cámaratérmica antes del ejercicio, durante y después del ejercicio, midiéndose la temperatura de la piel (Tp) en las regiones de interésdel pectorales, bíceps braquiales y parte superior de la espalda. Se utilizó un ANOVA de medidas repetidas para comparar Tpen función del tiempo y entre condiciones, considerando p<0,05 como estadísticamente significativo.Resultados: En los pectorales y bíceps braquiales, las condiciones LF y HF redujeron en todo momento la Tp comparadas conNF (p<0,05). La reducción de Tp fue mayor con HF que con LF en bíceps a los 30, 40 y 45 min (p<0,05). En la espalda superior,la Tp se mantuvo siempre por debajo de la línea base durante el ejercicio solo en la condición HF (p<0,05). En condicionesde NF y LF la Tp volvió a valores de referencia a los 30 min de ejercicio (p>0,05).Conclusiones: El flujo de viento frontal mejora la disipación del calor corporal en pectorales, bíceps braquiales y parte superiorde la espalda durante la carrera de intensidad moderada, con una relación directa de la velocidad del flujo y la reducción dela Tp durante el ejercicio.(AU)

Exergaming and Aquatic Exercises Affect Lung Function and Weight Loss in Obese Children.

We investigated the effect of exergames and aquatic exercises on lung function and weight loss in obese children. Sixty-one obese male primary-school children were randomly allocated to video game, aquatic exercise, and control groups. Lung functions and anthropometric variables were measured before and after the intervention and after one month (follow-up). In the video game group, an Xbox Kinect game was played for 60 min during three sessions a week. The aquatic aerobic exercise was performed three times per week and consisted of a warm-up, main exercises, and a cool down phase. For the video game group, there was a significant reduction in body weight between (i) pre- and (ii) post-intervention and follow-up. In the aquatic exercise group, there was a significant reduction in body weight between pre- and post-intervention and between pre-intervention and follow-up. Both exercise groups improved the waist/hip ratio index compared to the control group. Forced vital capacity was significantly improved in the follow-up of the video game group and the aquatic exercise group compared to the control group. A significant improvement was found in forced expiratory volume in the first second at post-intervention and follow-up in the video game and the aquatic exercise groups. Exergames and aquatic exercises improved weight loss and lung function in obese children.

Efectos del entrenamiento de intervalos de alta intensidad en altitud simulada. Revisión sistemática / Effects of high-intensity interval training at simulated Altitude. Systematic review

Introducción: en la actualidad, los entrenadores buscan la manera de mejorar las capacidades físicas de los atletas mediante diferentes estrategias de entrenamiento, como la exposición constante o intermitente a la altitud y el entrenamiento de intervalos de alta intensidad. Objetivo: Revisar la literatura actual y describir los efectos sobre el organismo del entrenamiento de intervalos de alta intensidad en altitud simulada en sujetos sedentarios, físicamente activos y entrenados. Resultados: el número de artículos revisados evidencia que, en hipoxia simulada en cámara hipobárica o normobárica (n=13) o máscara de simulación de altitud (n=1), todos utilizaron intensidades altas (n=13) a submáximas (n=1). Los participantes de las investigaciones fueron mujeres con obesidad sedentarias (n=3), hombres y mujeres físicamente activos (n=9) y sujetos entrenados (n=3). El tiempo de intervención de los estudios fue de 3 a 12 semanas, con una altitud simulada de 1824 a 4500 m.s.n.m. Se observaron efectos beneficiosos sobre la composición corporal, aptitud cardiorrespiratoria, aumentos en hemoglobina, eritropoyetina, consumo energético, fuerza máxima concéntrica e isométrica, fuerza absoluta y mejor tolerancia al ejercicio (percepción del esfuerzo). Conclusiones: La combinación de entrenamientos de intervalos de alta intensidad, combinado con una exposición en altitud simulada, puede evidenciar mejoras significativas en el rendimiento cardiorrespiratorio, así como en aspectos de composición corporal, lo que permitiría una mejor predisposición a intensidades más elevadas de actividad y ejercicio físico.

Introduction: Today, coaches are looking for ways to improve athletes' physical abilities through different training strategies, such as constant or intermittent exposu-re to altitude and high intensity interval training. Objective: To review the current literature and describe the effects on the body of simulated high-intensity interval training at altitude in sedentary, physically active, and trained subjects. Results: the number of articles reviewed evidences that, in simulated hypoxia in hypobaric or normobaric chamber (n = 13) or altitude simulation mask (n = 1), all used high intensities (n = 13) to submaximal (n = 1). The research participants were women with sedentary obesity (n = 3), physically active men and women (n = 9), and trained subjects (n = 3). The intervention time of the studies was 3 to 12 weeks, with a simulated altitude of 1824 to 4500 meters. Beneficial effects on body composition were observed, as well as cardiorespiratory fitness, increases in hemoglobin, erythro-poietin, energy consumption, concentric and isometric maximum strength, absolute strength and better exercise tolerance (perception of effort). Conclusions: The combination of high intensity interval training combined with a simulated altitude exposure can show significant improvements in cardiorespiratory performance, as well as in aspects of body composition, which would allow a better predisposition to higher intensities of activity and physical exercise.

Energy expenditure during a Vinyasa yoga session.

BACKGROUND: Vinyasa yoga has been recently promoted as one of the most popular mindful exercises to improve overall health, including body weight management. The purpose of this study was to determine the metabolic response of 24 moderately trained individuals during a 90-min group Vinyasa yoga routine. METHODS: Heart rate (HR) time course of 12 males and 12 females (age: 39±7.33 years) was recorded during two group Vinyasa yoga sessions consisted of four sections (warm-up, high-intensity Surya Namaskar (HSN), no Surya Namaskar postures, and cool-down). Maximal oxygen uptake (V̇O2peak) and maximum HR had been estimated earlier after a maximal treadmill test. V̇O2 during Vinyasa yoga sessions was estimated from individual regression equations using the relationship of V̇O2 and HR values derived from V̇O2peak test, while the metabolic rate (kcal/min) was calculated from the relationship of HR and kcal/min. Total session energy consumption was the average value of the two yoga sessions. RESULTS: The 2 (gender) × 4 (sections) mixed ANOVA revealed no significant interaction between the two factors (P=0.101) for the mean metabolic rate (7.1±2.6 kcal/min). Mean metabolic rate thought was higher (P=0.015) in males compared to females at each section. Also, significant differences were found among the four Vinyasa yoga sections (P<0.001) in the rate of energy expenditure, with HSN presenting the highest mean values (P<0.05). CONCLUSIONS: It seems that systematic participation in Vinyasa yoga may effectively improve cardiorespiratory fitness and promote body weight loss, as an alternative method to traditional aerobic exercise.

Running coaches and running group leaders' engagement with, and beliefs and perceived barriers to prehabilitation and injury prevention strategies for runners.

OBJECTIVES: To identify which pre-and post-run injury risk reduction activities and prehabilitation (prehab) strategies Coaches and Running Group Leaders (Coaches/RGLs) engage in with runners; to explore their beliefs on why runners get injured; to identify Coaches/RGLs confidence providing injury prevention activities, and what they believe are effective for reducing risk of injury; to identify their perceived barriers to including prehab during running coaching/training. DESIGN: Survey; Participants: UK Coaches/RGLs (N = 100) OUTCOME MEASURES: Online questionnaire with open, closed and Likert scale questions. RESULTS: Most Coaches/RGLs performed active warm-ups (97%), cool-downs (94%),gave injury prevention advice (91%), and advice on recovery strategies (84%) during training. Fewer coaches/RGLs incorporated prehab (67%). Although they collectively exhibited a wide range of knowledge, individually there was less consistency and confidence providing this. Prehab was rated as very important for injury risk reduction, with supervision recommended to facilitate runner engagement. Coaches/RGLs found conflicting advice, time, environment, and resistance from runners as barriers to incorporating prehab into training. CONCLUSION: Coaches/RGLs believe prehab is important for runners however lack of confidence and knowledge appeared to limit the wider inclusion of prehab with runners. Coaches/RGLs welcomed reputable information on prehab from evidence-based sources. This may assist in reducing injury.

Perceptions and use of recovery strategies: Do swimmers and coaches believe they are effective?

This study aimed to investigate swimmer's use and coach prescription of recovery strategies during training and competition while examining perceived challenges, barriers, and beliefs in the importance of their effectiveness. A mixed-methods sequential explanatory design was implemented. Thirty-seven male and 45 female sub-elite to elite swimmers (age 18 ± 3 y), and 4 male and 6 female coaches (age 40 ± 9 y) completed an online, 78-item recovery strategy survey. Swimmers and coaches responded to questions regarding when, why, and how they used recovery strategies, perceived challenges and barriers to strategy inclusion during training and competition. Data were coded and analysed thematically. Fisher's Exact Test was conducted on 5-point Likert scale responses. Most recovery strategies were used and prescribed more during competition. Swimmers reported active recovery as the most effective recovery strategy (44%), whereas coaches rated sleep or napping (40%). Swimmers and coaches perceived most recovery strategies to be more effective and important during competition than in training. Swimmers used, and coaches prescribed, recovery strategies more during the competition, highlighting the discrepancies in use between training and competition. Targeted education programmes should enhance athletes and coach's recovery knowledge and practical application of strategies, while accounting for individual sport and life demands.

Sports science for golf: A survey of high-skilled golfers' "perceptions" and "practices".

Despite a growing body of evidence on the positive impact of sports science for golf, there is still a paucity of research investigating the "perceptions" and "practices" of high-skilled golfers. Professional Golfers' Association Assistant Professionals (future-qualified coaches; n = 430) were surveyed on their "perceptions" and "practices" of "sports science", "warm-ups", "cool-downs" and "strength and conditioning" for golf. Participants perceived the discipline of sports science as beneficial to golfers but lacked implementation in coaching settings. Warm-up protocols were also perceived to be beneficial to all aspects of golf performance; however, the duration of tournament-based (37.84 ± 20.05 min), warm-ups was significantly greater (p < 0.001) than practice rounds (26.26 ± 18.63 min) and range sessions (13.00 ± 13.38 min). Education continues to be required to raise the understanding of warm-ups for golf. There were mixed perceptions regarding the benefits of a cool-down, with 62.1% of the high-skilled golfers omitting a cool-down following tournament play and practice. Strength and conditioning was perceived as beneficial, with 78.51% engaging in some form of training throughout the year. Results confirm, however, that certain misconceptions around surveyed sports science practices still exist and it is imperative that education disseminates research findings and validated applied practices to coaches and golfers alike.

[Non-randomized trial to evaluate a continuous physiotherapy program versus interval in overweight patients suffering from acute coronary syndrome]. / Ensayo no aleatorizado de un programa de fisioterapia continuo frente a interválico para pacientes con sobrepeso y síndrome coronario agudo.

We present a non-randomised trial to evaluate a continuous physiotherapy program versus a periodic one in overweight patients suffering from acute coronary syndrome. AIM: To detect differences between a continuous (CONT) physiotherapy program (PF) and a periodic (INT) physiotherapy program in overweight patients with acute coronary syndrome on anthropometric parameters, analytical parameters, heart rate, adherence, drop-outs, safety and tolerance. DESIGN: A multicentre, non-randomised two-armed quasi-experimental study with pre-post design. LOCATION: Community cardiac prevention centres (Manises, Valencia-LaFe, Játiva-Onteniente Health Department). PARTICIPANTS: The study included a total of 339 overweight participants with acute coronary syndrome; living in the community; aged more than 18; no contraindication for physical exercise; no previous participation in a PF. INTERVENTIONS: Participants were assigned to a CONT training or an INT training (2 months). Each session was divided in warm-up, endurance, and cool-down. Endurance was performed at 12-13 Borg intensity and with heat rate calculated, with maximum heat rate obtained in the baseline ergometry. MAIN MEASUREMENTS: Body mass index, waist circumference, lipid profile, blood glucose, glycosylated haemoglobin, resting heat rate, adherence, drop-outs, safety, and tolerance were assessed. RESULTS: The CONT group showed significantly better differences in body mass index, waist circumference, total cholesterol, triglycerides, blood glucose, glycosylated haemoglobin and resting heat rate. No differences were observed in adherence, drop-outs, safety, and tolerance. CONCLUSIONS: The CONT group obtained better results in all variables except for HDL cholesterol. Both programs offered a high adherence, safety, and tolerance.

Effects of Various Recovery Strategies on Repeated Bouts of Simulated Intermittent Activity.

Crowther, FA, Sealey, RM, Crowe, MJ, Edwards, AM, and Halson, SL. Effects of various recovery strategies on repeated bouts of simulated intermittent activity. J Strength Cond Res 33(7): 1781-1794, 2019-A large variety of recovery strategies are used between and after bouts of exercise to maximize performance and perceptual recovery, with limited conclusive evidence regarding the effectiveness of these strategies. The aim of this study was to compare 5 postexercise recovery strategies (cold water immersion, contrast water therapy, active recovery, a combined cold water immersion and active recovery, and a control condition) to determine which is most effective for the recovery of performance, perceptual, and flexibility measures during and after repeated bouts of simulated small-sided team sport demands. Fourteen recreationally active males (mean ± SD; age: 26 ± 6 years; height: 180 ± 5 cm; mass: 81 ± 9 kg) undertook repeated bouts of exercise, simulating a rugby sevens tournament day followed by the above listed recovery strategies (randomized, 1 per week). Perceptual, performance, and flexibility variables were measured immediately before, 5 minutes after all 3 exercise bouts, and at 75 minutes after the first 2 exercise bouts. Contrast water therapy was found to be superior to active at 75 minutes after bout 2 and 5 minutes after bout 3 for repeated-sprint ability and relative average power. The combined recovery strategy was superior to active for repeated-sprint ability at 5 minutes after bout 3; relative best power at 5 minutes after bout 2; total quality recovery before bout 2, 75 minutes after bout 2, and before bout 3; was superior to active for muscle soreness from 75 minutes after bout 1 and for the remainder of the day; and was superior to the control at 75 minutes after bout 1, 75 minutes after bout 2, and before bout 3. The active recovery was detrimental to total sprint time and relative average power at 75 minutes after bout 2 and 5 minutes after bout 3 in comparison with contrast water therapy and the control (not relative average power). Relative average power was decreased after active at 5 minutes after bout 2 in comparison with the combined recovery strategy and the control. Relative average power after cold water immersion was decreased at 75 minutes after bout 2 in comparison with the control and contrast water therapy. Total quality recovery was significantly reduced after active in comparison with the combined recovery strategy before bout 2, 75 minutes after bout 2, and before bout 3. Muscle soreness was also significantly increased after active recovery at 75 minutes after bout 1 and for the remainder of the day in comparison with the combined recovery strategy and was increased at 5 minutes after bout 3 in comparison with the control. Active recovery is not recommended because of the detrimental performance and perceptual results noted. As no recovery strategies were significantly better than the control condition for performance recovery and the combined recovery strategy is the only superior recovery strategy in comparison with the control for perceptual recovery (muscle soreness only), it is difficult to recommend a recovery strategy that should be used for both performance and perceptual recovery. Thus, based on the methodology and findings of this study unless already in use by athletes, no water immersion recovery strategies are recommended in preference to a control because of the resource-intensive (time and equipment) nature of water immersion recovery strategies.

Efficacy of Various Cooling Techniques During Exercise in Persons With Spinal Cord Injury: A Pilot Crossover Intervention Study.

Background: Decentralization of the sympathetic nervous system in persons with spinal cord injury (SCI) results in impaired vasomotor and sudomotor activity and, subsequently, impaired thermoregulatory capacity during exercise in the heat. Hyperthermia can be life-threatening and, as such, cooling interventions are needed to prevent this sequela. Objectives: To measure change in core temperature (ΔTC) over time during exercise in normothermic and high ambient heat conditions to compare thermoregulatory capacity in persons with varying degrees of intact vasomotor and sudomotor activity and to determine the efficacy of three cooling interventions in mitigating TC rise. Methods: Three persons participated: a 51-year-old with complete (AIS A) tetraplegia (TP), a 32-year-old with AIS A paraplegia (PP), and a 40-year-old without SCI (AB). Each exercised for 30 minutes on a wheelchair treadmill propelled at 30 revolutions per minute under five different conditions: (1) cool (C) = 75°F without cooling, (2) hot (H) = 90°F without cooling, (3) 90°F with cooling vest (CV), (4) 90°F with water spray (WS), and (5) 90°F with ice slurry ingestion (IS). ΔTC was compared for all conditions in all participants. Results: ΔTC in the C and H conditions was proportional to the neurological level of injury, with Tc rising highest in the TP followed by the PP then AB. WS was most efficacious at mitigating rise in TC followed by IS and CV in TP and PP. None of the cooling interventions provided an added TC cooling effect in AB. Conclusion: WS was most efficacious at mitigating rise in TC in TP>PP during exercise in the heat and should be studied in a larger SCI population.

Precooling, Exertional Heatstroke Risk Factors, and Postexercise Cooling Rates.

BACKGROUND: Precooling (PC) before exercise may help prevent severe hyperthermia and exertional heatstroke (EHS). Before clinicians can advocate PC as an EHS prevention strategy, it must effectively mitigate factors associated with EHS development while not lessening the effectiveness of EHS treatment. Therefore, this study determined if PC affected rectal temperature (Trec), body heat storage, heart rate (HR), ratings of perceived exertion (RPE), thermal sensation, sweat rate, and postexercise cold-water immersion (CWI) Trec cooling rates.METHODS: In this randomized, crossover, counterbalanced study, 12 subjects (6 men, 6 women; age = 22 ± 2 yr; mass = 73.5 ± 7.9 kg; height = 171 ± 7 cm) underwent 15 min of CWI (10.0 ± 0.03°C) in an environmental chamber (38.6 ± 0.6°C; 36 ± 2% humidity). After a 10-min rest, they exercised to a Trec of 39.5°C. Subsequently, they underwent CWI (9.99 ± 0.03°C) until Trec reached 38°C. On control (CON) days, the same procedures occurred without the 15-min PC intervention. Trec, HR, thermal sensation, and RPE were measured at various times before, during, and after exercise.RESULTS: PC lowered body heat storage and Trec by 15.7 ± 15.0 W · m-2 and 0.42 ± 0.40°C, respectively, before exercise. Subjects exercised significantly longer (PC = 66.7 ± 16.3 min, CON = 45.7 ± 9.5 min) and at lower Trec (∼0.5 ± 0.5°C) and HR (∼10 ± 7 bpm) following PC. PC significantly lowered sweat rate (PC = 1.02 ± 0.31 L · h-1, CON = 1.22 ± 0.39 L · h-1), but did not affect RPE or CWI cooling rates (PC = 0.18 ± 0.14°C · min-1; CON = 0.19 ± 0.05°C · min-1). Thermal sensation significantly differed between conditions only at pre-exercise (PC = 3 ± 1, CON = 5 ± 0.5).DISCUSSION: PC delayed severe hyperthermia and mitigated dehydration without affecting thermal perception or cooling rates posthyperthermia. PC may help prevent dangerous hyperthermia in athletes.Wohlfert TM, Miller KC. Precooling, exertional heatstroke risk factors, and postexercise cooling rates. Aerosp Med Hum Perform. 2019; 90(1):12-17.

Optimizing recovery to support multi-evening cycling competition performance.

Road criterium and track bicycle racing occur at high speeds, demand repeated high power outputs, last 10-90 min, and offer little chance for recovery after the event. Consecutive evenings of criterium and track racing are respectively known as speed-week or six-day events and take place in evening hours over the course of a week. Given the schedule and timing of these competitions, return to homeostasis can be compromised. No recommendations exist on how to optimize recovery for cyclists participating in these types of repeated evening competitions. Criterium and track cyclists spend considerable time, near and above the individual lactate threshold and therefore mostly utilize carbohydrate as their chief energy substrate. Henceforth, pre - and post-race nutrition and hydration is examined and recommendations are brought forward for carbohydrate, protein, and fluid intake. As evening high-intensity exercise perturbs sleep, strategies to optimize sleep are discussed and recommendations for an optimal sleep environment are given. Active recovery is examined, and the benefits of a short duration low intensity exercise reviewed. Passive recovery methods such as compression garments and cold water immersion are recommended, while evidence for massage, pneumatic compression devices, and neuromuscular electrical stimulation is still lacking. Optimizing recovery strategies will facilitate a return to the resting state following strenuous night competition.

Evidence-based post-exercise recovery strategies in rugby: a narrative review.

In the sport of rugby, athletes need a multitude of sport-specific skills along with endurance, power, and speed to optimize performance. Further, it is not unusual for athletes to play several competitive matches with insufficient recovery time. Rugby requires repeated bouts of high-intensity actions intermixed with brief periods of low-to-moderate active recovery or passive rest. Specifically, a match is characterized by repeated explosive activities, such as jumps, shuffles, and rapid changes of direction. To facilitate adequate recovery, it is necessary to understand the type of fatigue induced and, if possible, its underlying mechanisms. Common approaches to recovery may include nutritional strategies as well as active (active recovery) and passive recovery (water immersions, stretching, and massage) methods. However, limited research exists to support the effectiveness of each strategy as it related to recovery from the sport of rugby. Therefore, the main aim of the current brief review is to present the relevant literature that pertains to recovery strategies in rugby.

Effect of new generation medium voltage electrical stimulation on the meat quality of beef slaughtered in a Chinese abattoir.

In this study, a medium voltage electrical stimulation (ES) system with three parameter combinations (A: 1A, 1.55 ms pulse width, 27 s; B: 0.55A, 1 ms pulse width, 34 s; C: 0.55A, 2 ms pulse width, 20s) were applied to beef carcases (n = 24; 319 ±â€¯26.4 kg), in the context of a very slow pH decline rate in the abattoir. All the ES combinations significantly accelerated the rate of pH decline (reflected by temp@pH 6.0, i.e. temperature when pH drops to 6.0), resulting in a tenderness improvement even after 14 days ageing compared to the controls. Sarcomere length was not different between treatments and controls, and it was not a contributor to the tenderness improvement, instead, physical disruption revealed by transmission electron microscopic images may have led to the improvement. Retail colour was significantly improved by either combination B or C after 7 days of ageing. Combination B shows the most promise for commercial application, however, verification on more animals is required before commercial adoption.

The Effect of Lower Extremity Strengthening Exercise Using Sliding Stander on Balance and Spasticity in Chronic Stroke: A Randomized Clinical Trial

PURPOSE: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment.METHODS: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system.RESULTS: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05).CONCLUSION: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

Playing-Related Musculoskeletal Disorders Among Classical Piano Students at Tertiary Institutions in Malaysia: Proportion and Associated Risk Factors.

Musicians are prone to performance injuries due to the nature of musical practice, and classical pianists are among the groups at high risk for playing-related musculoskeletal disorders (PRMDs). With the growing number of classical pianists in Malaysia, this study aimed to investigate the proportion of PRMDs occurring among classical piano students in tertiary institutions in Malaysia. Associations between gender, practice habits, diet, sports involvement, and PRMD were investigated. A survey was conducted among classical piano students (n=192) at tertiary institutions of Kuala Lumpur and Selangor. Results showed that 35.8% (n=68) students reported having PRMD. The shoulder was the most commonly affected body site, followed by the arm, finger, and wrist. Pain, fatigue, and stiffness were the most cited symptoms by those who suffered from a PRMD. Chi-square analysis showed a significant relationship between the occurrence of PRMD and practice hours (p=0.031), the habit of taking breaks during practice (p=0.045), physical cool-down exercises (p=0.037), and special diet (p=0.007). Multivariate logistic regression analyses confirmed the independent correlation between PRMDs and the lack of taking a break during practice, physical cool-down exercises, and special diet. Because PRMDs are reported at various severity levels, this study should increase awareness of PRMD among classical piano students and encourage injury prevention in musicians in the future to ensure long-lasting music careers.

Measurements of the Acoustic Speaking Voice After Vocal Warm-up and Cooldown in Choir Singers.

OBJECTIVES: The aim of this study was to evaluate the acoustic measurements of the vowel /a/ in modal recording before and after a singing voice resistance test and after 30 minutes of absolute rest in female choir singers. STUDY DESIGN: This is a prospective cohort study. METHODS: A total of 13 soprano choir singers with experience in choir singing were evaluated through analysis of acoustic voice parameters at three points in time: before continuous use of the voice, after vocal warm-up and a singing test 60 minutes in duration respecting the pauses for breathing, and after vocal cooldown and an absolute voice rest for 30 minutes. RESULTS: The fundamental frequency increased after the voice resistance test (P = 0.012) and remained elevated after the 30 minutes of voice rest (P = 0.01). The jitter decreased after the voice resistance test (P = 0.02) and after the 30 minutes of voice rest. A significant difference was detected for the acoustic voice parameters relative average perturbation (RAP), (P = 0.05), and pitch perturbation quotient (PPQ), (P = 0.04), compared with the initial time point. CONCLUSIONS: The fundamental frequency increased after 60 minutes of singing and remained elevated after vocal cooldown and absolute rest for 30 minutes, proving an efficient parameter for identifying the changes inherent to voice demand during singing.

The Impact of Vocal Cool-down Exercises: A Subjective Study of Singers' and Listeners' Perceptions.

OBJECTIVE: Using subjective measures, this study investigated singers' and listeners' perceptions of changes in voice condition after vocal cool-down exercises. STUDY DESIGN: A single-subject crossover was designed to evaluate whether there were discernible differences in either singer or listener perceptions from pre (no vocal cool downs) to post (with cool downs) test. Subjective questionnaires were completed throughout the study. METHODS: Twenty classically trained female singers documented self-ratings and perceptual judgments through the Evaluation of the Ability to Sing Easily survey, the Singing Voice Handicap Index, and Self-Perceptual Questionnaires after a 60-minute voice load. Recordings were made and assessed by four expert listeners. RESULTS: The assessed data from the Singing Voice Handicap Index, the Evaluation of the Ability to Sing Easily, and Daily Perceptual Questionnaires show 68%, 67%, and 74% of singers reported improvement, respectively. However, because of significant variability in the underlying scores, the amount of improvement was not deemed to be statistically significant. Expert listeners correctly identified the cool-down week 46% of the time. CONCLUSIONS: Singers strongly perceived positive impact from the cool-down exercises on both their speaking and singing voices. Even though the objective data were statistically insignificant, the singers' subjective data clearly indicates a perceived sense of vocal well-being after utilizing the vocal cool-down protocol. The variability in the daily life of a singer (eg, stress, menses, reflux, vocal load, and vocal hygiene) makes it difficult to objectively quantify the impact of vocal cool downs.