Effectiveness of a cardiac rehabilitation program on biomechanical, imaging, and physiological biomarkers in elderly patients with heart failure with preserved ejection fraction (HFpEF): FUNNEL + study protocol.

BACKGROUND: Patients with heart failure with preserved ejection fraction (HFpEF) have a low functional status, which in turn is a risk factor for hospital admission and an important predictor of survival in HFpEF. HFpFE is a heterogeneous syndrome and recent studies have suggested an important role for careful, pathophysiological-based phenotyping to improve patient characterization. Cardiac rehabilitation has proven to be a useful tool in the framework of secondary prevention in patients with HFpEF. Facilitating decision-making and implementing cardiac rehabilitation programs is a challenge in public health systems for HFpEF management. The FUNNEL + study proposes to evaluate the efficacy of an exercise and education-based cardiac rehabilitation program on biomechanical, physiological, and imaging biomarkers in patients with HFpEF. METHODS: A randomised crossover clinical trial is presented among people older than 70 years with a diagnosis of HFpEF. The experimental group will receive a cardiac rehabilitation intervention for 12 weeks. Participants in the control group will receive one educational session per week for 12 weeks on HFpEF complications, functional decline, and healthy lifestyle habits. VO2peak is the primary outcome. Biomechanical, imaging and physiological biomarkers will be assessed as secondary outcomes. Outcomes will be assessed at baseline, 12 weeks, and 24 weeks. DISCUSSION: Identifying objective functional parameters indicative of HFpEF and the subsequent development of functional level stratification based on functional impairment ("biomechanical phenotypes") may help clinicians identify cardiac rehabilitation responders and non-responders and make future clinical decisions. In this way, future pharmacological and non-pharmacological interventions, such as exercise, could be improved and tailored to improve quality of life and prognosis and reducing patients' hospital readmissions, thereby reducing healthcare costs. TRIAL REGISTRATION: NCT05393362 (Clinicaltrials.gov).

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

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

The Benefits of a Therapeutic Exercise and Educational Intervention Program on Central Sensitization Symptoms and Pain-Related Fear Avoidance in Breast Cancer Survivors.

BACKGROUND: Central sensitization symptoms and pain-related fear avoidance are two common problems in breast cancer survivors. Non-pharmacologic interventions such as therapeutic exercise and patient education can be effective in this population. AIMS: This study aimed to: (1) analyze the benefits of a therapeutic exercise and educational program on central sensitization symptoms and pain-related fear avoidance in breast cancer survivors, and (2) explore the association between pain-related fear avoidance and central sensitization symptoms. DESIGN: A single group pre-post intervention study was conducted. METHODS: Patients were recruited from the service of Medical Oncology of the University Clinical Hospital Virgen de la Victoria, in Málaga (Spain). The intervention consisted of a therapeutic exercise and educational program that lasted 12 weeks, twice a week, for 1 hour. Two instruments were used: the Spanish version of the Central Sensitization Inventory and the Spanish Fear Avoidance Components Scale. RESULTS: A total of 82 breast cancer survivors participated in the study. Pre-post change on Central Sensitization Inventory was statistically significant (p = .007). There was a trend towards a significant difference for the Spanish Fear Avoidance Components Scale (p = .062). There was a statistically significant correlation between pain-related fear avoidance and central sensitization symptoms (r = 0.536, p < .001). CONCLUSIONS: The current study has provided preliminary evidence on the benefits of this intervention in pain-related fear avoidance and central sensitization symptoms in breast cancer survivors. The Spanish version of the Central Sensitization Inventory and the Spanish Fear Avoidance Components Scale demonstrated responsiveness to change.

The Validity of the Energy Expenditure Criteria Based on Open Source Code through two Inertial Sensors.

Through this study, we developed and validated a system for energy expenditure calculation, which only requires low-cost inertial sensors and open source R software. Five healthy subjects ran at ten different speeds while their kinematic variables were recorded on the thigh and wrist. Two ActiGraph wireless inertial sensors and a low-cost Bluetooth-based inertial sensor (Lis2DH12), assembled by SensorID, were used. Ten energy expenditure equations were automatically calculated in a developed open source R software (our own creation). A correlation analysis was used to compare the results of the energy expenditure equations. A high interclass correlation coefficient of estimated energy expenditure on the thigh and wrist was observed with an Actigraph and Sensor ID accelerometer; the corrected Freedson equation showed the highest values, and the Santos-Lozano vector magnitude equation and Sasaki equation demonstrated the lowest one. Energy expenditure was compared between the wrist and thigh and showed low correlation values. Despite the positive results obtained, it was necessary to design specific equations for the estimation of energy expenditure measured with inertial sensors on the thigh. The use of the same formula equation in two different placements did not report a positive interclass correlation coefficient.

Responsiveness of monopodal postural stability tests in recreational athletes.

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

Kinematic parameters related to functional capacity, fatigue, and breathlessness during the 6-min walk test in older adults with heart failure with preserved ejection fraction.

AIMS: This paper aims to assess kinematic parameters related to functional capacity, fatigue, and breathlessness during the 6-min walk test (6MWT) in patients with heart failure with preserved ejection fraction (HFpEF). METHODS AND RESULTS: A cross-sectional study was conducted in which adults 70 years or older with HFpEF were voluntarily recruited between April 2019 and March 2020. An inertial sensor was placed at the L3-L4 level and another on the sternum to assess kinematic parameters. The 6MWT was divided into two 3-min phases. Leg fatigue and breathlessness, assessed by the Borg scale, the heart rate (HR), and the oxygen saturation (SpO2), were measured at the beginning and the end of the 6MWT. The difference in kinematic parameters between the 6MWT two 3-min phases was also calculated. Bivariate Pearson correlations and subsequent multivariate linear regression analysis were performed. Seventy older adults with HFpEF (mean = 80.74 years old) were included. Kinematic parameters explained 81.00% of the functional capacity, 45.50% of the leg fatigue and 66.10% of the breathlessness variance. Moreover, kinematic parameters could explain 30.90% of the SpO2 variance at the end of the 6MWT. Kinematic parameters also explained 33.10% of the SpO2 difference between the beginning and end of 6MWT. Kinematic parameters explained neither the HR variance at the end of 6MWT nor the HR difference between the beginning and end. CONCLUSION: Gait kinematics from L3-L4 and sternum explain a part of the variance in subjective outcomes, assessed by the Borg scale, and objective outcomes such as functional capacity and SpO2. The kinematic assessment allows clinicians to quantify fatigue and breathlessness through objective parameters related to the patient's functional capacity. REGISTRATION: ClinicalTrials.gov NCT03909919.

Pain neuroscience education in persistent painful tendinopathies: A scoping review from the Tendon PNE Network.

OBJECTIVE: to conduct and report a scoping review of the available evidence of the effects and content of pain neuroscience education for patients with persistent painful tendinopathies. METHODS: PubMed, Embase, Web of Science, CINAHL, SPORTDiscus, and grey literature databases were searched from database inception to May 2022. Randomised and non-randomised controlled trials, non-controlled clinical trials, cohort studies, case series, case studies including people with persistent painful tendinopathy aged ≥18 years, a pain education intervention, and in English were included. Studies were excluded if they were cross-sectional studies, reviews, editorials, abstracts, or full-text not available or if included heterogeneous study cohorts, patients with tendon rupture, or patients with systemic diseases. RESULTS: five studies (n = 164) were included. Pain neuroscience education entailed face-to-face discussion sessions or educational materials including videos, brochures, paper drawings, and review questions. All studies used pain neuroscience education in conjunction with other interventions, obtaining significant benefits in outcomes related to pain, physical performance, or self-reported function, among others. CONCLUSIONS: The application of pain neuroscience education in conjunction with other interventions seemed to improve several outcomes. However, considering the current knowledge about tendon pain and the scarcity of well-designed trials studying pain neuroscience education in tendinopathy, additional research is needed.

Effectiveness of a gamified digital intervention based on lifestyle modification (iGAME) in secondary prevention: a protocol for a randomised controlled trial.

INTRODUCTION: Combating physical inactivity and reducing sitting time are one of the principal challenges proposed by public health systems. Gamification has been seen as an innovative, functional and motivating strategy to encourage patients to increase their physical activity (PA) and reduce sedentary lifestyles through behaviour change techniques (BCT). However, the effectiveness of these interventions is not usually studied before their use. The main objective of this study will be to analyse the effectiveness of a gamified mobile application (iGAME) developed in the context of promoting PA and reducing sitting time with the BCT approach, as an intervention of secondary prevention in sedentary patients. METHODS AND ANALYSIS: A randomised clinical trial will be conducted among sedentary patients with one of these conditions: non-specific low back pain, cancer survivors and mild depression. The experimental group will receive a 12-week intervention based on a gamified mobile health application using BCT to promote PA and reduce sedentarism. Participants in the control group will be educated about the benefits of PA. The International Physical Activity Questionnaire will be considered the primary outcome. International Sedentary Assessment Tool, EuroQoL-5D, MEDRISK Instruments and consumption of Health System resources will be evaluated as secondary outcomes. Specific questionnaires will be administered depending on the clinical population. Outcomes will be assessed at baseline, at 6 weeks, at the end of the intervention (12 weeks), at 26 weeks and at 52 weeks. ETHICS AND DISSEMINATION: The study has been approved by the Portal de Ética de la Investigación Biomédica de Andalucía Ethics Committee (RCT-iGAME 24092020). All participants will be informed about the purpose and content of the study and written informed consent will be completed. The results of this study will be published in a peer-reviewed journal and disseminated electronically and in print. TRIAL REGISTRATION NUMBER: NCT04019119.

Modelling and in vivo evaluation of tendon forces and strain in dynamic rehabilitation exercises: a scoping review.

OBJECTIVES: Although exercise is considered the preferred approach for tendinopathies, the actual load that acts on the tendon in loading programmes is usually unknown. The objective of this study was to review the techniques that have been applied in vivo to estimate the forces and strain that act on the human tendon in dynamic exercises used during rehabilitation. DESIGN: Scoping review. DATA SOURCES: Embase, PubMed, Web of Science and Google Scholar were searched from database inception to February 2021. ELIGIBILITY CRITERIA: Cross-sectional studies available in English or Spanish language were included if they focused on evaluating the forces or strain of human tendons in vivo during dynamic exercises. Studies were excluded if they did not evaluate tendon forces or strain; if they evaluated running, walking, jumping, landing or no dynamic exercise at all; and if they were conference proceedings or book chapters. DATA EXTRACTION AND SYNTHESIS: Data extracted included year of publication, study setting, study population characteristics, technique used and exercises evaluated. The studies were grouped by the types of techniques and the tendon location. RESULTS: Twenty-one studies were included. Fourteen studies used an indirect methodology based on inverse dynamics, nine of them in the Achilles and five in the patellar tendon. Six studies implemented force transducers for measuring tendon forces in open carpal tunnel release surgery patients. One study applied an optic fibre technique to detect forces in the patellar tendon. Four studies measured strain using ultrasound-based techniques. CONCLUSIONS: There is a predominant use of inverse dynamics, but force transducers, optic fibre and estimations from strain data are also used. Although these tools may be used to make general estimates of tendon forces and strains, the invasiveness of some methods and the loss of immediacy of others make it difficult to provide immediate feedback to the individuals.

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

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

Estimation of Functional Aerobic Capacity Using the Sit-to-Stand Test in Older Adults with Heart Failure with Preserved Ejection Fraction.

Background: The 6-Min Walking Test (6MWT) has been proposed to assess functional aerobic capacity in patients with heart failure, but many older adults with heart failure cannot complete it. The adequacy of the 5-repetition Sit-To-Stand (5-STS), a simpler test than 6MWT, to assess the functional aerobic capacity in older adults with heart failure has not been evaluated. Objectives: This study aimed to assess the usefulness of 5-STS in estimating maximal oxygen uptake (VO2 peak) in older adults with heart failure with preserved ejection fraction (HFpEF). Methods: A cross-sectional study was carried out. Patients 70 years and older with HFpEF were included. A bivariant Pearson correlation and subsequent multivariate linear regression analysis were used to analyze the correlations between the 5-STS and the estimated VO2 peak. Results: Seventy-six patients (80.74 (5.89) years) were recruited. The 5-STS showed a moderate and inversely correlation with the estimated VO2 peak (r = −0.555, p < 0.001). The 5-STS explained 40.4% of the variance in the estimated VO2 peak, adjusted by age, sex, and BMI. When older adults were stratified by BMI, the 5-STS explained 70% and 31.4% of the variance in the estimated VO2 peak in older adults with normal weight and overweight/obesity, respectively. Conclusions: The 5-STS may be an easy tool to assess functional aerobic capacity in older adults with HFpEF, especially for those with normal weight.

Responsiveness of the new index muscular echotexture in women with metastatic breast cancer: an exercise intervention study.

Ultrasound imaging texture analyses may provide information on tissue homogeneity changes in metastatic breast cancer (MBC) through second-order analyzes based on the gray-level co-occurrence matrix. This study aimed to analyze the responsiveness and correlations of biomarkers of muscular and fat echotexture after an exercise intervention in women with MBC. A 12-week exercise intervention was conducted in 2019, including aerobic and strength training. Echotexture variables were obtained at baseline and after intervention from the quadriceps (Q) and biceps brachii and brachialis. Mean differences were calculated using the T-Student parametric test for dependent samples of the differences in the means (P = 0.05; 95% CI). Data obtained from 13 MBC women showed significant differences in some echotexture variables after the intervention. QLQ-BR23 questionnaire correlated with several echotexture variables from muscle and subcutaneous fat. PFS-R scale correlated positively with the Q Subcutaneous Fat Non-Contraction Homogeneity (R = 0.43, P < 0.05). Q Muscle Non-Contraction Energy and Q Muscle Non-Contraction Textural Correlation explained 90% of the variance of QLQ-BR23. Some muscle and subcutaneous fat echotexture biomarkers showed good responsiveness after the exercise intervention. Additionally, some muscle and subcutaneous fat variables correlated with QLQ-BR23 and cancer-related fatigue measured by PFS-R scale in MBC patients.Trial registration: NCT03879096.

Kinematic Parameters That Can Discriminate in Levels of Functionality in the Six-Minute Walk Test in Patients with Heart Failure with a Preserved Ejection Fraction.

It is a challenge to manage and assess heart failure with preserved left ventricular ejection fraction (HFpEF) patients. Six-Minute Walk Test (6MWT) is used in this clinical population as a functional test. The objective of the study was to assess gait and kinematic parameters in HFpEF patients during the 6MWT with an inertial sensor and to discriminate patients according to their performance in the 6MWT: (1) walk more or less than 300 m, (2) finish or stop the test, (3) women or men and (4) fallen or did not fall in the last year. A cross-sectional study was performed in patients with HFpEF older than 70 years. 6MWT was carried out in a closed corridor larger than 30 m. Two Shimmer3 inertial sensors were used in the chest and lumbar region. Pure kinematic parameters analysed were angular velocity and linear acceleration in the three axes. Using these data, an algorithm calculated gait kinematic parameters: total distance, lap time, gait speed and step and stride variables. Two analyses were done according to the performance. Student's t-test measured differences between groups and receiver operating characteristic assessed discriminant ability. Seventy patients performed the 6MWT. Step time, step symmetry, stride time and stride symmetry in both analyses showed high AUC values (>0.75). More significant differences in velocity and acceleration in the maximum Y axis or vertical movements. Three pure kinematic parameters obtained good discriminant capacity (AUC > 0.75). The new methodology proved differences in gait and pure kinematic parameters that can distinguish two groups according to the performance in the 6MWT and they had discriminant capacity.

Reliability Study of Inertial Sensors LIS2DH12 Compared to ActiGraph GT9X: Based on Free Code.

The study's purpose was to assess the reliability of the LIS2DH12 in two different positions, using the commercial sensor Actigraph GT9X as a reference instrument. Five participants completed two gait tests on a treadmill. Firstly, both sensors were worn on the wrist and around the thigh. Each test consisted of a 1 min walk for participants to become accustomed to the treadmill, followed by a 2 min trial at ten pre-set speeds. Data from both sensors were collected in real-time. Intraclass correlation coefficient (ICC) was used to evaluate the equality of characteristics obtained by both sensors: maximum peaks, minimum peaks, and the mean of the complete signal (sequence of acceleration values along the time) by each axis and speed were extracted to evaluate the equality of characteristics obtained with LIS2DH12 compared to Actigraph. Intraclass correlation coefficient (ICC) was extracted, and a standard deviation of the mean was obtained from the data. Our results show that LIS2DH12 measurements present more reliability than Actigraph GT9X, ICC > 0.8 at three axes. This study concludes that LIS2DH12 is as reliable and accurate as Actigraph GT9X Link and, therefore, would be a suitable tool for future kinematic studies.

Effect of a common exercise programme with an individualised progression criterion based on the measurement of neuromuscular capacity versus current best practice for lower limb tendinopathies (MaLaGa trial): a protocol for a randomised clinical trial.

INTRODUCTION: High-load resistance training has shown positive effects in pain and function in lower limb tendinopathies. However, some authors suggest that current exercise programmes produce an increase in tolerance to load and exercise in general but without fixing some existing issues in tendinopathy. This may indicate the need to include training aspects not currently taken into account in the current programmes. The main objective of this study will be to compare the effect of a common exercise protocol for the three predominant lower limb tendinopathies (Achilles, patellar and gluteal), based on an individualised control of the dose and training of specific aspects of the neuromuscular system versus the current best practice for each location. METHODS AND ANALYSIS: This study will be conducted among people with mid-portion Achilles, patellar or gluteal tendinopathy. The participants allocated to the experimental group will perform a 14-week innovative common therapeutic exercise programme. Participants allocated to the control group will carry out a 14-week exercise programme based on the best current practice for each of the studied locations. The Victorian Institute of Sports Assessment questionnaire will be considered the primary outcome. Pain, central sensitisation, fear avoidance behaviour, quality of life, treatment satisfaction, lower-limb strength and function, and high-density electromyography profile will be evaluated as secondary outcomes. Outcomes will be assessed at baseline, 7 weeks, after the intervention (week 14), 26 weeks and 52 weeks. ETHICS AND DISSEMINATION: The study has been approved by the Portal de Ética de la Investigación Biomédica de Andalucía Ethics Committee (1221-N-19). All participants will be informed about the purpose and content of the study and written informed consent will be completed. The results of this study will be published in a peer-reviewed journal and will be disseminated electronically and in print. TRIAL REGISTRATION NUMBER: NCT03853122; Pre-results.

Effects of exercise on muscle mass, strength, and physical performance in older adults with sarcopenia: A systematic review and meta-analysis according to the EWGSOP criteria.

BACKGROUND: In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) updated the definition and the diagnosis criteria of sarcopenia. Previous systematic reviews have shown the effect of exercise on sarcopenia including people with different sarcopenia diagnostic criteria. OBJECTIVE: This systematic review and meta-analysis aims to summarise and synthesise the evidence about the effect of exercise on muscle mass, strength and physical performance in older adults with sarcopenia according to the EWGSOP criteria. METHODS: Major electronic databases were searched for articles published until September 2020. Randomised controlled trials (RCTs) and non-randomised interventional studies examining the effect of exercise on muscle mass, strength or physical performance in adults older than 60 years with sarcopenia according to the EWGSOP criteria were included. RESULTS: Four RCTs and three non-randomised interventional studies with a total of 235 patients with sarcopenia were included. Five of the seven included studies reported a low risk of bias. Exercise showed a large effect on physical performance (d = 1.21, 95%CI [0.79 to 1.62]; P < 0.001), a medium effect on muscle strength (d = 0.51, 95%CI [0.25 to 0.76]; P < 0.001), and no effect on muscle mass (d = 0.27, 95%CI [-0.05 to 0.58]; P = 0.10). CONCLUSION: The present systematic review showed an effect of exercise on physical performance and muscle strength but an inconsistent effect on muscle mass. The grading of recommendations assessment, development and evaluation criteria showed a low level of evidence in muscle mass, a low or moderate level of evidence in muscle strength and a high level of evidence in physical performance.

The Importance of Lifestyle Factors for Work Ability among Physical Therapists: A Cross-Sectional Study.

Lifestyle factors such as smoking, sedentarism, low physical activity levels, and overweight are associated with poor health, and they can potentially influence work ability. However, it remains unknown which lifestyle habits are associated with work ability among physical therapists (PTs). The aim of this study was to examine the associations between smoking, alcohol consumption, BMI, sitting time, and physical activity levels with work ability among PTs utilizing a nationwide questionnaire. Associations were modeled using logistic regression controlled for various confounders. Overweight, sitting >150 min/day, and <75 min/week of leisure-time vigorous physical activity were associated with lower work ability among PTs. Further, the existence of two unhealthy habits showed a weak-to-moderate positive association with lower work ability scores (Model 1: OR, 2.21, 95% CI = 1.16-4.22; Model 2: OR, 2.32, 95% CI, 1.18-4.54), with even stronger associations when three unhealthy habits (Model 1: OR = 3.30, 95% CI, 1.58-6.86; Model 2: OR, 3.34, 95% CI, 1.54-7.26) or four unhealthy habits (Model 1: OR = 8.91, 95% CI, 2.55-31.1; Model 2: OR = 8.20, 95% CI, 2.15-31.2) were present. In conclusion, overweight, low physical activity, and sedentarism were associated with lower levels of work ability, especially when ≥2 unhealthy lifestyle factors were present.

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

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

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

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

Ultrasound use in metastatic breast cancer to measure body composition changes following an exercise intervention.

Changes in body composition and muscle dysfunction are common in metastatic breast cancer (MBC). Ultrasound imaging (US) offers reliable information about muscle and fat tissue architecture (thickness) and quality (echo-intensity). This study aimed to analyze the responsiveness of thickness and echo-intensity and its possible relationship with functional and patient reported-outcomes (PRO) in MBC patients after an exercise intervention. A prospective study was conducted in 2019. A 12-week exercise program was performed, including aerobic exercise and strength training. Measurements were made at baseline and after intervention. Thickness and echo-intensity were obtained from the quadriceps and biceps brachii and brachialis (BB). Mean differences were calculated using the T-Student parametric test for dependent samples of the differences in the means before and after the intervention (p = 0.05; 95% CI). Data from 13 MBC patients showed that some US muscle variables had significant differences after intervention. Best correlations were found between the quality of life questionnaire (QLQ-BR23) PRO and variables from BB muscle thickness in contraction (r = 0.61, p < 0.01), and Non-contraction (r = 0.55, p < 0.01). BB Muscle Non-contraction Thickness also explained 70% of QLQ-BR23 variance. In conclusion, muscle architecture biomarkers showed great responsiveness and are correlated with PRO after an exercise intervention in MBC patients.