Pelvic Floor Muscle Training in Female Athletes: A Randomized Controlled Pilot Study.

The aim of this study was to investigate the effects of pelvic floor muscles training in elite female volleyball athletes and whether it is an effective therapy for stress urinary incontinence. Fourteen athletes, both continent and incontinent, between 18 and 30 years of age, were randomly assigned to an experimental group or a control group. The experimental group received a protocol for pelvic floor muscle training for 4 months. This consisted of three phases: awareness/stabilization, strength training and power. The control group was not subject to any intervention during the same period. Measures were collected at the initial and final phase for both groups. Maximum voluntary contractions were evaluated with a perineometer, involuntary urine loss with a Pad test and quality of life with the King's Health Questionnaire. Baseline sociodemographic and anthropometric characteristics were not significantly different. Comparing the two groups, the experimental group improved maximum voluntary pelvic contractions (p<0.001) and reduced urine loss (p=0.025), indicating the existence of significant differences between groups in the variation from the initial and final phases. The percentage of urine loss decreased in the experimental group, from 71.4-42.9%, suggesting that the protocol intervention for 16 weeks may help athletes with stress urinary incontinence.

Diagnostic Validity of an Isokinetic Testing to Identify Partial Anterior Cruciate Ligament Injuries.

OBJECTIVE: To assess the diagnostic validity of an isokinetic testing to detect partial injuries on the anterior cruciate ligament (ACL). DESIGN: Prospective diagnostic study. SETTINGS: Orthopedic clinic, physiotherapy clinic, orthopedic hospital, and diagnostic/image clinic. PARTICIPANTS: Consecutive patients (n = 29) with unilateral knee complaint submitted to physical examination, magnetic resonance images (MRIs), and isokinetic testing prior to surgery of ACL reconstruction. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The isokinetic torque curves data from extensor and flexor muscles were converted to frequency domain by fast Fourier transformation and compared with healthy contralateral limb. Differences were categorized as unstable knees and these conclusions were compared with patient's physical examinations (doctor's conclusion on ACL integrity) and MRIs (as the radiologist conclusions on ACL integrity). After surgery, all intraoperatively confirmed partial injured patient's data were collected. The diagnostic accuracy measures to compare the conclusions of all 3 professionals included sensitivity, specificity, positive predictive value, negative predictive value, disease prevalence, positive likelihood ratio, and accuracy-all using a confidence interval of 95%. RESULTS: Compared with MRI, the sensitivity of isokinetic test for an ACL partial injury was 90.00%, specificity 83.33%, positive predictive value 52.94%, negative predictive value 97.56%, and accuracy 84.48%. Compared with physical examination, the sensitivity of isokinetic test for an ACL partial injury was 85.71%, specificity 78.43%, positive predictive value 35.29%, negative predictive value 97.56%, and accuracy 79.31%. CONCLUSIONS: This method of isokinetic data analysis through fast Fourier transformation can be used to improve diagnostic accuracy of a difficult detection injury. Even present, a partial ACL injury can produce a stable knee during isokinetic testing and could be used to detect candidates for conservative treatment based on strengthening exercises, reducing surgery risks, and financial and social impact on patient's life.

Differences in foot contact times between obese and non-obese postmenopausal women when crossing obstacles.

OBJECTIVE: This study aimed to investigate the foot contact time differences between obese and non-obese subjects during walking when crossing obstacles. METHODS: Ninety-eight postmenopausal women were assigned to four groups, and their plantar pressure temporal data were collected using a two-step protocol during walking when crossing an obstacle set at 30% height of lower limb length of each subject. The initial, final, and duration of contact of 10 foot areas were measured. RESULTS: Leading limb: (1) the heel groups initiated foot contact using the heel, and the non-heel groups initiated contact using the metatarsals; (2) heel obese subjects showed an earlier initial contact and a longer contact duration of metatarsals 2-3; (3) non-heel obese subjects showed an earlier midfoot initial contact. Regarding the trailing limb: (4) heel obese subjects showed an earlier midfoot initial contact and a longer contact duration of metatarsal 5; (5) non-heel obese subjects showed an earlier initial contact and a longer contact duration of metatarsals 4-5. CONCLUSIONS: (1) The non-heel groups' foot rollover pattern may result from an attempt of rapidly restoring stability; (2) the heel obese subjects seem to regulate their plantar foot muscles to overcome their overweight; (3) the overweight of the non-heel obese subjects leads to a quicker backward foot roll-over from the metatarsals to the heel; (4) the overweight of the heel obese subjects can distort their footprints and/or their higher inertia may precipitate an anticipation of the midfoot contact, which can also explain the result observed for 5.

Foot Rollover Temporal Parameters During Walking Straight Ahead and Stepping Over Obstacles: Obese and Non-Obese Postmenopausal Women.

The aim of this study was to compare the temporal foot rollover data between walking straight ahead and stepping over obstacles for obese and non-obese postmenopausal women. Plantar pressure data were collected from 67 women. The initial, final, and duration of contact of 10 foot areas were measured. Both limbs of both groups showed a longer foot contact duration on the obstacle task. Significant temporal differences were found for both groups between straight ahead and crossing obstacles on the initial, final, and duration of contact for several foot areas. The propulsion phase of the trailing limb during the obstacle task was anticipated. Regarding the leading limb, the first foot contact was not made with the heel areas; however, a backward foot rollover movement from the metatarsal to the heel areas occurred, possibly to provide support to better control the trailing limb swing phase.

Females Present Reduced Minimum Toe Clearance During Walking As Compared to Males in Active Older Adults.

BACKGROUND: Physical decline due to aging has been associated with the risk of falls. Minimum toe clearance (MTC) is a gait parameter that might play a role in the mechanism of tripping and falling. However, it is unclear if there are any sex-related effects regarding MTC as people age. The present study investigated if there are sex-related differences in MTC in older active adults. METHODS: Twenty-three females and 23 males (F: 65.5 ±â€…4.8 years; M: 61.9 ±â€…5.2 years) walked on a treadmill at a preferred walking speed, while kinematic data were obtained at a sampling frequency of 100 Hz and up-sampled to 120 and 240 Hz. MTC was calculated from the kinematics data and evaluated concerning its magnitude (ie, MTC and MTC/leg length), the time between left/right MTC (ie, T-MTC), amount of variability (ie, coefficient of variation [CV] and coefficient of variation modified [CVm]), and temporal structure of variability, that is, the complexity of the time series (ie, MTC α, T-MTC α). RESULTS: No sex effects were found for MTC/leg length, for the amount of variability (ie, CV and CVm), and for the complexity of the time series (MTC α, T-MTC α). However, females exhibited significantly lower MTC and T-MTC after adjusting for walking speed, mass, and age as covariates. CONCLUSIONS: The reduced MTC in females suggests a potential sex-related disparity in the risk of tripping and falling among active older adults.

Mechanical properties of the triceps surae: differences between football and non-football players.

We investigated the mechanical properties of the triceps surae between professional, junior, and non-football players. Fifty-nine men participated in this study. The mechanical properties of the right legs' triceps surae were measured in vivo using a free oscillation technique; no significant differences existed between the groups. The mean results for musculo-articular stiffness, damping coefficient, and damping ratio were as follows: professional football players (21523 N· m⁻¹, 330.8 N · s · m⁻¹, and 0.201); junior football players (21063 N · m⁻¹, 274.4 N · s · m⁻¹, and 0.173); and non-players (19457 N · m⁻¹, 281.5 N · s · m⁻¹, and 0.184). When analysed according to position, the results were as follows: defender (21447 N · m⁻¹, 308.6 N · s · m⁻¹, and 0.189); midfielder (20762 N · m⁻¹, 250.7 N · s · m⁻¹, and 0.157); winger (21322 N · m⁻¹, 335.1 N · s · m⁻¹, and 0.212); forward (22085 N · m⁻¹, 416.2 N · s · m⁻¹, and 0.254); and non-players (19457 N · m⁻¹, 281.5 N · s · m⁻¹, and 0.184). Thus, football training, football games, and the position played had no effect on triceps surae mechanical properties. These results may be attributed to opposing adaptations between different types of training that are usually implemented in football. Alternatively, the minimum strain amplitude and/or frequency threshold of the triceps surae required to trigger adaptations of mechanical properties might not be achieved by football players with football training and matches.

Free-oscillation technique: The effect of the magnitude of the impulse applied on muscle and tendon stiffness around the ankle.

The importance of the muscle-tendon complex in sport and for activities of everyday living is well recognised. The free oscillation technique is frequently used to determine the musculo-articular "apparent" stiffness (obtained from vertical ground reaction force) and other parameters. However, an in-depth understanding of the muscle-tendon complex can be gained by separating the muscle (soleus) and the tendon (Achilles tendon) components and studying the "true" stiffness for each of these components (by considering the ankle joint moment arms), which can be valuable in improving our understanding of training, injury prevention, and recovery programs. Hence, this study aimed to investigate if muscle and tendon stiffness (i.e., "true" stiffness) are similarly affected by different impulse magnitudes when using the free-oscillation technique. Three impulse magnitudes (impulse 1, 2 and 3), corresponding to peak forces of 100, 150 and 200 N, were used to estimate the stiffness of the ankle joint in 27 males, using multiple loads (10, 15, 20, 25, 30, 35, and 40 kg). A significant decrease (p < 0.0005) was found in musculo-articular "apparent" stiffness (29224 ± 5087 N.m-1; 27839 ± 4914 N.m-1; 26835 ± 4880 N.m-1) between impulses 1, 2 and 3 respectively, when loads were collapsed across groups. However, significant differences (p < 0.001) were only found between the median (Mdn) of impulse 1 (Mdn = 564.31 (kN/m)/kN) and 2 (Mdn = 468.88 (kN/m)/kN) and between impulse 1 (Mdn = 564.31 (kN/m)/kN) and 3 (Mdn = 422.19 (kN/m)/kN), for "true" muscle stiffness, but not for "true" tendon stiffness (Mdn = 197.35 kN/m; Mdn = 210.26 kN/m; Mdn = 201.60 kN/m). The results suggest that the musculo-articular "apparent" stiffness around the ankle joint is influenced by the magnitude of the impulse applied. Interestingly, this is driven by muscle stiffness, whereas tendon stiffness appears to be unaffected.

Distance to Natural Environments, Physical Activity, Sleep, and Body Composition in Women: An Exploratory Analysis.

A growing body of evidence indicates that living close to nature is associated with better health and well-being. However, the literature still lacks studies analyzing the benefits of this proximity for sleep and obesity, particularly in women. The purpose of this study was to explore how distance to natural spaces is reflected in women's physical activity, sleep, and adiposity levels. The sample consisted of 111 adult women (37.78 ± 14.70). Accessibility to green and blue spaces was assessed using a geographic-information-system-based method. Physical activity and sleep parameters were measured using ActiGraph accelerometers (wGT3X-BT), and body composition was assessed using octopolar bioimpedance (InBody 720). Nonlinear canonical correlation analysis was used to analyze the data. Our findings reveal that women living in green spaces close to their homes had lower levels of obesity and intra-abdominal adiposity. We also demonstrated that a shorter distance to green spaces seemed to correlate with better sleep onset latency. However, no relationship was found between physical activity and sleep duration. In relation to blue spaces, the distance to these environments was not related to any health indicator analyzed in this study.

Pro-Environmental Behaviors: Relationship With Nature Visits, Connectedness to Nature and Physical Activity.

PURPOSE: Examine the association of visits to the natural environment, connectedness to nature, physical activity, and the adoption of pro-environmental behaviors (PEBs) in individuals aged 18 years or older. DESIGN: Cross-sectional study. SETTING: City of Vila Real, located in the north of Portugal. SUBJECTS: We recruited 194 individuals (61 men and 133 women) aged 18-75 years. MESURES: A self-administered questionnaire was used to measure nature visits, connectedness to nature, PEBs, and demographic characteristics. Neighborhood green space was appreciated through a Simplified Land Occupation Map and physical activity was measured using ActiGraph accelerometers (wGT3X-BT). ANALYSIS: Correlations and nonlinear canonical correlation analysis were used to analyze the data. The coefficients of canonical and multiple correlations were calculated. RESULTS: Nature visits were associated with involvement in environmental volunteering (V = .317, P ≤ .05) among men. In these, higher levels of moderate-vigorous PA were associated with green travel behavior (η2 = .325, P ≤ .05). Connectedness with nature was related (P ≤ .05) to private sphere behaviors, such as purchase of eco-products (η2 = .191) and local/seasonal products (η2 = .186) in females and encouraging care and protection of natural environment (η2 = .336, P ≤ .01) in males. CONCLUSIONS: Nature visits, connection to nature, and physical activity levels were related to the adoption of PEBs in the private and public sphere, and these relationships differed between men and women.

Contribution of Home Gardens to Sustainable Development: Perspectives from A Supported Opinion Essay.

Home gardening has a long history that started when humans became sedentary, being traditionally considered an accessible source of food and medicinal plants to treat common illnesses. With trends towards urbanization and industrialization, particularly in the post-World War II period, the importance of home gardens as important spaces for growing food and medicinal plants reduced and they began to be increasingly seen as decorative and leisure spaces. However, the growing awareness of the negative impacts of agricultural intensification and urbanization for human health, food quality, ecosystem resilience, and biodiversity conservation motivated the emergence of new approaches concerning home gardens. Societies began to question the potential of nearby green infrastructures to human wellbeing, food provisioning, and the conservation of traditional varieties, as well as providers of important services, such as ecological corridors for wild species and carbon sinks. In this context. and to foster adaptive and resilient social-ecological systems, our supported viewpoint intends to be more than an exhaustive set of perceptions, but a reflection of ideas about the important contribution of home gardens to sustainable development. We envision these humble spaces strengthening social and ecological components, by providing a set of diversified and intermingled goods and services for an increasingly urban population.

Classification of the Effort Index and Biomechanical Overload in Natural Trails of UNESCO Global Geoparks-A Network Perspective of Trails of the Araripe UGG (NE Brazil).

Natural trails in UNESCO Global Geopark territories show strong salutogenic, inclusive and interactive characteristics as potentials and opportunities for ecosystem health. It is essential to provide information to inform the hiker as to the characteristics of the environment and the attractions and challenges of the route. Based on a network analysis methodology we aimed to identify the indicators of centrality and strength of connection in order to classify the effort index and biomechanical overload of the Araripe UNESCO Global Geopark trails in Brazil. The results showed strong connection and centrality of the variables related to the biomechanical overload in the effort index. In the trail of Pontal de Cruz the altimetric variation and the surface of the ground are highlighted in the biomechanical overload that presented a horizontal course equivalent 2.6 times larger than the presented distance. In Sítio Fundão trail, the surface of the ground also stood out, increasing the exposure in 36% of the presented distance. On the Missão Velha Waterfall trail, the variable that stood out was the biomechanical overload on the knee, equivalent to a horizontal increase of 28% of the measured distance. The methodology presented sought to optimise the mapping, management and consolidation of a network of natural trails aggregated to a high geotouristic, scientific, educational, cultural and well-being potential as presented in the Araripe UGG territory.

Leg stiffness and muscle power vs manometer in sportswomen with symptoms of stress urinary incontinence.

BACKGROUND: Pelvic floor muscle training can cure or alleviate stress urinary incontinence. This study aimed to evaluate maximum voluntary contractions of the pelvic floor muscle in sportswomen and verify the association with leg stiffness and muscle power, both maximal and submaximal. METHODS: The sample consisted of 41 sportswomen between 18 and 42 years of age. Pelvic floor muscle strength was measured by the manometer. The sportswomen were instructed to perform 3 maximum voluntary contractions of the perineum, held for 3 seconds. Maximal and submaximal leg stiffness and muscle power were measured with a force platform, in two conditions: 1st condition was the sub-maximal, double leg hop test, which was performed allowing sportswomen to self-select their preferred frequency and 2nd condition was the maximal double leg hop test, which was performed asking athletes to maximize hop height and minimize contact time on the top of the force platform for 6 consecutive hops. FINDINGS: Maximal and submaximal leg stiffness values increase with increasing age, weight, height, and body mass index, showing positive and significant (p <0.05) or close correlations. There are strong positive correlations between maximal and submaximal leg stiffness (r = 0.759) and between maximal and submaximal muscle power. Maximum voluntary contractions values decrease with increasing leg stiffness: the correlation is significant with maximal leg stiffness. INTERPRETATION: Maximum voluntary contractions values decrease with increasing leg stiffness and increase with increasing muscle power values. If the training program aims to increase muscle power, it may also increase maximum voluntary contractions.

Obesity and Natural Spaces in Adults and Older People: A Systematic Review.

BACKGROUND: Obesity is an important public health issue that has increased globally in the last decade and continues to be one of the main causes of morbidity and premature mortality. An accumulating body of evidence suggests that contact with nature is a valuable resource for the promotion of a more active lifestyle and seems to have a central role in maintaining a healthy weight. The authors conducted a systematic review to summarize the findings of studies that investigated the relationship between natural spaces and obesity. METHODS: Following Primary Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was conducted using 11 databases for studies fully available in English and published between 2010 and 2020, with adults (18-64 y) and/or older people (≥65 y). RESULTS: Fifty studies were found that met all the inclusion criteria. The majority (68%) of papers found that higher availability and less distance to green and blue spaces are associated with lower levels of adiposity. These associations were positive, even after adjusting for the demographic and socioeconomic factors. CONCLUSIONS: Exploring the characteristics of green and blue spaces seems to be a promising tool for urban planning and health policies. The authors suggest the implementation of exercise programs in contact with nature for future interventions.

Connectedness to Nature Does Not Explain the Variation in Physical Activity and Body Composition in Adults and Older People.

Connectedness to nature (CN) is a significant predictor of pro-environmental behaviours, human health and well-being. However, research on how this connection to the natural world might promote a more active lifestyle and improve body mass composition according to gender is lacking. This study investigated the influence of CN on physical activity (PA) and body composition in adults and older people. We recruited a sample of 219 individuals (77 men and 142 women), and a self-administered questionnaire was used to measure CN and obtain demographic data. Body composition was assessed by bioimpedance, and PA was assessed by accelerometry. Correlations and stepwise multiple regressions were used in data analysis. CN's association with other variables was more pronounced in women than in men, and we only identified significant associations with steps/day and body composition. However, this variable would not be included in the regression models that we developed. Adiposity levels and muscle status were significant predictors of PA in women. In both genders, age, percentage of fat mass and fat-free mass were selected as regressors in the models developed for visceral fat area and muscle condition (R2 Adjusted ≥ 0.908).

Assessment of pelvic floor muscles in sportswomen: Quality of life and related factors.

OBJECTIVES: To evaluate Maximum Voluntary Contraction (MVC) of the Pelvic Floor Muscles (PFM) in sportswomen, to observe the urinary symptoms and their impact on the Quality of Life (QoL). DESIGN: Observational cross-sectional study. SETTING: Gyms and teams in the North of Portugal. PARTICIPANTS: Sportswomen (n = 197). MAIN OUTCOME MEASURES: The measurement was performed using a manometer. The sportswomen were instructed to perform 3 MVC of the perineum, held for 3 s. The Kings Health Questionnaire (KHQ) was used to evaluate urinary symptoms and the QoL of the sportswomen. RESULTS: Age significantly influenced (p < 0.05) the QoL in all domains. An increase in BMI was also significantly associated with a decrease in the QoL. MVC values had a highly significant effect on the overall QoL and all domains, including a reduction in urinary symptoms. The weekly time of physical activity was associated with a better QoL in symptomatology. The practice of high-impact activities decreased the QoL (compared to low-impact activities). The vaginal resting pressure values ranged from 1.60 to 59.80 (24.34 ± 11.00). CONCLUSIONS: Age, BMI and high-impact sports appear to be the leading factors that promote the onset of SUI, which in turn decrease the QoL in sportswomen. There was a positive association between MVC and weekly time of physical activity in the QoL.

The effect of sex and localised fatigue on triceps surae musculoarticular stiffness.

PURPOSE: The main purpose of this study was to investigate the influence of fatigue on musculoarticular stiffness (MAS) of the ankle joint across sexes. METHODS: Twenty-seven males and 26 females participated in the study. After baseline assessment of MAS and related variables, localised fatigue was induced in triceps surae using the standing heel-rise test during which the subjects were instructed to lift and drop the heel at a frequency of 0.5 Hz. When subjects were unable to continue due to exhaustion the test was terminated and another MAS test was performed soon after. RESULTS: Significant higher triceps surae MAS was found in men compared to women (p < .01). MAS decreased (p < .01) between pre- and post-fatigue on average from 18.0 to 17.0 KN m-1 and from 14.5 to 13.9 KN m-1 in men and women, respectively. Percentage changes revealed, however, that in relative terms the changes in all the variables evaluated were similar (p > .01) between sexes, with MAS less than 5%. CONCLUSION: Despite the sex-related differences at baseline, fatigue seems to affect biomechanical properties of the ankle joint similarly in men and women.

Musculo-articular stiffness is affected by the magnitude of the impulse applied when assessed with the free-oscillation technique.

Musculo-articular stiffness (MAS) of the triceps surae can be assessed using the free-oscillation technique whereby an impulse is applied and the ensuing damped oscillations are recorded. The purpose of this study was to investigate if impulses of different magnitudes can affect the measurement of MAS. Twenty seven males (20.7±1.3 years) participated in this study. Three impulses of different magnitude (1.5, 2.3 and 3.1Ns) and four different loads (10, 20, 30, 40kg) were employed in the assessment of triceps surae MAS, which was quantified and compared across loads and perturbations. As the magnitude of the impulse applied increased, the MAS (p<0.0005, ES 1.20) and natural frequency of oscillation (f) decreased while the amplitude of movement (AM), angular velocity (ω) and damping coefficient (C) increased significantly. As the load level increased, the MAS (p<0.0005, ES 2.25) and the baseline ground reaction force (BGRF) increased whereas f, AM and ω decreased significantly. Even though the effect of the load is stronger, it appears that the level of MAS recorded (ranging from 24.0 to 21.3KN/m for the 10kg load and from 32.9 to 31.0KN/m for the 40kg load, for impulse 1 and 3 respectively), including several underlying factors, are affected by the magnitude of the impulse, therefore its accurate determination is pivotal. Caution should be exercised when comparing results from previous studies where the magnitude of the impulse has only been estimated but not controlled for.

Foot Rollover Temporal Parameters During Straight-Ahead and Side-Cut Walking in Obese and Nonobese Postmenopausal Women.

The purpose of this study was to compare the temporal foot rollover data between straight-ahead and side-cut walking and to establish a reference dataset for obese and nonobese postmenopausal women. Pressure data were collected using the two-step protocol. The initial, final, and duration of contact of 10 foot areas were measured, as 5 instants and 4 phases. Significant temporal foot rollover differences were found during walking with and without directional changes; however, most of these differences were common for obese and nonobese subjects.The trailing limb during the side-cut task anticipated the initial and final contact of the lateral forefoot and increased midfoot and toes duration, suggesting a greater role of these areas in the initial break and in foot stability. The leading limb throughout the side-cut task exhibited longer duration of the heel, midfoot, and stance phase probably due to an increase in the stride length of the trailing limb and leaning of the trunk toward the inner side of the turn. Additionally, obese women revealed a later final contact and longer contact duration of some metatarsal areas suggesting that the greater inertia of these subjects demands more time to stabilize and prepare the foot for the next step. Please provide 3 to 5 keywords for the article.