Exercise-Based Muscle Development Programmes and Their Effectiveness in the Functional Recovery of Rotator Cuff Tendinopathy: A Systematic Review.

(1) Background: Rotator cuff (RC) tendinopathy causes pain and functional limitation of the shoulder. Physical exercises are effective therapies but there is no consensus on which exercise programme is the most appropriate. Objective: To analyze and compare the effectiveness of different intervention modalities-based exclusively on physical exercise muscle-development programs to improve shoulder pain and function in RC tendinopathy. (2) Methods: Systematic review (PRISMA) through a search in PubMed, WOS, PEDro, Cinahl, Scopus and Dialnet. The PEDro Scale and the Cochrane Risk of Bias analyzed the methodological quality. A pre-established table collected data on: patients, interventions, outcome measures and results. A narrative synthesis of the results was conducted. (3) Results: eight articles were selected (Cochrane: low risk of bias; PEDro: good quality). All assessed programs were effective. Only one study found statistically and clinically significant differences in favour of eccentric training. The exercises used were: eccentric/concentric/conventional, open/closed kinetic chain, with/without co-activation of glenohumeral muscle, with/without pain, and in clinic/at home. (4) Conclusions: All exercise programs were effective in RC tendinopathy, improving pain and shoulder function. No solid results were obtained when the interventions were compared due to their heterogeneity. Patients perception assessment tools were the most widely used. Amount of load applied should be considered.

Strength-Duration Curves of the Common Fibular Nerve Show Hypoexcitability in People With Functional Ankle Instability.

BACKGROUND: Some motor impairments, such as decreased reaction of peroneal muscles, altered kinematics, or poor postural control, have been described in people with functional ankle instability. Evidence shows a possible relationship between fibular nerve impairments and functional ankle instability. OBJECTIVE: To investigate the electrophysiologic excitability of the common fibular nerve, as measured by strength-duration curves, in subjects with functional ankle instability compared with a control group without ankle impairment. DESIGN: A cross-sectional study. SETTING: University Research laboratory. PARTICIPANTS: Fifty subjects with functional ankle instability (35 men, 15 women; ages 24.36 ± 5.01 years) and 63 uninjured control patients (44 men, 19 women; ages 22.67 ± 4.85 years) were recruited by convenience sampling. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Strength-duration curves of the common fibular nerve were made in all participants. Rheobase, chronaxie, Bawen index, accommodation index, galvano-tetanic threshold, and intensity thresholds for different pulse durations were obtained and compared between the 2 groups. RESULTS: Subjects with functional ankle instability show increased values of chronaxie (0.58 ± 0.24 ms versus 0.47 ± 0.16 ms; P = .004), Bawen index (1.53 ± 0.24 versus 1.39 ± 0.21; P = .002), and intensity thresholds for pulse durations ≤2 ms both for rectangular and triangular pulse wave forms. The accommodation index was smaller in subjects with functional ankle instability than controls (3.7 ± 0.72 versus 4.05 ± 0.98; P = .036). The remaining parameters did not show significant differences between groups. CONCLUSIONS: These findings suggest that subjects with functional ankle instability show a decreased excitability in their common fibular nerve when compared with subjects without ankle injuries.

Psychometric properties of the Spanish version of the Cumberland Ankle Instability Tool.

PURPOSE: To estimate the psychometric properties of the Spanish version of the Cumberland Ankle Instability Tool (CAIT-Sv). METHOD: One hundred and seventy-one subjects participated. The psychometric properties tested for CAIT-Sv were internal consistency with Cronbach's α (n = 171) in the first measurement; test-retest reliability using the intraclass correlation coefficient (ICC2,1) (n = 171) in two measurements separated by one week; criterion validity by ICC2,1 between the original CAIT and CAIT-Sv in two measurements separated by two weeks for a subgroup of 54 bilingual subjects; ceiling and floor effects (n = 78 subjects with a history of at least one ankle sprain), and responsiveness using Cohen's d in a subgroup of 25 subjects with a history of at least one ankle sprain and a score ≤24 points on the CAIT-Sv and treated with a rehabilitation program during four weeks. RESULTS: Internal consistency was excellent (Cronbach's α: 0.8-0.84). Test-retest reliability was high (ICC2,1: 0.95). Criterion validity was high (ICC2,1: 0.91; 95% CI: 0.84-0.94; p < 0.001 for dominant ankle). There were no ceiling (9%) and floor (0%) effects. Responsiveness was moderate (Cohen's d: 0.6995; CI: 0.11-1.27). CONCLUSIONS: CAIT-Sv is a reliable instrument with high criterion validity to measure the presence and severity of chronic ankle instability (CAI) in the Spanish population. Implications for Rehabilitation Chronic ankle instability is the most prevalent complication after ankle injuries. CAIT is a widely used tool for clinical detection of subjects with chronic ankle instability (CAI). In this study, CAIT-Sv has shown good phsychometric properties for using with Spanish speaking individuals.