Efficacy of whole-body cryotherapy in the treatment of chronic low back pain: Quasi-experimental study.

STUDY DESIGN: Single arm, quasi-experimental study design. BACKGROUND: To describe the effects of whole-body cryotherapy on pain, disability, and serum inflammatory markers in patients with chronic low back pain. METHODS: A quasi-experimental trial was performed on adult patients between 18 and 65 years with chronic low back pain. After obtaining informed consent, participants underwent 20 sessions of whole-body cryotherapy (at -160 °C) during a 5-week time span. Patient reported pain and disability measures (Pain Numerical Rating Scale [PNRS], Oswestry Disability Index [OSI], and Roland Morris Questionnaire [RMQ]) were obtained at each of the twenty sessions. Blood samples were obtained to analyze serum inflammatory markers at baseline, 10th and 20th session. RESULTS: Forty-one participants were included in the study. A significant decrease was observed between the initial and final PNRS, ODI, and RMQ scores (p < 0.001). A significant reduction in the PNRS was found after 4 sessions of whole-body cryotherapy (p < 0.001). We observed decreasing values of pro-inflammatory serum marker IL-2 (p = 0.046) and a significant increase in the anti-inflammatory serum marker IL-10 (p = 0.003). No adverse events were reported during the study. CONCLUSIONS: Whole-body cryotherapy is an effective therapy for pain and disability treatment in chronic low back pain. It also produces changes in serum markers of inflammation, decreasing pro-inflammatory markers and increasing anti-inflammatory markers.

Design of a Rheumatology Transition Clinic for a Resource-Constrained Setting.

OBJECTIVES: To describe the design process of a medical care program for adolescents with pediatric onset rheumatic diseases (PRD) during the transition from pediatric to adult care in a resource-constrained hospital. METHODS: The model of attention was developed in three steps: 1) the selection of a multidisciplinary team, 2) the evaluation of the state of readiness of patients and caregivers for the transition, and 3) the design of a strategy of attention according to local needs. The results of the first two steps were used in order to develop the strategy of attention. RESULTS: The transition process was structured in three stages: pretransition (at pediatric rheumatology clinic), Transition Clinic for Adolescents with Rheumatic Diseases (TCARD, the main intervention), and post-transition (at adult rheumatology clinic). Each stage was divided, in turn, into a variable number of phases (8 in total), which included activities and goals that patients and caregivers were to accomplish during the process. A multidisciplinary approach was planned by pediatric and adult rheumatologists, nutritionists, physiatrists, psychiatrist, psychologist, nurse, and social worker. During TCARD, counseling, education, nutritional, physical, and mental health interventions were considered. CONCLUSIONS: The proposed transition model for patients with rheumatic diseases can be a useful tool in developing countries.

Comparison of the effect of whole-body vibration therapy versus conventional therapy on functional balance of patients with Parkinson's disease: adding a mixed group.

OBJECTIVE: Assess the effect of Whole-Body Vibration (WBV) therapy in functional balance status of Parkinson's disease (PD) patients and compare this to conventional and combined therapy. INTRODUCTION: PD patients experience a decreased mobility, inactivity, and loss of independence as consequence of disturbances in gait, posture, and balance. Rehabilitation therapy is a non-pharmacological way of improving functionality. One of the most studied modalities is WBV, with multiple studies showing improvement in motor function. However, results in this manner are inconsistent. METHODS: Forty-five patients were enrolled in a non-randomized controlled trial and divided into three groups. Group 1 received conventional therapy (thermotherapy, stretching, strengthening, coordination and balance). Group 2 received WBV therapy, and group 3 patients underwent a combined therapy protocol. A total of 20 sessions (3 per week) were conducted, assessing Berg Balance Scale (BBS) before initial and after final session. RESULTS: The 3 intervention groups showed significant improvement in BBS scores after concluding the 20-session trial compared to initial assessment. When comparing mean change in BBS score from initial to final assessment, the combined therapy group had a greater increase compared to conventional therapy, but no significant differences were observed comparing to WBV group. Mean change in BBS score showed no significant difference between conventional therapy and WBV therapy group. CONCLUSIONS: WBV therapy is a useful tool as co-adjuvant in conventional therapy. The combination of both therapies is a significant therapeutic alternative for the improvement of functional balance status in PD patients compared to conventional therapy alone.

Prevalence of electrocardiographic abnormalities in elite and sub-elite professional athletes / Prevalencia de alteraciones electrocardiográficas en deportistas élite y sub-élite

Objective: The objective of this study is to determine the prevalence of electrocardiographic abnormalities that could endanger the lives of elite and sub-elite professional athletes based on normal, borderline, and abnormal findings described in international recommendations. Material and method: This retrospective observational study was performed only on men elite football players, men elite baseball players, men elite basketball players, and men sub-elite football players (second division, third division, U-15, U-17, and U-20). Data were collected from pre-competition ECGs performed by team-affiliated physicians in the 2012 – 2019 preseasons of active-roster athletes and sub-elite players. The qualitative characteristics of each ECG were analyzed using the international recommendations for electrocardiographic interpretation in athletes to detect accepted training-related ECG findings and findings classified as borderline and abnormal. Results: A total of 716 ECGs were included. Common training-related ECG changes were found in 63.1%; sinus bradycardia was the most prevalent training-related ECG change (47.2%). The prevalence of borderline ECG readings among all the participants was 3.9%; the most frequent change was right axis deviation. The prevalence of abnormal ECG findings overall was 4.2%. Conclusion: Electrocardiographic changes in athletes are frequently seen; however, a constant review of changes within abnormal or borderline parameters is recommended. It is suggested that further research studies should study the electrocardiographic changes in elite and sub-elite athletes and compare these changes considering the biological sex of the athletes to see if there are any differences.(AU)

Objetivo: El objetivo del presente estudio es evaluar la prevalencia de anormalidades electrocardiográficas que puedan poner en peligro la vida de deportistas profesionales élite y sub-élite, a partir de hallazgos normales, limítrofes y anormales en el ECG descritas en consensos internacionales. Material y método: Estudio retrospectivo y observacional donde se analizaron los ECGs de 12 derivaciones en reposo de jugadores de élite de fútbol, béisbol y baloncesto y jugadores sub-élite de fútbol, solamente del género masculino. Los datos se recopilaron de ECGs previos a la competencia realizados por médicos afiliados al equipo en las pretemporadas 2012-2019 en deportistas de la lista activa y jugadores sub-élite. Se utilizaron las recomendaciones internacionales para la interpretación electrocardiográfica de deportistas en las variables cuantitativas para conocer las alteraciones electrocardiográficas aceptadas y evaluar la detección de anormalidades en el trazo para clasificarlas en anormal o en el límite.Resultados: Un total de 716 ECGs fueron incluidos. Se encontraron cambios comunes en el ECG relacionados con el entrenamiento en el 63,1%; la bradicardia sinusal fue el cambio en el ECG relacionado con el entrenamiento más frecuente (47,2%). La prevalencia de lecturas limítrofes de ECG entre todos los participantes fue del 3,9%; el cambio más frecuente fue la desviación del eje a la derecha. La prevalencia de hallazgos ECG anormales en general fue del 4,2%. Conclusiones: Los cambios electrocardiográficos en los deportistas se ven con frecuencia, sin embargo, se recomienda constante revisión de cambios dentro de parámetros anormales o en limitrófes. Se sugiere que estudios de investigación estudien los cambios electrocardiográficos en deportistas élite y sub-élite y que se comparen estos cambios teniendo en cuenta el sexo biológico de los deportistas para ver si existen diferencias.(AU)

Unilateral and bilateral isokinetic knee strength indices in professional soccer players / Índices de fuerza isocinética unilateral y bilateral de rodilla en jugadores profesionales de futbol

INTRODUCTION: The maximum isokinetic torque is one of the most commonly applied methods to assess the muscle strength of the lower extremities in soccer. Knee force indices have been used extensively to identify possible risk factors for injuries such as torn hamstring muscles or rupture of the anterior cruciate ligament. There are previous studies that describe the isokinetic profile in different populations and there are few in Latin American population. The objective of this study is to describe the isokinetic profile and strength indices in a population of soccer players from a professional Mexican team. METHODOLOGY: This is an observational, retrospective, analytical study. The maximum torque was measured with an angular velocity of 60°/s in 375 professional soccer players from 1st, 2nd and 3rd division from 2010 to 2015 in the Department of Sports Medicine and Rehabilitation of the "Dr. José Eleuterio González" University Hospital, Monterrey Nuevo León, Mexico. RESULTS: The results obtained were general, clinimetry and isokinetic parameters. The maximum torque was cataloged by group in injured and non-injured players according to the division: 1st (n = 142), 2nd (n = 86) and 3rd (n = 147). From these, the isokinetic strength indices of each of the players were obtained, observing anthropometric differences, in the unilateral and bilateral knee indices, between each category, and even more so in players with injuries. It is important to have isokinetic parameters and identify at-risk players according to their category as this will provide reference data for future assessments of professional soccer players and they can be used to categorize muscle function as normal or at risk of injury

INTRODUCCIÓN: El torque máximo isocinético es uno de los métodos más comúnmente aplicados para evaluar la fuerza muscular de las extremidades inferiores en el futbol. Se han empleado índices de fuerza de la rodilla extensivamente para identificar posibles factores de riesgo para lesiones como desgarros de la musculatura isquiotibial o la ruptura del ligamento cruzado anterior. Hay estudios previos que describen el perfil isocinético en distintas poblaciones y hay pocas en población latinoamericana. El objetivo de este estudio es describir el perfil isocinético y los índices de fuerza en una población de jugadores de soccer de un equipo profesional mexicano. METODOLOGÍA: Es un estudio observacional, retrospectivo y analítico. Se midió el torque máximo con una velocidad angular de 60°/s en 375 futbolistas profesionales de 1°, 2° y 3° división del 2010 al 2015 en el Departamento de Medicina del Deporte y Rehabilitación del Hospital Universitario "Dr. José Eleuterio González", Monterrey Nuevo León, México. RESULTADOS: Los resultados recabados fueron generales, clinimetria y parámetros isocinéticos. Los torques máximos fueron catalogados por grupo en jugadores lesionados y no lesionados de acuerdo a la división: 1°(n = 142), 2° (n = 86) y 3° (n = 147). A partir de estos se obtuvieron los índices de fuerza isocinética de cada uno de los jugadores existiendo diferencias antropométricas, en los índices unilateral y bilateral de rodilla, entre cada categoría, y más aún en jugadores con lesiones. Es importante tener parámetros isocinéticos e identificar jugadores en riesgo según su categoría ya que esto aportar datos de referencia para futuras valoraciones en los jugadores profesionales de soccer y pueden ser utilizados para categorizar la función muscular como normal o con riesgo de lesión

Relationship between left ventricular hypertrophy and somatotype of high performance athletes using structural equations modeling / Relación entre la hipertrofia ventricular izquierda y el somatotipo en atletas de alto rendimiento utilizando modelamiento de ecuaciones estructurales

Introduction: Sports induce morphological and functional adaptations in the human heart that directly relate to the type, duration and intensity of training and the years of practice. These changes are present in different ways in the electrocardiogram. A high QRS voltage is the most significant finding. Its correlation with left ventricular hypertrophy is low. In this study, the aim was to determine if a relationship exists between electrocardiographic alterations of left ventricular hypertrophy and somatotype in high performance athletes. Methods: A retrospective, cross-sectional, quantitative, multiple correlation, observational and analytical study of a database of 180 resting electrocardiograms and anthropometric evaluations of men's soccer, women's soccer, swimming, cycling, basketball, and tennis athletes was performed. A database containing somatotype and Sokolow-Lyon electrocardiographic voltage criteria was created. Results: The study group was composed of 83.3% men and 16.7% women. Age ranged from 10 to 51 years with a mean of 19.73 ± 5.8. Weight ranged from 35.90 to 122.3 kg with a mean of 66.98 ± 12.67 and height ranged from 143 to 213 cm with a mean of 174.11 ± 10.29 cm. Endomorphy for the entire group ranged from 1.0 to 5.7 with a mean of 2.5 ± 0.9. Mesomorphy ranged from 1.6 to 7.1 with a mean of 4.2 ± 0.95. Ectomorphy ranged from 1.1 to 5.8 with a mean of 2.9 ± 0.96. The structural equation model had a normal multivariable distribution of 3.161, reaching a Pearson of .26 for mesomorphy with a goodness of fit and a variance of 0% for mesomorphy and left ventricular hypertrophy. Conclusion: Based on the findings, we can say that somatotype does not predict left ventricular hypertrophy in high per-formance athletes

Introducción: Los deportes inducen adaptaciones morfológicas y funcionales en el corazón humano directamente relacionadas con el tipo, duración e intensidad del entrenamiento y los años de práctica. Estos cambios se manifiestan de diversas formas en el electrocardiograma. Un alto voltaje del QRS es el hallazgo más significativo. Su correlación con la hipertrofia ventricular izquierda es baja. En este estudio, el objetivo era determinar si existe una relación entre las alteraciones electrocardiográficas de hipertrofia ventricular izquierda y el somatotipo en deportistas de alto rendimiento. Métodos: Se efectuó un estudio transversal, cuantitativo, observacional, analítico retrospectivo de correlación múltiple de una base de datos de 180 electrocardiogramas en reposo y antropometría de atletas de soccer varonil, soccer femenil, natación, basquetbol, ciclismo y tenis. Se creó una base de datos con el somatotipo y los criterios de voltaje electrocardiográfico de Sokolow-Lyon. Resultados: El grupo de estudio estaba compuesto por 83,3% varones y 16,7% mujeres. El rango de edad fue de 10 a 51 años con una media de 19,73 ± 5,8. El peso varió de 35,90 a 122,3 kg con una media de 66,98 ± 12,67 y la estatura varió de 143 a 213 cm con una media de 174,11 ± 10,29 cm. Endomorfia para todo el grupo osciló entre 1,0 y 5,7 con una media de 2,55 ± 0,9. Mesomorfia varió de 1,6 a 7,1 con una media de 4,2 ± 0,95. Ectomorfia varió de 1,1 a 5,8 con una media de 2,9 ± 0,96. El modelo de ecuaciones estructurales tenía una distribución multivariable normal de 3.161, alcanzando un Pearson de 0,26 para mesomorfia con una bondad de ajuste y una varianza de 0% para mesomorfia e hipertrofia ventricular izquierda. Conclusiones: En base a los hallazgos podemos decir que el somatotipo no predice hipertrofia ventricular izquierda en atletas de alto rendimiento

Effect of disease duration on somatotype in a Mexican population with type 2 diabetes mellitus using structural equation modeling / Efecto del tiempo de evolución de la enfermedad en el somatotipo de una población Mexicana con diabetes mellitus tipo 2 usando modelamiento de ecuaciones estructurales

Background: Diabetes mellitus (DM) is a well-known health problem. Nevertheless, its etiology, natural history, and epidemiology are still incomplete. Its prevalence has increased, cases of DM have doubled and its association with body mass index and obesity is high. The objective was to determine the effect of disease duration on somatotype of patients with type 2 DM using structural equation modeling (SEM). Methods: Two hundred participants underwent anthropometry following the restricted profile of the International Society for the Advancement of Kinanthropometry (ISAK). A database was made using age, height, weight, the other anthropometry measures, the three components of somatotype, and disease duration of DM. Results: Mean age for men was 58,7 ± 11,1 and for women 56,4 ± 10,7 years; mean body weight for men was 80,0 ± 14,2 and for women 74,8 ± 8,0 kg; mean height for men was 168,3 ± 7,4 and women 154,9 ± 6,0 cm.The median and interquartile interval for the non-parametrical variables in men were endomorphy 4.86 (4.04 to 6.00), mesomorphy 5.82 (4.59 to 7.20), ectomorphy 0.49 (.10 to 1.22) and disease duration 9.00 (4.00 to 17.00); for women, endomorphy 7.52 (6.30 to 8.27), mesomorphy 6.28 (5.05 to 8.15), ectomorphy 0.100 (.10 to.500) and disease duration 9.00 (4.00 to 15.00). A correlation between disease duration and somatotype was found. Conclusions: Longer disease duration is associated with an increase in endomorphy and mesomorphy; however, ectomorphy decreases. SEM showed that DM disease duration impacts somatotype but this relationship is different in men and women. More research is necessary to understand this relationship. SEM is a feasible technique for modeling disease duration and somatotype

Introducción: La diabetes mellitus (DM) es un problema de salud bien conocido. Sin embargo, su etiología, historia natural y epidemiología sigue incompleto. Su prevalencia ha aumentado, los casos de DM se han duplicado y su asociación con índice de masa corporal y obesidad es alta. El objetivo fue determinar los efectos de la duración de la enfermedad en el somatotipo de pacientes con DM tipo 2 utilizando modelamiento de ecuaciones estructurales (SEM). Métodos: Se sometieron a antropometría doscientos participantes siguiendo el perfil restringido de la Sociedad Internacional para el Avance de la Kinanthropometry (ISAK). Se elaboró una base de datos utilizando edad, talla, peso, las medidas antropométricas restantes, los tres componentes del somatotipo y el tiempo de evolución de DM. Resultados: Edad promedio para hombres fue 58,7 ± 11,1 y para mujeres 56,4 ± 10,7 años; peso promedio de hombres fue 80 ± 14.2 y de mujeres 74,8 ± 18.0 kg. Estatura promedio de hombres fue 168.3 ± 7.4 y de mujeres 154.9 ± 6.0 cm. La mediana y el intervalo intercuartil para las variables no paramétricas en hombres fueron endomorfia 4.86 (4.04 a 6.00), mesomorfia 5.82 (4.59 a 7.20), ectomorfia 0.49 (.10 a 1.22) y duración de la enfermedad 9.00 (4.00 a 17.00) y para mujeres endomorfia 7.52 (6.30 a 8.27), mesomorfia 6.28 (5.05 a 8.15), ectomorfia 0.100 (.10 a.500) y duración de la enfermedad 9.00 (4.00 a 15.00). Se encontró una correlación entre evolución de la enfermedad y somatotipo. Conclusiones: Mayor tiempo de evolución se asocia con aumento de la endomorfia y la mesomorfia; sin embargo, la ectomorfia disminuye. SEM mostró que la evolución de DM afecta somatotipo, pero esta relación es diferente en hombres y mujeres. Se necesita más investigación para entender esta relación. SEM es una técnica factible para modelar duración de la enfermedad y somatotipo