The Effects of 2 Different Soft Tissue Mobilization Techniques on Delayed Onset Muscle Soreness in Male Recreational Athletes: A Single-Blinded Randomized Controlled Trial.

CONTEXT: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes. DESIGN: A parallel, single-blinded, randomized controlled trial. METHODS: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups. RESULTS: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750). CONCLUSIONS: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes.

Investigating the lower extremity-related anaerobic exercise capacity and functional status in adult patients with familial Mediterranean fever.

OBJECTIVES: No studies examined the lower extremity-related anaerobic exercise capacity or functional status in adult patients with FMF. METHODS: Twenty-four patients with FMF (12 males) and 24 age-sex-matched healthy controls (13 males) were included in the study. Lower extremity-related anaerobic exercise capacity was assessed by using Wingate Anaerobic Test. Lower extremity-related functional status was examined by using 9-Step Stair Climb Test, 10-Repetition Chair Stand Test, and Six-Minute Walking Distance. Muscle strength of hip flexors, hip extensors, knee flexors, and knee extensors were evaluated by using a hand-held dynamometer. RESULTS: Patients with FMF had significantly poorer results in all anaerobic exercise capacity parameters and functional status assessments (P < 0.05), except muscle strength measurements (P > 0.05). Both average and peak anaerobic exercise capacities correlated significantly with all muscle strength measurements, 9-Step Stair Climb Test, 10-Repetition Chair Stand Test times, and Six-Minute Walk Distances (P < 0.05) in patients with FMF. CONCLUSION: Lower extremity-related anaerobic exercise capacity and functional status seem to be diminished in adult patients with FMF. Evaluating these parameters may be beneficial for planning more appropriate and individualized treatment regimens such as patient education and exercise counselling for patients with FMF.

Are Functional Movement Screen Tests Performed at the Right Time, if It Is an Injury Risk Predictor?

CONTEXT: Sports injuries are more common when players are fatigued and occur more frequently at the end of matches; therefore, determining the right time for employing an injury screening test is important. OBJECTIVE: To determine the role of timing (prematch vs postmatch fatigue) on the functional movement screen (FMS) scores, a frequently used injury risk screening method. DESIGN: Cross-sectional study. SETTING: Field. PARTICIPANTS: Twenty-four women soccer players from a professional team were included. MAIN OUTCOME MEASURES: The players were evaluated with a visual analog scale for perceived fatigue and with the FMS. Assessments were conducted before and after a 60-minute match. RESULTS: The subtest scores for deep squat, hurdle line, in-line lunge, trunk stability push-up, and the total FMS scores showed a significant decrease following the match (P < .05). Compared with prematch, the number of players who could achieve the highest score of 3/3 postmatch was lower for all subtests except right shoulder mobility. CONCLUSIONS: Our results suggest a negative relationship between perceived fatigue level and performance on the deep squat, hurdle line, in-line lunge, and trunk stability push-up subtest scores and in the total FMS score. Therefore, the authors suggest that screening tests such as the FMS should be employed following a match when players present with fatigue.

The Acute Effect of Talocrural Joint Mobilization on Dorsiflexor Muscle Strength in Healthy Individuals: A Randomized Controlled Single-Blind Study.

CONTEXT: Mobilization has been used for enhancing muscle strength. OBJECTIVE: The aim of this study was to investigate the acute effect of talocrural joint mobilization on ankle dorsiflexor muscle strength in healthy individuals, which has not yet been studied. DESIGN: Randomized controlled single-blind study. SETTING: University laboratory. PARTICIPANTS: Forty-eight healthy individuals. INTERVENTIONS: Maitland grade III (study group) versus Maitland grade I (control group) mobilizations. MAIN OUTCOME MEASURES: Muscle strength measurements were performed using a handheld dynamometer at baseline, immediately after the mobilization, and 30 minutes after mobilization. RESULTS: At baseline, the physical characteristics and muscular strength were similar in both groups (P > .05). According to Friedman analysis, a significant difference was detected following the mobilization in the study group (P < .001), and while the muscle strength at immediately after the mobilization and at 30 minutes after mobilization was significantly higher than baseline (P < .001), no significant differences were observed between 30 minutes after mobilization and immediately after the mobilization (P = .17). However, no significant changes were detected in the control group. The study group was found superior to the control group in terms of muscle strength differences following the mobilization (P < .001). CONCLUSION: The ankle dorsiflexor muscle strength might be increased by performing Maitland grade III mobilization, and this increase might be preserved for 30 minutes, while Maitland grade I mobilization did not lead to such an improvement in healthy individuals.

Reference values and prediction equation for the 6-minute walk test in healthy children aged 6­12 years old

Background/aim: The 6-minute walk test (6MWT) is the most commonly used and well-established test to measure functional exercise capacity in research and clinical settings. Country-specific reference values are important to interpret the results of 6MWT. However, no reference values have been reported for healthy Turkish children aged between 6 and 12 years old. The aim of this study was to determine normal reference values for the 6MWT test of healthy Turkish children aged between 6 and 12 years old. Materials and methods: Two hundred and sixty-two healthy children aged between 6 and 12 years old were included in this cross-sectional study. Measures included height, weight, body mass index (BMI), leg length, and 6MWT distance (6MWD). Results: The mean 6MWD was 572.58 (SD = 117.72) m. There were significant correlations between 6MWD and age (r = 0.764, P < 0.001), height (r = 0.742, P < 0.001), weight (r = 0.605, P < 0.001), BMI (r = 0.234, P < 0.001), and lower extremity length (r = 0.708, P < 0.001). In the stepwise multiple linear regression model, age and height explained about 60% of the variability of the 6MWT distance for the total sample. Conclusion: Reference values and prediction equation for the 6MWT in healthy Turkish children aged 6­12 years old have been reported for the first time in this study. Researchers and clinicians can use them to interpret the effectiveness of a treatment and/or to compare the results of disabled children with healthy ones.

Functional Reach and Lateral Reach Tests in Turkish Children.

AIMS: The functional reach test (FRT) and lateral reach test (LRT) provide important measures of postural stability. The aims of this study were to (1) establish the normative values for FRT and LRT, and (2) examine the effects of age, gender, and various anthropometric measurements on FRT and LRT. METHODS: Two hundred eighty children, aged 6-12 years, completed the study. One hundred fifty-two subjects were females. The mean age was 9.0 ± 2.0 years. Each child performed two trials of FRT and LRT. RESULTS: No significant differences were detected in any age group between males and females. The normal values of FRT ranged between 23.0 and 36.5 cm, and that of LRT between 18.0 and 28.0 cm. Height, length of upper and lower extremity, and arm span had a higher correlation with FRT. Age and weight showed a good correlation with FRT. Age, height, weight, length of upper and lower extremity, and arm span showed good correlation with LRT. CONCLUSIONS: These normative data will be useful for clinicians in the assessment of balance of individual children and in the diagnosis of potential balance deficits at an early age in the Turkish population.

The association between aerobic capacity and spinal curvature and mobility in young soccer players.

BACKGROUND: There is a lot of research in terms of injuries and performance in football and nowadays aerobic capacity, spinal posture and mobility have been taken into consideration separately in terms of performance. Considering from a biomechanical perspective, we thought spinal curvature and mobility may affect aerobic performance and investigated the relationship between them. RESEARCH QUESTION: Do young soccer players' segmental spinal curvature and mobility affect their aerobic capacity and maximal exercise performance? METHODS: Thirty-four young league players (mean age 16.56 ±1.11 years) were evaluated pre-season. Spinal assessments in the sagittal plane with a non-invasive, computer-assisted electromechanical device and aerobic capacity assessment with a cardiopulmonary exercise-testing device were applied. The relationship between spinal postural variables with aerobic capacity was done by Pearson correlation analysis, and simple linear regression analysis was used to estimate the effect of spinal curvature and mobility on aerobic performance. RESULTS: Various parameters of aerobic performance were related to spinal curvature and mobility. Maximal oxygen uptake (VO2max) and maximal heart rate (HRmax) were negatively correlated with thoracic angle (r=-0.343, p=0.047 and r=-0.344, p=0.046; respectively). Thoracic angle was also associated with tidal volume (VT) and VO2/HR (r=-0.347, p=0.044 and r=-0.348, p=0.044; respectively). Higher thoracic mobility caused to reach the anaerobic threshold (VAT) earlier (r=-0.368, p=0.032), at a lower speed (r=-0.367, p=0.033). In other segments, lumbar mobility was negatively correlated with VT at VAT (r=-0.346; p=0.045), while spinal inclination with HR at VAT (r=-0.387, p=0.024). SIGNIFICANCE: Although it is within physiological ranges, increased spinal curvature and mobility are associated with a decrease in aerobic capacity in young soccer players. Spinal curvature and mobility especially in the thoracic region may affect the aerobic performance of a soccer player. The trainers should consider spinal alignment for not only the technical and tactical but also the general performance of the soccer player.

Are eSports more than just sitting? A study comparing energy expenditure.

Aim: To investigate the energy expenditure of amateur eSport athletes between sitting and an eSport gaming session. Materials & methods: Eleven amateur male eSport athletes (age: 21.73 ± 3.50 years, weight: 76.00 ± 12.51 kg, height: 1.81 ± 0.06 m) were included. After recording the resting values, eSports playing values were recorded using an open circulation oxygen consumption analyzer (QuarkCPET, COSMED, Albano Laziale, Italy). Also, action per min (APM) scores were recorded. Results: When comparing the respiratory frequency, metabolic equivalent of task values and energy expenditure values of the participants, a significant increase was observed in all three values (p < 0.05 for each). Conclusion: eSports players, who are considered to be physically inactive by sitting, spend approximately 40% more energy than sitting, even at the amateur level. According to APM, more energy can be spent in tournaments and at the elite level.

Assessing the knee flexion range of motion after total knee arthroplasty: Technology versus senses.

INTRODUCTION: Following total knee arthroplasty surgery, attention should be paid to post-operative knee range of motion to achieve daily activities. Goniometer assessment is widely used to assess the range of motion in the post-operative period. This study aimed to determine the inter-rater ability of a smartphone application and visual estimation of the knee joint after total knee arthroplasty among different professions that commonly work together and compare whether any method is superior to another. METHOD: Range of motion measurements was performed by four clinicians as two physiotherapists and two orthopedic fellows. They utilized the Goniometer Reports application for smartphones, universal goniometer, and visual estimation to measure angles of knees which was operated. A two-way mixed model of intra-class correlation coefficient (ICC) with a 95% confidence level was used to assess inter-rater reliability. RESULTS: Thirteen patients (11 female) and 20 knees (10 right) were assessed. The ICCs were found excellent both for between methods and between raters. CONCLUSION: Our results show that technology seems a more accurate way to determine the knee range of motion after knee arthroplasty compared to senses. However, in lack of technological resources or time, or to avoid possible infection, visual estimation also could provide useful information.

Arm span as a predictor of the six-minute walk test in healthy children.

BACKGROUND: Six-minute walk test (6MWT) is the most used test to assess functional capacity. Including arm span in the prediction equations for 6MWT performance might be an alternative for use in traditional reference equations. OBJECTIVE: The aim was to investigate the usability of arm span to predict the 6MWT distance in healthy children. METHODS: 262 healthy children aged between 6 and 12 years old participated in this study. 6MWT was conducted according to the standardized protocol. Height, weight, and arm span were measured before performing the 6MWT. A multiple stepwise linear regression analysis was used to generate the regression model. RESULTS: The 6MWT distance had strong positive correlations with age, arm span, height, and weight (p<0.001). There was also a very strong correlation between arm span and height (p<0.001). Age and arm span were found as significant predictors in the first regression model. These two variables explained 60.2% of the variance in the 6MWT distance. Age and height were also found as significant predictors, explaining 60.5% of the variance in the 6MWT distance. The two following formula were obtained to predict the 6MWT distance: (-23.09+(31.12×Age)+(2.39×Arm span)) or (-80.0+(28.98×Age)+(2.92×Height)). CONCLUSIONS: The results suggest that the combination of arm span (or height) and age are strong predictors of the 6MWT distance in healthy children.

The comparison of regional spinal curvatures and movements in sitting posture in ambulatory children with cerebral palsy having minimal-to-moderate functional limitations.

AIM: To examine the regional spinal curvatures and movements in the sagittal and frontal planes during sitting position, and the ability to act independently in patients with CP and to compare the differences between children and adolescents with minimal-to-moderate functional limitations. METHOD: Twenty-one participants diagnosed with CP aged 5-16 years were included. The participants' Gross Motor Function Classification System (GMFCS) levels were determined and those at levels I (minimal functional limitation group: minFLG) or II-III (moderate functional limitation group: modFLG) were included. Spinal curvatures, mobilities, and inclinations in the sagittal and frontal planes were evaluated in the sitting position using a hand-held, computer-assisted non-invasive electromechanical device. Participants' functional independence levels were assessed with the Functional Independence Measure (WeeFIM). RESULTS: In the sagittal plane, there were no differences in terms of spinal curvatures between the minFLG and modFLG (p > 0.05). Spinal mobility degrees for flexion (thoracic and lumbar regions and total spine), extension (sacral region), and total spine mobility scores were significantly greater in the minFLG (p < 0.05). In the frontal plane, lumbar spinal curvature significantly increased, and total spine mobility in the right/left lateral motions and functional independence decreased in the modFLG (p < 0.05). INTERPRETATION: The children/adolescents with minimal functional limitations had greater spinal mobility during flexion, extension, and lateral flexions. Spinal curvatures were similar between groups in the sagittal plane. The lumbar region posture scores in the frontal plane observed as lordoscoliosis were higher, and functional independence was lower in the modFLG.

The Publication Rates of Pediatric Rheumatology Abstracts Presented in European League Against Rheumatism 2009 Congress.

OBJECTIVES: This study aims to evaluate the publication rates and features of the abstracts related to pediatric rheumatology presented in European League against Rheumatism 2009 congress. PATIENTS AND METHODS: A systematic search was performed to find full-text publications of abstracts related to pediatric rheumatology in European League against Rheumatism 2009 congress. Full-text publication rate, the elapsed time between presentation and full-text publication, type of the disease in the studies, distribution of abstracts and full-texts according to countries, journals, and presentation types were investigated. RESULTS: Totally 220 abstracts were detected related to pediatric rheumatology. Twenty-two of them had only the title, authors' names, and institution of origin, but no abstract. Therefore, a total number of 198 abstracts were evaluated. Eighty-six (43.4%) abstracts were found to be accepted as full-text articles. The elapsed time between presentation and full text publication was median 19 months (range 0 to 64 months). While 12 orally presented abstracts (34%) became full-text articles, this rate was 45% (74 abstracts) for poster presentations. There was no significant difference in the elapsed time to reach full-text publication and impact factors between presentation types (p=0.832 and p=0.053, respectively). CONCLUSION: The full-text publication rates were within similar ranges when compared to other reports in rheumatology field. It seems that even though European League against Rheumatism is a general rheumatology congress, it takes an important place in pediatric rheumatology field as well.