Effect of Paralympic powerlifting training on sleep and its relationship with training load

Abstract Aim: This study aims to compare the sleep parameters in Paralympic powerlifting athletes during days with and without training, and to analyze the relationship between the training load and sleep on the same day and the relationship between the previous night's sleep and the training load of the following day. Methods: Actigraphy was used to analyze the sleep parameters of 11 Paralympic powerlifting athletes for 14 days (7 days without and with training), whereas Ratings of Perceived Exertion (RPE) analysis was used to assess training load. In addition, the Horne and östberg chronotype questionnaire and the Epworth Sleepiness Scale were applied. Results: Athletes show morning and indifferent chronotype and low daytime sleepiness. We found that on training days, sleep onset latency (SOL) was lower (average 5.3 min faster), whereas total sleep time (TST) and sleep efficiency (SE) were higher (TST averaged 169 min and SE 7% higher) compared to non-training days. In addition, the TST of the night before the training days correlated positively with the RPE of the following day, and the training volume correlated negatively with the SE of the same day. Conclusion: Our findings show that Paralympic powerlifting training had positive effects in increasing TST and SE and decreasing SOL on training days. These results show the positive effects of this type of training in improving sleep in athletes with physical disabilities. In addition, a good night's sleep the day before training can make it possible to put more effort into the next day's training. Therefore, guiding athletes to sleep more before training with more intense loads is recommended.

External rotation elastic bands at the lower limb decrease rearfoot eversion during walking: a preliminary proof of concept

ABSTRACT Background Reducing rearfoot eversion is a commonly desired effect in clinical practice to prevent or treat musculoskeletal dysfunction. Interventions that pull the lower limb into external rotation may reduce rearfoot eversion. Objective This study investigated whether the use of external rotation elastic bands, of different levels of stiffness, will decrease rearfoot eversion during walking. We hypothesized that the use of elastic bands would decrease rearfoot eversion and that the greater the band stiffness, the greater the eversion reduction. Method Seventeen healthy participants underwent three-dimensional kinematic analysis of the rearfoot and shank. The participants walked on a treadmill with and without high- and low-stiffness bands. Frontal-plane kinematics of the rearfoot-shank joint complex was obtained during the stance phase of walking. Repeated-measures ANOVAs were used to compare discrete variables that described rearfoot eversion-inversion: mean eversion-inversion; eversion peak; and eversion-inversion range of motion. Results The low-stiffness and high-stiffness bands significantly decreased eversion and increased mean eversion-inversion (p≤0.037) and eversion peak (p≤0.006) compared with the control condition. Both bands also decreased eversion-inversion range of motion (p≤0.047) compared with control by reducing eversion. The high-stiffness band condition was not significantly different from the low-stiffness band condition for any variables (p≥0.479). Conclusion The results indicated that the external rotation bands decreased rearfoot eversion during walking. This constitutes preliminary experimental evidence suggesting that increasing external rotation moments at the lower limb may reduce rearfoot eversion, which needs further testing.

Reabilitação baseada em movimento para melhora de dor e atividade em indivíduos com espondilólise ou espondilolistese: revisão sistemática / Movement-based rehabilitation to reduce pain and improve activity in people with spondylolysis and spondylolisthesis: a systematic review

Introdução: Alterações em estrutura e função decorrentes de espondilólise/espondilolistese podem incluir dor lombar e/ou irradiada para membros inferiores com limitações de atividade. Objetivo: avaliar a eficácia de programas de reabilitação baseados em movimento para redução da dor e melhora de atividade em indivíduos com diagnóstico de espondilólise/espondilolistese. Método: Revisão sistemática de ensaios clínicos aleatorizados, cuja intervenção foi programa de reabilitação baseado em exercício. As medidas de desfecho foram dor e atividade. Resultados: Cinco estudos foram incluídos. Dois estudos investigaram a eficácia da intervenção experimental comparada a placebo/não-intervenção, encontrando resultados inconclusivos. Três estudos investigaram a eficácia da intervenção experimental em comparação ao tratamento cirúrgico, reportando superioridade do tratamento cirúrgico. Conclusão: Os resultados são inconclusivos em relação à eficácia da reabilitação baseada em movimento, e sugerem que é menos eficaz do que tratamentos cirúrgicos na redução da intensidade de dor e melhora de atividade de indivíduos com diagnóstico de espondilólise/espondilolistese.

Introduction: Body structure and function impairments due to spondylolysis/spondylolisthesis may include low back pain and/or radiating pain, leading to activity limitations. Objective: To investigate the efficacy of movement-based rehabilitation programs to reduce pain and improve activity in people with spondylolysis/spondylolisthesis. Method: Systematic review of randomised clinical trials. Experimental intervention was movement-based rehabilitation program and outcome measures were pain and activity. Result: Five trials were included. Two trials examined the efficacy of the experimental intervention compared with placebo/no-intervention, and found inconclusive results. Three trials examined the efficacy of the experimental intervention compared with a surgical treatment, and reported superiority in favour of the surgical treatments. Conclusion: The results are inconclusive regarding the efficacy of movement-based rehabilitation, and suggested that it is less effective than surgical treatments.

Desenvolvimento de um modelo de pé segmentado para avaliação de indivíduos calçados / Development of a segmented foot model for assessing individuals with shoes

INTRODUÇÃO: O uso de calçados pode influenciar parâmetros cinemáticos dos segmentos do pé durante a marcha. OBJETIVO: Testar um modelo biomecânico para avaliar o deslocamento angular dos segmentos do pé durante a marcha de indivíduos calçados. MATERIAIS E MÉTODOS: Dez indivíduos adultos jovens saudáveis participaram do estudo. Um par de tênis foi utilizado durante o estudo. O sistema Qualisys Pró-Reflex foi utilizado para a avaliação das variáveis de desfecho: deslocamento angular de retropé nos planos sagital, frontal e transverso e de antepé nos planos frontal e transverso. O Coeficiente de Correlação Intraclasse foi usado para verificar o grau de associação das seguintes variáveis entre as duas visitas: valores angulares máximos e mínimos e deslocamento angular total. RESULTADOS: As variáveis de desfecho apresentaram confiabilidade teste-reteste de moderada a excelente. DISCUSSÃO: O nível de confiabilidade encontrado foi considerado aceitável, fornecendo, assim, uma base sólida para a avaliação objetiva da cinemática dos segmentos do pé de indivíduos calçados em ambientes laboratoriais, para fins de pesquisas científicas e avaliações clínicas da cinemática da marcha humana. CONCLUSÃO: A qualidade do método desenvolvido e da análise de confiabilidade realizada detectou padrões de movimento dos segmentos do pé próximos aos descritos na literatura. Além disso, o protocolo de aquisição apresentado não é invasivo, não requer uma estrutura extra de referência, posicionamento da articulação subtalar em neutro nem é dependente da informação fornecida por raios-X.

INTRODUCTION: The use of shoes may influence the kinematics parameters of the foot segments during gait. OBJECTIVE: To test a biomechanical model developed to measure the angular displacement of the foot segments during gait of individuals using shoes. MATERIALS AND METHODS: Ten healthy young individuals participated in the study. A pair of shoes was used during the study. The Qualisys Pró-Reflex system was used to measure the following outcome variables: angular displacement of the rearfoot in the sagittal, frontal and transverse planes of motion and forefoot in the frontal and transverse planes. The Intraclass Correlation Coefficient was calculated to verify the association between the following variables between visits: maximum and minimum joint angles and the total range of motion. RESULTS: The investigated outcomes demonstrated values of intra-rater reliability ranging from moderate to excellent. DISCUSSION: This study presented a feasible and reliable method to measure the angular displacement of the foot segments during gait using shoes. The methods can be applied during scientific researches and clinical assessments of the kinematics during human gait. CONCLUSION: The quality of the method developed and the reliability analysis realized demonstrated motion patterns of the segments of the foot similar to what is demonstrated in the literature. In addition, the protocol is noninvasive, does not require an additional reference device, subtalar neutral position and does not depend on information provided by X-ray images.

Sistema GaitGrabber na captação de dados cinemáticos durante a marcha / GaitGrabber system on kinematic gait analyses

O objetivo do presente estudo foi desenvolver e testar a confiabilidade e validade do Sistema GaitGrabber na obtenção de dados cinemáticos no plano sagital durante a marcha. Dezoito indivíduos participaram do estudo de confiabilidade e 28 do estudo de validade concorrente. O Sistema Qualisys Pro-Reflex foi usado como padrão ouro. O GaitGrabber calcula os ângulos relativos de quadril, joelho e tornozelo no plano sagital. O Coeficiente de Correlação Intraclasse (CCI) foi usado para comparação das médias dos picos angulares entre visitas. Para a validade, foi aplicada a análise de componentes principais. Os CCI variaram de moderados a excelentes e a validade do sistema foi comprovada para o tornozelo. Foi demonstrada diferença significativa na amplitude de movimento de quadril e joelho, a qual foi atribuída a características técnicas dos instrumentos. O Sistema GaitGrabber é válido e confiável e pode ser usado na clínica para análise cinemática da marcha no plano sagital.

The purpose of this study was to develop and test the validity and reliability of the GaitGrabber System in measuring kinematic variables in the sagittal plane during gait. Eighteen individuals participated in the reliability study and 28 in the concurrent validity study. The Qualisys Pro-Reflex System used as a gold standard reference system. The GaitGrabber calculates the relative angles at the hip, knee and ankle in the sagittal plane. The Intraclass Correlation Coefficient (ICC) was used to compare the average of the angular peaks between visits. The principal component analysis was used to test the validity of the system. The ICC ranged from moderate to excellent and the validity of the system was proved for the ankle. There were significant differences in the range of motion for the hip and knee joints which were attributed to different instrumental characteristics. The GaitGrabber system is valid and reliable and can be clinically used to analyze kinematics during gait in the sagittal plane.

Aplicação da análise de componentes principais na cinemática da marcha de idosas com osteoartrite de joelho / Application of principal component analysis on gait kinematics in elderly women with knee osteoarthritis

CONTEXTUALIZAÇÃO: A aplicabilidade da análise de marcha foi aprimorada com a introdução da análise de componentes principais (ACP), uma técnica estatística que reduz o volume de dados, permitindo a comparação de todo o ciclo entre grupos de indivíduos. OBJETIVOS: Comparar, por meio da ACP, a cinemática da articulação do joelho durante a marcha nos planos sagital e frontal, entre mulheres idosas sem e com diagnóstico de leve a moderado de osteoartrite (OA). MÉTODOS: Participaram 38 mulheres idosas (69,6±8,1 anos) com OA de joelhos e 40 assintomáticas (70,3±7,7 anos). A cinemática foi obtida usando o sistema Qualisys Pró-reflex. RESULTADOS: O grupo OA apresentou menor velocidade da marcha e comprimento da passada (p<0,05) e caracterizou-se por maior escore de dor no WOMAC. No plano frontal, as componentes não foram significativas entre os grupos. No plano sagital, três componentes explicaram 90,7 por cento da variância dos dados. A análise discriminante indicou que a componente 2 (CP2) e a 3 (CP3) classificaram corretamente 71,8 por cento dos indivíduos. Entretanto, a CP3, que capta a diferença de amplitude do ângulo de flexão do joelho durante a marcha, foi a variável com maior poder de discriminação entre os grupos. CONCLUSÕES: A ACP é uma técnica estatística multivariada, efetiva para a análise das variáveis cinemáticas do ciclo da marcha. A perda de flexão de joelho na marcha do grupo com OA foi apontada como fator discriminante importante entre os grupos, sendo, portanto, uma variável que deve ser considerada na avaliação e tratamento fisioterápico da mulher idosa com OA de joelho.

BACKGROUND: The applicability of gait analysis has been implemented with the introduction of the principal component analysis (PCA), a statistical data reduction technique that allows the comparison of the whole cycle between groups of individuals. OBJECTIVES: Applying PCA, to compare the kinematics of the knee joint during gait, in the frontal and sagittal planes, between a group of elderly women with and without diagnosis in the initial and moderate stages of Osteoarthritis (OA). METHODS: A total of 38 elderly women (69.6±8.1 years) with knee OA and 40 asymptomatic (70.3±7.7 years) participated on this study. The kinematics was obtained using the Qualisys Pro-reflex system. RESULTS: The OA group showed decreased gait velocity and stride length (p<0.05) and was characterized with higher WOMAC pain score. In the frontal plane, the between-group differences of the components were not significant. In the sagittal plane, three principal components explained 99.7 percent of the data variance. Discriminant analysis indicated that component 2 and 3 could classify correctly 71.8 percent of the individuals. However, CP3, which captures the difference in the flexion knee angle magnitude during gait, was the variable with higher discrimination power between groups. CONCLUSIONS: PCA is an effective multivariate statistical technique to analyse the kinematic gait waveform during the gait cycle. The smaller knee flexion angle in the OA group was appointed as a discriminatory factor between groups, therefore, it should be considered in the physical therapy evaluation and treatment of elderly women with knee OA.