Are Previous Joint Injuries Associated with Muscle Performance in Volleyball Athletes? / Lesões articulares prévias são associadas ao desempenho muscular de jogadores de voleibol?

Abstract Objective The aim of the present study is to determine whether previous shoulder and knee injuries were associated with isokinetic fatigue index and agonist/antagonist ratio of shoulder internal/external rotators and knee flexors/extensors in male volleyball athletes. Methods The current study is a cross-sectional investigation of 49 male elite volleyball players competing at a high level in Brazil. Isokinetic fatigue index and agonist/antagonist profiles were assessed during the preseason. Additionally, in order to record previous injuries, the athletes answered a standardized questionnaire. We conducted a receiver operating characteristic (ROC) curve analysis to determine the association strength and the clinically relevant cut-off point for variables presenting statistical significance for the area under the curve (AUC) (α = 0.05). An independent t-test was used to compare isokinetic variables between athletes with and without previous injury (α = 0.05). Results The results of the ROC curve analysis indicated that hamstring fatigue index values at 300o/s were associated with the presence of previous knee injury (area under the curve [AUC] = 73%, p= 0.004), and shoulder external rotators fatigue index values at 360°/s were not associated with the presence of previous shoulder injury (AUC = 68%, p= 0.053). Conclusions Elite volleyball athletes who reported previous knee injuries were prone to a higher fatigue index than those reporting no injuries. Knee flexor resistance training might be useful for those athletes who reported knee injuries in the previous season.

Resumo Objetivo O objetivo deste estudo é determinar se lesões prévias de ombro e joelho estavam associadas ao índice de fadiga isocinética e razão agonista/antagonista dos rotadores internos/externos do ombro e flexores/extensores do joelho em jogadores de voleibol. Métodos Esta é uma investigação transversal com 49 jogadores de voleibol de elite que competem em alto nível no Brasil. O índice de fadiga isocinética e os perfis de agonistas/antagonistas foram avaliados durante a pré-temporada. Além disso, para registro de lesões anteriores, os atletas responderam a um questionário padronizado. Conduzimos uma análise da curva de característica de operação do receptor (receiver operating characteristic, ROC) para determinar a força de associação e o ponto de corte clinicamente relevante de variáveis com significância estatística na área sob a curva (AUC) (α = 0,05). Um teste t independente comparou as variáveis isocinéticas entre atletas com e sem lesão prévia (α = 0,05). Resultados Os resultados da análise da curva ROC indicam que os valores do índice de fadiga dos isquiotibiais a 300o/s foram associados à presença de lesão prévia no joelho (área soba a curva [AUC] = 73%, p= 0,004), enquanto os valores do índice de fadiga dos rotadores externos do ombro a 360°/s não foram associados à presença de lesão prévia no ombro (AUC = 68%, p= 0.053). Conclusões Atletas de voleibol de elite que relataram lesões anteriores no joelho estavam propensos a um índice de fadiga maior do que aqueles que não relataram lesões. O treinamento de resistência de flexores do joelho pode ser útil para atletas com relatos de lesões no joelho na temporada anterior.

Assessment of intensity effort of middle-aged adults practicing regular walking

Background: Walking is one of the most commonly recommended activities for sedentary individuals. When performed at the correct intensity, it can provide cardiovascular, respiratory, metabolic, and other benefits by providing a training effect in addition to reducing the risk of death from cardiovascular diseases and other chronic health conditions. Objectives: The primary aim of this study was to assess whether individuals who practiced regular unsupervised walking carry out the activity safely and with sufficient effort intensity parameters to have a positive physiological (training) effect. The secondary objective was to compare the training heart rate (HR) and the stability of the HR within the ideal range of training between the sexes. Method: Individuals were selected from walking tracks within the city of Belo Horizonte, Brazil. The study included subjects from 40 to 60 years of age who had practiced walking for at least two months prior to the study, walking at least three times a week. Individuals who agreed to participate in the survey were asked to walk 15 minutes at their usual pace with their HR measured every 5 minutes using a heart rate monitor. Their average walking HR was compared to the average training HR based on the formula: (220 - age) × 70 to 80% that would result in a positive physiological training effect. Results: Of the 142 individuals evaluated, 25.4% achieved the average training HR. This result was significantly lower than those who did not achieve the average training HR while walking (p=0.002). There were significant differences between men and women who had reached the training HR (p=0.0001). Conclusion: The authors found that individuals who walk regularly performed outside the range of the ideal HR intensity that would cause a positive physiological effect and therefore would probably not achieve a beneficial training effect while walking.

Análise do perfil, funções e habilidades do fisioterapeuta com atuação na área esportiva nas modalidades de futebol e voleibol no Brasil / Analysis of the profile, areas of action and abilities of Brazilian sports physical therapists working with soccer and volleyball

OBJETIVO: Investigar o perfil do fisioterapeuta com atuação na área esportiva nas modalidades de futebol e voleibol no Brasil no que tange à sua formação, atuação e grau de autonomia dentro da equipe interdisciplinar. MÉTODOS: Foram analisados questionários estruturados para levantamento de dados sociodemográficos, dados relativos ao ambiente de trabalho e à prática clínica e os seus domínios, referentes a 49 fisioterapeutas de clubes e seleções de futebol e voleibol. RESULTADOS: Do total de entrevistados, apenas cinco fisioterapeutas eram do sexo feminino, e a idade média do grupo era de 32,2 anos. A maioria dos fisioterapeutas brasileiros que atuam no esporte possuem especialização em diversas áreas (78,2 por cento), foram contratados por indicação (78,2 por cento), trabalham mais de 8 horas/dia ou em regime de dedicação exclusiva (80,0 por cento) e recebem de sete a dez ou mais salários mínimos (58,2 por cento). Além disso, observou-se uma grande participação do fisioterapeuta nos domínios do atendimento emergencial (87,3 por cento), prevenção (92,7 por cento), reabilitação funcional (98,2 por cento) e retorno após lesão (100 por cento). O fisioterapeuta com atuação no esporte relata haver uma boa relação interdisciplinar, sobretudo com o preparador físico na reabilitação funcional (70,9 por cento), com o médico do clube na decisão do retorno do atleta após reabilitação (74,5 por cento) e no veto ou liberação do atleta para jogos/treinos (63,6 por cento). Entretanto, muitos reclamaram de ameaças à sua autonomia, principalmente pelo profissional médico. CONCLUSÃO: Ainda existe a necessidade de investir na formação específica do profissional fisioterapeuta esportivo, visando a uma melhor especialização na área esportiva e consolidando conceitos importantes da área por meio de um melhor entendimento de referenciais teóricos e de atuação clínica.

OBJECTIVE: To analyze the profile of Brazilian physical therapists working with soccer and volleyball professional teams, by verifying their level of education (graduate or undergraduate), as well as their role and insertion within the interdisciplinary team. METHODS: Structured questionnaires were administered to forty-nine physical therapists working at soccer, volleyball clubs and Brazilian national teams. These questionnaires provided data on social demographic, characteristics of the work environment and organization of clinical practice and its domains. RESULTS: From the 49 participants in this study only five were female. Mean age of all participants was 32.2 years. The majority of the sports physical therapists had specialization degrees in different areas (78.2 percent), were hired through referral (78.2 percent), worked more than 8 hours a day or were exclusively dedicated to their clubs (80.0 percent) and earned seven to ten Brazilian minimal wages (58.2 percent). They reported to have participation in the domains of emergency care (87.3 percent), prevention (92.7 percent), functional rehabilitation (98.2 percent) and return to competition (100 percent). They had interdisciplinary relationships with physical educators during functional rehabilitation programs (70.9 percent) and with physicians in the decision process of return to activity after rehabilitation (74.5 percent) and on the veto of an athlete to take part in practices or matches (63.6 percent). Therapists also complained of threats to their professional autonomy, specially directed by the team's physician. CONCLUSION: There is still a need to invest in continuing education of sports physical therapists with the objective to improve their educational level and to strengthen their professional autonomy.