Is the Absence of Manual Lymphatic Drainage-Based Treatment in Lymphedema after Breast Cancer Harmful? A Randomized Crossover Study.

(1) Background: Manual lymphatic drainage (MLD), included within the complex decongestive therapy, as a therapy for the treatment of lymphedema has raised controversy about its benefits for lymphedema after breast cancer. The aim of this research is to test the effects of MLD on lymphedema after breast cancer during the treatment maintenance phase. (2) Methods: A randomized, single-blinded, controlled crossover trial was conducted to analyze the effects of a manual lymphatic drainage intervention compared to a control group without MLD intervention for the treatment of lymphedema. Arm volume measured by circumference measurement, subcutaneous tissue thickness measured by ultrasound, and the sensation of pain, heaviness, and swelling were evaluated as outcome measures. (3) Results: For the control group, an increase in volume was found in some of the circumference and subcutaneous tissue thickness measurements, in addition to a worsening of arm pain, swelling and heaviness. (4) Conclusion: The absence of treatment based on MLD in lymphedema after breast cancer worsens volume measurements, as well as arm heaviness. Therefore, it would be advisable to carry out this type of therapy as part of the maintenance treatment for lymphedema in breast cancer.

Entrenamiento de equilibrio en la inestabilidad crónica de tobillo. Una revisión sistemática / Treino de equilíbrio na instabilidade crónica do tornozelo. Uma revisão sistemática. / Balance training in chronic ankle instability. A systematic review

Introducción: El objetivo de este trabajo es conocer la evidencia científica de los tratamientos centrados en el equilibrio en pacientes con inestabilidadcrónica de tobillo. Métodos: Se realizó una revisión de la literatura científica mediante una búsqueda sistematizada en febrero de 2022 en las siguientes bases de datos:PubMed, Scopus, PEDro, Web of Science, y Medline. Resultados: Se incluyeron ensayos clínicos aleatorizados en los últimos 5 años, obteniendo un total de 16 artículos para el análisis de esta revisiónsistemática. La calidad metodológica fue evaluada mediante la escala PEDro. Los principales resultados obtenidos mostraron mejoras en el equilibrioestático y dinámico en comparación con el grupo control. Sin embargo, en su mayoría, se muestran diferencias poco significativas entre gruposexperimentales. Conclusión: Los efectos que produce el entrenamiento de equilibrio en pacientes con inestabilidad crónica de tobillo parecen ser positivos.(AU)

Background: The aim of this work is to know the scientific evidence of treatments focused on balance in patients with chronic ankle instability. Methods: A review of the scientific literature was carried out by means of a systematized search in February 2022 in the following databases: PubMed,Scopus, PEDro, Web of Science, and Medline. Results: Randomized clinical trials in the last 5 years were included, obtaining a total of 16 articles for the analysis of this systematic review. Themethodological quality was evaluated using the PEDro scale. The main results obtained showed improvements in static and dynamic balance comparedto the control group. However, for the most part, insignificant differences between experimental groups were shown. Conclusion: The effects of balance training in patients with chronic ankle instability appear to be positive.(AU)

Introdução: O objectivo deste estudo é descobrir as provas científicas de tratamentos centrados no equilíbrio em pacientes com instabilidade crónica dotornozelo. Métodos: Foi realizada uma revisão da literatura científica através de uma pesquisa sistematizada em Fevereiro de 2022 nas seguintes bases de dados:PubMed, Scopus, PEDro, Web of Science, e Medline. Resultados: Foram incluídos ensaios clínicos aleatórios nos últimos 5 anos, obtendo-se um total de 16 artigos para a análise desta revisão sistemática. Aqualidade metodológica foi avaliada utilizando a escala PEDro. Os principais resultados obtidos mostraram melhorias no equilíbrio estático e dinâmicoem comparação com o grupo de controlo. No entanto, na sua maioria, foram mostradas diferenças insignificantes entre os grupos experimentais.Conclusão: Os efeitos do treino de equilíbrio em pacientes com instabilidade crónica do tornozelo parecem ser positivos.(AU)

Efficacy of perturbation-based balance training in anterior cruciate ligament tears. A systematic review

Anterior cruciate ligament (ACL) tear is a serious and debilitating injury with significant physical, psychological, and socioeconomic consequences. Perturbation-based balance training (PBBT) is a type of neuromuscular training that involves the manipulation of mobile support surfaces, using controlled, unpredictable, multidirectional forces, in order to perturb the balance of the trained individual and thus improve the efficiency of muscle contraction patterns and the dynamic stability of the lower extremity joints. The aim of this review is to analyze the efficacy of the PBBT as a neuromuscular re-education method of choice for the recovery of functional capacity in individuals with ACL knee rupture. A systematic search was carried out in PubMed, Cinahl, Cochrane Library, Medline, PEDro Physiotherapy Evidence Database, Scopus, Web of Science and Sport Discus during January 2022. Only randomized clinical trials conducted in humans and published in English or Spanish were considered. The methodological quality was assessed using the PEDro scale and the risk of bias using the Risk-of-Bias tool of The Cochrane.12 studies were included. In 3 of them, the intervention with PBBT took place before ACL reconstruction, in 7 after ACL reconstruction and in 2 the subjects did not undergo surgical intervention. PBBT appears to be effective in the non-surgical recovery, improving joint stability and neuromuscular control. It was also effective as a preoperative treatment in normalizing knee excursion after ACL surgery. In contrast, the evidence does not support its efficacy as the neuromuscular re-education method of choice in the return-to-sport phase in previously operated athletes. (AU)

Menstrual Cycle and Sport Injuries: A Systematic Review.

The presence of female athletes has only increased in recent years, as has the incidence of injuries in female sports activities. These injuries are conditioned by multiple factors, including hormonal agents. It is estimated that the menstrual cycle may be related to the predisposition to suffer an injury. However, a causal relationship has not yet been established. The aim of this study was to analyse the relationship between the menstrual cycle and injuries in female sports practice. A systematic search of the scientific literature available in PubMed, Medline, Scopus, Web of Science, and Sport Discus was carried out in January 2022. With 138 articles, only eight studies were found that met the selection criteria for this study. Peak estradiol is associated with increased laxity, strength, and poor use of neuromuscular control. Thus, the ovulatory phase is associated with an increased risk of injury. In conclusion, it seems that hormonal fluctuations throughout the menstrual cycle alter values such as laxity, strength, body temperature, and neuromuscular control, among others. This fact causes women to constantly adapt to hormonal variations, which exposes them to a higher risk of injury.

La vuelta al fútbol tras la reconstrucción del ligamento cruzado anterior / Return to football practice after anterior cruciate reconstruction / Retornar ao treino de futebol após a reconstrução do cruzado anterior

OBJETIVO: analizar las publicaciones recientes que se centran en la vuelta a la práctica futbolística tras la reconstrucción del ligamento cruzado anterior. MÉTODO: se revisaron artículos originales inglés, español y portugués publicados en los últimos cinco años en las bases de datos Pubmed, Medline, Scopus, Cinhal y Sport Discus. RESULTADOS: se encontraron 49 artículos y tras la aplicación de criterios de inclusión y exclusión se procedieron a analizar 14 artículos. De estos, 8 tenían una muestra de futbolistas masculinos, 5 con femeninas y uno con ambos sexos. CONCLUSIÓN: Los artículos seleccionados ponen de relieve que existen ciertos factores que pueden marcar el regreso a la práctica futbolística tras la reconstrucción del ligamento cruzado anterior como el nivel de profesionalización, el dolor, la falta de confianza, el sexo o el tipo de injerto

OBJECTIVE: The objective of this review will be to analyze recent publications that focus on the return to football practice after the reconstruction of the anterior cruciate ligament. METHOD: We reviewed original English, Spanish and Portuguese articles published in the last five years in the Pubmed, Medline, Scopus, Cinhal and Sport Discus databases. RESULTS: 49 articles were found and after applying the inclusion and exclusion criteria, 14 articles were analyzed. Of these, 8 had a sample of male soccer players, 5 with female players and one with both sexes. CONCLUSIONS: The selected articles highlight that there are certain factors that can mark the return to football practice after the reconstruction of the anterior cruciate ligament as the level of professionalization, pain, lack of confidence, sex or type of graft

OBJETIVO: analisar publicações recentes que enfocam o retorno à prática de futebol após a reconstrução do ligamento cruzado anterior. MÉTODO: artigos originais em inglês, espanhol e português publicados nos últimos cinco anos foram revisados nas bases de dados Medline, Pubmed, Scopus, Cinhal e Sport Discus. RESULTADOS: foram encontrados 49 artigos e, após a aplicação dos critérios de inclusão e exclusão, foram analisados 14 artigos. Destes, 8 tinham uma amostra de jogadores de futebol do sexo masculino, 5 com jogadores do sexo feminino e um com ambos os sexos. CONCLUSÃO: Os artigos selecionados destacam que existem alguns fatores que podem marcar o retorno à prática do futebol após a reconstrução do ligamento cruzado anterior. como o nível de profissionalização, dor, falta de confiança, sexo ou tipo de enxerto

Changes in rectus femoris architecture induced by the reverse nordic hamstring exercises.

BACKGROUND: Injuries and mechanical stimuli alter the muscle architecture and, therefore, its function. The changes in the architecture of the rectus femoris (RF) induced by an eccentric training protocol with reverse nordic hamstring exercises (RNHE) have never been studied. Therefore, the aim of the present study was to determine the architectural adaptations of the RF after an eccentric training with RNHE, followed by a subsequent detraining period. METHODS: Twenty-six subjects performed a first week of control, 8 weeks of eccentric training, concluding with a 4-week period of detraining. The architectural characteristics of the RF were evaluated using 2D ultrasound at rest (pretest: week 1), after the training (post-test: week 9), and at the end of the detraining period (retest: week 13). RESULTS: At the end of the training period, a significant increase in the muscle fascicle length (FL) (t=-8.96, d=2.22, P<0.001), muscle thickness (MT) (t=-8.76, d=2.219, P<0.001), pennation angle (PA) (t=-9.83, d=2.49, P<0.05) and cross-sectional area (CSA) (t=-13.06, d=3.06, P<0.001) was observed. After the detraining period FL, MT, PA and CSA showed a significant decrease. CONCLUSIONS: The eccentric training with RNHE may cause changes in the architectural conditions of RF, which, in addition, are also reversible after a 4-week detraining period. The adaptations produced by RNHE may have practical implications for injury prevention and rehabilitation programs, which include the changes in muscle architecture variables.

Análise da incidência lesional na ginástica aeróbica espanhola de elite / Analysis of incidence of injury in Spanish elite in aerobic gymnastics

INTRODUÇÃO: A ginástica aeróbica (GA) é uma disciplina que possui exigências físicas específicas e treinamento adequado para prevenir ou minimizar a ocorrência de lesões esportivas. OBJETIVO: Analisar a incidência de lesões na GA e a sua vinculação com fatores de treinamento MÉTODO: Realizou-se um estudo em 40 desportistas valencianos com idades compreendidas entre nove e 17 anos. O procedimento de coleta de informações foi através de um questionário de morbidade. A variável dependente foram as lesões durante a temporada 2009-2010 e as variáveis independentes principais foram a carga de treinamento, o material de proteção, superfície de treinamento, gesto técnico e tipo de lesão e zona corporal lesionada. RESULTADOS: As lesões mais reincidentes foram as relacionadas a ligamentos, afetando por igual os membros superior e inferior. A metade das lesões ocorreu após a realização dos saltos, apesar do uso de algum material de proteção, além de terem ocorrido no início da temporada. Relações significativas entre o número de lesões e a experiência, os dias de treinamento e o número de competições (p < 0,05) foram encontradas. CONCLUSÕES: O número de lesões diminuiu enquanto o uso de medidas de proteção, com destaque para as munhequeiras, aumentou. Metade das lesões produziu-se durante o período de aprendizagem técnica de dificuldades.

INTRODUCTION: Aerobic Gymnastics (GA) is a gymnastic discipline that requires specific physical needs and proper training to prevent or minimize the occurrence of sports injuries. OBJECTIVE: To analyze the incidence of injuries in the GA and its relationship with training factors. METHODS: A study with 40 Valencian athletes aged between 9 and 17 years was performed. Data was collected through a questionnaire of morbidity. The dependent variable was the injuries during the 2009-2010 season and the main independent variables were the training load, the protective equipment, training surface, technical movements and type of injury and body part injured. RESULTS: The most recurrent injuries were the ones related to ligaments, affecting both the upper and lower limbs. Half of the injuries occurred after performing jumps, despite the use of protective equipment and took place at the beginning of the season. Significant correlation was found between the number of injuries and the experience, training days and number of competitions (p <0.05). CONCLUSIONS: the number of injuries has decreased and the use of protective equipment has increased, with special attention to wristbands. Half of the injuries occurred during the learning period of technical difficulties.