Systematic Review of Patient-Reported Outcome Measures for Patients with Exercise-Induced Leg Pain.

Background and Objectives: To determine the most commonly used patient-reported outcome measures (PROMs) in exercise-induced leg pain (EILP) and to identify specific PROMs for EILP in order to evaluate their psychometric properties and methodological quality. Materials and Methods: A strategic search was performed in different databases to identify and extract the characteristics of studies based on the use of PROMs in patients with EILP. Specific PROMs were evaluated according to the Terwee et al. and COSMIN criteria. Results: Fifty-six studies were included in the review. The Medial Tibial Stress Syndrome Score (MTSSS), Lower Extremity Functional Scale (LEFS) and Exercise-Induced Leg Pain Questionnaire (EILP-Q) were identified as specific PROMs for EILP. The Visual Analog Scale (VAS) was the most widely used instrument in the assessment of EILP. The methodological quality assessment showed six positive values for the LEFS, four for the MTSSS and three for the EILP-Q for the eight psychometric properties analyzed according to the COSMIN criteria. The evaluation of the nine psychometric properties according to Terwee showed five positive values for the LEFS and MTSSS, and three for the EILP-Q. Conclusions: The overall methodological quality of the PROMs used was low. The VAS was the most widely used instrument in the assessment of EILP, and the LEFS was the highest quality PROM available for EILP, followed by the MTSSS and EILP-Q, respectively.

Relationship between Running Spatiotemporal Kinematics and Muscle Performance in Well-Trained Youth Female Athletes. A Cross-Sectional Study.

The purpose of this cross-sectional study was to analyse the relationship of neuromuscular performance and spatiotemporal parameters in 18 adolescent distance athletes (age, 15.5 ± 1.1 years). Using the OptoGait system, the power, rhythm, reactive strength index, jump flying time, and jump height of the squat jump, countermovement jump, and eight maximal hoppings test (HT8max) and the contact time (CT), flying time (FT), step frequency, stride angle, and step length of running at different speeds were measured. Maturity offset was determined based on anthropometric variables. Analysis of variance (ANOVA) of repeated measurements showed a reduction in CT (p < 0.000) and an increase in step frequency, step length, and stride angle (p < 0.001), as the velocity increased. The HT8max test showed significant correlations with very large effect sizes between neuromuscular performance variables (reactive strength index, power, jump flying time, jump height, and rhythm) and both step frequency and step length. Multiple linear regression found this relationship after adjusting spatiotemporal parameters with neuromuscular performance variables. Some variables of neuromuscular performance, mainly in reactive tests, were the predictors of spatiotemporal parameters (CT, FT, stride angle, and VO). Rhythm and jump flying time in the HT8max test and power in the countermovement jump test are parameters that can predict variables associated with running biomechanics, such as VO, CT, FT, and stride angle.

Age and Training-Related Changes on Body Composition and Fitness in Male Amateur Cyclists.

Master athletes are considered as a model of healthy aging because they can limit the age-related decline of physiological abilities compared to sedentary individuals. The main objective of this study is to analyze age-related changes and annual training on body composition (BC) and cardiorespiratory fitness (CRF) parameters. The participants in this retrospective cross-sectional study were 176 male cyclists, aged 40-60 years. BC was evaluated through anthropometric measurements and CRF was determined by an incremental cycle ergometer test to exhaustion. A comparative study between age groups was carried out through a one-way ANOVA test and the associations between the variables were assessed by Spearman's correlation coefficients and multiple regression analysis to estimate the performance. Training was generally associated with a decrease in both body weight and body fat (p < 0.05). A decrease in resting heart rate was observed as a vagal effect of kilometers cycled per year (p < 0.05). Kilometers cycled per year were associated with an increase in peak power output, which was larger in the master 40 group (p < 0.05) with a non-significant upward in VO2max (p > 0.05). In the performance prediction model, the included variables explained 52% of the variance. In summary, the changes induced by age were minimal in BC and negligible in CRF, whereas HR decreased with age. Training load was generally associated with a decrease in body weight, BMI and body fat percentage that was particularly notable in the abdominal skin folds. A decrease in HRrest was observed as a vagal effect due to kilometers cycled per year, and age did not seem to have a significant effect. The annual cycling kilometers were associated with to high PPO that is greater in the M40 group and a non-significant upward trend in VO2max.

The Predictive Role of Raw Bioelectrical Impedance Variables in Disordered Eating Attitudes in Female Ballet Dance Students.

The present study used receiver operating characteristic (ROC) curve analysis to investigate the accuracy of body composition and raw bioelectrical impedance analysis (BIA) in correctly classifying disordered eating attitudes (DEA) in dance students. Participants were 81 female dancers assigned in two groups: beginner training (BT; age (mean ± SD) = 10.09 ± 1.2 years, n = 32) and advanced training (AT; age = 15.37 ± 2.1 years, n = 49). Fat mass (FM) was estimated by Slaughter's equation and skeletal muscle with Poortman's equation. Impedance (Z), resistance (R), reactance (Xc) and phase angle (PhA) were obtained through multifrequency BIA at a frequency of 50 kHz. Fat-free mass (FFM) was assessed using Sun's equation. For evaluation of DEA, the Eating Attitudes Test-26 (EAT-26) questionnaire was performed. We defined an EAT-26 score ≥ 20 as positive for DEA. Comparisons between groups were performed by a one-way ANOVA test or Kruskall-Wallis test. Spearman's rank correlation coefficients were performed to assess associations between variables. ROC curve analysis was utilized to test the accuracy of body composition and BIA variables in predicting DEA. In the BT group, Xc and PhA demonstrated high accuracy in predicting DEA with an area under the curve (AUC) of 0.976 (95% confidence interval (CI): 0.85-1.00) and 0.957 (95% CI: 0.82-0.99), respectively, (both p < 0.0001). FFM Sun had an AUC of 0.836 (95% CI: 0.66-0.94) (p < 0.0001) in the BT group and FFM Slaughter was 0.797 (95% CI: 0.66-0.90) (p < 0.001) in the AT group. Reactance and Phase angle were excellent and useful predictors of DEA in the BT group.

Somatotype Components as Useful Predictors of Disordered Eating Attitudes in Young Female Ballet Dance Students.

The current study used receiver operating characteristic (ROC) curve analysis to examine the accuracy of somatotype components in correctly classifying disordered eating attitudes (DEA) in female dance students. Participants were a sample of 81 female dancers distributed in two groups: beginner training (BT; age (mean ± SD) = 10.09 ± 1.2 years, n = 32) and advanced training (AT; age = 15.37 ± 2.1 years, n = 49). For evaluation of DEA, the Eating Attitudes Test- 26 (EAT-26) questionnaire was used. We defined an EAT-26 score ≥20 as positive for DEA. Somatotype components were calculated using the Heath-Carter anthropometric method. The risk of presenting DEA was 28.1% (n = 9) in the BT group and 6.1% (n = 3) in the AT group. In the BT group, mesomorphy demonstrated moderate-high accuracy in predicting DEA (area under the curve (AUC) = 0.82, 95% confidence interval (CI): 0.64-0.93). The optimal cut-off of 6.34 yielded a sensitivity of 0.77 and a specificity of 0.95. Ectomorphy showed moderate accuracy in predicting DEA (AUC = 0.768, 95% CI: 0.58-0.89). The optimal cut-off of 2.41 yielded a sensitivity of 0.78 and a specificity of 0.78. In the AT group, none of the components demonstrated accuracy in predicting DEA. Somatotype components were good predictors of disordered eating attitudes in the younger dance student group (beginner training). Further research is needed to identify the determinants of these differences between the two groups.

Clinician Assessment Tools for Patients with Diabetic Foot Disease: A Systematic Review.

The amputation rate in patients with diabetes is 15 to 40 times higher than in patients without diabetes. To avoid major complications, the identification of high-risk in patients with diabetes through early assessment highlights as a crucial action. Clinician assessment tools are scales in which clinical examiners are specifically trained to make a correct judgment based on patient outcomes that helps to identify at-risk patients and monitor the intervention. The aim of this study is to carry out a systematic review of valid and reliable Clinician assessment tools for measuring diabetic foot disease-related variables and analysing their psychometric properties. The databases used were PubMed, Scopus, SciELO, CINAHL, Cochrane, PEDro, and EMBASE. The search terms used were foot, ankle, diabetes, diabetic foot, assessment, tools, instruments, score, scale, validity, and reliability. The results showed 29 validated studies with 39 Clinician assessment tools and six variables. There is limited evidence on all of the psychometric characteristics of the Clinician assessment tools included in this review, although some instruments have been shown to be valid and reliable for the assessment of diabetic neuropathy (Utah Early Neuropathy Scale or UENS); ulceration risk (Queensland High Risk Foot Form or QHRFF); diabetic foot ulcer assessment, scoring, and amputation risk (Perfusion, extent, depth, infection and sensation scale or PEDIS and Site, Ischemia, Neuropathy, Bacterial Infection, and Depth score or SINBAD); and diabetic foot ulcer measurement (Leg Ulcer Measurement Tool LUMT).

Longitudinal validity of abdominal adiposity assessment by regional bioelectrical impedance.

The main goal of this study was to analyze the longitudinal agreement between changes in trunk and abdominal adiposity variables assessed by DXA and portable bioimpedance device (ViScan). A total of 44 women, enrolled in a 4-month exercise intervention, were included in this analysis. Trunk/abdominal compartments were assessed by ViScan and DXA. Adjusted correlations for age and FM at first assessment (pre) were utilized to perform concurrent validation among methods and completed with an agreement analysis. We observed significant differences between the changes detected by DXA and ViScan for %TFM (difference = -1.41%; p < 0.05), and proportional bias (Kendall's Tau = 0.53; p < 0.0001). Changes in abdominal adiposity were similar (difference = -0.1037 z-score units, p = 0.53), although there was proportional bias (Kendall's Tau = -0.24, p < 0.022). ViScan has a limited capability to evaluated changes in trunk and abdominal adiposity, at least for clinical purposes in adult women.

Cambios de la composición corporal tras un periodo de desentrenamiento deportivo / Body composition changes after sport detraining period

Introducción: la influencia del ejercicio físico en sujetos entrenados tiene efectos beneficiosos en la condición física y la composición corporal. Sin embargo, el desentrenamiento tiene un efecto desfavorable en todas ellas. Objetivo: el propósito del estudio fue analizar los cambios de la composición corporal después de un periodo de desentrenamiento de seis semanas de duración en dos grupos: uno de 43 jóvenes varones jugadores de fútbol (grupo experimental [GE], n = 43), y un grupo control de escolares no activos de la misma edad (grupo control [GC], n = 10). Métodos: las variables de composición corporal fueron evaluadas mediante antropometría, para estimar la masa grasa (MG) y la masa muscular esquelética (MME), y mediciones de bioimpedancia eléctrica, para estimar agua corporal total (ACT), agua extra (AEC) e intracelular (AIC). Las mediciones se realizaron tanto en situación de entrenamiento como de desentrenamiento. Resultados: tras el desentrenamiento, se encontraron diferencias significativas en el ACT (35,5 ± 5,2 vs. 36,7 ± 4,9 kg), el AIC (14,2 ± 1,8 vs. 14,8 ± 1,6 kg) y el AEC (21,5 ± 3,6 vs. 22,0 ± 3,4 kg, p < 0,001 para todas las variables), sin existir diferencias en los ratios AEC/ACT (0,4 ± 0,02 vs. 0,4 ± 0,02) y AIC/ACT (0,6 ± 0,02 vs. 0,597 ± 0,02, ambos p > 0,05). La MG aumentó significativamente (8,6 ± 3,2 vs. 8.95 ± 3,1 kg, p < 0,01); sin embargo, la MME no sufrió modificaciones (21,2 ± 2,5 vs. 22,22 ± 2,8 kg, p > 0,05) Conclusiones: el principal resultado de este estudio fue que en un periodo de desentrenamiento de seis semanas se observaron aumentos del ACT y de su distribución en el grupo de jóvenes futbolistas. La importancia fisiológica de esta desadaptación en el rendimiento deportivo tiene que ser analizada en futuros estudios (AU)

Introduction: The influence of exercise in trained subjects has beneficial effects in the physical fitness and body composition; however, detraining has an unfavorable effect in all of them. Objective: The current study was designed to ascertain the influence of a six week-detraining period on body composition in both well-trained young soccer players (GE, n = 43) and sedentary male adolescents (GC, n = 10). Methods: Forty-three well-trained soccer players and ten sedentary adolescents accepted to participate in the study. Body composition measurements included fat mass and skeletal muscle mass (SMM), which were estimated by anthropometry. In addition, total body water (TBW), intracellular water (ICW) and extracellular water (ECW) were assessed by bioelectrical impedance analysis (BIA) at the end of training and after detraining periods. Results: After the six-week-detraining period, significant increments were found in TBW (35.5 ± 5.2 vs. 36.7 ± 4.9 kg; p < 0.001), ICW (14.2 ± 1.8 vs. 14.8 ± 1.6 kg; p < 0.001) and ECW (21.5 ± 3.6 vs. 22.0 ± 3.4 kg; p < 0.001) in soccer players. Conversely, no changes were observed in ECW/TBW (0.4 ± 0.02 vs. 0.4 ± 0.02; p > 0.05) and ICW/TBW (0.6 ± 0.02 vs. 0.597 ± 0.02; p > 0.05) ratios. Finally, fat mass was significantly increased (8.6 ± 3.2 vs. 8.95 ± 3.1 kg; p < 0.01) in the detrained group. No significant changes were found in SMM (21.2 ± 2.5 vs. 22.22 ± 2.8 kg, p > 0.05). Conclusions: After a six-week detraining period, body composition changed significantly in well-trained adolescents. The main finding of this study was that increments of TBW and water distribution were observed in the soccer group, which reflects an increase of fat free mass compartment. The physiological importance of this miss-adaptation needs to be elucidated in future research. Further studies on this topic are still required to assess its impact on physical performance (AU)