Validity and reliability of Veloflex to measure active cervical range of motion in asymptomatic and symptomatic subjects.

BACKGROUND: Neck pain has a high annual incidence and decreases the cervical active range of motion (ROM). Clinicians use various methods to evaluate cervical range of motion (CROM) that some of them have also been proposed to give instant feedback. Accordingly, this study aimed to examine the validity and reliability of Veloflex (VF) to measure the CROM by comparison with the cervical range of motion (CROM) device, and to examine their test-retest reliability. METHODS: Thirty-eight healthy and 20 symptomatic participants were evaluated. Cervical flexion-extension, side bending, and rotations were tested in two sessions, first by the CROM and VF and in the second only with the VF. To evaluate the concurrent validity and agreement between CROM and VF, Pearson correlation coefficient (r) and Bland-Altmann plots were used. Reliability were evaluated using intra-class correlation (ICC), standard error of measurement (SEM) and minimal detectable change (MDC). RESULTS: CROM and VF showed excellent correlation for all movements (r > 0.960). Both devices provided small mean 'bias' (≤1.29%) in all movements regarding CROM measures. The intra-rater and inter-rater reliability of the VF was excellent (ICC > 0.98). SEMs ranging from 0.72% to 2.38% and the MDC ranging from 1.22° to 2.60° in all participants. The results support the validity and reliability of VF to measure CROM. For its use, with a basic training is enough to get reliable measurements.

Validity of an inertial system for measuring velocity, force, and power during hamstring exercises performed on a flywheel resistance training device.

BACKGROUND: Inertial hamstring exercises promote functional changes leading to lower rates of hamstring injuries. However, variable training measurement systems have not been specifically validated for hamstring exercises. Accordingly, this study aimed to evaluate the validity of the Inertial Measurement System (IMS) to measure the velocity, force, and power during the performance of different hamstring exercises on a flywheel resistance training device. METHODS: Fifteen males (average age: 22.4 ± 2.5 years; body mass: 77.3 ± 9.8 kg; height: 179.5 ± 7.4 cm; weekly physical activity: 434.0 ± 169.2 min; years of strength training: 4.3 ± 2.2 years) performed the bilateral stiff-leg deadlift (SDL), 45° hip extension (HE), and unilateral straight knee bridge (SKB) in two sessions (familiarization and evaluation) with a 1-week interval between them. The velocity, force, and power (average and peak values) in the concentric and eccentric phases for each of the exercises were recorded simultaneously with IMS and MuscleLab. RESULTS: Consistency between IMS and MuscleLab was good to excellent for all variables, with r ranges from 0.824 to 0.966 in SDL, from 0.822 to 0.971 in HE, and from 0.806 to 0.969 in SKB. Acceptable levels of agreement between devices were observed in general for all exercises, the "bias" ranging from 1.1% to 13.2%. Although MuscleLab showed higher values than IMS for peak velocity, force and power values, the effect size was only relevant for 5 of the 36 parameters. IMS is a new and valid system to monitor inertial hamstring exercises on a new flywheel device. In this way, IMS could have potential practical applications for any professional or athlete who wants to monitor inertial hamstring exercises.

Intra- and inter-rater reliability of electrical impedance myography using adhesive electrodes in healthy volunteers.

In spite of the growing use of the electrical impedance myography (EIM) measures for clinical assessment and follow-up of diseased muscle tissue, reliability studies are scarce. We evaluate the reliability of the (EIM) technique using four adhesive electrodes over the muscle of interest. Intra- and inter-rater reliability was studied within the same session and between sessions. Thirty-one healthy and volunteer subjects aged between 20 and 26 years were recruited. Phase angle, reactance and resistance were assessed for each EIM measurement. Intraclass correlation coefficient (ICC) was used to determine the relative reliability. Absolute reliability was expressed as the standard error of measurement and the minimum detectable change. Relative reliability within the same session and between sessions for the EIM technique was excellent (ICCs > 0.9) concerning both intra- and inter-rater reliability, except for the component reactance. The absolute reliability was very high for the three EIM components. EIM measures using four adhesive electrodes over the area of interest is a reliable technique to assess muscle tissue status. This study confirms that these measurement results barely vary depending on the examiner and the moment. The present study also confirms phase angle as the least affected EIM component by examiner and evaluation moment.

A New Therapeutic Application of Platelet-Rich Plasma to Chronic Breast Wounds: A Prospective Observational Study.

The aim of this study was to investigate the usefulness of platelet-rich plasma (PRP) treatment for chronic wounds (CWs) of the breast. A prospective study was performed in 23 patients with CW of the breast who were treated with PRP. The procedure was repeated until the wound was closed completely. The study included patients with a history of breast cancer (n = 8) and patients without cancer (n = 15). The treatment with PRP was successful in all cases and observed in ≤4 weeks in 82.6% (19/23) of patients. The patients without breast cancer showed significantly less time for wound closure than the patients with a history of breast cancer. Moreover, a greater number of PRP treatments were necessary to achieve wound closure in patients undergoing conservative breast treatment. No patients had complications associated with the application of PRP. Conclusions: To the best of our knowledge, this is the first study to reveal that PRP treatment for CWs of the breast is safe, simple, useful and well-tolerated by patients.

A New Treatment for Mammillary Fistulas Using Ultrasound-Guided Percutaneous Needle Electrolysis.

The aim of this study was to investigate the efficacy of ultrasound-guided percutaneous needle electrolysis (PNE) in mammillary fistulas (MFs). A prospective study was performed in 18 patients with MF who were treated with the PNE technique. The technique was repeated in the case of no response or recurrence. The results obtained show that MFs revealing an elongated appearance with the ultrasound (US) are generally resolved with two sessions of PNE, whereas ovoid MFs require several sessions of PNE for complete resolution and they tend to recur. Success of the treatment with PNE was observed in 88.8% of the patients (16/18), and failure, after five or six sessions in two cases (11.2%), which were referred for surgery. Conclusions: To the best of our knowledge this is the first study to reveal that the PNE technique is safe, effective, quick, and well-tolerated by patients.

Tensiomyographical responsiveness to peripheral fatigue in quadriceps femoris.

BACKGROUND: Fatigue influences athletic performance and can also increase the risk of injury in sports, and most of the methods to evaluate it require an additional voluntary effort. Tensiomyography (TMG), which uses electrical stimulation and a displacement sensor to evaluate muscle contraction properties of one or more muscle bellies, has emerged as a technique that can assess the presence of peripheral and central fatigue without requiring additional voluntary efforts. However, the evaluation of the TMG's ability to detect fatigue is limited, both at the level of muscle bellies and statistical methods. Thus, the aim of the present study was twofold: (i) to examine and compare the tensiomyographical responsiveness to quadriceps femoris (QF) fatigue by multiple statistical methods and (ii) to analyze sex differences in the variation produced by fatigue in TMG parameters. METHODS: Thirty-nine recreational athletes participated (19 males/20 females; aged 22 ± 2 years). TMG parameters of QF bellies and maximal voluntary isometric contraction (MVIC) were measured before and after a fatigue protocol. TMG parameters used were maximum radial deformation (Dm), contraction time between 10-90% of the Dm (Tc), contraction velocity between 10-90% (Vc) and of the first 10% (V10) of the Dm. Internal responsiveness of TMG to fatigue was analyzed by paired t-test and standardized response mean (SRM). External responsiveness was examined by correlations, regression models, and receiver operating characteristic (ROC) curves. RESULTS: All TMG parameters, except for Tc of rectus femoris and vastus medialis, showed large internal responsiveness. In adjusted regression models by sex, only Dm and V10 of rectus femoris were statistically associated (p < 0.05) with b coefficients of 0.40 and 0.43, respectively. r2 explained the 22% of the total variance. In addition, these parameters could discriminate between QF with and without fatigue. CONCLUSION: Since the QF is the main strength contributor during multiple physical activities, clinicians and trainers will be able to discriminate the presence of fatigue and the magnitude of changes in the QF strength by TMG evaluation.

Effect of different ergonomic supports on muscle activity of dentists during posterior composite restoration.

BACKGROUND: The aim of this study was to evaluate the effect of different ergonomic supports on the muscle activity of two trunk muscles while a group of dentists performed a common dental procedure on a phantom head, divided into three tasks. METHODS: A one-way repeated measures study (ANOVA) was conducted on a group of 36 dentists. The middle trapezius and lumbar erector spinae muscles were measured with and without the use of different ergonomic supports (ergonomic stool, magnification lenses and both) using a portable surface electromyography (sEMG) device. Intraclass correlation coefficients (ICCs) and the absolute standard error of measurement (SEM) were used to establish the reliability of the baseline measures without ergonomic supports. RESULTS: The sEMG showed excellent ICCs (ranging from 0.92 to 0.99) and SEM. Bonferroni post hoc tests showed differences between the three ergonomic supports (p < 0.001) in both muscles studied. The lowest muscle activity measurement occurred with the isolated used of magnification lenses. The use of the ergonomic stool increased the muscle activity of the middle trapezius and lumbar erector spinae muscles to a greater extent than the magnification lenses. The combination of the ergonomic stool and the magnification lenses produced a different effect on each muscle.

Validity and Reliability of a New Optoelectronic System for Measuring Active Range of Motion of Upper Limb Joints in Asymptomatic and Symptomatic Subjects.

The aim of this study was to evaluate the validity of the Veloflex infrared dynamic angle-meter (Veloflex-IDA) and the intra- and inter-rater reliability when measuring the ranges of motion (ROMs) of the upper limb joints. Thirty-five healthy and 20 symptomatic participants were evaluated. Twelve upper limb movements were measured in two sessions with the Veloflex-IDA, which is a device composed of a camera that tracks the trajectory of retro-reflective markers. In addition, a goniometer was used in the first session to evaluate concurrent validity. Validity and agreement were evaluated by Pearson correlation coefficient (r) and Bland-Altmann plots. Intra- and inter-rater reliability were evaluated using intra-class correlation (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). Both instruments showed excellent correlation for all movements (r range from 0.992 to 0.999). The intra- and inter-rater reliability were excellent (ICC range from 0.95 to 0.99 and 0.90 to 0.98, respectively). Intra-rater reliability showed SEMs <1.38% and <5.19% and inter-rater reliability SEMs <2.26% and <5.22% for asymptomatic and symptomatic, respectively. Veloflex-IDA is a valid and reliable alternative to measure the upper limb joints' ROM and it can be used in clinical practice and research after basic training.

The Combination of Different Ergonomic Supports during Dental Procedures Reduces the Muscle Activity of the Neck and Shoulder.

Ergonomic supports have become popular for the prevention of musculoskeletal disorders. This study sought to evaluate the efficacy of different ergonomic supports and their combination to reduce muscle activity of the neck and shoulder muscles. A one-way repeated measures design was used to evaluate 36 practicing dentists while they performed three posterior composite restoration procedures on a phantom head. Portable surface electromyography (sEMG) recordings were used to measure the muscle activity of three muscles (Upper Trapezius, Lateral Deltoid and Anterior Deltoid) in the dominant upper extremity, with and without the use of different ergonomic supports (ergonomic stool, magnification lenses and both) during the performance of these tasks. A repeated measures analysis of variance was used. The muscle activity of all muscles differed significantly across the four ergonomic conditions during the three tasks. The use of ergonomic supports such as magnification lenses, the ergonomic stool, or the combination of both, is effective for decreasing the muscle activity of the three muscles during the three tasks, when compared to standard practice. In addition, the decrease of muscle activity was higher using magnification lenses when compared to the ergonomic stool. Furthermore, the greatest decrease was found with the combination of both supports.

An Optoelectronic System for Measuring the Range of Motion in Healthy Volunteers: A Cross-Sectional Study.

Background and Objectives: Within the clinical evaluation of multiple pathologies of the lower limb, the measurement of range of motion (ROM) of its joints is fundamental. To this end, there are various tools, from the goniometer as a reference to more recent devices such as inclinometry-based applications, photo capture applications, or motion capture systems. This study aimed to assess the validity, intra-rater, and inter-rater reliability of the VeloFlex system (VS), which is a new camera-based tool designed for tracking joint trajectories and measuring joint ROM. Materials and Methods: Thirty-five healthy volunteers (16 females; aged 18-61 years) participated in this study. All participants were assessed on two separate occasions, one week apart. During the first assessment session, measurements were obtained using a goniometer and the VS, whereas, in the second session, only the VS was used. In each assessment session, nine active movements were examined. For each movement, three trials were tested, and the mean of these three measures was used for analysis. To evaluate the concurrent validity and agreement, the Pearson correlation coefficient (r) and Bland-Altmann plots were used. Intra-rater and inter-rater reliability were evaluated using intra-class correlation (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). Results: Both devices showed excellent correlations for all movements (r ranged from 0.992 to 0.999). The intra-rater reliability of the VS was excellent (ICC ranged from 0.93 to 0.99), SEMs ranged from 0.53% to 2.61% and the MDC ranged from 0.68° to 3.26°. The inter-rater reliability of the VS was also excellent (ICC ranged from 0.88 to 0.98), SEMs ranged from 0.81% to 4.76% and the MDC ranged from 2.27° to 4.42°. Conclusions: The VS is a valid and reliable tool for the measurement of ROM of lower limb joints in healthy subjects.

Factors Associated with Parents' Adherence to Different Types of Exercises in Home Programs for Children with Disabilities.

There is a lack of knowledge with regard to the adherence to different types of exercises prescribed for children with disabilities. The aim was to examine parents' adherence to prescriptions of different types of home exercises; to identify associated factors related to the parents, the children and the environment, and to assess the relative influence of the behaviour of health professionals. Parents (393) were recruited from 18 early intervention centres. A cross-sectional survey using a self-reported questionnaire was used to examine whether three types of exercises ("flexibility exercises", "neuromotor development training" and "body mechanics and postural stabilisation") were prescribed in their home programs; if the child had received exercises according to a prescription; and items related to the parents, child, environment, and health professionals. The adherence rates were different among the types of exercises. Parents with low perception of barriers and high self-efficacy had a higher adherence to neuromotor development training and postural stabilization, whereas parents with a high level of knowledge increased their odds of adherence to flexibility exercises. Health professionals' behaviour had a distinct influence on the adherence to different exercises. This study suggests the need to specifically consider the types of exercises prescribed in the management of adherence to home programs.

Ultrasound-guided percutaneous electrolysis: A new therapeutic option for mammary fistulas.

Mammary fistula (MF) is a recurrent condition characterised by the draining of abscesses around the areola. The best management for MF remains challenging. Moreover, the main problem is the high recurrence rate of this disease. MF is considered a chronic process. The percutaneous electrolysis (PE) technique involves the application of a galvanic current with an ultrasound-guided needle to induce ablation and repair of the affected tissue. Good results have been obtained with PE in chronic tendinopathies. Below we present a hypothesis that PE may be a new therapeutic option for MF.

Five times sit-to-stand test in subjects with total knee replacement: Reliability and relationship with functional mobility tests.

The objective was to determine the inter-observer and test/retest reliability of the "Five-repetition sit-to-stand" (5STS) test in patients with total knee replacement (TKR). To explore correlation between 5STS and two mobility tests. A reliability study was conducted among 24 (mean age 72.13, S.D. 10.67; 50% were women) outpatients with TKR. They were recruited from a traumatology unit of a public hospital via convenience sampling. A physiotherapist and trauma physician assessed each patient at the same time. The same physiotherapist realized a 5STS second measurement 45-60min after the first one. Reliability was assessed with intraclass correlation coefficients (ICCs) and Bland-Altman plots. Pearson coefficient was calculated to assess the correlation between 5STS, time up to go test (TUG) and four meters gait speed (4MGS). ICC for inter-observer and test-retest reliability of the 5STS were 0.998 (95% confidence interval [CI], 0.995-0.999) and 0.982 (95% CI, 0.959-0.992). Bland-Altman plot inter-observer showed limits between -0.82 and 1.06 with a mean of 0.11 and no heteroscedasticity within the data. Bland-Altman plot for test-retest showed the limits between 1.76 and 4.16, a mean of 1.20 and heteroscedasticity within the data. Pearson correlation coefficient revealed significant correlation between 5STS and TUG (r=0.7, p<0.001) and 4MGS (r=-0.583, p=0.003). This study demonstrates excellent inter-observer and test-retest reliability when it is used in people with TKR, and also significant correlation with other functional mobility tests. These findings support the use of 5STS as outcome measure in TKR population.