Injuries in Judo Athletes With Disabilities: Prevalence, Magnitude, and Sport-Related Mechanisms.

CONTEXT: The participation of judo athletes with disabilities in competitions has increased over the years as well as the burden of sports-related injuries and illnesses in this population. However, there is limited knowledge about sports-related injuries in judo athletes with different disabilities. OBJECTIVE: To investigate the prevalence of injuries in judo athletes with disabilities, considering the different impairment groups, magnitude of injury (ie, mechanism, nature, and severity of injury), and specific body parts. DESIGN: Cross-sectional study (level of evidence, 3). SETTING: Brazilian Judo athletes with disabilities. PATIENTS: Fifty-one judo athletes with disabilities (15 men and 36 women) participated in this study. MAIN OUTCOME MEASURES: Data were obtained from an adapted injury report form. The prevalence of injuries was assessed, considering type of impairment, body parts, mechanisms, and severity as well as differences between male and female athletes, with the significance level set at P < .05. RESULTS: The results demonstrated a high prevalence of injuries in female athletes with visual impairment (n = 11, 73.3%) and male athletes with amputations (n = 14, 38.8%). A high prevalence was found in the national group, especially for male athletes (n = 29, 80.5%). Among athletes who had injuries, 69.4% (n = 12) of male and 80.0% (n = 25) of female athletes' injuries occurred due to direct contact with other athletes, and 72.2% (n = 26) of male and 86.6% (n = 13) of female athletes' injuries were in the training environment. The magnitude of injuries ranged from moderate to severe for male and female athletes. The knee (n = 25, 49.0%) and shoulder (n = 12, 23.5%) were the body parts most affected by injuries in both male and female athletes. CONCLUSION: A large percentage of judo athletes with disabilities reported experiencing an injury during the previous 2 years; percentages were greater in athletes with visual and physical impairment. Moreover, most injuries occurred in the knee or shoulder, during training, and in direct contact with other athletes and were of severe magnitude.

Outcomes between different validated questionnaires to assess the level of physical activity in cardiac patients adhering to a rehabilitation program / Desfechos entre diferentes questionários validados para a avaliação do nível de atividade física em cardiopatas adeptos a um programa de reabilitação

Abstract Introduction The International Physical Activity Ques-tionnaire (IPAQ) and Baecke inventory are commonly used in cardiovascular rehabilitation routines. Thus, it is understood that investigations on the equivalence of outcomes between these two tools may be relevant to measure the magnitude of possible reproducibility and correlations between them. Objective To compare in cardiac patients the level of physical activity obtained through the IPAQ and Baecke inventory and correlate outcomes obtained with a 6-minute walk test. Methods In total, 65 heart disease patients included in a cardiovascular rehabilitation program (40 male and 25 female) were included, with a mean age of 65.8 ± 10.5 years. The data were obtained from the application of a standardized form, containing the proposed study objects, which were the IPAQ and Baecke inventory. In addition, data regarding anthropometric measurements (body mass, height, and body mass index - BMI), waist-to-hip ratio, blood pressure, and performance in the 6-minute walk test were measured. Results The main outcomes refer to the weak association between the instruments evaluated, which showed a strong relationship only between free time physical activity (r = 1), while in the other categories and when compared to the 6-minute walk test, the verified agreement was not significant. Conclusion The questionnaires are strongly equivalent only for free time physical activity, in the other categories and when compared to the 6-minute walk test, the agreement was not significant. Thus, based on the results, implementation in clinical practice considering the use of these tools with equivalence is not recommended.

Resumo Introdução O Questionário Internacional de Atividade Física (IPAQ) e o inventário de Baecke são comumente utilizados em rotinas de reabilitação cardiovascular. Assim, entende-se que investigações sobre a equiva-lência de desfechos entre essas duas ferramentas possam ser relevantes para mensurar a magnitude da possível reprodutibilidade e correlação entre tais métodos. Objetivo Comparar em cardiopatas o nível de atividade física obtido por meio do IPAQ e do Baecke e correlacionar desfechos obtidos com o teste de cami-nhada de 6 minutos (TC6). Métodos Foram incluídos no estudo 65 cardiopatias inseridos em um programa de reabilitação cardiovascular, sendo 40 do sexo masculino e 25 do sexo feminino, com idade média correspondente a 65,8 ± 10,5 anos. Os dados foram obtidos a partir de um formulário padronizado, contendo os objetos de estudo propostos (IPAQ e Baecke). Além disso, dados referentes a medidas antropométricas (massa corporal, estatura e índice de massa corpórea), relação de cintura quadril, pressão arterial e TC6 foram avaliados. Resultados Os principais desfechos se referem à fraca associação entre os instrumentos avaliados, que demonstraram relação forte somente entre atividade física de tempo livre (r = 1), sendo que nas demais categorias e quando comparadas ao TC6 a concordância verificada não apresentou significância estatística. Conclusão Os questionários se equivalem fortemente somente quando diz respeito à atividade física de tempo livre. Desta forma, não faz sentido a implementação de prática clínica que considere a utilização das ferramentas IPAQ e Baecke com equivalência, o que verificou-se não existir.

Anti-inflammatories for delayed onset muscle soreness: systematic review and meta-analysis / Antiinflamatorios para el dolor muscular de inicio tardío: revisión sistemática y metanálisis / Anti-inflamatórios para dor muscular de início tardio: revisão sistemática e metanálise

ABSTRACT Objective: To investigate the effectiveness of pharmacological interventions in the treatment of delayed onset muscle soreness (DOMS). Design: A systematic review and meta-analysis of randomized controlled clinical trials (RCTs). Data sources: The PubMed/MEDLINE, EMBASE, SPORTDiscus, Scielo and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for RCTs published prior to August 3, 2020. Eligibility criteria for selecting studies: Studies that 1) used an RCT design; 2) evaluated the effectiveness of steroidal or nonsteroidal anti-inflammatory drugs (NSAIDs) in treating DOMS; and 3) therapeutically used drugs after exercise were included. Results: In total, 26 studies (patients = 934) were eligible for inclusion in the qualitative analysis on the treatment of DOMS. The results of the meta-analysis showed no superiority between the use and non-use of NSAIDs in the improvement of late muscle pain, as no statistically significant differences were verified (21 studies, n= 955; standard mean difference (SMD)= 0.02; 95% confidence interval (CI) −0.58, 0.63; p=0.94; I2=93%). The quality of the synthesized evidence was very low according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and there was significant heterogeneity among the included studies. Conclusion: The results demonstrate that NSAIDs are not superior to controls/placebos in treating DOMS. The inclusion of both studies with dose-response protocols and those with exercise protocols may have influenced the results. In addition, the high risk of bias identified reveals that limitations need to be considered when interpreting the results. Level of evidence I; ystematic review of RCT (Randomized and Controlled Clinical Trials).

RESUMEN Objetivo: Investigar la efectividad de las intervenciones farmacológicas en el tratamiento del dolor muscular de aparición tardía (DOMS). Metodología: Revisión sistemática y metanálisis de ensayos clínicos controlados aleatorios (RCT). Fuentes de datos: Se realizaron búsquedas en las bases de datos de PubMed/MEDLINE, EMBASE, SPORTDiscus, Scielo y Cochrane Central Register of Controlled Trials (CENTRAL) para ECA publicados antes del 3 de agosto de 2020. Criterios de elegibilidad para la selección de estudios: Estudios en los que 1) se utilizó un diseño de RCT; 2) se evaluó la eficacia de los fármacos antiinflamatorios no esteroideos (AINE) y esteroideos en el tratamiento de DOMS; y 3) se incluyó el uso terapéutico de medicamentos para dolor después del ejercicio. Resultados: En total, 26 estudios (pacientes = 934) fueron elegibles para su inclusión en el análisis cualitativo sobre el tratamiento de DOMS. Los resultados encontrados en el metanálisis no demostraron superioridad entre el uso y no uso de AINE para mejorar el dolor muscular tardío cuando se comparó con una condición de control, ya que no hubo diferencias estadísticamente significativas (21 estudios, n = 955; media estándar diferencia = 0,02; intervalo de confianza (IC) del 95% −0,58, 0,63; p = 0,94; I2 = 93%). La calidad de la evidencia encontrada se clasificó como muy baja según los criterios del "Grading of Recommendations Assessment, Development and Evaluation" (GRADE), principalmente porque existe una heterogeneidad significativa entre los estudios incluidos. Conclusión: Los resultados demuestran que los AINE no son superiores a los controles o placebos en el tratamiento de DOMS. La inclusión de ambos modelos de estudio con protocolos de dosis-respuesta y protocolos de ejercicio puede haber influido en los resultados. Además, el alto riesgo de sesgo identificado revela que la interpretación de los resultados debe verse con limitaciones. Nivel de evidencia: I; Revisión sistemática de ECRC (Ensayos clínicos aleatorizados y controlados).

RESUMO Objetivo: Investigar a eficácia das intervenções farmacológicas no tratamento da dor muscular de início tardio (DOMS). Desenho: Revisão sistemática e metanálise de estudos clínicos randomizados e controlados (RCTs). Fontes de dados: Os bancos de dados PubMed/MEDLINE, EMBASE, SPORTDiscus, Scielo e Cochrane Central Register of Controlled Trials (CENTRAL) foram pesquisados em busca de RCTs publicados antes de 3 de agosto de 2020. Critérios de elegibilidade para selecionar estudos: Estudos que 1) usaram um desenho de RCT; 2) avaliaram a eficácia de anti-inflamatórios esteroides ou não esteroides (AINEs) no tratamento de DOMS e 3) incluíram tratamento medicamentoso depois de exercício. Resultados: No total, 26 estudos (pacientes = 934) foram elegíveis para inclusão na análise qualitativa do tratamento de DOMS. Os resultados da metanálise não mostraram superioridade entre o uso e não uso de AINEs na melhora da dor muscular tardia, pois não foram verificadas diferenças estatisticamente significativas (21 estudos, n = 955; diferença média padronizada (SMD) = 0,02; Intervalo de confiança (IC) de 95% −0,58, 0,63; p = 0,94; I2 = 93%). A qualidade da evidência encontrada foi muito baixa de acordo com os critérios da Grading of Recommendations Assessment, Development and Evaluation (GRADE), e verificou-se heterogeneidade significante entre os estudos incluídos. Conclusão: Os resultados demonstram que os AINEs não são superiores aos controles ou placebos no tratamento de DOMS. A inclusão de estudos com protocolos de dose-resposta e com protocolos de exercícios podem ter influenciado os resultados. Além disso, o alto risco de viés identificado revela que as limitações devem ser consideradas na interpretação dos resultados. Nível de evidência I; Revisão sistemática de ECRC (Estudos clínicos randomizados e controlados).

Efficacy of Ultrasound for Localized Fat Treatment on Clinical and Psychological Outcomes: A Randomized, Single-Blind, Placebo-Controlled Clinical Trial.

BACKGROUND: The use of ultrasound for localized fat treatment on possible psychological influences is little explored to date. Therefore, it is relevant to elaborate studies that include a placebo group in order to measure the real effects of the exclusive application of ultrasound. OBJECTIVES: To verify the influence of ultrasound application for localized fat treatment on clinical, functional, and psychological outcomes. METHODS: Thirty female participants who were candidates for localized abdominal fat treatment were included and randomly divided into three groups: control (CG, n = 10), experimental (EG, n = 10), and placebo (PG, n = 10). The CG did not receive any intervention. The EG received 10 ultrasound sessions for 20 minutes. For the PG, ultrasound was also applied for 20 minutes, but with zero intensities. Anthropometric assessment, cardiovascular parameters, circumference measurements, photography, endurance test, and subjective questionnaires were performed before and after the treatment protocols. RESULTS: The EG photographs show an improvement of 60% in the visual appearance. Regarding the other analyzed outcomes, no statistically significant differences were found between moments and groups (P > 0.05). CONCLUSIONS: Pretreatment and posttreatment photographs analysis demonstrate visual improvement in the appearance of abdominal localized fat in the EG. However, ultrasound application, when compared with CG and PG, is not a superior method for improving clinical, functional, and psychological parameters.

Phototherapy on Management of Creatine Kinase Activity in General Versus Localized Exercise: A Systematic Review and Meta-Analysis.

OBJECTIVE: The main focus of this systematic review was to determine the efficacy of phototherapy in the management of creatine kinase (CK) activity after exercise and furthermore to identify for which exercise model protocol phototherapy provides the best results. DESIGN: Meta-analysis comparing phototherapy with a control condition. SETTING: The MEDLINE, EMBASE, SPORTDiscus, PEDro, and CENTRAL databases were searched from their earliest records to October 03, 2016. Data were pooled in a meta-analysis and described as standardized mean difference (SMD) with 95% confidence intervals (CIs) using a random effects model. PARTICIPANTS: Healthy subjects (no restrictions were applied, eg, age, sex, and exercise level). INTERVENTION: Phototherapy (low-level laser therapy and/or light-emitting diode therapy) before or after exercise and a placebo or control condition. MAIN OUTCOME MEASURES: Creatine kinase activity (no restriction to any analysis, eg, serum, plasma, or capillary blood). RESULTS: Fourteen studies were included for review. The results revealed that phototherapy has a more positive effect than control condition in management of CK activity [SMD = 0.77, 95% CI (0.32 to 1.22); P = 0.0007; I = 72%]. In exploratory analysis, the results showed that phototherapy was effective only in the exercise protocol with localized exercise with large effect size [localized exercise: SMD = 0.89, 95% CI (0.26 to 1.51); P = 0.0002; I = 76%; general exercise: SMD = 0.61, 95% CI (-0.05 to 1.26); P = 0.07; I = 67%]. CONCLUSIONS: The available evidence suggest that phototherapy has beneficial effects on the management of CK activity and demonstrate a possible relationship based on damage caused by exercise, providing a greater effect in studies that used localized exercise.

Training with elastic and conventional devices on body composition: systematic review and meta-analysis / Treinamento em dispositivos elásticos e convencionais sobre a composição corporal: revisão sistemática e meta-análise / Entrenamiento en dispositivos elásticos y convencionales sobre composición corporal: revisión sistemática y metaanálisis

Abstract Introduction: Given the practicality and low cost of elastic devices, a comparison with conventional devices may be able to quantify gains from both tools for further conclusions. Objective: Compare the effect of resistance training with elastic (tubes and resistance band) and conventional (weight machines and dumbbells) devices on body composition. Method: This is a systematic review and meta-analysis. The PubMed/MEDLINE, Embase, PEDro and CENTRAL databases were searched from the earliest records to July 25, 2018. Data were described in standardized mean difference (SMD) with a 95% confidence interval (95% CI). Results: Four studies were included. The results of the meta-analysis did not show superiority among the analyzed methods for the variables investigated (SMD = -2.04, 95% CI -7.56, 3.48, p < 0.00001, lean mass: SMD = 0.28, 95% CI -0.29, 0.85, p = 0.97, body fat: SMD = 2.77, 95% CI -0.05, 5.59, p = 0.92, body mass: SMD = 1.22, 95% CI -0.29, 2.74, p = 0.11). Conclusion: The results of the meta-analysis showed superiority of outcome from training in conventional devices only for the variable fat mass. For the other variables, no statistically significant differences were found. Elastic resistance can promote similar outcomes to resistance in different population profiles and from various protocols on variables related to body composition.

Resumo Introdução: Tendo em vista a praticidade e o baixo custo dos dispositivos elásticos, uma comparação com dispositivos convencionais (halteres e máquinas de peso) pode ser capaz de quantificar os resultados observados para posteriores conclusões sobre eventual tendência de superioridade verificada entre os métodos investigados. Objetivo: Comparar o efeito do treinamento resistido em dispositivos elásticos (tubos e faixa elástica) e convencionais (máquinas de peso e halteres) sobre a composição corporal. Método: Trata-se de uma revisão sistemática e meta-análise. Foram pesquisadas as bases de dados PubMed/MEDLINE, Embase, PEDro e CENTRAL desde os registros mais antigos até 25 de julho de 2018. Os dados foram descritos em standardized mean difference (SMD) com intervalo de confiança de 95% (95% CI). Resultados: Quatro estudos foram incluídos. Os resultados da meta-análise não demonstraram superioridade entre os métodos analisados para as variáveis investigadas (massa gorda: SMD= -2.04; 95% CI 7.56, 3.48; p < 0.00001; massa magra: SMD = 0.28; 95% CI -0.29, 0.85; p = 0.97; gordura corporal: SMD = 2.77; 95% CI -0.05, 5.59; p = 0.92; massa corporal: SMD = 1.22; 95% CI -0.29, 2.74; p = 0.11). Conclusão: Houve superioridade de resultado apenas para a variável massa gorda, que demonstrou melhores resultados oriundos do treinamento em dispositivos convencionais. Para as demais variáveis, não foram identificadas diferenças estatisticamente significantes. A resistência elástica é capaz de promover desfechos similares a resistência convencional, em diferentes perfis de população e a partir de protocolos diversos sobre variáveis relacionadas a composição corporal.

Resumen Introducción: Debido a la practicidad y el bajo costo de los dispositivos elásticos, una comparación con los dispositivos convencionales (pesas y mancuernas) puede cuantificar los beneficios de ambas herramientas para obtener conclusiones adicionales. Objetivo: Comparar el efecto del entrenamiento de resistencia en dispositivos elásticos (tubos y banda elástica) y convencionales (pesas y mancuernas) en la composición corporal. Método: Esta es una revisión sistemática y metaanálisis. En las bases de datos PubMed/MEDLINE, Embase, PEDro y CENTRAL se buscaron desde los registros más antiguos hasta el 25 de julio de 2018. Los datos se describieron en la diferencia de medias estandarizada (DME) con un intervalo de confianza del 95% (IC del 95%). Resultados: Se incluyeron cuatro estudios. Los resultados del metaanálisis no mostraron una superioridad entre los métodos analizados para las variables investigadas (masa grasa, SMD=-2.04, IC 95% -7.56, 3.48, p < 0,00001, masa magra: SMD = 0.28, IC 95% -0.29, 0.85 , p = 0,97, grasa corporal: SMD = 2,77, IC 95% -0,05, 5,59, p = 0,92, masa corporal: SMD = 1,22, IC 95% -0,29, 2,74, p = 0,11). Conclusión: Hubo una superioridad de los resultados del entrenamiento en dispositivos convencionales solo para la variable masa grasa. Para las otras variables, no se encontraron diferencias estadísticamente significativas. La resistencia elástica es capaz de promover resultados similares a la resistencia convencional en diferentes perfiles de población y de varios protocolos sobre variables relacionadas con la composición corporal.

Níveis de ansiedade, depressão e estresse em funcionários de uma instituição de ensino superior pública do interior do estado de São Paulo / Anxiety, depression and stress among employees of a public higher education institution in São Paulo, Brazil

Introdução: A saúde do trabalhador ganha destaque em âmbito científico, sendo tema de pesquisas e debates internacionais, apresentando o estresse laboral como potencial agente estressor. Objetivo: Caracterizar a incidência de sintomatologia referente à ansiedade e à depressão correlacionada aos níveis socioeconômicos em servidores técnico-administrativos de uma universidade estadual do estado de São Paulo. Métodos: A amostra foi composta de 89 participantes. Os dados foram obtidos por meio do inventário de sintomas de estresse para adultos de Lipp, para detectar o nível de estresse; da escala hospitalar de ansiedade e depressão, para análise de ansiedade e depressão; e de um questionário informativo para detectar o nível educacional e sociodemográfico. Resultados: Verificou-se que 47% dos participantes apresentaram sintomas de ansiedade e 39% de depressão, não havendo relação direta com o nível socioeconômico. Além disso, observou-se que, entre os indivíduos que apresentavam ansiedade, 50% eram docentes, e, do total de indivíduos com depressão, 38,4% eram do setor administrativo. O estresse encontra-se em maior escala nas categorias ensino superior (29,6%) e pós-graduados (33,3%). Conclusões: Os achados demonstraram elevada prevalência de ansiedade e depressão em todas as classes socioeconômicas investigadas. Ademais, indivíduos de nível educacional elevado são mais estressados que os de nível educacional inferior.

Background: Occupational health is increasing in visibility within the scientific community and has become a field of international research and discussions in which occupational stress is described as a possible stressor. Objective: To analyze the relationship between anxiety and depression symptoms and socioeconomic level among technical-administrative employees of a public university in the state of São Paulo, Brazil. Methods: The sample comprised 89 participants. Data were obtained through Lipp's Inventory of Stress Symptoms for adults to identify levels of stress and the Hospital Anxiety and Depression scale. An additional questionnaire was administered to gather information on educational and socioeconomic levels. Results: About 45% of the participants exhibited symptoms of anxiety and 39% of depression, however, without direct relationship with their socioeconomic level. Among the participants with depression 50% were professors, and among those with depression 38.4% were administrative employees. Stress was more frequent among the participants who had attended higher education (29.6%) and graduate studies (33.3%). Conclusion: The study results indicate a high prevalence of anxiety and depression regardless of the socioeconomic level of the participants. Stress was more frequent among the participants with higher educational level.

Effects of training with elastic resistance versus conventional resistance on muscular strength: A systematic review and meta-analysis.

Given the practicality and low cost of using elastic resistance in training for different populations and its effectiveness in a range of outcomes, a comparison with conventional devices could clarify and quantify the benefits provided by both mode. To compare the effects of resistance training with elastic devices (tubes and Thera-Bands) and conventional devices (weight machines and dumbbells) on the outcome muscular strength. A search was performed in the databases PubMed/MEDLINE, EMBASE, PEDro (Physiotherapy Evidence Database), and CENTRAL (Cochrane Central Register of Controlled Trials) from the earliest records up to 20 December 2017. Data were pooled into a meta-analysis and described as standardized mean difference with a 95% confidence interval (registration number: CRD42016042152). Eight studies were included. The results of the meta-analysis demonstrated no superiority between the methods analyzed for lower limb (SMD = -0.11, 95% CI -0.40, 0.19, p = 0.48) or upper limb muscular strength (SMD=0.09; 95% CI -0.18, 0.35; p = 0.52) [corrected]. Elastic resistance training is able to promote similar strength gains to conventional resistance training, in different population profiles and using diverse protocols.

Anxiety, depression and stress among employees of a public higher education institution in São Paulo, Brazil.

BACKGROUND: Occupational health is increasing in visibility within the scientific community and has become a field of international research and discussions in which occupational stress is described as a possible stressor. OBJECTIVE: To analyze the relationship between anxiety and depression symptoms and socioeconomic level among technical-administrative employees of a public university in the state of São Paulo, Brazil. METHODS: The sample comprised 89 participants. Data were obtained through Lipp's Inventory of Stress Symptoms for adults to identify levels of stress and the Hospital Anxiety and Depression scale. An additional questionnaire was administered to gather information on educational and socioeconomic levels. RESULTS: About 45% of the participants exhibited symptoms of anxiety and 39% of depression, however, without direct relationship with their socioeconomic level. Among the participants with depression 50% were professors, and among those with depression 38.4% were administrative employees. Stress was more frequent among the participants who had attended higher education (29.6%) and graduate studies (33.3%). CONCLUSION: The study results indicate a high prevalence of anxiety and depression regardless of the socioeconomic level of the participants. Stress was more frequent among the participants with higher educational level.

INTRODUÇÃO: A saúde do trabalhador ganha destaque em âmbito científico, sendo tema de pesquisas e debates internacionais, apresentando o estresse laboral como potencial agente estressor. OBJETIVO: Caracterizar a incidência de sintomatologia referente à ansiedade e à depressão correlacionada aos níveis socioeconômicos em servidores técnico-administrativos de uma universidade estadual do estado de São Paulo. MÉTODOS: A amostra foi composta de 89 participantes. Os dados foram obtidos por meio do inventário de sintomas de estresse para adultos de Lipp, para detectar o nível de estresse; da escala hospitalar de ansiedade e depressão, para análise de ansiedade e depressão; e de um questionário informativo para detectar o nível educacional e sociodemográfico. RESULTADOS: Verificou-se que 47% dos participantes apresentaram sintomas de ansiedade e 39% de depressão, não havendo relação direta com o nível socioeconômico. Além disso, observou-se que, entre os indivíduos que apresentavam ansiedade, 50% eram docentes, e, do total de indivíduos com depressão, 38,4% eram do setor administrativo. O estresse encontra-se em maior escala nas categorias ensino superior (29,6%) e pós-graduados (33,3%). CONCLUSÕES: Os achados demonstraram elevada prevalência de ansiedade e depressão em todas as classes socioeconômicas investigadas. Ademais, indivíduos de nível educacional elevado são mais estressados que os de nível educacional inferior.

Specific interventions for prevention of muscle injury in lower limbs: systematic review and meta-analysis / Intervenções específicas para prevenção de lesão muscular em membros inferiores: revisão sistemática e meta-análise / Intervenciones específicas para la prevención de lesiones musculares en miembros inferiores: revisión sistemática y meta-análisis

Abstract Introduction: Muscle injuries show an incidence associated with extreme stretching, or even a high-intensity eccentric contraction. Such injuries cause severe damage to athletes, including lower performance, withdrawal, and psychological distress. In this scenario, the study of effective preventive methods is an indispensable factor in the routine of professional athletes, to reduce the incidence of injuries. Objective: To verify the effectiveness of three different interventions (warm-up, neuromuscular training, and eccentric exercise) to prevent muscle injuries in the lower limbs. Method: We searched the Cochrane Library, EMBASE, SPORTDiscus, PEDro, and PubMed databases from the earliest records until January 20, 2018. The search was performed from word combinations such as clinical trial, muscle strain, injury prevention. The data related to the outcome of prevention were grouped in meta-analysis and described in Risk Ratio (RR) with 95% confidence interval. Results: Sixteen studies were included: five assessed eccentric exercise, three investigated neuromuscular training, and eight observed warm-up. The eccentric exercise (RR = 3.49, 95% CI 2.36, 5.16, p < 0.00001) and the neuromuscular training (RR = 2.73, 95% CI 2.03, 2.68, p < 0.00001) showed significant effects on the prevention of muscle injuries in lower limbs. On the other hand, warm-up (RR = 1.57, 95% CI 0.92, 2.7, p = 0.10) was irrelevant in reducing the incidence of injuries in the body segment investigated. Conclusion: The outcomes presented provide clinical relevance inherent in the field practices, with intrinsic potential for practical application in the management of specific preventive techniques.

Resumo Introdução: Lesões musculares apresentam incidência associada à alongamento extremo, ou ainda, a uma contração excêntrica de alta intensidade. Tais lesões, acarretam prejuízos graves aos atletas que incluem queda de rendimento, afastamento e transtornos psicológicos. Neste cenário, o estudo de métodos preventivos eficazes, constituem fator indispensável na rotina de atletas profissionais, a fim de, reduzir a incidência de lesões. Objetivo: Verificar a eficácia de três diferentes intervenções (aquecimento, treinamento neuromuscular e exercício excêntrico) para prevenção de lesões musculares em membros inferiores. Método: Foram pesquisadas as bases de dados Cochrane Library, EMBASE, Sports Discus, PEDro e PubMed desde os registros mais antigos até 20 de janeiro de 2018. A busca foi realizada a partir de combinações de palavras, como, clinical trial, muscle strain, injury prevention. Os dados relacionados ao desfecho prevenção foram agrupados em meta-análise e descritos em Risk Ratio (RR) com intervalo de confiança de 95%. Resultados: Foram incluídos 16 estudos. Destes, cinco avaliaram o exercício excêntrico, três investigaram o treino neuromuscular e oito observaram o aquecimento. O exercício excêntrico (RR = 3.49; 95% CI 2.36, 5.16; p < 0.00001) e o treino neuromuscular (RR = 2.73; 95% CI 2.03, 2.68; p < 0.00001) demonstram efeitos significativos na prevenção de lesões musculares em membros inferiores. Por outro lado, o aquecimento (RR = 1.57; 95% CI 0.92, 2.7; p = 0.10) mostrou-se irrelevante na diminuição da incidência de lesões no segmento corporal investigado. Conclusão: Os desfechos apresentados fornecem relevância clínica inerente as práticas de campo, com potencial intrínseco para aplicação prática no manejo de técnicas preventivas específicas.

Resumen Introducción: Lesiones musculares presentan incidencia asociada al estiramiento extremo, o, a una contracción excéntrica de alta intensidad. Tales lesiones, acarrean graves daños a los atletas que incluyen caída de rendimiento, alejamiento y trastornos psicológicos. En este escenario, el estudio de métodos preventivos eficaces, constituyen un factor indispensable en la rutina de atletas profesionales, a fin de reducir la incidencia de lesiones. Objetivo: Verificar la eficacia de tres diferentes intervenciones (calentamiento, entrenamiento neuromuscular y ejercicio excéntrico) para prevención de lesiones musculares en miembros inferiores. Método: Se ha investigado la base de datos Cochrane Library, EMBASE, Sports Discus, PEDRO y PubMed desde los registros más antiguos hasta el 20 de enero de 2018. La búsqueda se realizó a partir de combinaciones de palabras, como, trial trial, prevención de la prevención. Los datos relacionados con el desenlace de prevención se agruparon en metaanálisis y se describieron em Risk Ratio (RR) con un intervalo de confianza del 95%. Resultados: Se incluyeron 16 estudios. De ellos, cinco evaluaron el ejercicio excéntrico, tres investigaron el entrenamiento neuromuscular y ocho observaron el calentamiento. El ejercicio excéntrico (RR = 3.49, 95% CI 2.36, 5.16, p < 0.00001) y el entrenamiento neuromuscular (RR = 2.73, 95% CI 2.03, 2.68, p < 0.00001) demuestran efectos significativos en la prevención de lesiones musculares en miembros inferiores. Por otro lado, el calentamiento (RR = 1.57, 95% CI 0.92, 2.7, p = 0.10) se mostró irrelevante en la disminución de la incidencia de lesiones en el segmento corporal investigado. Conclusión: Los resultados presentados proporcionan relevancia clínica inherente a las prácticas de campo, con potencial intrínseco para aplicación práctica en el manejo de técnicas preventivas específicas.

Test-retest reliability of knee extensors endurance test with elastic resistance.

BACKGROUND: Reliable clinical tests capable of measuring resistance are important tools for rehabilitation. One alternative that has recently increased in popularity is the use of elastic tubes, which stand out for being easy to handle, low cost, practical, and feasible. OBJECTIVE: Analyze the test-retest reliability of the knee extensors muscle fatigue resistance test (FRT) with elastic tubes. METHODS: A total of 116 healthy young males, aged between 18 and 30 years old, participated in the study. Participants performed three pre-test stages: orientation, load presentation, and familiarization with equipment, lasting two weeks. Subsequently, they performed the FRT on two occasions (test and retest), with an interval of seven days. The reliability analyzes were performed using the intraclass correlation coefficient (ICC) with 95% confidence interval and typical measurement error (TME), also expressed as coefficient of variation (CV%). RESULTS: The findings regarding the reliability of the test demonstrated satisfactory values (time: ICC = 0.66; 95%CI [0.50; 0.76]; CV(%) = 9.34; repetition: ICC = 0.61; 95%CI [0.46; 0.73], CV(%) = 13.66; rhythm: ICC = 0.52; 95%CI [0.35; 0.67], CV(%) = 10.29. CONCLUSION: From the findings presented, it is concluded that the proposed clinical test with elastic tubes demonstrates evidence of acceptable values.