Manual myofascial release and muscle energy enhances trunk flexibility and strength in recreationally resistance-trained women: Cross-over study.

The purpose of this study was to compare the effects of myofascial release and muscle energy on acute outcomes in trunk extensors active range-of-motion and strength in recreationally resistance-trained women. Seventeen apparently healthy women performed three experimental protocols using a cross-over, randomized (counterbalanced in Latin Square format), and within-subjects design: a) range-of-motion and strength test after a manual myofascial release protocol (MFR); b) flexibility and strength test after a muscle energy protocol (ME); and c) range-of-motion and strength test without myofascial release or muscle energy (control condition). Active trunk range-of-motion was measured via a sit-and-reach test and trunk extension strength via isometric dorsal dynamometer. A significant increase in range-of-motion was found for MFR (p = 0.002; d = 0.71) and ME (p < 0.001; d = 0.47) when comparing post-intervention with baseline values. Similarly, a significant increase for strength was found for MFR (p = 0.018; d = 0.10) when comparing post-intervention with baseline values. In conclusion, both techniques (MFR and ME) improved trunk range-of-motion with the sit and reach test immediately post-intervention; however, MFR showed greater magnitude increases in range-of-motion (MFR: (medium magnitude) vs ME: small magnitude). Due to the potential health implications, both (MFR and ME) responses should be among the many considerations for rehabilitation and performance exercise prescription when prescribing an exercise regimen.

Whole-body vibration improves the functional parameters of individuals with metabolic syndrome: an exploratory study.

BACKGROUND: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increases the cardiovascular risk. Regular physical exercise can promote benefits, but the MetS individuals are demotivated to perform it. Thus, new possibilities are important as an alternative intervention. The whole-body vibration can be considered an exercise modality and would be a safe and low-cost strategy to improve functional parameters of individuals in different clinical conditions. The aim of this exploratory study was to assess effects of whole-body vibration on functional parameters of MetS individuals. The hypothesis of this work was that the whole-body vibration could improve the functionality of MetS individuals. METHODS: Twenty-two individuals performed the intervention. The vibration frequency varied from 5 to 14 Hz and the peak-to-peak displacements, from 2.5 to 7.5 mm. Each session consisted of one minute-bout of working time followed by a one minute-bout of passive rest in each peak-to-peak displacement for three-times. The whole-body vibration protocol was applied twice per week for 5 weeks. Data from the trunk flexion, gait speed, sit-to-stand test and handgrip strength were collected. Physiological parameters (blood pressure and heart rate) were also evaluated. The Wilcoxon Rank test and Student t-test were used. RESULTS: No significant changes (p > 0.05) were observed in physiological parameters (arterial blood pressure and heart rate). Significant improvements were found in trunk flexion (p = 0.01), gait speed (p = 0.02), sit-to-stand test (p = 0.005) and handgrip strength (p = 0.04) after the whole-body vibration. CONCLUSIONS: In conclusion, whole-body vibration may induce biological responses that improve functional parameters in participants with MetS without interfering in physiological parameters, comparing before and after a 5-week whole-body vibration protocol. TRIAL REGISTRATION: Register in the Registro Brasileiro de Ensaios Clínicos (ReBEC) with the number RBR 2bghmh (June 6th, 2016) and UTN: U1111-1181-1177. (virgula).

Monitoring bone changes due to calcium, magnesium, and phosphorus loss in rat femurs using Quantitative Ultrasound.

Bone mineral density is an important parameter for the diagnosis of bone diseases, as well as for predicting fractures and treatment monitoring. Thus, the aim of the present study was to evaluate the potential of Quantitative Ultrasound (QUS) to monitor bone changes after calcium, phosphorus, and magnesium loss in rat femurs in vitro during a demineralization process. Four quantitative ultrasound parameters were estimated from bone surface echoes in eight femur diaphysis of rats. The echo signals were acquired during a decalcification process by Ethylenediaminetetraacetic Acid (EDTA). The results were compared to Quantitative Computed Tomography (QCT) and inductively coupled plasma optical emission spectrometry measurements for validation. Integrated Reflection Coefficient (IRC) reflection parameters and Frequency Slope of Reflection Transfer Function (FSRTF) during demineralization tended to decrease, while the backscattering parameter Apparent Integrated Backscatter (AIB) increased and Frequency Slope of Apparent Backscatter (FSAB) showed an oscillatory behavior with no defined trend. Results indicate a clear relation between demineralization and the corresponding decrease in the reflection parameters and increase in the scattering parameters. The trend analysis of the fall curve of the chemical elements showed a better relationship between IRC and QCT. It was possible to monitor bone changes after ions losses, through the QUS. Thus, it is an indication that the proposed protocol has potential to characterize bone tissue in animal models, providing consistent results towards standardization of bone characterization studies by QUS endorsing its use in humans.

Can early hepatic fibrosis stages be discriminated by combining ultrasonic parameters?

In this study, we put forward a new approach to classify early stages of fibrosis based on a multiparametric characterization using backscatter ultrasonic signals. Ultrasonic parameters, such as backscatter coefficient (Bc), speed of sound (SoS), attenuation coefficient (Ac), mean scatterer spacing (MSS), and spectral slope (SS), have shown their potential to differentiate between healthy and pathologic samples in different organs (eye, breast, prostate, liver). Recently, our group looked into the characterization of stages of hepatic fibrosis using the parameters cited above. The results showed that none of them could individually distinguish between the different stages. Therefore, we explored a multiparametric approach by combining these parameters in two and three, to test their potential to discriminate between the stages of liver fibrosis: F0 (normal), F1, F3, and/without F4 (cirrhosis), according to METAVIR Score. Discriminant analysis showed that the most relevant individual parameter was Bc, followed by SoS, SS, MSS, and Ac. The combination of (Bc, SoS) along with the four stages was the best in differentiating between the stages of fibrosis and correctly classified 85% of the liver samples with a high level of significance (p<0.0001). Nevertheless, when taking into account only stages F0, F1, and F3, the discriminant analysis showed that the parameters (Bc, SoS) and (Bc, Ac) had a better classification (93%) with a high level of significance (p<0.0001). The combination of the three parameters (Bc, SoS, and Ac) led to a 100% correct classification. In conclusion, the current findings show that the multiparametric approach has great potential in differentiating between the stages of fibrosis, and thus could play an important role in the diagnosis and follow-up of hepatic fibrosis.

Efeitos do Método Pilates sobre a variabilidade da frequência cardíaca, flexibilidade e variáveis antropométricas em indivíduos sedentários / Effects of the Pilates Method on heart rate variability, flexibility and anthropometric variables in sedentary subjects

O objetivo deste estudo foi avaliar os efeitos do Método Pilates sobre a variabilidade da frequência cardíaca, na flexibilidade e nas variáveis antropométricas em indivíduos sedentários. O presente estudo contou com 14 voluntárias do sexo feminino, na faixa etária entre 40 e 55 anos, que realizaram 20 sessões de exercícios do Método Pilates, duas vezes por semana, com duração de 45 minutos cada sessão, dividida em três fases: repouso, exercício e recuperação. As variáveis estudadas foram: os dados antropométricos, flexibilidade avaliada utilizando o teste de sentar-e-alcançar com o Banco de Wells, e intervalos R-R usando um cardiotacômetro. O processamento dos sinais da frequência cardíaca foi efetuado em ambiente MatLab 6.1®, utilizando a TWC. Os dados coletados foram submetidos ao teste de normalidade de Shapiro Wilk e foi utilizado o teste de Wilcoxon e Anova One Way (α = 0,05). Nos resultados, observou-se que não houve diferenças significativas entre os valores antropométricos e de frequência cardíaca, porém houve aumento da flexibilidade com o treinamento. Comparando a primeira e a Artigo original vigésima sessão com relação aos parâmetros low frequency (LF), high frequency (HF), e relação LF/HF, não houve diferença na fase de repouso e foram constatadas diferenças significativas de LF (p = 0,04) e HF (p = 0,04) na fase de exercício e diferença significativa de LF/ HF (p = 0,05) na fase de recuperação. Comparando os parâmetros nos períodos de repouso, exercícios e recuperação durante a primeira sessão e durante a vigésima sessão, não houve diferença significativa nos parâmetros LF, HF e LF/HF. Pode-se concluir que, em relação à flexibilidade, foi observada uma melhora significativa, enquanto a análise da frequência cardíaca caracterizou a intensidade do exercício de 50% da capacidade funcional das voluntárias. Em relação aos parâmetros LF, HF e LF/HF foram observados um aumento da variabilidade da frequência cardíaca, provavelmente produto da atividade do Método Pilates. A Transformada Wavelet (TWC) mostrou-se um Método adequado para as análises da variabilidade da frequência cardíaca. (AU)

The aim of this study was to evaluate the effects of the Pilates method on cardiovascular system through heart rate analysis with Continuous Wavelet Transformation (CWT). In the present study, 14 women, 40 to 55 years old, performed 20 sets of Pilates method exercises twice a week with duration of 45 minutes each set divided in three phases: rest, exercise and recovery. The studied variables were anthropometric data, flexibility which was evaluated using the sit-and-reach test (bench of wells), heart frequency which was monitored through a model s810i (Polar) cardiotachometer and the RR intervals were stored. The signals processing of the FC was computed in MatLab 6.1® environment, utilizing the CWT. The collected data were analyzed using Shapiro Wilk normality test and Wilcoxon and Anova One Way (α = 0.05) tests to compare the parameters. There were no significant differences between anthropometric values and heart rate; however there was an increase in flexibility. Comparing the parameters during the phases rest, exercise and recovery in the first and later in the last session, it was not observed statistically significant changes in heart frequency. Regarding to low frequency (LF), high frequency (HF) and LF/HF parameters, there was no significant difference. Significant differences of LF (p = 0.04) and HF (p = 0.04) were reported in exercise phase and significant difference (p = 0.05) in recovery phase. There was no significant difference in LF, HF and LF/HF parameters in the resting periods, exercises and recovery in the first and twentieth set. In relation to flexibility, a significant improvement was observed, while the heart rate analysis characterized the intensity of the exercise of fifty per cent of the functional capacity of the subjects. In relation to LF, HF and LF/HF parameters, a VFC increase was reported, result of Pilates method activity. The CWT showed itself an adequate method for the heart rate frequency analysis. (AU)

Whole body vibration exercises and the improvement of the flexibility in patient with metabolic syndrome.

Vibrations produced in oscillating/vibratory platform generate whole body vibration (WBV) exercises, which are important in sports, as well as in treating diseases, promoting rehabilitation, and improving the quality of life. WBV exercises relevantly increase the muscle strength, muscle power, and the bone mineral density, as well as improving the postural control, the balance, and the gait. An important number of publications are found in the PubMed database with the keyword "flexibility" and eight of the analyzed papers involving WBV and flexibility reached a level of evidence II. The biggest distance between the third finger of the hand to the floor (DBTFF) of a patient with metabolic syndrome (MS) was found before the first session and was considered to be 100%. The percentages to the other measurements in the different sessions were determined to be related to the 100%. It is possible to see an immediate improvement after each session with a decrease of the %DBTFF. As the presence of MS is associated with poorer physical performance, a simple and safe protocol using WBV exercises promoted an improvement of the flexibility in a patient with MS.

Experimental and simulation results on the effect of cortical bone mineralization in ultrasound axial transmission measurements: a model for fracture healing ultrasound monitoring.

Ultrasound axial transmission (UAT), a technique using propagation of ultrasound waves along the cortex of cortical bones, has been proposed as a diagnostic technique for the evaluation of fracture healing. Quantitative ultrasound parameters have been reported to be sensitive to callus changes during the regeneration process. The aim of this work was to identify the specific effect of cortical bone mineralization on UAT measurements by means of numerical simulations and experiments using a reverse fracture healing approach. A cortical bovine femur sample was used, in which a 3mm fracture gap was drilled. A 3mm thick cortical bone slice, extracted from another location in the bone sample, was submitted to a progressive demineralization process with EDTA during 12 days. UAT measurements and simulations using a 1MHz probe were performed with the demineralized slice placed into the fracture gap to mimic different stages of mineralization during the healing process. The calcium loss of the slice due to the EDTA treatment was recorded everyday, and its temporal evolution could be modeled by an exponential law. A 50MHz scanning acoustic microscopy was also used to assess the mineralization degree of the bone slice at the end of the intervention. These data were used in the numerical simulations to derive a model of the time evolution of bone slice mechanical properties. From both the experiments and the simulations, a significant and progressive increase in the time of flight (TOF; p<0.001) of the propagating waves measured by UAT was observed during the beginning of the demineralization process (first 4 days). Although the simulated TOF values were slightly larger than the experimental ones, they both exhibited a similar time-dependence, validating the simulation approach. Our results suggest that TOF measured in axial transmission is affected by local changes of speed of sound induced by changes in local mineralization. TOF may be an appropriate indicator to monitor callus maturation.

Computational evaluation of the compositional factors in fracture healing affecting ultrasound axial transmission measurements.

This work aimed at computationally evaluating the compositional factors in fracture healing affecting ultrasound axial transmission (UAT), using four numerical daily-changing healing models, representing more realistic clinical conditions. Using two-dimensional (2-D) simulations, a 1-MHz source and a receiver were positioned parallel to the bone surface to detect the first arriving signal (FAS). The time-of-flight of the FAS (TOF(FAS)) was found to be sensitive only to superficial modifications in the propagation path. It was also shown that callus mature bone better explained alone the variation in TOF(FAS) (R(2) >or= 0.70, p < 0.001). Better TOF(FAS) predictions are obtained when using the callus composition inside cortical fracture gap (R(2) = 0.98, p < 0.01). Callus composition could not well explain the changes in energy attenuation. These results suggest that UAT may be an important clinical tool for fracture healing assessment, identifying callus degree of mineralization and possible consolidation delays and nonunions.

Characterization of pseudarthrosis with ultrasound backscattered signals in rats.

PURPOSE: To propose a novel model of pseudarthrosis in a small animal and to investigate the ability of backscatter parameters from ultrasound signals in differentiating normal bone from those ones with pseudarthrosis. METHODS: Twelve Rattus norvegicus albinus free from pathogenic species (SPF) were randomly divided in two groups, with six animals each. In the Control group a surgical approach to the femur was made, followed by the synthesis of the muscle and skin layers. The Experimental group was submitted to an osteotomy of the femur and a vascularized flap of the fascia lata was interposed in the line of the fractured bone. Then the alignment and bone stabilization were accomplished, by using nylon stitch in U shape introduced in holes made in the proximal and distal fractured bone. Bone samples were scanned with ultrasound and signals were collected for each one to analyze the parameter Apparent Integrated Backscatter - AIB. RESULTS: Radiological and anatomopathologic studies revealed the absence of bone consolidation with persistence of fiber-osteoid tissue. Values of the ultrasound parameter AIB from normal bones were statistically different from those with pseudarthrosis. CONCLUSION: The experimental model was suitable for pseudarthrosis development in rats and the ultrasound backscatter parameters were able to identify such a bone disease in vitro.

Characterization of pseudarthrosis with ultrasound backscattered signals in rats / Caracterização da pseudoartrose com sinais de retroespalhamentos de ultrassom em ratos

PURPOSE: To propose a novel model of pseudarthrosis in a small animal and to investigate the ability of backscatter parameters from ultrasound signals in differentiating normal bone from those ones with pseudarthorsis. METHODS: Twelve Rattus norvegicus albinus free from pathogenic species (SPF) were randomly divided in two groups, with six animals each. In the Control group a surgical approach to the femur was made, followed by the synthesis of the muscle and skin layers. The Experimental group was submitted to an osteotomy of the femur and a vascularized flap of the fascia lata was interposed in the line of the fractured bone. Then the alignment and bone stabilization were accomplished, by using nylon stitch in U shape introduced in holes made in the proximal and distal fractured bone. Bone samples were scanned with ultrasound and signals were collected for each one to analyze the parameter Apparent Integrated Backscatter - AIB. RESULTS: Radiological and anatomopathologic studies revealed the absence of bone consolidation with persistence of fiber-osteoid tissue. Values of the ultrasound parameter AIB from normal bones were statistically different from those with pseudarthrosis. CONCLUSION: The experimental model was suitable for pseudarthrosis development in rats and the ultrasound backscatter parameters were able to identify such a bone disease in vitro.

OBJETIVO: Propor um novo modelo de pseudoartrose em animais de pequeno porte e investigar o potencial de parâmetros de retroespalhamento de ultrassônico em diferenciar osso normal e com pseudoartrose. MÉTODOS: Doze Rattus norvegicus albinus (SPF) foram distribuídos aleatoriamente em dois grupos, tendo cada grupo seis animais. No grupo Controle realizou-se uma abordagem cirúrgica ao fêmur, seguida da síntese por planos do músculo e da pele. O grupo Experimental foi submetido à osteotomia do fêmur aduzida da confecção de um retalho pediculado de fascia lata para interposição entre os segmentos resultantes da fratura induzida cirurgicamente. Prosseguiu-se com o alinhamento e estabilização óssea, mediante a confecção de um nó com fio de náilon em formato de U, introduzido em orifícios efetuados nas extremidades proximal e distal à fratura. As amostras ósseas foram irradiadas pelo ultrassom e sinais foram coletados para cada uma no intuito de analisar o parâmetro Retroespalhamento Integrado Aparente - AIB. RESULTADOS: Estudos radiológicos e anatomopatológicos evidenciaram a ausência de consolidação óssea com persistência de tecido fibro-osteóide. Os valores de AIB para ossos normais foram estatisticamente diferentes em relação aos ossos com pseudoartrose. CONCLUSÃO: O modelo experimental apresentou-se adequado para a formação de pseudoartrose em ratos e o parâmetro de retroespalhamento de ultrassom foi capaz de detectar tal doença óssea, in vitro.

Há preferência pelo sexo do fisioterapeuta para a terapia? / Is there a preference regarding physical therapist gender for therapy?

A relação médico-paciente tem sido estudada, principalmente no que se refere à escolha do profissional. Entretanto, não há na literatura referências à relação fisioterapeuta-paciente, na qual envolve maior contato físico. Este estudo visa identificar se haveria uma preferência pelo sexo do fisioterapeuta, na possível iminência de tratamento. Um questionário foi desenvolvido, validado e aplicado a 800 estudantes universitários. As perguntas principais foram quanto à preferência pelo sexo do profissional nas situações: fisioterapia em membros, tronco e genitália ou áreas adjacentes. Para análise, utilizou-se teste qui-quadrado (p < 0,05) e análise de homogeneidade com 3 dimensões. Os resultados mostraram que a maioria dos respondentes não se importaria com o sexo. Em terapia em áreas genitais, há mais mulheres que preferem uma mulher fisioterapeuta (p < 0,01). Homens não diferem nas três situações (p ≤ 0,01). Há correspondência entre as perguntas sobre tratamento em membros e tronco, mas pode diferir em genitália.

The physician-patient relation has been studied, mainly regarding to the choice for a therapist. However, there is no literature references on physical therapist-patient relation, which involves more physical contact. This study aims to identify whether there is a preference for therapist gender in the possible imminence of treatment. A questionnaire was developed, validated and applied to 800 university students. The main questions were related to the preference for therapist gender in the following situations: physical therapy in limbs, trunk and genital or adjacent areas. For analysis, chi-square test (p < 0,05) and homogeneity analysis with 3 dimensions were used. The results show that the majority of respondents would not care about gender. In genital areas therapy, there are more women that prefer a female physical therapist (p < 0,01). Men do not disagree in all situations (p ≤ 0,01). There is correspondence between questions about limbs and trunk treatment, but it may differ in genital therapy.

Characterization of in vitro healthy and pathological human liver tissue periodicity using backscattered ultrasound signals.

This work studied the periodicity of in vitro healthy and pathologic liver tissue, using backscattered ultrasound (US) signals. It utilized the mean scatterer spacing (MSS) as a parameter of tissue characterization, estimated by three methods: the spectral autocorrelation (SAC), the singular spectrum analysis (SSA) and the quadratic transformation method (SIMON). The liver samples were classified in terms of tissue status using the METAVIR scoring system. Twenty tissue samples were classified in four groups: F0, F1, F3 and F4 (five samples for each). The Kolmogorov-Smirnov test (applied on group pairs) resulted as nonsignificant (p > 0.05) for two pairs only: F1/F3 (for SSA) and F3/F4 (for SAC). A discriminant analysis was applied using as parameters the MSS mean (MSS) and standard deviation (sigmaMSS), the estimates histogram mode (mMSS), and the speed of US (mc(foie)) in the medium, to evaluate the degree of discrimination among healthy and pathologic tissues. The better accuracy (Ac) with SAC (80%) was with parameter group (MSS, sigmaMSS, mc(foie)), achieving a sensitivity (Ss) of 92.3% and a specificity (Sp) of 57.1%. For SSA, the group with all four parameters showed an Ac of 75%, an Ss of 78.6% and an Sp of 66.70%. SIMON obtained the best Ac of all (85%) with group (MSS, mMSS, mc(foie)), an Ss of 100%, but with an Sp of 50%.

Proposta de um metodo de avaliaçao de variaveis temporais da marcha usando microfones: resultado preliminares em individuos saudaveis / Proposal of an assessment method of gait temporal variables using microphones: preliminary results with health subjects

A avaliaçao quantitativa da marcha quase sempre representa um procedimento dificil e caro, devido á necessidade de equipamentos complexos e de alto custo. O objetivo desse trabalho é desenvolver um algoritmo capaz de estimar as variaveis temporais da marcha, assim como fornecer estatisticas basicas, usando a gravaçao do som proveniente de microfones, colocados um em cada pe do individuo, uma vez que esse dispositivo pode captar o toque do calcanhar no chao no inicio do passo. Para a obtençao de resultados preliminares, foram recrutados individuos aparentemente saudaveis, sem nenhum disturbio locomotor visivel. Os resultados mostram uma consistencia nas estimativas. Apesar de apresentar algumas limitaçoes, o novo metodo se mostra promissor, capacitando fisioterapeutas a seguir continuamente o progresso de pacientes, sem dificuldade consideraveis.