Interaction of Biomechanical, Anthropometric, and Demographic Factors Associated with Patellofemoral Pain in Rearfoot Strike Runners: A Classification and Regression Tree Approach.

BACKGROUND: Patellofemoral pain (PFP) is among the most common injuries in runners. While multiple risk factors for patellofemoral pain have been investigated, the interactions of variables contributing to this condition have not been explored. This study aimed to classify runners with patellofemoral pain using a combination of factors including biomechanical, anthropometric, and demographic factors through a Classification and Regression Tree analysis. RESULTS: Thirty-eight runners with PFP and 38 healthy controls (CON) were selected with mean (standard deviation) age 33 (16) years old and body mass index 22.3 (2.6) kg/m2. Each ran at self-selected speed, but no between-group difference was identified (PFP = 2.54 (0.2) m/s x CON = 2.55 (0.1) m/s, P = .660). Runners with patellofemoral pain had different patterns of interactions involving braking ground reaction force impulse, contact time, vertical average loading rate, and age. The classification and regression tree model classified 84.2% of runners with patellofemoral pain, and 78.9% of healthy controls. The prevalence ratios ranged from 0.06 (95% confidence interval: 0.02-0.23) to 9.86 (95% confidence interval: 1.16-83.34). The strongest model identified runners with patellofemoral pain as having higher braking ground reaction force impulse, lower contact times, higher vertical average loading rate, and older age. The receiver operating characteristic curve demonstrated high accuracy at 0.83 (95% confidence interval: 0.74-0.93; standard error: 0.04; P < .001). CONCLUSIONS: The classification and regression tree model identified an influence of multiple factors associated with patellofemoral pain in runners. Future studies may clarify whether addressing modifiable biomechanical factors may address this form of injury.

Effects of two gait retraining programs on pain, function, and lower limb kinematics in runners with patellofemoral pain: A randomized controlled trial.

BACKGROUND: Patellofemoral Pain (PFP) is one of the main injuries in runners. Consistent evidence support strengthening programs to modulate symptoms, however, few studies investigated the effects of gait retraining programs. OBJECTIVE: To investigate the effects of two different two-week partially supervised gait retraining programs on pain, function, and lower limb kinematics of runners with PFP. METHODS: Randomized controlled trial. Thirty runners were allocated to gait retraining groups focusing on impact (n = 10) or cadence (n = 10), or to a control group (n = 10). Impact group received guidance to reduce tibial acceleration by 50%, while cadence group was asked to increase cadence by 7.5-10%. The control group did not receive any intervention. Usual and running pain, knee function, and lower limb kinematics (contralateral pelvic drop, hip adduction, knee flexion, ankle dorsiflexion, tibia inclination, and foot inclination) were evaluated before (T0), immediately after the intervention (T2), and six months after the protocol (T24). RESULTS: A significant group x time interaction was found for running pain (p = 0.010) and knee function (p = 0.019). Both programs had greater improvements in running pain compared to no intervention at T24 (Impact x Control-mean difference (MD) -3.2, 95% CI -5.1 to -1.3, p = 0.001; Cadence x Control-MD -2.9, 95% CI -4.8 to -1.0, p = 0.002). Participants of the impact group had greater improvements in knee function compared to no intervention at T2 (Impact x Control-MD 10.8, 95% CI 1.0 to 20.6, p = 0.027). No between-group differences in usual pain and lower limb kinematics were found (p>0.05). CONCLUSION: Compared to no intervention, both programs were more effective in improving running pain six months after the protocol. The program focused on impact was more effective in improving knee function immediately after the intervention. Clinical trial registry number: RBR-8yb47v.

Atletas de Taekwondo apresentam desequilíbrio muscular entre os músculos flexores e extensores do joelho: achados preliminares / Taekwondo athletes have muscle imbalance between knee flexors and extensions: preliminary findings / Los atletas de Taekwondo presentan un desequilibrio muscular entre los flexores y los extensores de la rodilla: hallazgos preliminares

Durante a prática de taekwondo com movimentos repetitivos, sistematizados e com certa sobrecarga de treino, o indivíduo pode gerar possíveis adaptações orgânicas que resultam em problemas posturais com grandes chances de desencadear desequilíbrio muscular. Objetivo: Verificar a presença de desequilíbrio entre os grupos musculares agonistas e antagonistas da articulação do joelho e entre membros dominantes e não dominantes de praticantes de taekwondo por meio da dinamometria isocinética. Método: Estudo transversal, observacional e descritivo realizado com nove praticantes de taekwondo do sexo masculino. Utilizou-se um dinamômetro isocinético para investigar o pico de torque, pico de torque por peso corporal, trabalho total, potência média, relação agonista/antagonista e índice de fadiga. Os dados dos membros dominante e não dominante foram comparados por meio do teste t-student para amostras pareadas. Foram calculados o intervalo de confiança de 95% da diferença média, o tamanho de efeito e o poder das análises. Resultados: Os músculos extensores dos membros dominante e não dominante apresentaram diferença média significante de 15,49 Nm (IC95% 7,27; 23,70; p=0,002) para pico de torque e de 22,64% (IC95% 11,83; 33,46; p=0,001) para pico de torque por peso corporal a 60°/s, representando tamanho de efeito médio. Conclusão: Os atletas de taekwondo apresentaram maior pico de torque e maior pico de torque por peso corporal dos músculos extensores do joelho a 60º/s no lado dominante. A relação agonista/ antagonista foi inferior a 60% e mais da metade dos atletas apresentaram uma diferença maior que 10% no pico de torque flexor no lado não dominante.

During taekwondo practice with the repetitive motions, systematized and with certain training overload, the person can generate possible organic adaptations that result in postural problems with a great chances of triggering muscle imbalance. Objective: To verify the presence of imbalance between agonist and antagonist muscle groups of knee joint and between dominant and non-dominant limbs through isokinetic dynamometry. Methods: Cross-sectional, observational and descriptive study realized with nine male taekwondo practitioners. An isokinetic dynamometer was used to investigate the peak torque, peak torque by body weight, total work, average power, agonist/antagonist ratio and fatigue index. Data from the dominant and non-dominant limbs were compared by t-student test for pared samples. The 95% confidence interval of the mean difference, the effect size and the power of analyses power were calculated. Results: The extensor muscles of the dominant and non-dominant limbs showed mean difference of 15,49 Nm (IC95% 7,27; 23,70; p=0,002) for peak torque and of 22,64% (IC95% 11,83; 33,46; p=0,001) for peak torque by body weight at 60°/s, representing average effect size. Conclusion: The taekwondo athletes had higher peak torque and higher peak torque by body weight of the knee extensors muscles in the dominant side. The agonist/ antagonist ratio was less than 60% and more than half of the athletes showed a difference greater than 10% in the peak flexor torque on the non-dominant side.

Durante la práctica de taekwondo con los movimientos repetitivos, sistematizados y con cierta sobrecarga de entrenamiento, la persona puede generar posibles adaptaciones orgánicas que deriven en problemas posturales con grandes posibilidades de desencadenar desequilibrios musculares. Objetivo: Verificar la presencia de desequilibrio entre grupos musculares agonistas y antagonistas de la articulación de la rodilla y entre miembros dominantes y no dominantes mediante dinamometría isocinética. Métodos: Estudio transversal, observacional y descriptivo realizado con nueve practicantes masculinos de taekwondo. Se utilizó un dinamómetro isocinético para investigar el par máximo, el par máximo por peso corporal, el trabajo total, la potencia media, la relación agonista/antagonista y el índice de fatiga. Los datos de las extremidades dominantes y no dominantes se compararon mediante la prueba t- student para muestras de pared. Se calcularon el intervalo de confianza del 95% de la diferencia media, el tamaño del efecto y la potencia de los análisis. Resultados: Los músculos extensores de los miembros dominantes y no dominantes mostraron una diferencia media de 15,49 Nm (IC95% 7,27; 23,70; p=0,002) para el par máximo y de 22,64% (IC95% 11,83; 33,46; p=0,001) para el par máximo por peso corporal a 60°/s, lo que representa el tamaño medio del efecto. Conclusiones: Los atletas de taekwondo presentaron un mayor par máximo y un mayor par máximo por peso corporal de los músculos extensores de la rodilla en el lado dominante. La relación agonista/antagonista fue inferior al 60% y más de la mitad de los atletas mostraron una diferencia superior al 10% en el pico de par flexor en el lado no dominante.

Comparison of the upper extremity physical performance tests between asymptomatic adults with and without scapular dyskinesis

Abstract Introduction Physical performance tests (PPTs) are screening tools widely available, easy to apply, and that can be performed in different environments and contexts. Scapular dyskinesis can be related to changes in glenohumeral angulation, acromioclavicular joint strain, subacromial space dimension, shoulder muscle strength/activation and humeral position/motion. Few studies were developed to understand the influence of aspects such as strength, stability mobility, and scapular dyskinesis on the scores of the upper extremity PPTs. Objective To compare the performance in the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), Seated Medicine Ball Throw Test (SMBT) and Upper Quarter Y Balance Test (UQYBT) between asymptomatic adults with and without scapular dyskinesis. Methods Cross-sectional study with 20 asymptomatic individuals: 10 with scapular dyskinesis and 10 without scapular dyskinesis. The average number of touches, number of touches normalized by height, and power score in the CKCUEST, distance covered by the ball in the SMBT, reach in the medial, inferolateral, and superolateral directions, total excursion and composite score of the UQYBT were compared between both groups. Results No significant differences were found for all variables (p > 0.05). Small to moderate effect sizes were found for the scores of the CKCUEST (d = 0.16-0.78), a small effect size was found for the distance in the SBMT (d = 0.12), and small to moderate effect sizes were found for the scores of the UQYBT (d = 0.02-0.43). The scapular dyskinesis group presented better performance in all tests. Conclusion The presence of scapular dyskinesis in asymptomatic individuals is not a factor related to worse scores in upper extremity physical performance tests.

Resumo Introdução Os testes de desempenho físico (PPTs) são instrumentos de triagem amplamente disponíveis, de fácil aplicação e que podem ser realizados em diferentes ambientes e contextos. A discinesia escapular pode estar relacionada a alterações na angulação glenoumeral, tensão na articulação acromioclavicular, dimensão do espaço subacromial, força/ativação muscular do ombro e posição/movimento umeral. Poucos estudos foram desenvolvidos para entender a influência de aspectos como força, estabilidade, mobilidade e discinese escapular nos escores dos PPTs de membros superiores. Objetivo Comparar o desempenho no Teste de Estabilidade de Extremidade Superior de Cadeia Cinética Fechada (CKCUEST), Teste de Arremesso de Medicine Ball Sentada (SMBT) e Teste de Equilíbrio em Y do Quarto Superior (UQYBT) entre adultos assintomáticos com e sem discinesia escapular. Métodos Estudo transversal com amostra de 20 indivíduos assintomáticos: 10 com discinesia escapular e 10 sem discinesia escapular. Comparou-se o número médio de toques, número de toques normalizados pela altura e pontuação de potência no CKCUEST, distância percorrida pela bola no SMBT, alcance nas direções medial, inferolateral e superolateral, excursão total e escore composto do UQYBT entre ambos os grupos. Resultados Não foram encontradas diferenças significativas para todas as variáveis (p > 0,05). Tamanho de efeito pequeno a moderado foi encontrado para os escores do CKCUEST (d = 0,16-0,78), tamanho de efeito pequeno foi encontrado para a distância no SBMT (d = 0,12) e tamanho de efeito pequeno a moderado foi encontrado para as pontuações do UQYBT (d = 0,02-0,43). O grupo com discinesia escapular apresentou melhor desempenho em todos os testes. Conclusão A pre-sença de discinesia escapular em indivíduos assintomáticos não é um fator relacionado a piores escores em testes de desempenho físico de membros superiores.

Prevalência de quadros álgicos em praticantes de brazilian jiu-jitsu / Prevalence of algic conditions in brazilian jiu-jitsu practitioners / Prevalencia de condiciones álgicas em practicantes brazilian de jiu-jitsu

Objetivo: Identificar a prevalência de queixas álgicas em praticantes de Brazilian Jiu-Jitsu (BJJ), as queixas que levaram ao afastamento dos treinamentos e as queixas de lesões prévias. Métodos: Trata-se de um estudo transversal, observacional e descritivo que incluiu praticantes regulares de BJJ do sexo masculino, com idades entre 18 e 40 anos. Foi elaborado um questionário para identificar o perfil dos praticantes: idade, graduação, tempo de prática da arte marcial, frequência de treinos, prática de outras atividades física e frequência. Para a investigação das queixas álgicas, foi aplicado o Questionário Nórdico de Sintomas Osteomusculares ­ QNSO, versão em português adaptada. Os dados foram registrados no programa Microsoft Excel 365 e foi realizada estatística descritiva. Resultados: Os 52 participantes da pesquisa possuíam idade média de 32 anos e tempo médio de 9 anos de prática de Jiu-Jitsu, 50% deles possuía graduação de faixa azul. Os praticantes apresentaram 45 relatos de queixas na semana anterior a aplicação do QNSO, 76 relatos no ano anterior, 43 relatos que levaram os praticantes a se afastarem do treinamento e 20 relatos de lesões prévias no ano anterior. Conclusão: A maior prevalência de queixas nos 7 dias prévios a aplicação do QNSO, ocorreu em joelhos, coluna lombar e quadril-coxas, e nos 12 meses prévios ocorreu em joelhos, coluna lombar e ombros. A maior prevalência que levou os praticantes ao afastamento dos treinamentos nos 12 meses prévios ocorreu em joelhos, coluna lombar e tornozelo-pés, e as queixas de lesões prévias ocorreram em joelhos, punhos e ombros.

Objective: To identify the prevalence of pain complaints in Brazilian Jiu- Jitsu (BJJ) practitioners, the complaints that led to withdrawal from training and the complaints of previous injuries. Methods: This is a cross-sectional, observational and descriptive study that included regular male BJJ practitioners aged between 18 and 40 years. A basic questionnaire was created to collect variables: age, graduation, time practicing martial art, frequency of training, practice of other physical activities and frequency. For the investigation of pain complaints, the Nordic Questionnaire of Musculoskeletal Symptoms - NQSO, adapted Portuguese version, was applied. Data were recorded in the Microsoft Excel 365 program and descriptive statistics were performed. Results: The 52 research participants had average an age of 32 years old and average time of 9 years of BJJ practice, 50% of them were blue belt graduation. The practitioners presented 45 reports of complaints in the week before the application of NQSO, 76 reports in previous year, 43 reports that led to withdrawal training and 20 reports of previous injuries in the previous year. Conclusion: The highest prevalence of complaints in the previous 7 days of the application of NQSO occurred in the knees, lumbar spine and hip- thighs, and in the previous 12 months occurred in the knees, lumbar spine and shoulders. The major prevalence that led to withdrawal training in the previous 12 month occurred in the knees, lumbar spine and ankle-foots, and the complaints of previous injuries occurred in the knees, wrists and shoulders.

Objetivo: Identificar la prevalencia de quejas de dolor en practicantes de Brazilian Jiu-Jitsu (BJJ), las quejas que llevaron a la retirada del entrenamiento y las quejas de lesiones anteriores. Métodos: Se trata de un estudio transversal, observacional y descriptivo que incluyó practicantes regulares de BJJ del sexo masculino, con edades entre 18 y 40 años. Se elaboró un cuestionario para identificar el perfil de los practicantes: edad, grado, tiempo de práctica del arte marcial, frecuencia de entrenamiento, práctica de otras actividades físicas y frecuencia. Para la investigación de las quejas de dolor, se aplicó el Cuestionario Nórdico de Síntomas Musculoesqueléticos ­ CNSO, versión portuguesa adaptada. Los datos se registraron en el programa Microsoft Excel 365 y se realizó estadística descriptiva. Resultados: Los 52 participantes de la investigación tenían una edad promedio de 32 años y un tiempo promedio de práctica de BJJ de 9 años, el 50% de ellos tenían graduación de cinturón azul. Los practicantes presentaron 45 reportes de denuncias en la semana anterior a la aplicación de la CNSO, 76 reportes en el año anterior, 43 reportes que llevaron a los practicantes a retirarse del entrenamiento y 20 reportes de lesiones anteriores en el año anterior. Conclusión: La mayor prevalencia de quejas en los 7 días previos a la aplicación de la CNSO se presentó en rodillas, columna lumbar y cadera-muslos, y en los 12 meses anteriores se presentó en rodillas, columna lumbar y hombros. La prevalencia más alta que llevó a los practicantes a retirarse del entrenamiento en los 12 meses anteriores ocurrió en rodillas, columna lumbar y tobillo-pie, y las quejas de lesiones previas ocurrieron en rodillas, muñecas y hombros.

Conhecimento, interesse e preferência por programas de retreinamento de corrida em corredores de rua: estudo transversal / Conocimiento, interés y preferencia por programas de reentrenamiento de corrida en los corredores de calle: un estudio transversal / Knowledge, interest, and preference for gait retraining programs in street runners: a cross-sectional study

RESUMO Com o intuito de prevenir ou reabilitar lesões musculoesqueléticas relacionadas à corrida, algumas modalidades de tratamento têm sido utilizadas, entre elas o retreinamento de corrida. O objetivo deste estudo foi avaliar o conhecimento, o interesse e a preferência acerca de programas de retreinamento de corrida por parte de corredores de rua e verificar se esses aspectos diferem entre corredores sem e com histórico de lesão. Trata-se de estudo transversal feito com 100 corredores. Inicialmente, um texto mostrando do que se tratava o retreinamento de corrida foi apresentado aos participantes, que então responderam com relação ao conhecimento (sim ou não) e ao interesse na realização (sim ou não). Posteriormente, um texto mostrando como seria a realização de um programa supervisionado e outro parcialmente supervisionado foi apresentado aos participantes, que responderam acerca de sua preferência por um deles (supervisionado ou parcialmente supervisionado). Constatou-se que a maioria desconhece os programas de retreinamento de corrida (69,8%), porém houve um alto interesse (87,1%) na realização do programa após a leitura do texto. Os participantes não apresentaram preferência por um protocolo totalmente supervisionado (48,2%) ou parcialmente supervisionado (51,8%). Foi encontrada uma diferença estatística quanto ao conhecimento (p=0,029) a favor dos participantes com histórico de lesão. Apesar das crescentes evidências disponíveis, observou-se que a maioria dos corredores não tem conhecimento prévio sobre esta modalidade. Devido ao alto interesse e à ausência de preferência por diferentes protocolos, sugere-se que os programas descritos sejam apresentados aos pacientes por profissionais da saúde que trabalhem com essa população.

RESUMEN Con el propósito de prevenir o rehabilitar las lesiones musculoesqueléticas relacionadas con la carrera, el reentrenamiento de carrera es una de las modalidades de tratamiento. El objetivo de este estudio fue evaluar el conocimiento, el interés y la preferencia por los programas de reentrenamiento de carrera por parte de corredores de calle, así como verificar si estos aspectos difieren entre los corredores sin antecedentes de lesiones o con. Se trata de un estudio transversal, realizado con 100 corredores. Inicialmente, los participantes recibieron un texto sobre el reentrenamiento de corrida y, luego, respondieron acerca del conocimiento (sí o no) y el interés por hacerlo (sí o no). Enseguida, los participantes recibieron un texto sobre cómo aplicar un programa supervisado y otro sobre el programa parcialmente supervisado, y respondieron su preferencia por uno de ellos (supervisado o parcialmente supervisado). Se constató que la mayoría de los respondientes desconoce los programas de reentrenamiento de corrida (69,8%), pero hubo un gran interés (87,1%) por aplicar el programa después de la lectura del texto. Los participantes no mostraron preferir un protocolo totalmente supervisado (48,2%) o parcialmente supervisado (51,8%). Se encontró una diferencia estadística en cuanto al conocimiento (p=0,029) sobre los participantes con antecedentes de lesión. A pesar de la creciente y disponible evidencia, se observó que la mayoría de los corredores no tienen conocimiento previo de esta modalidad. Debido al gran interés y la falta de preferencia por uno de los protocolos, los programas descritos deberían de ser presentados a los pacientes por los profesionales de la salud que trabajan con esta población.

ABSTRACT Some treatment modalities have been used to prevent or treat running-related musculoskeletal injuries, among them, gait retraining. This study aimed to evaluate street runners' knowledge, interest, and preference for gait retraining programs and assess if these aspects differ between runners with and without history of injury. This is a cross-sectional study with 100 runners. Initially, a text showing what gait retraining was about was presented to participants. Then, they answered questions about their knowledge (yes x no) and interest (yes x no) on the programs. Subsequently, a text showing how fully and partially supervised programs would be conducted was offered to participants. Then, they reported their preference for one of them (fully x partially supervised). We found that most athletes were unaware of gait retraining programs (69.8%), though they showed great interest in performing them after explanation (87.1%). We observed no preference for a fully (48.2%) or partially supervised (51.8%) protocol. We also found a statistical difference in knowledge (p=0.029) in favor of participants with history of injury. Despite the growing evidence available, we observed that most runners lack any prior knowledge of this modality. Due to the great interest and lack of preference for different protocols shown, we suggest that healthcare providers who treat this population offer the programs described to patients.

Reliability and validity of the One Arm Hop Test and Seated Medicine Ball Throw Test in young adults: A cross-sectional study.

BACKGROUND: Functional performance tests are inexpensive, accessible, and easy to apply tools that can be used to help practitioners in daily decision making process. The purpose of this study was to evaluate the reliability and validity of the One Arm Hop Test (OAHT) and Seated Medicine Ball Throw Test (SBMT) in young adults. METHODS: Cross-sectional study with a sample consisted of 59 young adults. The subjects performed the OAHT and SMBT in two moments separated by seven days and by two examiners. The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) was performed at the second moment. The time in OAHT, distance in SMBT, mean number of touches, normalized score, and power of the CKCUEST were measured. Reliability was determined using Intraclass Correlation Coeficient (ICC) and Bland-Altman Plots. Validity was assessed via Pearson's Correlation Coefficient (r) between these tests and CKCUEST. RESULTS: We found good reliability of the OAHT between different raters (dominant limb - ICC = 0.83; non-dominant limb - ICC = 0.80) and moderate reliability between the same rater (dominant limb - ICC = 0.63; non-dominant limb - ICC = 0.62). In the SMBT we found good reliability inter-examiner (ICC = 0.84) and intra-examiner (ICC = 0.77). Low to moderate correlations with the CKCUEST were found (r < 0.70; p < 0.05). CONCLUSIONS: The OAHT and the SMBT show moderate/good reliability intra and inter-examiner, however these tests are poorly correlated with CKCUEST. The SMBT presented higher values of ICC than OAHT. A combination of the SMBT and CKCUEST is recommended in clinical practice.

Effects of gait retraining with focus on impact versus gait retraining with focus on cadence on pain, function and lower limb kinematics in runners with patellofemoral pain: Protocol of a randomized, blinded, parallel group trial with 6-month follow-up.

Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14-MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.

Effects of Kinesio Taping on peak torque and muscle activity in women with low back pain presenting fears and beliefs related to physical activity.

BACKGROUND: KT is an elastic taping that has been widely used as an adjunct to conventional physiotherapy. The purpose of this study was to evaluate the effects of Kinesio Taping on peak torque, muscle fatigue index and muscle activity of erector spinae in women with low back pain presenting fears and beliefs related to physical activity. METHODS: This is a pilot controlled clinical trial. The subjects were divided into two groups according to the Fear Beliefs Avoidance Questionnaire (FABQ): Group A (Patients with no fears and/or beliefs related to physical activity) and Group B (Patients with fears and/or beliefs related to physical activity). The Kinesio Taping was applied in "I" in order to facilitate erector spinae. An isokinetic dynamometer and a surface electromyography were used to evaluate the outcomes. The evaluations were performed without and with the KT. RESULTS: Sample of 16 women equally divided into two groups with similar characteristics regarding age, weight, height, body mass index, functional capacity and pain levels in the evaluations without and with Kinesio Taping. There were within-groups and between-groups differences in the peak torque (p ≤ .05), with better results in the Group B. No differences were found on muscle fatigue index and muscle activity in both groups (p > .05). CONCLUSION: It was concluded that Kinesio Taping had immediate effects in the peak torque of the erector spinae of women with nonspecific chronic low back pain presenting fears and beliefs related to physical activity. It is suggested that such results occurred by placebo effect. NCT: RBR-5xh3ch.

The immediate effect of thumb orthoses on upper extremity's movement: A kinematic analysis of five unique devices.

BACKGROUND: Thumb orthoses are a standard treatment modality, with substantial evidence to support its usage for multiple conditions affecting the upper extremity. Despite commonly prescribed, little is known about the immediate impact of such devices on the upper extremity, including potential modifications on motor patterns. RESEARCH QUESTION: We aimed to determine the changes in the upper limb kinematics during the usage of thumb orthotics, comparing differences in orthotic design, length, and fabrication materials. METHODS: In this cross-sectional study, subjects performed a standardized reaching task and the placing subtest of the Minnesota Manual Dexterity Test (MMDT) while wearing five unique thumb orthoses. Besides the active range of motion of the shoulder, elbow, wrist and hand joints, movement smoothness (Number of Movement Units-NMU), speed, and motion control strategies were analyzed through eight Qualisys Oqus 300 cameras (Qualisys AB, Göteborg, Sweden). FINDINGS: Ten non-disabled, university students participated in this study. Despite differences in fabrication materials, all orthotics reduced thumb's abduction (13.3° to 4.3°), and metacarpophalangeal flexion (11.5° to 4.2°). Although orthotics impacted movement smoothness and hand function during its usage, forearm-based devices further increased the NMUs and the time required for the MMDT performance (Control: NMU = 4.8, MMDT = 58.1; Long Orthotics: NMU = 6.6, MMDT = 78.2), while short, flexible orthoses provided thumb stabilization without significant impact on upper extremity movement strategies. SIGNIFICANCE: Although joint stabilization was similar among orthotics fabricated with rigid and flexible materials, the improved hand dexterity observed during the use of flexible devices suggests an advantage of flexible orthotics for enhanced stability and hand function. These results can assist healthcare professionals during the selection and prescription of thumb orthotics, providing information not only on the range of motion but other sensorimotor aspects involved in upper extremity movement patterns that may be affected by orthotics usage.

Hyperelastic tape modifies the kinematics of the pronated foot in young women: self-controlled clinical trial / A bandagem hiperelástica modifica a cinemática do pé pronado em mulheres jovens: ensaio clínico autocontrolado

Abstract Introduction: Excessive pronation has been linked to increased risk of developing lower limb injuries. In this respect, assessing the effectiveness of therapeutic resources, such as hyperelastic taping, becomes relevant. Objective: evaluate the influence of adhesive hyperelastic taping on excessive pronation of the ankle-foot complex in young women. Method: Self-controlled clinical trial of ten women with excessive pronation (Foot Posture Index ≥ 6). Three-dimensional gait was assessed according to the Vicon Oxford Foot Model before and after taping. Hyperelastic tape was applied on the side with greater pronation (experimental side) and the opposite side was used as control (control side). The segments evaluated were the hindfoot, midfoot and forefoot. The Shapiro-Wilk normality, paired t and Wilcoxon tests were applied and Significance was set at p <0.05. Results: No change (p> 0.05) was observed in the hindfoot on the experimental or control side; the midfoot showed a decrease in arch height (p <0.05) only on the experimental side; forefoot eversion (p <0.05) declined only on the experimental side. Conclusion: The use of hyperelastic tape reduced forefoot eversion; however, this decrease is not clinically desirable, since excessive pronation in a closed chain increased in the sample of young women studied.

Resumo Introdução: A pronação excessiva tem sido relacionada ao aumento do risco de desenvolver lesões nos membros inferiores. Nesse sentido, verificar a efetividade de recursos terapêuticos, como a bandagem hiperelástica, tornou-se relevante. Objetivo: Avaliar a influência da bandagem hiperelástica na pronação excessiva do pé em mulheres jovens. Método: Ensaio clínico autocontrolado, no qual participaram dez mulheres com pronação excessiva (Foot Posture Index ≥ 6). Realizou-se então a avaliação tridimensional da marcha de acordo com o modelo Oxford Foot Model da Vicon em dois momentos: antes e após a bandagem. Foi aplicada bandagem hiperelástica no lado com maior pronação (lado experimental) e o lado oposto foi utilizado como controle (lado controle). Quanto aos segmentos avaliados, estes foram o retropé, antepé e mediopé. Para análise dos dados aplicou-se o teste de normalidade Shapiro Wilk, testes t pareado e Wilcoxon. E o nível de significância foi considerado como p<0,05. Resultados: No retropé não foi verificada mudança (p>0,05) no lado experimental ou controle; no mediopé foi observado redução da altura do arco (p<0,05) somente no lado experimental, porém sem diferença entre grupos (p>0,05); e no antepé foi observado redução da eversão (p<0,05) somente no lado experimental. Conclusão: A aplicação utilizada de bandagem hiperelástica reduziu a eversão do antepé, porém essa redução não é desejável clinicamente, uma vez que em cadeia fechada a pronação excessiva aumenta na amostra de mulheres jovens estudadas.

Sintomas osteomioarticulares em bombeiros militares do Distrito Federal / Osteomioarticular symptoms in military fire fighters of the Federal District

Objetivo: Verificar a prevalência de sintomas osteomioarticulares em bombeiros militares do Distrito Federal. Metódo: Trata-se de um estudo transversal, realizado com bombeiros militares de idades entre 18 e 55 anos. Foi utilizado o Questionário Nórdico de Sintomas Osteomusculares e os participantes relataram a ocorrência dos sintomas nos 12 meses e nos sete dias precedentes à entrevista, bem como os afastamentos das atividades no último ano. Os dados foram tabulados no programa Microsoft Excel 2016 e foi feita a estatística descritiva. Resultados: Dos 178 bombeiros participantes, 89% eram do sexo masculino, com idade média de 39 anos e média do índice de massa corporal de 25,93. As regiões de maior prevalência foram a região lombar (20,90%), seguida dos joelhos (14,24%) e da região dorsal (12,26%) nos últimos 12 meses e a região lombar (20,35%), seguida dos joelhos (16,48%) e dos ombros (11,97%) nos últimos sete dias. Conclusão: Verificou-se maior prevalência de sintomas osteomioarticulares na região lombar, joelhos e região dorsal para alterações crônicas, e maior prevalência de sintomas na região lombar, joelhos e ombros para alterações agudas. Os bombeiros apontaram como causas a realização de força, fadiga e/ou cansaço, posturas mantidas por um longo período de tempo, movimentos bruscos e movimentos repetitivos.

Objective: Verify the prevalence of osteomioarticular symptoms in military firefighters in the Federal District. Method: This is a cross-sectional study with military firefighters aged between 18 and 55 years. The Nordic Osteomuscular Symptoms Questionnaire was used and the participants reported the occurrence of symptoms in the 12 months and seven days preceding the interview, as well as the withdrawal of the activities in the last year. The data were tabulated in the Microsoft Excel 2016 program and the descriptive statistics were made. Results: Of the 178 firefighters involved, 89% were males, with a mean age of 39 years and a mean body mass index of 25.93. The regions with the highest prevalence were the lumbar region (20.90%), followed by the knees (14.24%) and the dorsal region (12.26%) in the last 12 months and the lumbar region (20.35%), followed by knees (16.48%) and shoulders (11.97%) in the last seven days. Conclusion: There was a higher prevalence of osteomioarticular symptoms in the lumbar region, knees and dorsal region for chronic changes, and a higher prevalence of symptoms in the lower back, knees and shoulders for acute changes. The firefighters pointed as causes of force, fatigue and /or tiredness, postures maintained for a long period of time, sudden movements and repetitive movements.

Effects of Kinesio Taping on the muscular performance of women with chronic lower back pain / Efeitos da Kinesio Taping no desempenho muscular de mulheres com dor lombar crônica

Nonspecific chronic back pain is defined as a pain in the lumbar region lasting more than 12 weeks, that is not relatedto specific pathologies. Several resources have been used to treat the different aspects of these patients (pain, disability,mobility, strength, endurance, psychological factors, limitation of activities and restrictions in participation), amongthese, elastic bandages such as Kinesio Taping (KT). The aim of this study was to evaluate the immediate effects ofKinesio Taping on muscle strength, activity, and fatigue of spinal erectors of subjects with nonspecific chronic lowerback pain. An isokinetic dynamometer and a surface electromyograph were used to evaluate the study outcomes. Theforce was measured by means of the peak torque, the activity was through the Root Mean Square and the muscularfatigue was by the median frequency. The Kinesio Taping elastic bandage was applied in an “I” for aiding the spineerectors according to the recommendations of the method. The subjects were evaluated with and without the KTbandage. The data were analyzed in the SPSS (Statistical Package for Social Sciences) version 23.0 considering p0.05). It was concluded that elastic bandaging does notpresent immediate effects on muscle strength, activity, and fatigue of the spinal erectors of subjects with nonspecific chronic lower back pain

A dor lombar crônica inespecífica é definida como uma dor na região lombar com duração maior que 12 semanas, quenão está relacionada a patologias específicas. Diversos recursos têm sido utilizados para tratar os diferentes aspectosdestes pacientes (dor, incapacidade, mobilidade, força, resistência, fatores psicológicos, limitações nas atividades erestrição à participação), entre estes as bandagens elásticas como a Kinesio Taping (KT). O objetivo do estudo foi avaliaros efeitos imediatos da Kinesio Taping sobre a força, atividade e fadiga muscular dos eretores da espinha de sujeitos comdor lombar crônica inespecífica. Utilizou-se um dinamômetro isocinético e um eletromiógrafo de superfície para avaliaros desfechos do estudo. A força foi mensurada por meio do pico de torque, a atividade por meio do Root Mean Square ea fadiga muscular pela frequência mediana. A bandagem elástica Kinesio Taping foi aplicada em “I” para facilitação doseretores da espinha seguindo as recomendações do método. Os sujeitos foram avaliados sem e com a bandagem KT. Osdados foram analisados no SPSS (Statistical Package for Social Sciences) versão 23.0 considerando-se p0,05). Conclui-se que a bandagem elástica não apresenta efeitos imediatos sobre a força, atividade efadiga muscular dos eretores da espinha de sujeitos com dor lombar crônica inespecífica

Kinesio Taping effects with different directions and tensions on strength and range of movement of the knee: a randomized controlled trial.

OBJECTIVE: To evaluate the Kinesio Taping effects with different directions and tensions on the strength of rectus femoris and range of movement of the knee in healthy individuals, but with a muscle imbalance caused by exposure to a continuous vibration. METHODS: This is a randomized controlled trial. The subjects were randomly allocated into two groups: Group application of the Kinesio Taping using origin to insertion and Group application of the Kinesio Taping using insertion to origin. In both groups the dominant limb received the application of Kinesio Taping on rectus femoris (experimental limb) while the non-dominant limb was used as control of the study (control limb). Three assessments were carried out with each subject at different time-points (baseline, post-application, 24h later). These evaluations were performed with 0%, 10% and 75% of tension. The continuous vibration was conducted on the patella tendon for 20min before the first evaluation on each subject. A handheld dynamometer and a digital goniometer were used to evaluate the strength of the rectus femoris and the range of movement of the knee. RESULTS: The sample consisted of 42 subjects, 79% women and 21% men, mean age 20.5 (SD=4.6), body mass index average of 18.7 (SD=2.34). There were no between-group differences for all outcomes. CONCLUSION: This study suggests that the use of Kinesio Taping in healthy individuals did not change muscle strength or increase range of movement. Future clinical trials are recommended for symptomatic patients. TRIAL REGISTRATION: NCT02501915 (https://clinicaltrials.gov/ct2/show/NCT025019150).

Comparison of the mechanical properties of therapeutic elastic tapes used in sports and clinical practice.

STUDY DESIGN: Cross-sectional laboratory study. OBJECTIVE: The aim of the present study was to evaluate and compare the mechanical properties of different therapeutic elastic tapes used in sports and clinical practice. BACKGROUND: Therapeutic tapes have been used since around the 1800s. They are composed of cotton, elastic filaments and adhesive glue that provides an effect of tactile and mechanical stimulation. However, as taping has evolved, manufacturers have implemented new materials and claim that the tensile properties and adhesion of tapes contribute more significantly in the rehabilitation process. METHODS: Fifty samples of elastic tapes (5 different manufacturers; 10 samples from each manufacturer) were submitted to longitudinal traction until rupture as well as surface adherence assays. Information was recorded on maximum deformation, maximum load, maximum tension and relative stiffness. RESULTS: In tensile testing the bandages brand Kinesio Tex Gold - FP® showed higher rates, 3 in 4 properties. During surface adherence tests on the therapeutic elastic tapes the brand Premium Kinesiology 3 NS Tex® showed higher rates, 3 in 4 properties analyzed. CONCLUSIONS: Tapes from different manufacturers exhibit different characteristics regarding traction and adherence mechanics. Knowledge of these characteristics is fundamental for the optimized use of each tape based on specific therapeutic needs.

Differences in orthotic design for thumb osteoarthritis and its impact on functional outcomes: A scoping review.

BACKGROUND: Orthoses are a well-known intervention for the treatment of thumb osteoarthritis; however, there is a multitude of orthotic designs and not enough evidence to support the efficacy of specific models. OBJECTIVE: To examine the influence of different orthoses on pain, hand strength, and hand function of patients with thumb osteoarthritis. STUDY DESIGN: Literature review. METHODS: A scoping literature review of 14 publications reporting orthotic interventions for patients with thumb osteoarthritis was conducted. Functional outcomes and measures were extracted and analyzed. RESULTS: In total, 12 studies reported improvements in pain and hand strength after the use of thumb orthoses. Comparisons between different orthotic designs were inconclusive. CONCLUSION: The use of orthoses can decrease pain and improve hand function of patients with thumb osteoarthritis; however, the effectiveness of different orthoses still needs support through adequate evidence. Clinical relevance Multiple orthoses for thumb osteoarthritis are available. Although current studies support their use to improve pain and hand function, there is no evidence to support the efficacy of specific orthotic designs. Improved functional outcomes can be achieved through the use of short orthoses, providing thumb stabilization without immobilizing adjacent joints.

Aumento da fadiga e redução da qualidade de vida após tratamento de câncer do colo do útero / Increased fatigue and reduced quality of life after treatment of cervical cancer

Introdução: o câncer do colo do útero (CCU) acarreta prejuízos físicos e emocionais, sendo um grande problema de saúde pública. Objetivo: avaliar fadiga, capacidade funcional e qualidade de vida antes e após o tratamento com quimiorradioterapia para o CCU. Métodos: a avaliação de fadiga e qualidade de vida foi realizada por meio dos questionários: Inventário Breve de Fadiga (BFI) e Functional Assessment of Chronic Therapy ­ Cervix Cancer (FACT-Cx), respectivamente, já a capacidade funcional por mensuração direta pelo Teste do degrau (TD6). Participaram 11 mulheres com CCU. O Graphpad Prism® foi utilizado para estatística. Resultados: após a quimiorradioterapia houve aumento significativo da fadiga (de 2,80 para 4,83), redução significativa da qualidade de vida (de 107,8 para 88,1) e redução da capacidade funcional (de 91 degraus para 82 degraus). Conclusão: aumento da fadiga e redução da qualidade de vida foram observados uma semana após a realização de quimiorradioterapia para o CCU.

Introduction: cervical cancer (CC) causes physical and emotional damage and is a major public health problem. Objective: to evaluate fatigue, functional capacity and quality of life before and after treatment with chemoradiotherapy for CC. Method: the evaluation of fatigue and quality of life were performed through questionnaires the Brief Fatigue Inventory (BFI) and Functional Assessment of Chronic Therapy (FACT-Cx), respectively, and the functional capacity by direct measurement by the Test of the step (TD6). Eleven women participated with CC. Graphpad Prism® was used for statistics. Results: after chemoradiotherapy, there was a significant increase in fatigue (from 2.80 to 4.83), a significant reduction in quality of life (from 107.8 to 88.1) and reduction in functional capacity (from 91 steps to 82 steps). Conclusion: increased fatigue and reduced quality of life were observed one week after the completion of chemoradiotherapy for CC.

Terapia ocupacional na artrite reumatoide: o que o reumatologista precisa saber? / Occupational therapy in rheumatoid arthritis: what rheumatologists need to know?

Intervenções voltadas para a educação e o autogerenciamento da artrite reumatoide (AR) pelo paciente aumentam a adesão e a eficácia da abordagem precoce. A combinação de tratamento medicamentoso e tratamento de reabilitação visa a potencializar as possibilidades de intervenção, retardar o aparecimento de novos sintomas, reduzir incapacidades, minimizar sequelas e reduzir o impacto dos sintomas sobre a funcionalidade do paciente. A terapia ocupacional é uma profissão da área da saúde que objetiva a melhoria do desempenho de atividades pelo paciente e fornece meios para a prevenção de limitações funcionais, adaptação a modificações no cotidiano e manutenção ou melhoria de seu estado emocional e participação social. Devido ao caráter sistêmico da AR o acompanhamento multidisciplinar é necessário para o adequado manejo do impacto da doença sobre os mais diversos aspetos da vida do paciente. Como membro da equipe de saúde, o terapeuta ocupacional objetiva a melhoria e manutenção da capacidade funcional do paciente, prevenir o agravamento de deformidades, auxiliar o processo de compreensão e enfrentamento da doença, fornecer meios para as atividades necessárias para o engajamento do indivíduo em ocupações significativas, favorecer sua autonomia e independência em atividades de autocuidado, laborais, educacionais, sociais e de lazer. O objetivo desta revisão é familiarizar o reumatologista com as ferramentas de avaliação e intervenção usadas na terapia ocupacional, com enfoque na aplicação desses princípios para o tratamento de pacientes com diagnóstico de AR.

Interventions focusing on education and self-management of rheumatoid arthritis (RA) by the patient improves adherence and effectiveness of early treatment. The combination of pharmacologic and rehabilitation treatment aims to maximize the possibilities of intervention, delaying the appearance of new symptoms, reducing disability and minimizing sequelae, decreasing the impact of symptoms on patient's functionality. Occupational therapy is a health profession that aims to improve the performance of daily activities by the patient, providing means for the prevention of functional limitations, adaptation to lifestyle changes and maintenance or improvement of psychosocial health. Due to the systemic nature of RA, multidisciplinary follow-up is necessary for the proper management of the impact of the disease on various aspects of life. As a member of the health team, occupational therapists objective to improve and maintaining functional capacity of the patient, preventing the progression of deformities, assisting the process of understanding and coping with the disease and providing means for carrying out the activities required for the engagement of the individual in meaningful occupations, favoring autonomy and independence in self-care activities, employment, educational, social and leisure. The objective of this review is to familiarize the rheumatologist with the tools used for assessment and intervention in occupational therapy, focusing on the application of these principles to the treatment of patients with RA.

Lesões em atletas de futevôlei / Lesions in footvolley athletes / Lesiones en atletas de footvolley

O futevôlei é um esporte genuinamente brasileiro, com tradição de 50 anos, e até então não havia conhecimento da prevalência de lesões. Assim, os objetivos deste estudo foram analisar a ocorrência das lesões, identificar as regiões anatômicas acometidas e descrever o perfil dos praticantes. Métodos Usou-se o inquérito de morbidade referida adaptado. Participaram do estudo 69 atletas, de ambos os gêneros. Resultados Do total de praticantes, 27 relataram lesões durante a prática do futevôlei. Em relação às maiores prevalências por região anatômica, 19 lesionaram os membros inferiores (55,8%) e 11 a coluna vertebral (32,3%). Conclusão A ocorrência de lesões no futevôlei foi de 39,1%, com predomínio de lesões no gênero masculino e naqueles com maior tempo de prática. .

The Brazilian footvolley is a genuinely native sport, with a tradition of 50 years, and until then there was no knowledge of the prevalence of injuries. The objectives were to analyze the occurrence of injuries, identify the anatomical regions affected and describe the profile. Methods The reported morbidity questionnaire adapted was used. The study included 69 athletes of both sexes. Results From the total of athletes, 27 reported injuries during the practice. Regarding higher prevalence by anatomic region, 19 injured lower limbs (55.8%) and 11 the vertebral column (32.3%). Conclusion The occurrence of lesions in footvolley was 39.1%, with predominance of injuries in male athletes and those with longer time of practice. .

El futvoley es un deporte de tradición genuinamente brasileña, con 50 años, y hasta entonces no había conocimiento de la prevalencia de las lesiones. Los objetivos fueron analizar la incidencia de las lesiones, identificar las regiones anatómicas afectadas y describir el perfil de los jugadores. Métodos Se utilizó la encuesta de morbilidad adaptada. Resultados Del total de los atletas, 27 reportaron lesiones durante la práctica. En cuanto a una mayor prevalencia por región anatómica, 19 resultaron con heridas en las extremidades inferiores (55,8%) y 11 en la columna (32,3%). Conclusión La incidencia de lesiones en el futvoley fue del 39,1%, con un predominio de las lesiones en atletas masculinos y en aquellos con un mayor tiempo de práctica. .

[Occupational therapy in rheumatoid arthritis: what rheumatologists need to know?]. / Terapia ocupacional na artrite reumatoide: o que o reumatologista precisa saber?

Interventions focusing on education and self-management of rheumatoid arthritis (RA) by the patient improves adherence and effectiveness of early treatment. The combination of pharmacologic and rehabilitation treatment aims to maximize the possibilities of intervention, delaying the appearance of new symptoms, reducing disability and minimizing sequelae, decreasing the impact of symptoms on patient's functionality. Occupational therapy is a health profession that aims to improve the performance of daily activities by the patient, providing means for the prevention of functional limitations, adaptation to lifestyle changes and maintenance or improvement of psychosocial health. Due to the systemic nature of RA, multidisciplinary follow-up is necessary for the proper management of the impact of the disease on various aspects of life. As a member of the health team, occupational therapists objective to improve and maintaining functional capacity of the patient, preventing the progression of deformities, assisting the process of understanding and coping with the disease and providing means for carrying out the activities required for the engagement of the individual in meaningful occupations, favoring autonomy and independence in self-care activities, employment, educational, social and leisure. The objective of this review is to familiarize the rheumatologist with the tools used for assessment and intervention in occupational therapy, focusing on the application of these principles to the treatment of patients with RA.