Effects of an eight-week physical exercise program on low back pain and function in fruit workers: A randomized controlled trial.

BACKGROUND: Low back pain is prevalent in workers' health and functional performance. OBJECTIVE: To evaluate the effects of a physical exercise program on low back pain and disability in fruit workers. METHODS: This randomized controlled trial assigned 44 workers (37 ± 9 years) to two groups. The experimental group consisted of 10 men and 12 women with an average age of 38 (± 9) years, and the control group consisted of 8 men and 14 women with an average age of 36 (± 10) years. The experimental group (EG) performed a program of strength and flexibility exercises for eight weeks, twice a week. The control group (CG) received minimal care, with a booklet with guidelines for performing exercises. The primary outcomes included changes in perceived disability and the intensity of pain evaluated by the Rolland-Morris questionnaire and the Numerical Pain Scale, respectively. All outcomes were measured at baseline and after eight weeks of intervention. RESULTS: A significant difference was observed in the within-group analysis, with a mean reduction in pain intensity in the EG and CG of -4.55 (95%CI -7.01 to -2.09) and -3.81 (95%CI 1.72-5.90), respectively. For disability, a reduction of -4.45 (95% CI -8.89 to -0.02) was observed in the EG and of -4.43 (-7.38 to -1.48) in the CG. There were no significant differences in the between-groups analysis. CONCLUSIONS: The exercise program was not superior to using the educational booklet. However, both interventions showed substantial decreases in pain and disability levels.

Treinamento de força com e sem instabilidade não melhora os níveis gerais de capacidade intrínseca em idosos com queixas cognitivas / Resistance training with and without instability does not improve overall levels of intrinsic capacity in older adults with cognitive complaints

INTRODUÇÃO: Capacidade intrínseca (CI) é um construto que engloba capacidades físicas e mentais para o autocuidado e envelhecimento saudável. A compreensão do papel potencial do treinamento resistido, com e sem instabilidade, para promover o CI precisa ser esclarecida. OBJETIVO: Avaliar o impacto do treinamento de força sobre os níveis de capacidade intrínseca em idosos com queixas cognitivas. MÉTODOS: Idosos com queixas cognitivas (n=67) foram aleatoriamente designados para 12 semanas de TF tradicional (n=23), TF com dispositivos de instabilidade (TFI) (n=22) ou controle (n=22). Ambos os grupos de treinamento realizaram três séries de 10- 15 repetições. O grupo TFI realizou exercícios utilizando dispositivos de instabilidade. O grupo controle recebeu aulas semanais de educação em saúde. Os domínios da CI foram de mobilidade e velocidade da marcha (locomotora), função global e executiva (cognitivo), força de preensão e teste de caminhada de seis minutos (vitalidade), e sintomas depressivos e autoeficácia (psicológicos) por meio de escores-z compostos. Calculamos os níveis globais de CI pela soma de cada pontuação composta. RESULTADOS: Diferença significativa intragrupo nos níveis gerais de CI (∆TFI = +1.69, ∆TF = +1.30) e seus respectivos domínios (Locomoção: ∆TFI = +2.32, ∆TF = +3.21; Cognição: ∆TFI = +2.31; Vitalidade: ∆TFI = +1.23, ∆TF = +1.42; e Psicológico: ∆TFI = -0.65, ∆TF = -0.62). Contudo, não houve diferenças entre os grupos. Análise de sensibilidade mesclando os grupos de treinamento revelou diferença significativa para o domínio locomotor após 12 semanas (+1.97, p=0.045). CONCLUSÃO: Treinamento de força com e sem dispositivos de instabilidade não melhorou os níveis de CI em idosos com queixas cognitivas.

INTRODUCTION: Intrinsic capacity (IC) is a construct that encompasses physical and mental capacities important for self-care and healthy aging. Understanding the potential role of resistance training with and without instability to promote IC needs to be clarified. OBJECTIVE: To assess the impact of resistance training on intrinsic capacity levels in older adults with cognitive complaints. METHODS: Older adults with cognitive complaints (n=67) were randomly assigned to either 12 weeks of traditional RE (n=23), RE with instability devices (REI) (n=22), or control (n=22). Both training groups performed three sets of 10-15 repetitions. REI group performed each exercise using instability devices. The control group received weekly health education classes. IC domains were analyzed using mobility and gait velocity (locomotor), global and executive functioning (cognitive), grip strength and six-minute walking test (vitality), and depressive symptoms and self-efficacy (psychological) through z-composite scores. We computed global levels of IC by the sum of each composite score. RESULTS: A significant within-group difference (improvement) in overall levels of IC (∆REI = +1.69, ∆RE = +1.30) and all their domains (Locomotion: ∆REI = +2.32, ∆RE = +3.21; Cognition: ∆REI = +2.31; Vitality: ∆REI = +1.23, ∆RE = +1.42; and Psychological: ∆REI = -0.65, ∆RE = -0.62). However, no between-group differences were observed at the completion of the trial. Sensitivity analysis merging training groups revealed a between-group difference for the locomotor domain (+1.97, p=0.045). CONCLUSION: Resistance training with and without instability devices did not improve IC levels among older adults with cognitive complaints.

Can the Use of Unstable Surfaces and Instruction for Conscious Abdominal Contraction Increase the EMG Activity of the Periscapular Muscles During the Dynamic Push-Up?

CONTEXT: It is believed that conscious abdominal contraction (CAC) during exercise encourages greater periscapular activation through existing myofascial connections. On the other hand, it is postulated that the use of unstable surfaces would promote greater neuromuscular demand. OBJECTIVE: To analyze the effect of CAC on periscapular muscle activity during push-up plus exercise on stable and unstable surfaces and to evaluate the correlation between electromyographic (EMG) activity of the serratus anterior (SA) and abdominal oblique muscles. DESIGN: Repeated-measures design in a single group, pre-post CAC. SETTING: Biomechanics laboratory. PARTICIPANTS: Twenty-three male volunteers without a history of lesions in the upper limbs participated in the study. MAIN OUTCOME MEASURES: Five repetitions of push-ups on stable and unstable surfaces were performed with and without instruction for CAC. The normalized amplitude of the EMG activity was obtained from the muscles of the upper, middle, and lower trapezius, SA upper (SA_5th) and lower (SA_7th) portions, external oblique (EO), and internal oblique. RESULTS: CAC increased the activity of the EO, internal oblique, middle trapezius, and SA (P < .05) in both surfaces. The use of the unstable surface increased the EMG activity of the EO, SA_7th, and middle trapezius and decreased the EMG activity of the SA_5th. However, all changes observed in EMG signals were of low magnitude, with effect sizes lower than 0.45. There was a weak correlation between the EMG activity of the EO and SA_5th (r = .24) and a strong correlation between the EO and SA_7th (r = .70). CONCLUSION: The isolated use of CAC or unstable surface during push-up seems to present no practical relevance, but the combined use of these strategies may increase activation of the SA_7th and middle trapezius muscles.

Does the stretching intensity matter when targeting a range of motion gains? a randomized trial

Abstract Aims: To verify the effects of flexibility training conducted at different intensities in young adults. Methods: Twenty-one (21) young adults of both genders with no history of surgery, fracture, and/or rheumatic diseases in the lower limbs and hip, were randomly assigned to low intensity (LI) or high intensity (HI) stretching groups. Two researchers were assigned to evaluate the active knee extension range of motion (ROM) of the volunteers and two other researchers were responsible for the training program. The training consisted of a single exercise for the hamstring muscles (biceps femoris, semimembranosus, semitendinosus). Each session consisted of three repetitions of passive static stretching, maintained for the 60s each, with 30s interval between them, and performed three times a week for four weeks. The stretching intensity was based on the Numerical Verbal Scale, the LI group maintained the intensity between 1 and 2, while the HI group between 9 and 10. Three ROM evaluations were performed pre-intervention, after the 6th session and at the end of the 12th session. Results: No difference was observed between the groups that underwent either high- or low-intensity programs. Both groups achieved gains in flexibility after four weeks of training. Conclusions: The study demonstrated that both high- and low-intensity stretching exercises are effective for ROM and there were no differences between them. Therefore, the intensity can be defined by the preference of the therapist or patient.

Reliability of the Closed Kinetic Chain Upper Extremity Stability Test in young adults.

OBJECTIVE: To analyze the reliability indicators of CKCUEST, and to investigate how many sessions are necessary to find a stable score. DESIGN: Reliability study. SETTING: Biomechanics laboratory. PARTICIPANTS: The sample consisted of 36 healthy young adults, of both genders. MAIN OUTCOME MEASURES: The subjects performed four CKCUEST with a minimum interval of three days between evaluations. The number of touches in each execution was counted, and then the average values of the number of rings, normalized score and power were calculated. RESULTS: The CKCUEST presented ICC ranging from 0.77 to 0.92 (mean number of touches), 0.80 to 0.94 (normalized score) and 0.91 to 0.98 (power). The Bland-Altman plots showed the presence of systematic error for all measures, as also confirmed by the ANOVA analysis. The scores increased every session for both genders. The boys' scores stabilized in the third session. However, the girls' scores did not stabilize. CONCLUSION: The CKCUEST presents excellent reliability; however, there is the presence of systematic error between measurements. It is necessary to perform at least three sessions to obtain reliable data for male participants, and the female results were not conclusive.

Shoulder Muscle Activation Levels During Exercises With Axial and Rotational Load on Stable and Unstable Surfaces.

This study evaluated the effects of instability on the EMG activity of scapular stabilizing and upper limb muscles during exercises with axial and rotational load. Twenty male volunteers (20.9 ± 1.8 years, 174.1 ± 0.04 cm, 73.17 ± 8.77 kg) experienced in strength training participated in a crossover design. Muscle activation of anterior deltoid (AD), posterior deltoid (PD), pectoralis major (PM), biceps brachii (BB), triceps brachii (TB), upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) were determined on both conditions. Participants performed a single series of 10 repetitions of bench press and fly exercises on stable (bench) and unstable (proprioceptive disc) conditions at 60% of 1-RM. The Friedman test and post hoc Dunn's indicated that the unstable condition showed greater EMG activity for AD (P = .001) and BB (P = .002) on the fly exercise, SA (P = .001) and LT (P = .048) on the bench press, and PM (P ≤ .002) on both exercises. These results show that using an unstable surface in exercises with rotational load provides superior EMG activity of the agonist muscles, while in exercise with axial load, the instability favors EMG activity of the scapular stabilizing muscles.