Tactile acuity and active joint repositioning sense in individuals with and without chronic low back pain: a cross-sectional study.

BACKGROUND: Sensorimotor dysfunction, as measured by tactile acuity and active joint repositioning, has been identified as a contributing factor of chronic low back pain (CLBP). Existing research suggests that further research is necessary to improve the characterization of sensorimotor perception in patients with CLBP. OBJECTIVES: The main aim is to investigate whether tactile acuity and repositioning errors differ between individuals with CLBP and controls without CLBP. A secondary aim was to investigate the association between age, body mass index (BMI) and physical activity, and tactile acuity and repositioning sense. METHODS: Cross-sectional study. Sixty-eight participants (36 with, 32 without CLBP) were examined. Two-Point Discrimination (TPD) test (four measures: horizontal and vertical run, left and right side) and Active Joint Reposition Sense (AJRS) test (2 directions: to flexion and to extension) were used. RESULTS: No differences were found for TPD (right horizontal run: p = .069; left horizontal run: p = .066; right vertical run: p = .933; left vertical run: p = .285) or AJRS (flexion: p = .792; extension: p = .956) between participants with and without CLBP. Older subjects had significantly worse tactile acuity (3 sites, p = .018, p = .004, p = .041) and worse repositioning sense (2 directions, p = .026, p = .040,) than younger subjects. Individuals with BMI ≥ 25 had significantly worse TPD compared to individuals with normal weight (2 sites, p = .028, p = .020). CONCLUSIONS: Individuals with CLBP did not have impaired tactile and repositioning accuracy when compared to controls without CLBP. Future studies comparing sensorimotor performance should consider age and BMI as potential confounding factors.

Exercise-based cardio-oncology rehabilitation for cardiotoxicity prevention during breast cancer chemotherapy: The ONCORE randomized controlled trial.

BACKGROUND: Breast cancer (BC) treatment with anthracyclines and/or anti-human epidermal growth factor receptor-2 (HER2) antibodies is associated with an increased risk of cardiovascular disease complications, including cancer therapy-related cardiac dysfunction (CTRCD). While Cardio-Oncology Rehabilitation (CORe) programs including exercise have emerged to minimize these risks, its role in preventing CTRCD is unclear. OBJECTIVES: We investigated the effectiveness of an exercise-based CORe program in preventing CTRCD [left ventricular ejection fraction (LVEF) drop ≥10% to a value <53% or a decrease >15% in global longitudinal strain (GLS)]. Secondary outcomes examined changes in cardiac biomarkers, physical performance including peak oxygen consumption, psychometric and lifestyle outcomes. Safety, adherence, and patient satisfaction were also assessed. METHODS: This is a randomized controlled trial including 122 early-stage BC women receiving anthracyclines and/or anti-HER2 antibodies, randomized to CORe (n = 60) or usual care with exercise recommendation (n = 62). Comprehensive assessments were performed at baseline and after cardiotoxic treatment completion. The average duration of the intervention was 5.8 months. RESULTS: No cases of CTRCD were identified during the study. LVEF decreased in both groups, but was significantly attenuated in the CORe group [-1.5% (-2.9, -0.1); p = 0.006], with no changes detected in GLS or cardiac biomarkers. The CORe intervention led to significant body mass index (BMI) reduction (p = 0.037), especially in obese patients [3.1 kg/m2 (1.3, 4.8)]. Physical performance and quality-of-life remained stable, while physical activity level increased in both groups. No adverse events were detected. CONCLUSIONS: This study suggests that CORe programs are safe and may help attenuate LVEF decline in BC women receiving cardiotoxic therapy and reduce BMI in obese patients.

A Randomized Controlled Trial to Evaluate the Impact of an Exercise Therapy Program Based on Sports in People with Acquired Brain Injury: Discover Study Protocol.

INTRODUCTION: Acquired brain injury (ABI) constitutes a significant and growing global public health concern. People with ABI often face a range of physical and psychosocial challenges that span the domains of "body structure and function", "activity", and "participation", as defined by the International Classification of Functioning, Disability, and Health. Multidisciplinary approaches based on exercise therapy with social leisure activities are essential to improve physical recovery and health-related quality of life after injury. METHODS: Adults with ABI, aged > 18 years, in the subacute or chronic stage (within more than one month after the injury) will be recruited through a rehabilitation center. Adults will be randomized to receive either a racket sports-based exercise therapy program combined with usual care (sET) or usual care alone (UC) using a random number sequence with a 1:1 allocation ratio. sET intervention consists of an 8-week exercise therapy program focusing on different racket sports skills, 1 h in duration, 2 days/week. It will be delivered by a physiotherapist in tailored, face-to-face, group-based sessions. Primary outcomes will be the health-related quality of life (SF-36) and upper extremity motor function (Fugl-Meyer Assessment-Upper Extremity Scale). DISCUSSION: The study proposes an intervention that combines sports-based exercise therapy with usual care. It aims to determine whether this intervention improves the health-related quality of life and upper limb motor function in adults with ABI compared with usual care alone. The results of this study may have clinical implications for the rehabilitation of this population.

Glycemic and Satiety Response to Three Mexican Honey Varieties.

Honey is considered one of the last untreated natural food substances, with a complex composition. It is produced by bees (Apis mellifera) from nectar. The glycemic index (GI) is a physiological assessment of a food's carbohydrate content via its effect on postprandial blood glucose concentrations. This study evaluated the GI and the satiety response to three Mexican types of honey administered to 26 healthy volunteers. The fructose values ranged from 272.40 g/kg to 395.10 g/kg, while the glucose value ranged from 232.20 g/kg to 355.50 g/kg. The fructose/glucose (F/G) ratio of honey was 1.45, 1.00, and 1.17 for highland, multifloral, and avocado honey, respectively. Highland and avocado honey were classified as medium-GI (69.20 ± 4.07 and 66.36 ± 5.74, respectively), while multifloral honey was classified as high-GI (74.24 ± 5.98). Highland honey presented a higher satiety values response than glucose. The difference in GI values and the satiety response effect of highland honey could be explained by its different carbohydrate composition and the possible presence of other honey components such as phytochemicals. Honey, especially avocado, could therefore be used as a sweetener without altering significantly the blood glucose concentration.

Impact of Fat Replacement by Using Organic-Candelilla-Wax-Based Oleogels on the Physicochemical and Sensorial Properties of a Model Cookie.

Oleogelation is an alternative process to improve the nutritional properties of food by creating soft-matter structures with the same functionality as commercial fats (shortenings). In this study, oleogels were produced by adding organic candelilla wax at 3% (OC03), 6% (OC06), and 9% (OC09) to extra-virgin linseed oil, and then characterized by their physicochemical properties. Furthermore, the physicochemical and sensorial properties of five cookie formulations were evaluated. Organic candelilla wax influenced the oleogel formulations, giving higher values of color (L* and b*), texture, acidity index, and melting point. In the cookie formulations, the luminosity values decreased when the percentage of oleogel was increased; reddish trends were obtained (a* values) for the cookie where 70% of the fat was replaced by the oleogel (C70), and more yellow trends were obtained (b* values) for C100. The moisture content was higher in cookies with oleogels, but it was within quality limits. The percentage of fat migration was lower in cookies with a mixture of fats and oleogels. In terms of hardness, the substitution of oleogels resulted in softer cookies. In terms of the sensory evaluation, the most accepted cookie was C70. Therefore, this study demonstrates the possibility of using organic-candelilla-wax-based oleogels in a real food model rich in unsaturated fats.

Acute effects of a single neurodynamic mobilization session on range of motion and H-reflex in asymptomatic young subjects: A controlled study.

Neurodynamic techniques have yielded good clinical results in the treatment of various pathologies. The objective of this study is to examine the short-term effects of neurodynamic techniques of the sciatic nerve on hip ROM (range of motion) and on the amplitude and latency of the soleus H-reflex and M-waves, in young asymptomatic subjects. In a double-blind controlled trial design, 60 young asymptomatic participants were randomly assigned into six groups with different levels of manipulation of the sciatic nerve. The passive straight leg raise test was used to evaluate the hip ROM amplitude. All evaluations were performed before, 1 min after, and 30 min after intervention. For each time-point, spinal and muscle excitability were also tested. ROM increased in all groups, but none of the treatment groups had superior effects than the group with no treatment. This means that ROM testing maneuvers increased ROM amplitude, with no add-on effect of the proposed neurodynamic techniques. Neurophysiological responses changed similarly in all groups, showing that the aftereffects were not intervention-specific. We observed a significant negative association between the change in limb temperature and the change in latencies of all potentials. ROM-testing procedures performed repeatedly increase ROM amplitude. This observation should be considered when evaluating the aftereffects of therapeutic interventions on ROM amplitude. None of the explored neurodynamic techniques produced acute aftereffects on hip ROM amplitude, spinal or muscle excitability different to the induced by the ROM testing maneuver.

Production and Characterization of Biocomposite Films of Bacterial Cellulose from Kombucha and Coated with Chitosan.

The purpose of this research is to produce and characterize bacterial cellulose (BC) films coated with chitosan (BC-CH). BC films were produced in a fermentation medium based on Camellia sinensis tea and dextrose (12 days at 25 °C) and subsequently treated with coating-forming solutions (CFSs) based on chitosan (BC-CH 0.5%, BC-CH 1.0%, and BC-CH 1.5%). As a result, the FTIR spectra of BC and BC-CH 1.5% showed the main characteristic bands of cellulose and chitosan. In the physicochemical characterization of the films, it was found that the incorporation of the chitosan coatings did not affect the thickness; however, it decreased the luminosity (L*) and increased redness (a*), yellowness (b*), and opacity (75.24%). Additionally, the light absorption properties in the UV-Vis range were improved. Furthermore, the application of the CFSs increased: the solubility (64.91%), the antimicrobial activity against S. aureus (6.55 mm) and E. coli (8.25 mm), as well as the antioxidant activity (57.71% and 24.57% free radical scavenging activity), and the content of total phenols (2.45 mg GAE/g). Finally, our results suggest that the BC-CH films developed in the present study show a potential application as active packaging material for food.

Are objective measures of sleep and sedentary behaviours related to low back pain flares?

ABSTRACT: Risk factors for low back pain (LBP) flares have been considered about self-reported measures. This case-crossover study aimed to investigate whether (1) objective measures of physical activity and sleep were associated with the risk of experiencing LBP flares and (2) these associations differed for flares defined as pain 2 or more points greater than average pain over the period using an 11-point Numerical rating scale (0-no pain and 10-worst pain imaginable) (pain-defined flare: PDF) and flares identified by participants according to a broader definition that considered emotions or coping (self-reported flare [SRF]). We included 126 participants who had experienced LBP for >3 months. Physical activity and sleep were monitored for 28 days using wearable sensors. Occurrence of flares (PDF or SRF) was assessed daily using a smartphone application. Data on exposure to risk factors 1, 2, and 3 days preceding PDF or SRF were compared with nonflare control periods. Conditional logistic regression determined association between each factor and flares. Data show that day-to-day variation in physical activity and in-bed time are associated with the risk of LBP flares, but associations differ depending on how flare is defined. Longer in-bed time increased the risk of PDF but not SRF. Although physical activity was not associated with the risk of PDF, greater sedentary behaviour increased the risk of SRF and being more physically active decreased the risk for SRF. These results highlight the potential role of targeting sleep and physical activity in interventions to prevent LBP flares and indicate that risk factors differ depending on how LBP flares are defined.

Thirty-second sit-to-stand test as an alternative for estimating peak oxygen uptake and 6-min walking distance in women with breast cancer: a cross-sectional study.

PURPOSE: To determine whether the 30-s sit-to-stand (30STS) test can be a valid tool for estimating and stratifying peak oxygen uptake (VO2peak) and 6-min walking distance (6MWD) in women with breast cancer. METHODS: This cross-sectional study uses data from the ONCORE randomized controlled trial, including 120 women aged 18-70 years with early-stage breast cancer under treatment with anthracycline and/or anti-HER2 antibodies. Participant characteristics were collected at baseline and pooled data from functional assessment (30STS test, relative and absolute VO2peak, and 6MWD) were collected at baseline and post-intervention (comprehensive cardio-oncology rehabilitation program vs. usual care). Bivariate correlations and multivariate linear regression analyses were performed to study the relationship between functional test variables. RESULTS: The number of repetitions in the 30STS test showed (i) a moderate correlation with relative VO2peak (ml/kg/min) (r = 0.419; p < 0.001; n = 126), (ii) a weak correlation with absolute VO2peak (ml/min) (r = 0.241; p = 0.008; n = 120), and (iii) a moderate correlation with the 6MWD (r = 0.440; p < 0.001; n = 85). The ONCORE equations obtained from the multivariate regression models allowed the estimation of VO2peak and 6MWD (r2 = 0.390; r2 = 0.261, respectively) based on the 30STS test, and its stratification into tertiles (low, moderate, and high). CONCLUSION: The 30STS test was found to be a useful tool to estimate VO2peak and/or 6MWD in women with early-stage breast cancer. Its use may facilitate the assessment and stratification of functional capacity in this population for the implementation of therapeutic exercise programs if cardiopulmonary exercise testing (CPET) or 6MWT are not available. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03964142. Registered on 28 May 2019. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT03964142.

Thirty Minutes Identified as the Threshold for Development of Pain in Low Back and Feet Regions, and Predictors of Intensity of Pain during 1-h Laboratory-Based Standing in Office Workers.

This study with 40 office workers investigated (a) the effect of time spent standing on low- back and lower limb pain during a 1-h laboratory-based task; (b) the standing time after which a significant increase in pain is likely; and (c) the individual, physical and psychosocial factors that predict pain. The primary outcome was bodily location of pain and pain intensity on a 100-mm Visual Analogue Scale recorded at baseline and every 15 min. Physical measures included trunk and hip motor control and endurance. Self-report history of pain, physical activity, psychosocial job characteristics, pain catastrophizing and general health status were collected. Univariate analysis and regression models were included. The prevalence of low-back pain increased from 15% to 40% after 30 min while feet pain increased to 25% from 0 at baseline. The intensity of low-back and lower limb pain also increased over time. A thirty-minute interval was identified as the threshold for the development and increase in low-back and feet pain. Modifiable factors were associated with low-back pain intensity-lower hip abductor muscle endurance and poorer physical health, and with feet symptoms-greater body mass index and less core stability.

How reliable is measurement of posture during sleep: real-world measurement of body posture and movement during sleep using accelerometers.

Objective. Understanding sleeping behaviours could improve prevention and treatment of sleep problems and associated health conditions. This study aimed to evaluate a method to assess body posture and movement during sleep using trunk-worn accelerometers for 28 nights.Approach. Participants (50 adults with low back pain (66% female); aged 32(±9) years) wore two activPAL-micro sensors (thigh, trunk) during their normal daily life for 28 consecutive days. Parameters related to body posture (e.g. time spent lying supine or prone) and movement (e.g. number of turns) during sleep were calculated for each night. Average values for each parameter were identified for different periods, the Spearman-Brown Prophecy Formula was used to estimate the minimum number of nights required to obtain a reliable estimate of each parameter, and repeatability of measures between different weeks was calculated.Main results. Participants spent 8.1(±0.8) h asleep and most time (44%) was spent in a supine posture. The minimum number of nights required for reliable estimates varied between sleep parameters, range 4-21 nights. The most stable parameters (i.e. requiring less than seven nights) were 'average activity', 'no. of turns', 'time spent prone', and 'posture changes in the first hour'. Some measures differed substantially between weeks.Significance. Most sleep parameters related to body posture and movement require a week or more of monitoring to provide reliable estimates of behaviour over one month. Notably, one week may not reflect behaviour in another week, and the time varying nature of sleep needs to be considered.

Protein Concentrates on Tepary Bean (Phaseolus acutifolius Gray) as a Functional Ingredient: In silico Docking of Tepary Bean Lectin to Peroxisome Proliferator-Activated Receptor Gamma.

The tepary bean (Phaseolus acutifolius Gray) is a US-Mexico frontier native crop, produces high yields in agriculture, and needs to be reconsidered because of its nutritional and functional properties. This study aimed to determine the technological and nutritional properties of flours and protein concentrates of tepary bean, besides determining an in silico agonist effect of tepary bean lectin to peroxisome proliferator-activated receptor gamma (PPAR-γ). We evaluated the technological properties of raw samples (tepary flour and tepary protein concentrate) and cooked samples (tepary flour and tepary protein concentrate). The flours present a significant difference (p < 0.05) concerning protein concentrates in water absorption and oil absorption capacity. The raw samples' emulsifying capacity was higher than that reported in the literature for other legumes, but not the cooked samples. The samples' foaming capacity had no significant difference in treatments (p > 0.05), and cooked tepary bean protein concentrate presented complete gelation at a lower concentration (2%). Nutritionally, raw samples present a protein percentage of 23.46 ± 0.06 and 71.38 ± 0.44 and cooked samples present a protein percentage of 25.27 ± 0.04 and 62.69 ± 0.14; a chemical score of 72, 86, 82, and 72; in vitro protein digestibility (%) = 48.20 ± 0.31, 49.80 ± 0.80, 61.77 ± 1.70, and 63.61 ± 4.19; and C-PER = 0.86, 1.34, 1.93, and 1.81, respectively. All the samples showed methionine + cysteine as the limiting amino acid. All these nutritional data are very similar to the common bean (Phaseolus vulgaris). SDS-PAGE preserves the lectin fraction in both protein concentrates. The in silico study of tepary lectin (PDB: 6tt9) shows that there were seven peptides that presented values below -120 kcal/mol: PEW, VSVGF, PSQK, TTPW, ATSF, ITY, and TSF, with VSVGF, PSQK, and PEW having the highest affinity for active sites of the PAPRγ receptor (binding energies from -5.32 to -7.04 kcal/mol). These peptides could show antiadipogenic or antidiabetic activity based on the intermolecular bond energies and open an interesting research item.

A randomized trial to evaluate the impact of exercise-based cardiac rehabilitation for the prevention of chemotherapy-induced cardiotoxicity in patients with breast cancer: ONCORE study protocol.

BACKGROUND: Anthracyclines and monoclonal antibodies against human epidermal growth factor receptor-2 (HER2) are frequently used to treat breast cancer but they are associated with risk of developing cardiotoxicity. Implementation of cardioprotective strategies as part of breast cancer treatment are needed. To date, a limited number of studies have examined the effectiveness of cardiac rehabilitation programs or exercise programs in the prevention of cardiotoxicity through an integral assessment of cardiac function. The ONCORE study proposes an exercise-based cardiac rehabilitation program as a non-pharmacological tool for the management of chemotherapy-induced cardiotoxicity. METHODS: The study protocol describes a prospective, randomized controlled trial aimed to determine whether an intervention through an exercise-based CR program can effectively prevent cardiotoxicity induced by anthracyclines and/or anti-HER2 antibodies in women with breast cancer. Three hundred and forty women with breast cancer at early stages scheduled to receive cardiotoxic chemotherapy will be randomly assigned (1:1) to participation in an exercise-based CR program (intervention group) or to usual care and physical activity recommendation (control group). Primary outcomes include changes in left ventricular ejection fraction and global longitudinal strain as markers of cardiac dysfunction assessed by transthoracic echocardiography. Secondary outcomes comprise levels of cardiovascular biomarkers and cardiopulmonary function through peak oxygen uptake determination, physical performance and psychosocial status. Supervised exercise program-related outcomes including safety, adherence/compliance, expectations and physical exercise in- and out-of-hospital are studied as exploratory outcomes. Transthoracic echocardiography, clinical test and questionnaires will be performed at the beginning and two weeks after completion of chemotherapy. DISCUSSION: The growing incidence of breast cancer and the risk of cardiotoxicity derived from cancer treatments demand adjuvant cardioprotective strategies. The proposed study may determine if an exercise-based CR program is effective in minimizing chemotherapy-induced cardiotoxicity in this population of women with early-stage breast cancer. The proposed research question is concrete, with relevant clinical implications, transferable to clinical practice and achievable with low risk. Trial registration ClinicalTrials.gov Identifier: NCT03964142. Registered on 28 May 2019. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT03964142.

What Psychosocial and Physical Characteristics Differentiate Office Workers Who Develop Standing-Induced Low Back Pain? A Cross-Sectional Study.

This study examines demographic, physical and psychosocial factors associated with an increase in low back pain (LBP) during a one-hour standing task. A cross-sectional survey with 40 office workers was conducted. The primary outcome was pain severity during a one-hour standing task recorded every 15 min using a 100 mm Visual Analogue Scale (VAS). Participants were defined as pain developers (PD), if they reported a change in pain of ≥10 mm from baseline, or non-pain developers (NPD). Physical outcomes included participant-rated and examiner-rated trunk and hip motor control and endurance. Self-report history of LBP, physical activity, psychosocial job characteristics, general health and pain catastrophising were collected. Fourteen participants were PD. Hip abduction, abdominal and spinal muscle endurance was lower for PD (p ≤ 0.05). PD had greater self-reported difficulty performing active hip abduction and active straight leg raise tests (p ≤ 0.04). Those reporting a lifetime, 12 month or 7-day history of LBP (p < 0.05) and lower self-reported physical function (p = 0.01) were more likely to develop LBP during the standing task. In conclusion, a history of LBP, reduced trunk and hip muscle endurance and deficits in lumbopelvic/hip motor control may be important to consider in office workers experiencing standing-induced LBP.

Development and Characterization of Gelled Double Emulsions Based on Chia (Salvia hispanica L.) Mucilage Mixed with Different Biopolymers and Loaded with Green Tea Extract (Camellia sinensis).

The aim of this research was to develop and characterize five gelled double emulsions based on chia mucilage (CM) and different biopolymers (κ-carrageenan, C; locust bean gum, L; thixogum, T; and whey protein concentrate, W) loaded with green tea extract (GTE). Gelled double emulsions consisted of W1 (whey-protein-concentrate/sodium-azide/NaCl/GTE)/O and (PGPR/canola-oi)/W2 (CM, CMC, CML, CMT and CMW), and were characterized based on physicochemical properties during 35 days of storage. Optical microscopy clearly showed the drops of the internal phase surrounded by droplets of oil dispersed in the second aqueous phase; the droplet size was higher for CMT and lowest for CMW. In addition, all emulsions were highly stable at creaming and were effective in reducing the loss of antioxidant activity (88.82%) and total phenols (64.26%) during storage; CMT, CML and CM were the most effective. Furthermore, all emulsions showed a protective effect by modulating the release of the GTE in a simulated gastrointestinal environment, allowing a controlled release during the gastric-intestinal digestion phases and reaching its maximum release in the intestinal phase (64.57-83.31%). Thus, gelled double emulsions are an alternative for the preservation of GTE and could be a potential alternative for their application in the development of functional foods.

Bayesian Methods in the Field of Rehabilitation.

Bayesian techniques, as an alternative method of statistical analysis in rehabilitation studies, have some advantages such as handling small sample sizes, allowing incorporation of previous experience of the researchers or clinicians, being suitable for different kinds of studies, and managing highly complex models. These characteristics are important in rehabilitation research. In the present article, the Bayesian approach is displayed through three examples in previously analyzed data with traditional or frequentist methods. The studies used as examples have small sample sizes and show that the Bayesian procedures enhance the statistical information of the results. The Bayesian credibility interval includes the true value of the corresponding parameter diminishing uncertainty about the treatment effect. In addition, the Bayes factor value quantifies the evidence provided by the data in favor of the alternative hypothesis as opposed to the null hypothesis. Bayesian inference could be an interesting and adaptable alternative statistical method for physical medicine and rehabilitation applications.

A Therapeutic Exercise Program Improves Pain and Physical Dimension of Health-Related Quality of Life in Young Adults: A Randomized Controlled Trial.

OBJECTIVE: The aim of this study was to evaluate the effects of an exercise therapy program on pain and physical dimension of health-related quality of life for young adults with musculoskeletal pain. DESIGN: This is a randomized controlled single-blind trial. Fifty-seven subjects (58% women) were randomly assigned to experimental [n = 28, 21.4 (2.9) yrs] and control [n = 29, 21.0 (4.2) yrs] groups. The experimental group participated in a 9-wk stabilization exercise therapy program, 60 mins/wk, whereas the control group did not exercise, with a preintervention and postintervention assessment. Primary outcome was Physical Component Summary of SF-36. Secondary outcomes were Nordic Musculoskeletal Questionnaire, Visual Analogue Scale, Oswestry Disability Index, Neck Disability Index, and Trunk Flexor Endurance Test. The Shapiro-Wilk, independent t test or Mann-Whitney U test, X, or Fisher's exact test were used for statistical analysis. RESULTS: After intervention, the experimental group improved by 3.2 (4.5) points on the Physical Component Summary (P = 0.01), decreased prevalence of low back pain in the last month (P = 0.02) and cervical disability (P = 0.02), and increased flexor trunk endurance (P = 0.005). CONCLUSIONS: This study confirmed that a 9-wk progressive exercise therapy program can improve physical health and reduce the prevalence of cervical disability and low back pain in the last month in young adults with musculoskeletal pain.

Effects of transcutaneous electrical nerve stimulation via peroneal nerve or soleus muscle on venous flow: A randomized cross-over study in healthy subjects.

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is used to prevent venous stasis and thromboembolism. However, best electrostimulation parameters have yet to be established. The aim of the study was to compare the hemodynamic effects and the participants' relative discomfort of 3 TENS sequences at the maximum tolerated intensity stimulus. METHODS: Twenty-four healthy university students (50% male) participated in a cross-over, randomized study. Each participant received 2 TENS sequences on peroneal nerve at 1 and 5 Hz, and the third one on soleus muscle at 5 Hz. Popliteal flow volume (FV) and peak velocity (PV) were measured using Doppler ultrasound and the relative change from basal values was recorded. Discomfort questionnaires -visual analogue scale (VAS) and verbal rating scale (VRS)- were also administered to compare sensations among the three applications. RESULTS: All interventions produced significant hemodynamic responses compared to baseline. Both 5 Hz applications obtained higher FV increments than 1 Hz TENS (P < .001). The muscle application resulted in the lowest PV increment (P < .001). TENS at 5 Hz on nerve location was the worst tolerated, with higher values in VRS (P = .056) and VAS (P = .11), although not significant. CONCLUSION: TENS at 5 Hz on soleus site may be the most appropriate protocol for enhancing venous return.

Prevalence and Associated Factors for Musculoskeletal Pain and Disability Among Spanish Music Conservatory Students.

OBJECTIVES: To assess the prevalence of and factors associated with musculoskeletal pain (MSP) and neck and upper limb disability among music conservatory students. METHODS: An observational study in two Spanish conservatories, investigating a total of 206 students, administered the Nordic Musculoskeletal Questionnaire, visual analog scale for pain intensity, Neck Disability Index, DASH, and SF-36. Demographic and lifestyle characteristics and musical performance variables were recorded. Regression models were performed to identify variables associated with MSP for the four most affected anatomical regions and with neck and upper limb disability. RESULTS: The locations with the highest prevalence of MSP were the neck, upper back, shoulders, and lower back. Mild disability affected 47% of participants in the neck and 31% in the upper limbs. Mental health (SF-36) was below the average for the general population (45.5±10.2). Women were more likely to suffer neck pain (odds ratio [OR] 1.1-5.2), lower back pain (OR 1.7-8.7), and neck disability (B 0.6-7.8). The risk for shoulder pain was higher in those who played for more hours (OR 1.7-24.7) and lower among those who performed physical activity (OR 0.23-1.00). Disability in the neck (B -0.3) and upper limbs (B -0.4) was associated with poorer mental health (SF-36). CONCLUSION: MSP is highly prevalent in music students. Neck and upper limb disability were slight to moderate and both were associated with poorer mental health. The main factors associated with MSP were being female, hours spent practicing, and physical activity. Physical and psychological factors should be taken into account in the prevention of MSP in student-musicians.

Impact of musculoskeletal pain on health-related quality of life among fishing sector workers.

This study aims to determine the impact of musculoskeletal pain (in terms of intensity of the pain, location and functional disability due to back pain) and other factors (socio-demographic, lifestyle and co-morbidity) on the health-related quality of life on a group of shellfish gatherers. This observational transversal study included 929 shellfish gatherers (18-69 years, 98.7 % women) who completed a self-administered questionnaire, including socio-demographic and lifestyle questions, co-morbidity, intensity and location of musculoskeletal pain, and Roland-Morris Disability Questionnaire (RMDQ). Health-related quality of life was assessed using the 36-item Short Form Survey (SF-36). Physical component summary (PCS) and mental component summary (MCS) of the SF-36 were considered as outcome variables. The impact of the different factors on the PCS and MCS scores was evaluated using a stepwise linear regression analysis. Physical health was found to be independently associated to intensity of musculoskeletal pain (regression coefficient, B = -0.96), number of locations with musculoskeletal pain (MSP) (B = -0.77), presence of pain in the hip-knee (B = -2.26), self-reported rheumatic disorders (B = -2.79), lower back pain (B = -1.62) and age (B = -0.06). Mental health was associated with the presence of self-reported depressive syndrome (B = -1043.1) and RMDQ score (B = -42.2). The sample had significantly lower values than the reference population in all of the dimensions of the SF-36. Intensity of the pain, pain in the hip-knee, lower back pain, functional disability due to back pain and number of locations with musculoskeletal pain were found to have a detrimental impact on the physical health of the workers. Depressive syndrome and greater functional disability due to back pain, in turn, predict worse mental health.