Effects of Manual Therapies and Resistance Exercise on Postexercise Hypotension in Women With Normal Blood Pressure.

ABSTRACT: Monteiro, ER, Pescatello, LS, Winchester, JB, Corrêa Neto, VG, Brown, AF, Budde, H, Marchetti, PH, Silva, JG, Vianna, JM, and Novaes, JdS. Effects of manual therapies and resistance exercise on postexercise hypotension in women with normal blood pressure. J Strength Cond Res 36(4): 948-954, 2022-The purpose of this investigation was to examine the acute effects of resistance exercise (RE) and different manual therapies (static stretching and manual massage [MM]) performed separately or combined on blood pressure (BP) responses during recovery in women with normal BP. Sixteen recreationally strength-trained women (age: 25.1 ± 2.9 years; height: 158.9 ± 4.1 cm; body mass: 59.5 ± 4.9 kg; body mass index: 23.5 ± 1.9 kg·m-2; baseline systolic BP median: 128 mm Hg; and baseline diastolic BP median: 78 mm Hg) were recruited. All subjects performed 6 experiments in a randomized order: (a) rest control (CON), (b) RE only (RE), (c) static-stretching exercise only (SS), (d) MM only, (e) RE immediately followed by SS (RE + SS), and (f) RE immediately followed by MM (RE + MM). RE consisted of 3 sets of bilateral bench press, back squat, front pull-down, and leg press exercises at 80% of 10RM. Static stretching and MM were applied unilaterally in 2 sets of 120 seconds to each of the quadriceps, hamstring, and calf regions. Systolic (SBP) and diastolic BP were measured before (rest) and every 10 minutes for 60 minutes following (Post 10-60) each intervention. There were significant intragroup differences for RE in Post-50 (p = 0.038; d = -2.24; ∆ = -4.0 mm Hg). Similarly, SBP intragroup differences were found for the SS protocol in Post-50 (p = 0.021; d = -2.67; ∆ = -5.0 mm Hg) and Post-60 (p = 0.008; d = -2.88; ∆ = -5.0 mm Hg). Still, SBP intragroup differences were found for the MM protocol in Post-50 (p = 0.011; d = -2.61; ∆ = -4.0 mm Hg) and Post-60 (p = 0.011; d = -2.74; ∆ = -4.0 mm Hg). Finally, a single SBP intragroup difference was found for the RE + SS protocol in Post-60 (p = 0.024; d = -3.12; ∆ = -5.0 mm Hg). Practitioners should be aware that SS and MM have the potential to influence BP responses in addition to RE or by themselves and therefore should be taken into consideration for persons who are hypertensive or hypotensive.

Brazilian Version of the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM-Br): Cross-Cultural Adaptation and Psychometric Properties.

OBJECTIVE: The present study aimed to adapt and validate the self-report tool named Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM-Br) into the Brazilian Portuguese language for professional orchestra musicians. METHODS: The cross-cultural adaptation process was divided into nine steps. Five experts evaluated the equivalences among versions and the content validity ratio (CVR). The structural validity was verified by exploratory factor analysis (EFA). Construct validity was checked by convergent/divergent validity by comparing the results obtained by the MPIIQM-Br, the Brief Pain Inventory (BPI), and Disabilities of the Arm, Shoulder, and Hand Questionnaire-optional module (DASH-PAM), and the Kenny Music Performance Anxiety Inventory (K-MPAI). Finally, reliability was tested with internal consistency and test-retest reliability. RESULTS: In total, 273 professional orchestra musicians (137 males) participated. The researchers found good equivalence among versions, and the CVR reached 0.99. EFA (n=212) showed that the MPIIQM-Br had two factors that explained 70% of the total variance. The convergent validity confirmed a strong positive correlation (r>0.7) and the divergent validity established a low correlation (r<0.4). Both internal consistency (Cronbach's a=0.90) and temporal stability (intraclass correlation coefficient=0.84) obtained high values. DISCUSSION: The psychometric evaluation showed a two-dimensional structure, internal consistency, and temporal stability similar to the original tool and the German and Polish versions of the MPIIQM. However, the pain prevalence rates among Brazilian musicians were higher. Extreme informality and the growing demotivation may explain these findings. CONCLUSIONS: The MPIIQM-Br is a transcultural equivalent, reliable, and valid tool for the measurement and evaluation of pain and pain interference among professional orchestra musicians.

Perceptual responses to continuous versus intermittent blood flow restriction exercise: A randomized controlled trial.

We investigated the perceptual responses to resistance exercise (RE) with continuous and intermittent blood flow restriction (BFR). Fourteen males randomly completed the following exercise conditions: low-load RE with continuous BFR (cBFR), low-load RE with intermittent BFR (iBFR), low-load RE without BFR (LI), and traditional high-load RE (HI). Participants completed 4 sets of 30-15-15-15 repetitions of bilateral leg press and knee extension exercises during the low-load conditions, at 20% of one-repetition maximum (1-RM), a 1.5­sec metronome-controlled pace, with a 1-min rest interval between sets; HI consisted of 4 sets of 10 repetitions of the same exercises, at 70% 1-RM, with the same pace and rest interval. Ratings of perceived exertion (RPE) and discomfort were assessed using psychometric scales before exercise and after each set. RPE displayed no significant differences (p > 0.05) between the BFR conditions for either exercise. Additionally, both BFR conditions elicited significantly (p < 0.05) greater RPE than LI and significantly (p <0.05) lower RPE than HI during both exercises. Rating of discomfort displayed no significant differences between BFR conditions during the first two sets of leg press; however, cBFR evoked greater discomfort compared to iBFR during the last two sets. There were no significant (p > 0.05) differences observed between conditions during the knee extension exercise. Rating of discomfort was similar between the BFR and HI conditions and each were significantly greater than LI during both exercises. Therefore, cBFR and iBFR seem to produce similar perceptual responses, which are greater than LI and lower than HI, but similar in regards to discomfort.

Accuracy of Motion Palpation Flexion-Extension Test in Identifying the Seventh Cervical Spinal Process.

OBJECTIVE: The aim of this study was to evaluate the accuracy of a motion palpation procedure, the flexion-extension test, in localizing the spinous process of the seventh cervical vertebra (C7). METHODS: We analyzed 101 adult participants with metal markers that permitted the identification of the C7 spinous process. This analysis occurred during a flexion-extension test and was confirmed by radiography. Data sample characteristics were analyzed by descriptive statistics, and the relationship between independent variables (weight, height, sex, age, and body mass index [BMI]) and dependent variables (coincidence between the most prominent vertebra and the stationary vertebra, as determined by the flexion-extension test) was determined via logistic regression. RESULTS: The sample population was 48.5% male with a mean age of 56.8 years (standard deviation, ±14.9) and a mean BMI of 25.54 kg/m2 (standard deviation, ±5.5). In 54.5% of cases, the C7 spinous process was correctly identified by the flexion-extension test. The agreement between the flexion-extension test and radiography in accuracy of localization of the C7 spinous process was significant (P = .021), as was the correct localization of C7 (P = .05). CONCLUSION: The localization of the C7 spinous process was more accurate in individuals with a BMI <25 kg/m2 and whose most prominent vertebra coincided with the stationary vertebra as determined by the flexion-extension test.

Prevalence and Associated Factors of Playing-Related Musculoskeletal Disorders in Brazilian Violin Players.

OBJECTIVE: To investigate the prevalence of playing-related musculoskeletal disorders (PRMD) and associated factors among violinists from the state of Rio de Janeiro, Brazil. METHODS: This cross-sectional study included 106 violinists from eight cities in the state of Rio de Janeiro. Sociodemographic and musical characteristic data, pain symptoms, and upper-limb functionality were collected using the DASH and the Standardized Nordic Questionnaires. The associations between musculoskeletal complaints and possible predictors were analyzed by binary logistic regression. RESULTS: Of the 106 surveyed violin players, 86.8% reported at least one painful area in the last 12 months and 77.4% in the last week. These symptoms were responsible for the temporary interruption of musical activity in 8.1% of musicians. More than 50% of violinists showed dysfunctional upper limbs according to the DASH optional module. Women were more likely to develop musculoskeletal disorders (OR 4.4, CI 1.9-10.0, p<0.001). In addition, older musicians were more likely to report pain in the last 7 days (OR 3.3, CI 5.1-10.97; p=0.04) and also had higher scores on the DASH (OR 1.8, CI 1.1-3.1; p=0.01). Other factors associated with the development of PRMD were body mass index, practice hours per week, and final DASH score. CONCLUSION: Violinists living and working in the state of Rio de Janeiro have a high prevalence of PRMD, especially women and older musicians.

Anatomical and Radiological Aspects of the Supratrochlear Foramen in Brazilians.

INTRODUCTION: The supratrochlear foramen is an anatomic variation of great clinical and anthropologic interest. Although many studies addressed this subject in different ethnic groups, there are no studies regarding Brazilians. AIM: To verify the incidence and morphometric measures of the supratrochlear foramen in Brazilian humeri. MATERIALS AND METHODS: A total of 330 dry humeri were analysed and divided in three groups: bones presenting the supratrochlear foramen (Group 1), bones displaying a translucent foramen (Group 2) and humeri without the foramen (Group 3). The aperture was measured with a digital vernier caliper. Radiographic pictures with different incidences were taken. RESULTS: Our analysis showed that 22.5% of humeri belonged in Group 1, 41.2% in Group 2, and 36.3% in Group 3. The mean vertical diameter and the mean horizontal diameter of the supratrochlear foramen on the left side were 2.779±2.050 mm and 2.332±1.23 mm, respectively. The mean vertical diameter and the mean horizontal diameter of the foramen on the right side were 2.778±2.197 mm, and 2.365±1.396 mm, respectively. The student's t-test showed that there was no significant difference regarding the size of the foramen between both sides. The best X-ray machine setup was 50 kilo voltage and 0.08 milliamperage per second, associated with a slight increase in the distance of the x-ray tube. CONCLUSION: The aperture seems to be the key point during the pre-operative planning of intramedullary fixation, since it has direct relation to the size of the intramedullary canal, thus, being an entity of clinical, anatomical, anthropological, radiological, and surgical interest.

Can Transcranial Direct Current Stimulation Improve the Resistance Strength and Decrease the Rating Perceived Scale in Recreational Weight-Training Experience?

Lattari, E, Andrade, ML, Filho, AS, Moura, AM, Neto, GM, Silva, JG, Rocha, NB, Yuan, T-F, Arias-Carrión, O, and Machado, S. Can transcranial direct current stimulation improve the resistance strength and decrease the rating perceived scale in recreational weight-training experience? J Strength Cond Res 30(12): 3381-3387, 2016-The goal of this study was to evaluate the acute efficacy of anodic transcranial direct current stimulation on the total volume of repetitions and perceived exertion in recreationally trained individuals in strength. The sample consisted of 10 participants trained in exercise against resistance for at least 3 months. Participants underwent elbow flexion exercise at barbell with a specific load of 10 repetition maximum (10RM), responded immediately after the OMNI-RES scale, and were stimulated for 20 minutes with a tDSC protocol (2 mA), depending on randomization. After applying the tDSC, subjects were again subjected to perform elbow flexion with 10RM load and, soon after, again responded to OMNI-RES scale. All subjects underwent the 3 experimental conditions of the study, c-tDSC, a-tDSC, and sham-tDSC, which were randomized. A range of 48-72 hours was allowed between each assessment visit. An interaction to condition and time (F = 52.395; p ≤ 0.001) has shown that repetitions completed after anodic condition were higher compared with the other conditions in the postsession. In relation to perceived exertion, verified by OMNI-RES scale, 2-way analysis of variance for repeated measures showed an interaction between condition and time (F = 28.445; p ≤ 0.001), where the perceived exertion was decreased after the a-tDSC condition and increased after the c-tDSC condition. In strict terms of performance, it seems to be beneficial to attend a session of 20 minutes a-tDSC, when strength training practitioners can no longer support high-volume training and have increased responses in the perceived exertion.

Motor neuron disease and acquired axonal neuropathy association in HIV infection: case report and update.

BACKGROUND: A possible viral etiology has been documented in the genesis of motor neuron disorders and acquired peripheral neuropathies, mainly due to the vulnerability of peripheral nerves and the anterior horn to certain viruses. In recent years, several reports show association of HIV infection with Amyotrophic Lateral Sclerosis - Syndrome, Motor Neuron Diseases and peripheral neuropathies. OBJECTIVE: To report a case of an association between Motor Neuron Disease and Acquired Axonal neuropathy in HIV infection, and describe the findings of neurological examination, cerebrospinal fluid, neuroimaging and electrophysiology. METHODS: The patient underwent neurological examination. General medical examinations were performed, including, specific neuromuscular tests, analysis of cerebrospinal fluid, muscle biopsy and imaging studies. RESULTS AND DISCUSSION: The initial clinical presentation of our case was marked by cramps and fasciculations with posterior distal paresis and atrophy in the left arm. We found electromyography tracings with deficits in the anterior horn of the spinal cord and peripheral nerves. Dysphagia and release of primitive reflexes were also identified. At the same time, the patient was informed to be HIV positive with high viral load. He received antiretroviral therapy, with load control but with no clinical remission. CONCLUSION: Motor Neuron disorders and peripheral neuropathy may occur in association with HIV infection. However, a causal relationship remains uncertain. It is noteworthy that the antiretroviral regimen may be implicated in some cases.

Bromazepam impairs motor response: an ERSP study.

This study aimed to investigate the acute modulatory effect of bromazepam, a benzodiazepine derivative drug, on alpha and beta bands (8-35Hz) in primary motor areas (M1) through event-related spectral perturbation (ERSP). Ten healthy subjects were submitted to a cross-over double-blind design. Subjects performed a visuomotor task where they had to identify rapidly the ball launched horizontally and catch it quickly, while electroencephalographic activity was acquired. We found a statistically significant difference on the time windows of 2920 ms for 13Hz in the electrodes C3 and Cz, and on the time window of 2000 ms for 18Hz in the electrodes C3, when compared the bromazepam and placebo conditions. We concluded that the acute effects of bromazepam provoked changes in information process in the left M1 represented by electrode C3 in both 13 Hz and 18 Hz. Our paradigm is relevant for a better understanding of the brain dynamics due to the information related to bromazepam effects on sensorimotor processes. We consider this report an invitation to conduct more studies in order to associate electro-cortical activity and psychometric tests.

Integración sensitivomotora: conceptos básicos, anomalías relacionadas con trastornos del movimiento y reorganización cortical inducida por el entrenamiento sensitivomotor / Sensorimotor integration: basic concepts, abnormalities related to movement disorders and sensorimotor training-induced cortical reorganization

Introducción. La integración sensitivomotora se define como la capacidad del sistema nervioso central para integrar diferentes fuentes de estímulos y, paralelamente, transformar dichas entradas en acciones motoras. Objetivos. Revisar los principios básicos de la integración sensitivomotora, como sus bases neuronales y sus mecanismos elementales implicados en tareas orientadas hacia la consecución de objetivos específicos realizadas por sujetos sanos, y las anomalías descritas en los trastornos del movimiento más frecuentes, como la enfermedad de Parkinson, la distonía y el accidente cerebrovascular, además de los mecanismos relacionados con la reorganización cortical. Desarrollo y conclusiones. Todavía no está claro si estos trastornos se asocian a una entrada sensitiva periférica anormal o a un procesamiento central defectuoso, pero la mayoría de datos respaldan un mecanismo central. Nuestros resultados muestran que el proceso de integración sensitivomotora desempeña un posible papel en los mecanismos elementales implicados en tareas orientadas hacia la consecución de objetivos específicos realizadas por sujetos sanos y en la aparición de anomalías en la mayoría de trastornos del movimiento más frecuentes; asimismo, desempeña un posible papel en la adquisición de habilidades que tienen como factor crítico el acoplamiento de diferentes datos sensitivos que constituirán la base de elaboración de entradas motoras orientadas conscientemente hacia la consecución de objetivos (AU)

Introduction. Sensorimotor integration is defined as the capability of the central nervous system to integrate different sources of stimuli, and parallelly, to transform such inputs in motor actions. Aim. To review the basic principles of sensorimotor integration, such as, its neural bases and its elementary mechanisms involved in specific goal-directed tasks performed by healthy subjects, and the abnormalities reported in the most common movement disorders, such as, Parkinson’ disease, dystonia and stroke, like the cortical reorganization-related mechanisms. Development and conclusions. Whether these disorders are associated with an abnormal peripheral sensory input or defective central processing is still unclear, but most of the data support a central mechanism. We found that the sensorimotor integration process plays a potential role in elementary mechanisms involved in specific goal-directed tasks performed by healthy subjects and in occurrence of abnormalities in most common movement disorders and, moreover, play a potential role on the acquisition of abilities that have as critical factor the coupling of different sensory data which will constitute the basis of elaboration of motor outputs consciously goal-directed (AU)

Sensorimotor integration: basic concepts, abnormalities related to movement disorders and sensorimotor training-induced cortical reorganization.

INTRODUCTION: Sensorimotor integration is defined as the capability of the central nervous system to integrate different sources of stimuli, and parallelly, to transform such inputs in motor actions. AIM: To review the basic principles of sensorimotor integration, such as, its neural bases and its elementary mechanisms involved in specific goal-directed tasks performed by healthy subjects, and the abnormalities reported in the most common movement disorders, such as, Parkinson' disease, dystonia and stroke, like the cortical reorganization-related mechanisms. DEVELOPMENT AND CONCLUSIONS: Whether these disorders are associated with an abnormal peripheral sensory input or defective central processing is still unclear, but most of the data support a central mechanism. We found that the sensorimotor integration process plays a potential role in elementary mechanisms involved in specific goal-directed tasks performed by healthy subjects and in occurrence of abnormalities in most common movement disorders and, moreover, play a potential role on the acquisition of abilities that have as critical factor the coupling of different sensory data which will constitute the basis of elaboration of motor outputs consciously goal-directed.

Efectos de un programa de facilitación neuromuscular propioceptiva sobre la amiotrofia focal benigna / Effects of a proprioceptive neuromuscular facilitation program on benign monomelic amyotrophy

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