Transcranial Direct Current Stimulation Associated With Functional Exercise Program for Treating Fibromyalgia: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effects of transcranial direct current stimulation (tDCS) associated with functional exercise on pain, functional performance, psychological symptoms, and quality of life of patients with fibromyalgia (FM). DESIGN: Randomized controlled trial. Participants were randomized by blocks into 2 groups: tDCS associated with functional exercise (n=17) and sham-tDCS associated with functional exercise (n=14). SETTING: Laboratory of neuromuscular performance in the department of physical therapy. PARTICIPANTS: Women with FM (N=31) according to American College of Rheumatology-2010 criteria. INTERVENTIONS: Anodal tDCS or sham-tDCS was applied over the left motor cortex for 5 consecutive days during the first week of intervention (2 mA; 20min). All volunteers also engaged in 8 weeks of functional exercises 3 times per week. MAIN OUTCOME MEASURES: Pain intensity, functional performance, psychological symptoms, and quality of life were assessed pre-exercise and immediately after the first, fourth, and eighth weeks of intervention. RESULTS: Pain intensity, functional performance, psychological symptoms, and quality of life increased significantly in both groups (P<.05); however, no significant differences between groups were found in all outcomes (P>.05). CONCLUSION: tDCS associated with functional exercises did not enhance the effects of physical exercise on pain, functional performance, psychological symptoms, and quality of life of patients with FM.

Chronic Effects of Static and Dynamic Stretching on Hamstrings Eccentric Strength and Functional Performance: A Randomized Controlled Trial.

Barbosa, GM, Trajano, GS, Dantas, GAF, Silva, BR, and Vieira, WHB. Chronic effects of static and dynamic stretching on hamstrings eccentric strength and functional performance: A randomized controlled trial. J Strength Cond Res 34(7): 2031-2039, 2020-The purpose of this study was to investigate the effect of static or dynamic stretching training program on hamstrings eccentric peak torque and functional performance. Forty-five active healthy men were randomly allocated into 3 groups (n = 15 per group): no stretching (control), static stretching (3 sets of 30 seconds), and dynamic stretching (3 sets of 30 repetitions). Static and dynamic stretching protocols on the hamstring muscles were performed 3 times a week until complete 10 sessions. Isokinetic knee flexor eccentric peak torque (60°·s), triple hop distance, and modified 20-m sprint time were assessed in a random order before and after stretching training. A mixed-design analysis of variance was performed, with an alpha level of 0.05. There was a significant decrease of eccentric peak torque (p ≤ 0.0001, -15.4 ± 10.4%, within-group effect size: 1.03) after static stretching training. The static stretching training reduced eccentric torque when compared with no stretching (-7.6 ± 21.7%, between-group effect size: 0.50) and dynamic stretching (-7.8 ± 29.8%, between-group effect size: 0.51). Moreover, the reached distance on triple hop test was also reduced after static stretching protocol (p = 0.009, -3.7 ± 4.1%, within-group effect size: 0.29). These findings suggest that static stretching training is sufficient to produce meaningful reductions on hamstrings eccentric torque and functional performance. Based on the results of this study, caution should be taken when prescribing of static stretching training in isolation when the purpose is to improve performance, and indirectly, to prevent hamstring strain injuries due to its possible negative effects on hopping performance and knee flexor eccentric torque.

Exercise training ameliorates matrix metalloproteinases 2 and 9 messenger RNA expression and mitigates adverse left ventricular remodeling in streptozotocin-induced diabetic rats.

BACKGROUND: The aim was to investigate whether exercise training (ExT) would ameliorate expression of key genes for myocardial morphostructure and mitigate adverse left ventricular (LV) remodeling in experimental type 1 diabetes (T1D). METHODS AND RESULTS: Male Wistar rats were divided into four groups: sedentary control (SC, n=9), trained control (TC, n=13), sedentary diabetic (SD, n=20), and trained diabetic (TD, n=17). T1D was induced by 40 mg/kg streptozotocin (single dose, i.v.). Training program consisted of 4-week treadmill running (60 min/day, 5 days/wk). Structure of the LV was evaluated using histomorphometric techniques. Gene expression changes of LV collagens I and III, metalloproteinases (MMPs) 2 and 9, and transforming growth factor-ß1 were detected by reverse transcriptase quantitative polymerase chain reaction. Compared with SC, SD rats presented LV eccentric remodeling, myocyte hypertrophy, and fibrosis, whereas TD animals showed normal LV geometry and collagen content but thinner myocytes. Expression of collagens and type I/III collagen messenger RNA (mRNA) ratio were diminished in diabetic hearts compared with SC. MMP-2 gene was down-regulated in SD, whereas TD group showed decreased MMP-9 mRNA levels and MMP-2 expression comparable to that of SC rats. CONCLUSIONS: Attenuation of MMP-2 down-regulation and reduction in MMP-9 mRNA expression may constitute an underlying mechanism by which ExT counteracts progression of adverse LV remodeling in T1D.

Efficacy of simple integrated group rehabilitation program for patients with knee osteoarthritis: Single-blind randomized controlled trial.

UNLABELLED: We investigated the role of an evidence-based integrated group rehabilitation program on the treatment of patients with knee osteoarthritis (KOA). This was a two-group, randomized controlled, 8 wk trial with 41 patients with moderate to very severe KOA. Patients were assigned to an intervention group (IG) or control group (CG). After both groups had received a self-management education program, IG participants underwent a rehabilitation program, including educational aspects about KOA followed by exercises. CG participants received only general health orientation about KOA during this period. The outcome measures were the Lequesne algofunctional index; 36-Item Short Form Health Survey (SF-36); and chair-stand, sit-and-reach, timed up-and-go, and 6-minute walk tests. Analysis of covariance revealed significant postintervention improvements of IG participants compared with CG participants (p < 0.05) on Lequesne total score and pain and function subdomains; SF-36 physical function, role physical, bodily pain, general health, vitality, and role emotional subdomains; and performance assessed by chair-stand, timed up-and-go, and 6-minute walk tests. Focusing on the primary outcome (Lequesne total score), the mean +/- standard deviation after 8 wk was 5.50 +/- 2.98 for the IG and 7.87 +/- 3.48 for the CG (p = 0.009). The corresponding effect size (partial eta squared with 90% confidence interval) was 0.23 (0.04-0.42), indicating a large effect. The presented rehabilitation program reduced pain and improved quality of life and function in patients with KOA. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; Progressive Collective-exercise Program on the Knee Osteoarthritis; NCT01850862; https://clinicaltrials.gov/ct2/show/NCT01850862?term=NCT01850862&rank=1.