Predictive Effect of Well-Known Risk Factors and Foot-Core Training in Lower Limb Running-Related Injuries in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial.

BACKGROUND: Running carries the risk of several types of running-related injuries (RRIs), especially in the lower limbs. The variety of risk factors and the lack of strong evidence for several of these injury risks hinder the ability to draw assertive conclusions about them, hampering the implementation of effective preventive strategies. Because the etiology of RRIs seems to be multifactorial, the presence of RRI risk factors might influence the outcome of therapeutic strategies in different ways. Thus, further investigations on how risk and protective factors influence the incidence and prevention of RRIs should be conducted. PURPOSE: To investigate the predictive effect of well-known risk factors and 1 protective factor-foot-core training-on the incidence of lower limb RRIs in recreational runners. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Middle- and long-distance recreational runners (N = 118) were assessed at baseline and randomly allocated to either an intervention group (n = 57) or a control group (n = 61). The intervention group underwent an 8-week (3 times/wk) foot-core training program. Participants were followed for a year after baseline assessment for the occurrence of RRIs. Logistic regression with backward elimination of variables was used to develop a model for prediction of RRI in recreational runners. Candidate predictor variables included age, sex, body mass index, years of running practice, number of races, training volume, training frequency, previous RRI, and the foot-core exercise training. RESULTS: The final logistic regression model included 3 variables. As previously shown, the foot-core exercise program is a protective factor for RRIs (odds ratio, 0.40; 95% CI, 0.15-0.98). In addition, older age (odds ratio, 1.07; 95% CI, 1.00-1.14) and higher training volume (odds ratio, 1.02; 95% CI, 1.00-1.03) were risk factors for RRIs. CONCLUSION: The foot-core training was identified as a protective effect against lower limb RRI, which can be negatively influenced by older age and higher weekly training volume. The predictive model showed that RRIs should be considered a multivariate entity owing to the interaction among several factors. REGISTRATION: NCT02306148 (ClinicalTrials.gov identifier).

Effect of adduction during glenohumeral external rotation exercises in the scapulohumeral muscles / Efecto de la adducción durante ejercicios de rotación externa glenohumeral en los músculos escapulohumerales

SUMMARY: The effect of adduction during glenohumeral external rotation (ER) exercises on the scapulohumeral muscles is controversial. The aim of this study was to evaluate the effect of carrying out adduction during external rotation exercises in low and high shoulder positions on the electromyographic (EMG) activity of the infraspinatus (IS), middle deltoid (MD), and posterior deltoid (PD) muscles. EMG activity of the IS, MD, and PD muscles of 20 healthy participants was evaluated. Subjects performed 6 ER exercises that combined two factors: i) different adduction pressures according to biofeedback unit (0, 5 and 10 mmHg), and ii) low and high shoulder position. The pressure was controlled using a biofeedback unit. The low and high shoulder positions were 20? and 90? of abduction. In the low shoulder position, the activity of the IS muscle increased as the pressure on the biofeedback unit increased and the MD and PD muscles presented the highest activity at 10 mmHg. In the high shoulder position, the activity of the IS muscle was higher at 0 and 10 mmHg, the MD muscle presented higher activity at 5 mmHg, and PD muscle activity did not vary with the pressure. The addition of adduction at a pressure of 5 mmHg in the low shoulder position promotes is activity. Likewise, adduction at a pressure of 10 mmHg will promote activity of the IS, MD, and PD.

RESUMEN: El efecto de la aducción durante los ejercicios de rotación externa (RE) glenohumeral sobre los músculos escapulohumerales es controversial. El objetivo de este estudio fue evaluar el efecto de la realización de la aducción durante los ejercicios de rotación externa en posiciones bajas y altas del hombro sobre la actividad electromiográfica (EMG) delos músculos infraespinoso (IS), deltoides medio (DM) y deltoides posterior (DP). Se evaluó la actividad EMG de los músculos IS, MD y PD de 20 participantes sanos. Los sujetos realizaron 6 ejercicios de RE que combinaron dos factores: i) diferentes presiones de aducción de acuerdo con la unidad de biorretroalimentación (0, 5 y 10 mmHg), y ii) posición del hombro baja y alta. La presión se controló mediante una unidad de biorretroalimentación. Las posiciones del hombro baja y alta fueron de 20? y 90? de abducción. En la posición del hombro bajo, la actividad del músculo IS aumentó a medida que aumentaba la presión sobre la unidad de biorretroalimentación y los músculos MD y PD presentaron la actividad más alta a 10 mmHg. En la posición del hombro alto, la actividad del músculo IS fue mayor a 0 y 10 mmHg, el músculo MD presentó mayor actividad a 5 mmHg y la actividad del músculo PD no varió con la presión. La adición de aducción a una presión de 5 mmHg en la posición baja del hombro promueve la actividad del músculo IS. Asimismo, la aducción a una presión de 10 mmHg promoverá la actividad del IS, MD y PD.

Ejercicio terapéutico para desarrollar cambios posturales en estudiantes universitarios / Therapeutic exercise for developing postural changes in university students

Introducción. La buena postura consiste en la alineación del cuerpo con una máxima eficacia fisiológica y biomecánica, que minimiza los esfuerzos y tensiones a los que se somete el sistema de soporte a causa de la gravedad. Los ejercicios terapéuticos alivian los síntomas, mejoran la función y mantienen o frenan el deterioro de la salud, acciones que se reflejan en una adecuada postura. Objetivo. Describir los cambios en la postura después de un programa de intervención con técnicas de ejercicios terapéuticos, tales como estiramientos analíticos, miofasciales, au-toposturas de rehabilitacion postural global, ejercicios propioceptivos, técnica de Klapp y método de McKensie®, en 17 sujetos de 18 a 23 años que cursaban el quinto semestre del programa de Fisioterapia de la Universidad de Boyacá. Material y métodos. Se llevó a cabo un estudio descriptivo, de serie de casos, en que se analizaron los cambios en los componentes posturales, después de la implementación de un programa de ejercicio terapéutico, de media hora o más al día, cinco veces por semana, durante 16 semanas. Se utilizó la carta de simetría postural como instrumento para evaluar la postura en sus diferentes planos, previo consentimiento informado de los sujetos partici-pantes. Resultados. Se evaluaron los cambios en la alineación de la cabeza, simetría de los hombros, caída de los dedos, rotación del tronco, simetría en las rodillas, y base de sustentación y apoyo.Conclusiones. Mediante el ejercicio terapéutico basado en técnicas utilizadas en forma se-cuencial según su complejidad, que se inicia con estiramientos analíticos, seguidos de esti-ramientos miofasciales, ejercicios propioceptivos, técnica de Klapp y método de McKenzie, y culmina con autoposturas de rehabilitación postural global, se producen cambios posturales.

The position involves aligning the body with maximum physiological efficiency and mini-mizing biomechanical stresses and strains carried by the support system because of gravity, where therapeutic exercises relieve symptoms, improve function and maintain or slow the deteriorating health, actions that are reflected in a proper posture. Objective: To describe changes in the posterior position to an intervention program with therapeutic exercise techniques such as analytical technique Mckenzie stretching, myofascial autoposturas Global Postural Rehabilitation, proprioceptive exercises, Klapp technique in 17 subjects aged 18-23 years, who were enrolled in the fifth semester of the program of Phys-iotherapy, Universidad de Boyacá. Material and methods: A descriptive case series that analyzed changes in postural compo-nents, after the implementation of a therapeutic exercise program with duration equal to or greater than half an hour a day, five times a week, for 16 weeks. We used the letter of pos-tural symmetry as an instrument to assess the position in its different levels, prior informed consent of participating subjects Results: Changes in the alignment of head, shoulders symmetry, flanks of light falling fingers trunk rotation, symmetry knees support base and support. Conclusions: The therapeutic exercise based on techniques used sequentially depending on their complexity, which begins with analytical stretching, followed by myofascial stretching, proprioceptive exercises, technique Klapp, technical and culminating autoposturas Mckenzie Global Postural Rehabilitation produce postural changes.