Functional training versus Mat Pilates in motor and non-motor symptoms of individuals with Parkinson's disease: study protocol for a randomized controlled trial

Abstract Aim: This study aims to compare a functional training protocol and Mat Pilates for individuals with Parkinson's disease and to evaluate the effects on motor symptoms, as well as non-motor symptoms using a randomized controlled trial. Methods: Protocol for a randomized clinical trial in which 45 individuals with Parkinson's disease will be recruited and randomly allocated to one of three groups: (1) functional training; (2) Mat Pilates; (3) control group. Both intervention groups will have 60 min classes twice a week for 12 weeks. The primary outcome will be analyzed through motor symptoms, including balance, mobility, muscle strength, handgrip strength, flexibility, range of motion, and cardiorespiratory fitness. Secondary outcomes will include non-motor symptoms such as cognition, aging perspective, mood, anxiety, and depression. Conclusion: This will be the first randomized trial to compare the effects of functional training and Mat Pilates in a population with Parkinson's disease. It is hypothesized that improvements in motor and non-motor symptoms will be greater and more lasting after functional training and Mat Pilates interventions than those that maintain their routine activities, given the benefits of exercise and the unprecedented protocols in this disease.

[Evolution of body image perception and distorsion with mat and apparatus Pilates practice in adult women]. / Evolución de la percepción y distorsión de la imagen corporal con la práctica de Pilates en suelo y con aparatos en mujeres adultas.

INTRODUCTION: Introduction: the systematic practice of physical exercise may influence the perception and distortion of body image in adult women. Objective: to analyze the evolution of body image perception and distortion in adult women who performed a systematic practice of mat Pilates (PM) or Pilates with apparatus (PA). Methods: a total of 35 adult women participated in a PM (n = 19) or PA (n = 26) program for 16 weeks, two days a week. Body image was assessed before and after the interventions using the Eating Behavior Inventory 3 (EBI-3), Gardner's body image assessment scale, and Thompson and Gray's silhouette scale questionnaires. Results: the PM group showed a significant reduction in dissatisfaction with buttocks, dissatisfaction with body image, perceived image, distortion index, dissatisfaction index, perceived mental image, perceived affective image, cognitive dissatisfaction index, and affective dissatisfaction index (p < 0.05; ES: 0.26-0.80). As compared to the PA group, a significant reduction was shown in dissatisfaction with thighs, dissatisfaction with hips, dissatisfaction with body image, dissatisfaction index, cognitive dissatisfaction index, and affective dissatisfaction index (p < 0.05; 0.22-0.79). Conclusion: the systematic practice of PM or PA improves body image in adult women, reducing their body dissatisfaction.

INTRODUCCIÓN: Introducción: la práctica sistemática de ejercicio físico podría influir en la percepción y distorsión de la imagen corporal de mujeres adultas. Objetivo: analizar la evolución de la percepción y la distorsión de la imagen corporal en mujeres adultas que realizan una práctica sistemática de Pilates en suelo (PS) o Pilates con aparatos (PA). Metodología: un total de 35 mujeres adultas participaron en un programa de PS (n = 19) o PA (n = 26) durante 16 semanas, dos días por semana. La imagen corporal se valoró antes y después de las intervenciones con el cuestionario "Inventario de la conducta alimentaria 3" (EDI-3), la escala de evaluación de la imagen corporal de Gardner y la escala de siluetas de Thompson y Gray. Resultados: el grupo de PS mostró una reducción significativa de la insatisfacción con los glúteos, la insatisfacción con la imagen corporal, la imagen percibida, el índice de distorsión, el índice de insatisfacción, la imagen mental percibida, la imagen afectiva percibida, el índice de insatisfacción cognitiva y el índice de insatisfacción afectiva (p < 0,05; TE: 0,26-0,80). En relación con el grupo de PA se encontró una disminución significativa de la insatisfacción con los muslos, la insatisfacción con las caderas, la insatisfacción con la imagen corporal, el índice de insatisfacción, el índice de insatisfacción cognitiva y el índice de insatisfacción afectiva (p < 0,05; 0,22-0,79). Conclusiones: la práctica sistemática de PS o PA mejora la imagen corporal en mujeres adultas, reduciéndose el grado de insatisfacción corporal de las mismas.

Estudio descriptivo de serie de casos sobre los efectos de la exposición a la realidad virtual sobre los signos vitales en adultos mayores sanos / Descriptive study of series of cases on the effects of exposure to virtual reality on the vital signs of healthy older adults

INTRODUCCIÓN: Las tecnologías para la rehabilitación son instrumentos, equipos, sistemas o dispositivos, que aportan a los procesos de recuperación de las capacidades humanas. La 4.ª revolución industrial ha hecho que se utilice la realidad virtual en procesos de rehabilitación, por lo cual es necesario conocer sus efectos fisiológicos en las personas. OBJETIVO: Determinar el efecto de la exposición a la RV sobre los signos vitales en 7 adultos mayores aparentemente sanos. MÉTODO: Se presenta un estudio epidemiológico descriptivo de una serie de 7 casos que permitió evaluar el comportamiento de los signos vitales. Los participantes fueron adultos mayores con edades entre 50 a 75 años, sin ningún tipo de patología osteomuscular y neuromuscular que impidan la ejecución de programa. Se contó con 4 tipos de ambientes virtuales programados progresivamente desde un ambiente de adaptación hasta el ambiente virtual de demandas reales. RESULTADOS: En la recolección de los signos vitales se evidenció un aumento significativo en FC, FR, TAM y SaO2 (P < 0,05), no se encontraron diferencias significativas de los signos vitales tomados previos a la exposición y 10 minutos posterior (P < 0,05). CONCLUSIÓN: Los cambios hemodinámicos antes de la exposición a RV no son permanentes en el tiempo. Los signos vitales 10 minutos posterior a la exposición regresan a los valores iniciales; lo cual permite aplicar la RV en personas mayores aparentemente sanas como estrategia terapéutica sin riesgo de presentar cambios fisiológicos concurrentes y nocivos, de acuerdo a la muestra de este estudio

INTRODUCTION: The technologies for rehabilitation are instruments, equipment, systems or devices, which contribute to the processes of recovery of human capabilities. The 4.th industrial revolution has brought about the use of virtual reality in rehabilitation processes, and therefore it is necessary to be aware of its physiological effects on people. OBJECTIVE: To determine the effect of VR exposure on vital signs in 7 apparently healthy older adults. METHOD: We present a descriptive epidemiological study of a series of 7 cases that allowed us to evaluate the behaviour of vital signs. The participants were older adults aged between 50 and 75 years, without any musculoskeletal or neuromuscular pathology to prevent them undertaking the programme. There were 4 types of virtual environments programmed progressively from an adaptation environment to the virtual environment of real demands. RESULTS: In the collection of vital signs, a significant increase in HR, FR, TAM and SaO2 (P < .05) was evidenced, no significant differences were found in the vital signs taken before and 10minutes after exposure (P < .05). CONCLUSION: Haemodynamic changes before exposure to RV are not permanent over time. Vital signs 10minutes after exposure return to initial values, which allows the application of RV in apparently healthy older people as a therapeutic strategy without risk of presenting concurrent and harmful physiological changes, according to the sample of this study

Feasibility of the Archercise biofeedback device to strengthen foot musculature.

BACKGROUND: Foot muscle weakness can produce foot deformity, pain and disability. Toe flexor and foot arch exercises focused on intrinsic foot muscle strength and functional control may mitigate the progression of foot deformity and disability. Ensuring correct exercise technique is challenging due to the specificity of muscle activation required to complete some foot exercises. Biofeedback has been used to improve adherence, muscle activity and movement patterns. We investigated the feasibility of using a novel medical device, known as "Archercise", to provide real-time biofeedback of correct arch movement via pressure change in an inflatable bladder, and foot location adherence via sensors embedded in a footplate during four-foot exercises. METHODS: Thirty adults (63% female, aged 23-68 years) performed four-foot exercises twice on the Archercise sensor footplate alone and then with biofeedback. One-way repeated measures ANOVA with pairwise comparisons were computed to assess the consistency of the exercise protocol between trial 1 and trial 2 (prior to biofeedback), and the effectiveness of the Archercise biofeedback device between trial 2 and trial 3 (with biofeedback). Outcome measures were: Arch movement exercises of arch elevation and lowering speed, controlled arch elevation, controlled arch lowering, endurance of arch elevation; Foot location adherence was determined by percentage of time the great toe, fifth toe and heel contacted footplate sensors during testing and were analysed with paired sample t-tests. Participant survey comments on the use of Archercise with biofeedback were reported thematically. RESULTS: Seventeen (89%) arch movement and foot location variables were collected consistently with Archercise during the foot exercises. Archercise with biofeedback improved foot location adherence for all exercises (p = 0.003-0.008), coefficient of determination for controlled arch elevation (p < 0.0001) and endurance area ratio (p = 0.001). Twenty-nine (97%) participants reported Archercise with biofeedback, helped correct exercise performance. CONCLUSIONS: Archercise is a feasible biofeedback device to assist healthy participants without foot pathologies perform foot doming exercises. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): 12616001559404. Registered 11 November 2016, http://www.ANZCTR.org.au/ACTRN12616001559404p.aspx.

Desenvolvimento e validação do Sistema de Observação do Clima de Aula em Aulas de Grupo de Fitness - aplicação piloto em idosos / Development and validation of the Class Climate Observation System in Group Fitness Classes - pilot application with the elderly / Desarrollo y validación del Sistema de Observación del Clima en Clases de Grupo de Fitness - aplicación piloto en ancianos

O presente estudo teve como principal objetivo desenvolver e validar um Sistema de Observação do Clima de Aula em Aulas de Grupo de Fitness (SOCA-AGF) bem como realizar uma aplicação piloto do mesmo. Participaram no estudo 6 instrutoras de 2 atividades (hidroginástica e localizada), em população idosa, para testar a funcionalidade do instrumento. Verificou-se que o SOCA-AGF, constituído por 2 dimensões, 36 categorias e 8 subcategorias, apresentou fiabilidade e validade. Os resultados obtidos indicam que o comportamento observável dos instrutores de fitness, em aulas de grupo, poderá ser codificado recorrendo a este instrumento. Concluiu-se que o SOCA-AGF regista aspetos fundamentais do comportamento que influencia o clima de aula dos instrutores de fitness em aulas de grupo e, como tal, poderá ser utilizado para estudar aspetos relevantes no âmbito do comportamento que influencia o clima de aula em diferentes atividades de grupo, no contexto do fitness, e em diferentes tipos de população

The main target of this study was to develop and validate an observation system of the environment in fitness group classes (SOCA-AGF), as well as to carry out a pilot implementation. A sample of 6 instructors from 2 activities (aquafitness and resistance training) with elderly people tested the functionality of the instrument. The observation system SOCA-AGF, which has 2 dimensions, 36 categories and 8 subcategories, showed reliability and validity. The results indicate that the observable behavior of fitness instructors in group classes can be codified by using this instrument. We concluded that the SOCA-AGF shows fundamental behavior aspects that influence the environment of the fitness instructor in group classes, therefore it can be used to study relevant aspects of the behavior that influences the class environment in different group activities, in the context of fitness and with different types of population

El presente estudio tuvo como principal objetivo desarrollar y validar un Sistema de Observación del Clima de Clase en Clases de Grupo de Fitness (SOCA-AGF), así como realizar una aplicación piloto del mismo. Para esta aplicación piloto se utilizó una muestra de 6 instructores de 2 actividades (hidrogimnasia y localizada), en población de tercera edad, para probar la funcionalidad del instrumento. Se verificó que el SOCA-AGF, constituido por 2 dimensiones, 36 categorías y 8 subcategorías, presentó fiabilidad y validez. Los resultados obtenidos indican que el comportamiento observable de los instructores, en clases de grupo, puede ser codificado recurriendo a este instrumento. Se concluyó que el SOCA-AGF registra aspectos fundamentales del comportamiento que influye en el clima de clase de los instructores de fitness en clases de grupo y, como tal, podrá ser utilizado para estudiar aspectos relevantes en el ámbito del comportamiento que influye en el clima de clase en diferentes actividades de grupo en el contexto del fitness y en diferentes tipos de población

Effectiveness of mat Pilates on postural alignment in the sagittal plane in school children: a randomized clinical trial

Abstract Aims: This study aimed to investigate the effectiveness of the mat Pilates method, an exercise program, on postural alignment in the sagittal plane among children aged between 8 and 12 years. Method: This study used a blind randomized controlled clinical trial, with a Pilates group (PG) and control group (CG) at the Early Childhood Education Institute. A total of 40 children were randomized, who have no prior knowledge of the Pilates method and no exercise training in the last six months. Mat Pilates exercises were administered twice a week for four months in 50-minute sessions. Postural alignment in the sagittal plane was assessed using photogrammetry. Results: There was no statistically significant difference between the groups post-intervention A significant difference was found in the following outcomes that represent an improvement in intragroup postural alignment: among the children in PG, in the right sagittal view in the vertical body alignment (p=0.019; effect size, ES = 0.70; standardize response mean, SRM = 0.57) and in the sagittal head angle (p=0.035; ES = 0.41; SRM = 0.51). Among the children in the CG, in the vertical alignment of the trunk in the left sagittal view (p= 0.016; ES = 0.50; SRM = 0.44). Conclusion: The effectiveness of Pilates on postural alignment in the sagittal plane among children aged between 8 and 12 years was not confirmed.

Mat Pilates is as effective as aquatic aerobic exercise in treating women with fibromyalgia: a clinical, randomized and blind trial

Abstract Background: The mat Pilates method is the therapeutic modalities which can be used in fibromyalgia treatment. Although there are no well-designed studies that prove the effectiveness of the mat Pilates method in this population. The objective was to evaluate the effectiveness of the mat Pilates method for improving symptoms in women with fibromyalgia. Methods: A single blind randomized controlled trial in which 42 women with fibromyalgia were randomized into two groups: mat Pilates and aquatic aerobic exercise. The exercises were performed twice a week for 12 weeks. Two evaluations were performed: one at baseline (T0), and another at 12 weeks after randomization (T12). The primary outcome was pain measured by the Visual Analogue Scale (VAS). Secondary outcomes were function (Fibromyalgia Impact Questionnaire), sleep (Pittsburgh Sleep Quality Index [PSQI]), quality of life (Short Form 36 [SF-36]), fear avoidance (Fear Avoidance Beliefs Questionnaire [FABQ-BR]) and pain catastrophizing (Pain-Related Catastrophizing Thoughts Scale [PRCTS]). Results: There was improvement in both groups in relation to pain and function (p < 0.05). The aspects related to quality of life and the FABQ questionnaire only showed improvement in the mat Pilates group (p < 0.05). There was improvement in the PSQI and PRCTS variables only in the aquatic aerobic exercise group (p < 0.05), but no differences were observed between the groups for any of the evaluated variables. Conclusion: Significant improvements were observed in the two groups in relation to the disease symptoms, and no differences were observed between mat Pilates and aquatic aerobic exercise in any of the measured variables. Trial registration: ClinicalTrials.gov Identifier (NCT03149198), May 11, 2017. Approved by the Ethics Committee of FACISA/UFRN (Number: 2.116.314).(AU)

Desempenho muscular respiratório após 12 sessões de treinamento utilizando o aparelho Reformer do método Pilates / Rendimiento muscular respiratorio después de 12 sesiones de entrenamiento utilizando el aparato Reformer del método Pilates / Respiratory muscle performance after 12 sessions of training using the apparatus Reformer of Pilates method

RESUMO Analisar o desempenho muscular respiratório em praticantes de exercícios utilizando o aparelho Reformer do Método Pilates após um treinamento de 12 sessões. O estudo foi realizado com 24 voluntárias, adultas jovens, saudáveis, não tabagistas e não praticantes de exercício físico regular, divididas em Grupo Controle (GC) e Grupo Treinado (GT). Os dois grupos foram submetidos às avaliações inicial e final para análise do desempenho dos músculos respiratórios por meio da manovacuometria e da eletromiografia do músculo reto abdominal. Utilizou-se o teste de Shapiro-Wilk para verificar a normalidade dos dados. A análise de variância two-way foi empregada para as comparações entre os grupos (GT e GC) e os momentos (inicial e final). Para comparações múltiplas, utilizou-se o teste post-hoc de Scheffé. Os GC e GT foram pareados para idade e IMC e, para verificação de diferenças entre os grupos, utilizou-se o teste t pareado. Considerou-se p<0,05 para significância. Houve diferença significante (p=0,039) entre os valores iniciais (116,6 ± 12,8) e finais (120 ± 12,8) de PImáx no GT, assim como entre os valores iniciais (75,3 ± 12,4) e finais (89,3 ± 13,7) de PEmáx nesse mesmo grupo (p=0,0005). Para a eletromiografia houve diferença significante (p=0,03) entre o momento inicial (42,1 ± 15,8) e final (76,7 ± 37,1) do GT para o músculo reto abdominal esquerdo. Conclui-se que as doze sessões de Pilates utilizando o aparelho Reformer melhoraram o desempenho muscular respiratório, aumentando a força da musculatura inspiratória e expiratória.

RESUMEN Evaluar el rendimiento de los músculos respiratorios en practicantes de ejercicios utilizando el método Reformer de Pilates después de un entrenamiento de 12 sesiones. Este estudio se realizó con 24 voluntarios, adultos jóvenes, sanos, no fumadores y no deportistas regulares, siendo divididos en grupo control (GC) y grupo entrenado (GE). El GE participó en un programa de entrenamiento ejecutando 6 ejercicios en el aparato Reformer. Ambos grupos se sometieron a evaluaciones iniciales y finales para analizar el rendimiento de los músculos respiratorios mediante la manovacuometría y la electromiografía del músculo recto abdominal. La prueba de Shapiro-Wilk se utilizó para verificar la normalidad de los datos. Se utilizó el análisis de varianza two-way para las comparaciones entre los grupos (GE y GC) y los momentos (inicial y final). Para comparaciones múltiples, se utilizó la prueba post-hoc de Scheffé. El GC y el GE se emparejaron por edad e IMC mediante la prueba t pareada. Se consideró el valor de significación p<0,05. Se observó una diferencia significativa (p=0,039) entre los valores iniciales (116,6 ± 12,8) y finales (120 ± 12,8) de PImax en el grupo entrenado, así como entre los valores de iniciales (75,3 ± 12,4) y finales (89,3 ± 13,7) de PEmax en el mismo grupo (p=0,0005). En la electromiografía, se observó una diferencia significativa (p=0,03) entre los momentos inicial (42,1 ± 15,8) y final (76,7 ± 37,1) del GE para el músculo recto abdominal izquierdo. Se concluye que las 12 sesiones de Pilates utilizando el aparato Reformer mejoran el rendimiento de los músculos respiratorios, aumentando la fuerza muscular inspiratoria y espiratoria.

ABSTRACT To analyze respiratory muscle performance in exercise practitioners using the Reformer of Pilates method after a 12-session training. This study was carried out with 24 volunteers, healthy young adults, non-smokers and non-regular exercisers, divided into control group (CG) and trained group (TG). The TG participated in a training program executing 6 exercises in the Reformer apparatus. Both groups were submitted to the initial and final evaluations to analyze the performance of the respiratory muscles through the manovacuometry and electromyography of the rectus abdominis muscle. The Shapiro-Wilk test was used to verify the data normality. Two-way analysis of variance was used for the comparisons between the groups (TG and CG) and moments (Initial and Final). For multiple comparisons, the Scheffé post hoc test was used. The groups Control and Trained were paired by age and BMI by paired t test. P <0.05 was considered for significance. A significant difference (p=0039) was observed between the initial (116.6 ± 12.8) and final (120 ± 12.8) values of MIP in the trained group, as well as between baseline values (75.3 ± 12.4) and final (89.3 ± 13.7) of MEP in the same group (p=0.0005). For electromyography, a significant difference (p=0.03) was observed between the initial (42.1 ± 15.8) and final (76.7 ± 37.1) moments of the TG for the left rectus abdominis muscle. The conclusion is that the 12 Pilates sessions using the Reformer apparatus improve respiratory muscle performance, increasing the inspiratory and expiratory muscle strength.

Exercising on Different Unstable Surfaces Increases Core Abdominal Muscle Thickness: An Observational Study Using Real-Time Ultrasound.

BACKGROUND: The training of abdominal muscles has a positive impact on the functional capacity of healthy adults, being applied practically in fields of athletics and fitness through rehabilitation for lower back pain. OBJECTIVE: The study compares abdominal muscle activity while performing graded isometric exercises on stable and unstable surfaces. The authors also examined perceived stability and comfort for the different surfaces. METHODS: A total of 30 young, healthy adults performed 3 graded isometric exercises on a Pilates table, foam roller, and Oov (a newly developed tool). Ultrasound investigation measured transversus abdominis, internal oblique abdominis, and external oblique abdominis thickness during each task, comparing muscle thickness between conditions using general linear modeling. RESULTS: Core abdominal activation was greater on the foam roller than the Oov and Pilates table during crook lying (bilateral leg support). Both Oov and foam roller elicited greater contralateral transversus abdominis and internal oblique abdominis thickness than the Pilates table during tabletop and straight leg raises (unilateral leg exercises). For transversus abdominis only, the foam roller elicited more muscle thickness than the Oov during straight leg raises. The Oov was rated more comfortable than the foam roller. DISCUSSION: Exercises performed on the Oov and foam roller elicit core greater abdominal muscle thickness than those performed on a Pilates table. Unilateral leg exercises in a supine position elicit more contralateral muscle thickness than those with bilateral leg support. CONCLUSIONS: These results provide information to support choices in exercise progression from flat stable to more unstable surfaces and from those with bilateral foot support to unilateral foot support. The Oov was more comfortable that the foam roller, and this may help with exercise adherence.

Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial.

BACKGROUND: Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time. METHODS: We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå, Sweden. We included people who were aged 40-67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m2 and 40 kg/m2. After the baseline measurement, we stratified participants by their BMI (25-30 kg/m2 and >30 to 40 kg/m2); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit-stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants. FINDINGS: Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time awake at weekdays increased between baseline and 13 months by 18 min (95% CI 9 to 26) in the intervention group and 1 min (-7 to 9) in the control group (difference 22 min [95% CI 7 to 37], pinteraction=0·00045); for weekend walking, the change from baseline to 13 months was 5 min (-8 to 18) in the intervention group and 8 min (-5 to 21) in the control group (difference -1 min [-19 to 17]; pinteraction=0·00045). Neither measure met our predetermined primary outcome of 30 min difference in total walking time between the intervention and control group, so the primary outcome of the trial was not met. One adverse event was reported in a participant who accidently stepped on their Achilles tendon. INTERPRETATION: In a sedentary work environment, treadmill workstations result in a statistically significant but smaller-than-expected increase in daily walking time. Future studies need to investigate how increasing physical activity at work might have potentially compensatory effects on non-work activity. FUNDING: Umeå University, the Västerbotten County Council, and the Mayo Clinic Foundation for Research.

Mirror therapy for improving motor function after stroke.

BACKGROUND: Mirror therapy is used to improve motor function after stroke. During mirror therapy, a mirror is placed in the person's midsagittal plane, thus reflecting movements of the non-paretic side as if it were the affected side. OBJECTIVES: To summarise the effectiveness of mirror therapy compared with no treatment, placebo or sham therapy, or other treatments for improving motor function and motor impairment after stroke. We also aimed to assess the effects of mirror therapy on activities of daily living, pain, and visuospatial neglect. SEARCH METHODS: We searched the Cochrane Stroke Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, AMED, PsycINFO and PEDro (last searched 16 August 2017). We also handsearched relevant conference proceedings, trials and research registers, checked reference lists, and contacted trialists, researchers and experts in our field of study. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and randomised cross-over trials comparing mirror therapy with any control intervention for people after stroke. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials based on the inclusion criteria, documented the methodological quality, assessed risks of bias in the included studies, and extracted data. We assessed the quality of the evidence using the GRADE approach. We analysed the results as standardised mean differences (SMDs) or mean differences (MDs) for continuous variables, and as odds ratios (ORs) for dichotomous variables. MAIN RESULTS: We included 62 studies with a total of 1982 participants that compared mirror therapy with other interventions. Of these, 57 were randomised controlled trials and five randomised cross-over trials. Participants had a mean age of 59 years (30 to 73 years). Mirror therapy was provided three to seven times a week, between 15 and 60 minutes for each session for two to eight weeks (on average five times a week, 30 minutes a session for four weeks).When compared with all other interventions, we found moderate-quality evidence that mirror therapy has a significant positive effect on motor function (SMD 0.47, 95% CI 0.27 to 0.67; 1173 participants; 36 studies) and motor impairment (SMD 0.49, 95% CI 0.32 to 0.66; 1292 participants; 39 studies). However, effects on motor function are influenced by the type of control intervention. Additionally, based on moderate-quality evidence, mirror therapy may improve activities of daily living (SMD 0.48, 95% CI 0.30 to 0.65; 622 participants; 19 studies). We found low-quality evidence for a significant positive effect on pain (SMD -0.89, 95% CI -1.67 to -0.11; 248 participants; 6 studies) and no clear effect for improving visuospatial neglect (SMD 1.06, 95% CI -0.10 to 2.23; 175 participants; 5 studies). No adverse effects were reported. AUTHORS' CONCLUSIONS: The results indicate evidence for the effectiveness of mirror therapy for improving upper extremity motor function, motor impairment, activities of daily living, and pain, at least as an adjunct to conventional rehabilitation for people after stroke. Major limitations are small sample sizes and lack of reporting of methodological details, resulting in uncertain evidence quality.

Effect of a novel mobilization with movement procedure on anterolateral ankle impingement - A case report.

This case report describes a 50-year-old male who presented with right anterolateral ankle pain managed unsuccessfully with rest, medications, bracing, injection, physical therapy, and massage therapy. Clinical diagnosis of anterolateral ankle impingement was based on concordant symptom reproduction with palpatory tenderness and a positive lateral synovial impingement test. This case report is a potential first time description of the successful management of anterolateral ankle impingement utilizing a novel Mulligan's mobilization with movement procedure (consisting of internal rotation of the distal tibia) and taping with immediate improvements noted in pain, range of motion, and function. The patient was seen twice a week and was discharged after four treatment sessions. A follow-up after 4 months revealed that the patient was pain free and fully functional.

¿Es efectivo el método pilates en el dolor lumbar? / Is effective the Pilates method for low back pain?

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Pilates Mat y composición corporal de mujeres posmenopáusicas. Estudio densitométrico / Pilates Mat and body composition of postmenopausal women. Densitometric study

El objetivo de este trabajo es cuantificar, mediante Absorciometría Dual Fotónica de Rayos- X (DXA), las modificaciones de la composición corporal que la práctica de Pilates Mat produce en mujeres posmenopaúsicas de vida sedentaria. Tras un programa de ejercicios de 9 meses de duración a razón de 2 sesiones por semana de 60 minutos cada una, se observó un aumento significativo del compartimento muscular a nivel de tronco (p=0,028), abdomen (p=0,010) y brazos (p=0,042), así como una disminución significativa de la grasa de las piernas (p=0,000). La densidad mineral ósea de la columna lumbar (L2, L3 y L4) también aumentó de forma significativa. Los resultados sugieren que la práctica de Pilates Mat en mujeres posmenopaúsicas mejora su composición corporal (AU)

The aim of this study was to quantify the changes in body composition after Mat Pilates practice in postmenopausal sedentary women using Dual X-ray Photon Absorptiometry (DXA). After a 9-month exercise program consisting of 2 sessions per week of 60 minutes each, a significant increase was observed in the muscle mass of the trunk (p = 0.028), abdomen (p = 0.010) and arms (p = 0.042). A significant decrease was observed in the leg fat mass (p = 0.000). Bone mineral density of the lumbar spine (L2, L3 and L4) also increased significantly. The results suggest that the practice of Mat Pilates in postmenopausal women improves their body composition (AU)

Treadmill interventions in children under six years of age at risk of neuromotor delay.

BACKGROUND: Delayed motor development may occur in children with Down syndrome, cerebral palsy, general developmental delay or children born preterm. It limits the child's exploration of the environment and can hinder cognitive and social-emotional development. Literature suggests that task-specific training, such as locomotor treadmill training, facilitates motor development. OBJECTIVES: To assess the effectiveness of treadmill interventions on locomotor development in children with delayed ambulation or in pre-ambulatory children (or both), who are under six years of age and who are at risk for neuromotor delay. SEARCH METHODS: In May 2017, we searched CENTRAL, MEDLINE, Embase, six other databases and a number of trials registers. We also searched the reference lists of relevant studies and systematic reviews. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs that evaluated the effect of treadmill intervention in the target population. DATA COLLECTION AND ANALYSIS: Four authors independently extracted the data. Outcome parameters were structured according to the International Classification of Functioning, Disability and Health model. MAIN RESULTS: This is an update of a Cochrane review from 2011, which included five trials. This update includes seven studies on treadmill intervention in 175 children: 104 were allocated to treadmill groups, and 71 were controls. The studies varied in population (children with Down syndrome, cerebral palsy, developmental delay or at moderate risk for neuromotor delay); comparison type (treadmill versus no treadmill; treadmill with versus without orthoses; high- versus low-intensity training); study duration, and assessed outcomes. Due to the diversity of the studies, only data from five studies were used in meta-analyses for five outcomes: age of independent walking onset, overall gross motor function, gross motor function related to standing and walking, and gait velocity. GRADE assessments of quality of the evidence ranged from high to very low.The effects of treadmill intervention on independent walking onset compared to no treadmill intervention was population dependent, but showed no overall effect (mean difference (MD) -2.08, 95% confidence intervals (CI) -5.38 to 1.22, 2 studies, 58 children; moderate-quality evidence): 30 children with Down syndrome benefited from treadmill training (MD -4.00, 95% CI -6.96 to -1.04), but 28 children at moderate risk of developmental delay did not (MD -0.60, 95% CI -2.34 to 1.14). We found no evidence regarding walking onset in two studies that compared treadmill intervention with and without orthotics in 17 children (MD 0.10, 95% CI -5.96 to 6.16), and high- versus low-intensity treadmill interventions in 30 children with Down syndrome (MD -2.13, 95% -4.96 to 0.70).Treadmill intervention did not improve overall gross motor function (MD 0.88, 95% CI -4.54 to 6.30, 2 studies, 36 children; moderate-quality evidence) or gross motor skills related to standing (MD 5.41, 95% CI -1.64 to 12.43, 2 studies, 32 children; low-quality evidence), and had a negligible improvement in gross motor skills related to walking (MD 4.51, 95% CI 0.29 to 8.73, 2 studies, 32 children; low-quality evidence). It led to improved walking skills in 20 ambulatory children with developmental delay (MD 7.60, 95% CI 0.88 to 14.32, 1 study) and favourable gross motor skills in 12 children with cerebral palsy (MD 8.00, 95% CI 3.18 to 12.82). A study which compared treadmill intervention with and without orthotics in 17 children with Down syndrome suggested that adding orthotics might hinder overall gross motor progress (MD -8.40, 95% CI -14.55 to -2.25).Overall, treadmill intervention showed a very small increase in walking speed compared to no treadmill intervention (MD 0.23, 95% CI 0.08 to 0.37, 2 studies, 32 children; high-quality evidence). Treadmill intervention increased walking speed in 20 ambulatory children with developmental delay (MD 0.25, 95% CI 0.08 to 0.42), but not in 12 children with cerebral palsy (MD 0.18, 95% CI -0.09 to 0.45). AUTHORS' CONCLUSIONS: This update of the review from 2011 provides additional evidence of the efficacy of treadmill intervention for certain groups of children up to six years of age, but power to find significant results still remains limited. The current findings indicate that treadmill intervention may accelerate the development of independent walking in children with Down syndrome and may accelerate motor skill attainment in children with cerebral palsy and general developmental delay. Future research should first confirm these findings with larger and better designed studies, especially for infants with cerebral palsy and developmental delay. Once efficacy is established, research should examine the optimal dosage of treadmill intervention in these populations.

Ejercicio físico como tratamiento en el manejo de lumbalgia / Exercise as a treatment for low back pain management

RESUMEN La lumbalgia es un padecimiento que conlleva grandes repercusiones económicas, sociales y se ha convertido en una de las primeras causas de incapacidad laboral a nivel global. Cuando ocurre el dolor en la parte baja de la espalda se genera la incertidumbre sobre los factores de riesgo o causas que pueden desencadenar la lumbalgia, sin embargo; su diagnóstico no es sencillo y cerca del 90 % de los casos generalmente no presentan algún tipo de lesión demostrable, por lo que el problema se cataloga como una lumbalgia inespecífica. El tratamiento incluye movimiento de la persona, ya que el reposo debilita y atrofia la musculatura de la espalda, además; dentro de los métodos de ejercicios recomendados se encuentran los ejercicios localizados en musculatura del tronco y abdomen principalmente, resistencia muscular, estabilidad espinal, Pilates, ejercicios de Williams y Mckenzie, técnicas de Feldenkrais y Alexander, entre otros.(AU)

ABSTRACT Low back pain is an illness with various economic and social repercussions since it is one on the most causes of work absence worldwide. When the patient feels pain in the back, there is an uncertainty regarding a possible risk or cause for low back pain; however, diagnosis is not easy, and around 90 % of the cases do not present physical evidence, therefore, the problem is classified as a non-specific low back pain. Treatment includes body movement, because rest weakens the back muscles and causes atrophy; the recommended exercise methods include exercises for the trunk and abdomen muscles mainly, muscular resistance, spinal stability, Pilates, Williams and Mckenzie exercises, Feldenkrais and Alexander techniques, among others.(AU)

Aportaciones sobre la eficacia del método Pilates en la fuerza, el equilibrio y el riesgo de caídas de personas mayores / Contribuições sobre a eficácia do método Pilates na força, equilíbrio e risco de quedas em pessoas idosas / Contributions on the effectiveness of the Pilates method in strength, balance and risk of falls in elderly people

Objetivo. Recopilar, resumir y comparar la evidencia científica sobre la eficacia del método Pilates en la fuerza, el equilibrio y las caídas en personas mayores. Método. Búsqueda acotada entre 2004 y 2014. Bases de datos: Medline, PubMed, Web of Knowledge, OVID, ScienceDirect y Academic Search Premier. La calidad metodológica se determinó con la escala PEDro. Resultados. En cuatro estudios se midió la fuerza y solo uno mejoró significativamente la fuerza isométrica de cadera. En nueve estudios se midió el equilibrio estático y dinámico, con resultados positivos en ocho de ellos. De estos, cinco estudios encuentran relación entre el equilibrio y la disminución del riesgo de caídas. Conclusiones. El método Pilates es eficaz para mejorar la fuerza isométrica de cadera y el equilibrio en personas mayores, reduciendo el riesgo de caídas. No existen evidencias suficientes para determinar si la fuerza del core tiene que ver con el equilibrio y las caídas (AU)

Objetivo. Coletar, resumir e comparar as evidências científicas sobre a eficácia do método Pilates na força, equilíbrio e risco de quedas em pessoas idosas. Método. Pesquisa foi delimitada entre 2004-2014. Bancos de dados: Medline, PubMed, Web of Knowledge, OVID, ScienceDirect e Academic Search Premier. A qualidade metodológica foi determinada pela escala PEDro. Resultados. Quatro estudos mediram a força e apenas um melhorou significativamente a força isométrica do quadril. Em 9 estudos, foi medido o equilíbrio estático e dinâmico, com resultados positivos em 8 deles. Destes, 5 encontraram relação entre o equilíbrio e redução do risco de quedas. Conclusões. O método Pilates é eficaz para melhorar a força isométrica e do quadril, e o equilíbrio em pessoas mais velhas, reduzindo o risco de quedas. Não há evidência suficiente para determinar se a força do core tem a ver com o equilíbrio e o risco de quedas (AU)

Objective. Collect, summarize and compare the scientific evidence on the effectiveness of the Pilates method in strength, balance and falls in older people. Method. Search limited between 2004 and 2014. Databases: Medline, PubMed, Web of Knowledge, OVID, ScienceDirect and Academic Search Premier. The methodological quality was determined by the PEDro scale. Results. Four studies measured the force and only one found significant improvements in isometric hip strength. In nine studies the static and dynamic balance was measured, showing positive results in eight of them. Of these, five studies are relationship between balance and reducing risk of falls. Conclusions. The Pilates method is effective for improving the isometric hip strength and balance in older people, reducing the risk of falls. There is insufficient evidence to determine whether the strength of the core has to do with balance and falls (AU)

Cardiovascular fitness is improved post-stroke with upper-limb Wii-based Movement Therapy but not dose-matched constraint therapy.

INTRODUCTION: Post-stroke cardiovascular fitness is typically half that of healthy age-matched people. Cardiovascular deconditioning is a risk factor for recurrent stroke that may be overlooked during routine rehabilitation. This study investigated the cardiovascular responses of two upper limb rehabilitation protocols. METHODS: Forty-six stroke patients completed a dose-matched program of Wii-based Movement Therapy (WMT) or modified Constraint-induced Movement Therapy (mCIMT). Heart rate and stepping were recorded during early (day 2)- and late (day 12-14)-therapy. Pre- and post-therapy motor assessments included the Wolf Motor Function Test and 6-min walk. RESULTS: Upper limb motor function improved for both groups after therapy (WMT p = 0.003, mCIMT p = 0.04). Relative peak heart rate increased from early- to late-therapy WMT by 33% (p < 0.001) and heart rate recovery (HRR) time was 40% faster (p = 0.04). Peak heart rate was higher and HRR faster during mCIMT than WMT, but neither measure changed during mCIMT. Stepping increased by 88% during Wii-tennis (p < 0.001) and 21% during Wii-boxing (p = 0.045) while mCIMT activities were predominantly sedentary. Six-min walk distances increased by 8% (p = 0.001) and 4% (p = 0.02) for WMT and mCIMT, respectively. DISCUSSION: Cardiovascular benefits were evident after WMT as both a cardiovascular challenge and improved cardiovascular fitness. The peak heart rate gradient across WMT activities suggests this therapy can be further individualized to address cardiovascular needs. The mCIMT data suggest a cardiovascular stress response. CONCLUSIONS: This is the first study to demonstrate a cardiovascular benefit during specifically targeted upper limb rehabilitation. Thus, WMT not only improves upper limb motor function but also improves cardiovascular fitness.

Exercise Countermeasure Hardware Evolution on ISS: The First Decade.

The hardware systems necessary to support exercise countermeasures to the deconditioning associated with microgravity exposure have evolved and improved significantly during the first decade of the International Space Station (ISS), resulting in both new types of hardware and enhanced performance capabilities for initial hardware items. The original suite of countermeasure hardware supported the first crews to arrive on the ISS and the improved countermeasure system delivered in later missions continues to serve the astronauts today with increased efficacy. Due to aggressive hardware development schedules and constrained budgets, the initial approach was to identify existing spaceflight-certified exercise countermeasure equipment, when available, and modify it for use on the ISS. Program management encouraged the use of commercial-off-the-shelf (COTS) hardware, or hardware previously developed (heritage hardware) for the Space Shuttle Program. However, in many cases the resultant hardware did not meet the additional requirements necessary to support crew health maintenance during long-duration missions (3 to 12 mo) and anticipated future utilization activities in support of biomedical research. Hardware development was further complicated by performance requirements that were not fully defined at the outset and tended to evolve over the course of design and fabrication. Modifications, ranging from simple to extensive, were necessary to meet these evolving requirements in each case where heritage hardware was proposed. Heritage hardware was anticipated to be inherently reliable without the need for extensive ground testing, due to its prior positive history during operational spaceflight utilization. As a result, developmental budgets were typically insufficient and schedules were too constrained to permit long-term evaluation of dedicated ground-test units ("fleet leader" type testing) to identify reliability issues when applied to long-duration use. In most cases, the exercise unit with the most operational history was the unit installed on the ISS.

Evolution of Russian Microgravity Countermeasures.

INTRODUCTION: Countermeasures to prevent or partially offset the negative physiologic changes that are caused by the effects of microgravity play an important role in supporting the performance of crewmembers in flight and their safe return to Earth. Research conducted in Russia on the orbital stations Salyut and Mir, as well as simulation experiments on the ground, have demonstrated that changes that occur during extended spaceflight in various physiologic systems can be prevented or significantly decreased by using countermeasures. Hardware and techniques used on the ISS have been substantially improved to reflect the experience of previous extended missions on Russian orbital stations. Countermeasures used during early ISS missions consisted of the U.S. treadmill (TVIS), cycle ergometer (ВБ-3), a set of resistance bands, a postural muscle loading suit (Penguin-3), electrical stimulator (Tonus-3), compression thigh cuffs (Braslet-М), a lower body negative pressure (LBNP) suit (Chibis), a lower body g-loading suit (Kentavr), and water/salt supplements. These countermeasures are described in this article.