Effects of a foot-ankle muscle strengthening program on pain and function in individuals with knee osteoarthritis: a randomized controlled trial.

BACKGROUND: Foot-ankle exercises could improve pain and function of individuals with KOA and need to be tested. OBJECTIVE: To investigate whether an 8-week foot-ankle muscle strengthening program is effective for individuals with KOA to reduce pain and improve function. METHODS: In this randomized controlled trial, individuals diagnosed with clinical and radiographic KOA were randomized into the intervention (supervised foot-ankle strengthening exercise program three times a week for 8 weeks) or control (usual care and recommendations of the healthcare team) group. Effectiveness was assessed by changes in clinical and functional outcomes between baseline and 8 weeks with pain as the primary outcome. ANCOVA tests using the intervention group as a reference and sex, body mass index, and baseline values as covariates assessed between-group differences. RESULTS: The intervention group showed lower pain scores (-4.4 units; 95%CI = -7.5, -1.1), better function (-7.1 units; 95%CI = -12.7, -1.4), higher total functional score (-11.9 units; 95%CI = -20.7, -3.1), with confidence intervals indicating a potential for the differences to be clinically meaningful, and better scores for the 30-s chair stand test (2.7 repetitions; 95%CI = 1.1, 4.1), with a confidence interval indicating a moderate clinically meaningful difference, compared to the controls. CONCLUSION: The 8-week foot-ankle exercise program showed positive, and potentially clinically meaningful, effects on knee pain and physical function among individuals with KOA, when compared to usual care. TRIAL REGISTRATION: NCT04154059. https://clinicaltrials.gov/ct2/show/NCT04154059.

Photobiomodulation does not provide incremental benefits to patients with knee osteoarthritis who receive a strengthening exercises program: a randomized controlled trial.

BACKGROUND: There is lack of agreement in the literature about the effectiveness of photobiomodulation (PBM) for reducing pain-related symptoms in patients with knee osteoarthritis (OA). OBJECTIVE: To evaluate whether PBM, when combined to exercises, provides incremental therapeutic benefits for pain, physical function, and quality of life (QoL) in patients with knee OA. METHODS: A six-month double-blind placebo-controlled randomized trial was conducted. Patients with knee OA were randomly assigned to one of three treatment groups: Exercise, Exercise plus Active PBM, or Exercise plus Placebo PBM. Treatment was provided over an eight-week period, three times per week. The primary outcomes were pain at rest and upon movement, assessed by a visual analogue scale (VAS). WOMAC global score, QoL, and a core-set of performance-based tests were measured as secondary outcomes. All outcomes were collected at baseline, immediately after treatment, and after three- and six-month post-treatment. RESULTS: 127 participants were allocated as follows: Exercise, N = 41; Exercise plus Active PBM, N = 44; and Exercise plus Placebo PBM, N = 42. There was no between-groups difference in improvement in pain, physical function, and QoL for all follow-up times. However, all groups presented significant, clinically relevant improvements in pain, physical function, and QoL immediately and three months after treatment compared with baseline measures. CONCLUSION: Patients with knee OA who received a strengthening exercises program did not experience incremental benefits regarding pain, physical function, or QoL when adding PBM to their therapeutic exercises.

Peak torque angle, acceleration time and time to peak torque as additional parameters extracted from isokinetic test in professional soccer players: a cross-sectional study.

This study investigated additional and traditional variables from isokinetic test of thigh muscles in soccer players across different field positions. One hundred and eighty-nine athletes performed maximal concentric isokinetic knee contractions on dominant (DL) and non-dominant limb (NDL) at 60º/s and 240º/s. The additional outcomes peak torque angle (AngPT), acceleration time (AcT) and time to peak torque (TPT) and traditional outcomes Peak torque (PT), total work (TW) and power (Pw) were extracted from the exam. Goalkeepers (GK), side backs (SB), central backs (CB), central defender midfielders (CDM), central attacking midfielders (CAM) and forwards (FW) were considered. Comparisons between limbs and positions demonstrated that SB extensors of the DL presented TPT lower (p = 0.006) and AngPT higher (p = 0.011) than NDL at 60°/s. CDM extensors of the DL showed lower TPT at 60°/s (p = 0.003) and 240°/s (p = 0.024). CAM flexors of the DL showed lower TPT (p = 0.026) and AcT (p = 0.021) at 240°/s than NDL. CB, CDM and CAM extensors of the NDL showed higher PT, TW and Pw than DL (p < 0.05). In conclusion, there are muscle imbalances between limbs in SB, CDM and CAM and across different field positions.

Effect of Pain Education, Cryotherapy, and Transcutaneous Electrical Nerve Stimulation on the Pain, Functional Capacity, and Quality of Life in Patients With Nonspecific Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial.

OBJECTIVE: The aim of the study was to analyze the effects of pain education and the combined use of cryotherapy and transcutaneous electrical nerve stimulation on the pain sensation, functional capacity, and quality of life of patients with nonspecific chronic low back pain. DESIGN: This is a randomized controlled and blind clinical trial including patients with nonspecific chronic low back pain in the following 4 groups: control group, cryotherapy group, burst transcutaneous electrical nerve stimulation group, and cryotherapy combined with burst transcutaneous electrical nerve stimulation group. They were evaluated at baseline and after the protocol was concluded using the following: Roland-Morris questionnaire and sit-to-stand test; quality-of-life questionnaire; and pain. The protocol consisted of 10 sessions with pain education associated the combination of the electrophysical agents. RESULTS: There were no statistical differences between groups after the intervention protocol. In the within analysis, all groups presented an improvement in visual analog scale scores, Roland-Morris questionnaire, sit-to-stand test, and pain domain of quality-of-life questionnaire. CONCLUSIONS: This study showed that with pain education, there was no difference between cryotherapy and transcutaneous electrical nerve stimulation alone, combined, or placebo mode in improving pain, functional capacity, and quality of life in patients with nonspecific chronic low back pain.

Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial.

INTRODUCTION: Studies have indicated that hip and knee muscle strengthening are effective in reducing pain, improving self-reported function and increasing lower limb strength, without, however, decreasing knee joint overload during gait in patients with knee osteoarthritis (KOA). Recent research has shown that strengthening the foot-ankle muscles improved function in diabetic patients and reduced patellofemoral pain. The aim of this paper is to investigate whether an 8-week therapeutic foot-ankle exercise programme improves pain, functionality, foot strength, foot kinematics and knee joint overload during gait, and decreases medication intake in individuals with KOA. METHODS AND ANALYSIS: This two-arm, prospectively registered, randomised controlled trial with blinded assessors will involve 88 patients with medial tibiofemoral osteoarthritis. Subjects will be randomly allocated to a control group that will receive no specific foot intervention and will follow treatment recommended by the medical team; or an intervention group that will undergo an 8-week physiotherapist-supervised strengthening programme for extrinsic and intrinsic foot muscles, three times a week. The primary outcome will be the pain domain of the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). The secondary outcomes include WOMAC stiffness and function domains, total WOMAC score, physical function, foot muscle isometric strength, foot kinematics and knee kinetics during gait, and medication intake. Data will be analysed on intention-to-treat principles and a per protocol basis. ETHICS AND DISSEMINATION: Investigators and sponsors will communicate trial results to participants and healthcare professionals through scientific databases and social media. In addition, findings will be reported in peer-review publications, and at national and international conference presentations. Ethics approval: Ethics Committee of the Universidade Federal de São Carlos, São Carlos, SP, Brazil (N° 3.488.466). TRIAL REGISTRATION NUMBER: NCT04154059.

Cold-Water Immersion Does Not Accelerate Performance Recovery After 10-km Street Run: Randomized Controlled Clinical Trial.

The use of strategies to assure better post-effort recovery is frequent in sports settings. There are several interventions available for exercise induced muscle damage recovery, but cold-water immersion (CWI) stands out among them. The effects of CWI are unclear in the literature and, although the number of street runners has been growing, there is a gap in the scientific evidence regarding the use of CWI to recover runners' performance after a 10-km street run. Purpose: The goal of our study was to analyze the effects of CWI on the recovery of muscle damage markers after a 10-km street run. Method: We randomly assigned thirty male recreational street runners, immediately after a 10-km street run, into three recovery groups: control (rest for 10 minutes), immersion (10 min immersed in water without ice at room temperature) and CWI (10 min immersed in water with ice at 10ºC). We assessed pain, triple hop distance, extensor peak torque and blood creatine kinase levels pre- and post-run, post-intervention and 24 hours after the run. Results: The 10-km run was enough to decrease triple hop distance and extensor peak torque, and increase levels of creatine kinase (p < 0.05); however, we found no time/group interactions in any of the assessed variables after we applied the appropriate interventions (p > 0.05). Conclusion: 10-min CWI at 10°C was no more effective than water immersion and rest in recovering muscle damage markers after 10-km runs.

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.

Sophrology versus resistance training for treatment of women with fibromyalgia: A randomized controlled trial.

INTRODUCTION: Physical training has been recommended to improve overall well-being in patients with fibromyalgia. Body relaxation exercises also seem to have some beneficial effect, however there is no consensus regarding this modality. OBJECTIVE: Comparing the effectiveness of sophrology and resistance training in improving the pain of women with fibromyalgia. METHOD: A randomized controlled clinical trial with a blind evaluator. Sixty (60) women with a medical diagnosis of fibromyalgia were randomized and included in two groups: sophrology group (SG) who participated in a relaxation program based on sophrology (n = 30), and resistance group (RG) (n = 30) who participated in a resistance training program for biceps, pectoral, triceps, knee extensors, trapezius, knee flexors, hip abductors. Both groups were treated twice a week for 12 weeks and reevaluated every 4 weeks. The assessment instruments used were the Visual Analog Scale for Pain (VAS), the one-repetition maximum test (1 RM), the overall quality of life (SF-36), the 6-min walk test (6MWT), the Timed Up and Go test (TUG) and the Fibromyalgia Impact Questionnaire (FIQ). RESULTS: We found that the RG presented statistically significant decreases in pain (VAS) during the evaluations (p < 0.05) and increased strength of the evaluated muscles (p < 0.05). A statistically significant decrease in pain (p < 0.05) was observed in the SG compared to T0, with no significant differences in muscle strength. Differences between groups were observed, with better indices only for 6MWT and functional capacity domain of the SF36 for the RG (p < 0.05). CONCLUSION: No differences in pain were found between the groups. Resistance training was more effective than sophrology in improving strength and functional capacity of women with fibromyalgia.

Static or dynamic stretching program does not change the acute responses of neuromuscular and functional performance in healthy subjects: a single-blind randomized controlled trial / Programa de alongamento estático ou dinâmico não altera as respostas agudas do desempenho neuromuscular e funcional de sujeitos saudáveis: ensaio controlado randomizado e cego / Un programa de estiramientos estáticos o dinámicos no modifica las respuestas agudas del rendimiento neuromuscular y funcional en individuos sanos: ensayo ciego controlado de distribución aleatoria

Abstract The purpose of this study was to compare the effects of a single hamstring static or dynamic stretching session and a 10-session stretching program on the range of motion, neuromuscular performance and functional performance of healthy subjects. Forty-five, healthy, active men were divided into three groups: control; static stretching and dynamic stretching. There were no significant differences in ratings between the experimental and control groups for any of the variables (p > 0.05). It can be concluded that neither a single session of hamstring static or dynamic stretching nor a 10-session stretching program affected range of motion, neuromuscular or functional performance.

Resumo A proposta deste estudo foi comparar os efeitos de uma única sessão de alongamento estático ou dinâmico dos isquiotibias e dez sessões do programa de alongamento na amplitude de movimento e desempenho neuromuscular e funcional de indivíduos saudáveis. Quarenta e cinco homens ativos e saudáveis, foram distribuídos em três grupos: controle, alongamento estático e alongamento dinâmico. Não houve diferença significativa entre os grupos experimentais e controle para todas as variáveis (p >0,05). Pode-se concluir que nem uma única sessão de alongamento estático e dinâmico dos isquiotibiais, nem 10 sessões do programa de alongamento afetaram a amplitude de movimento e o desempenho neuromuscular e funcional.

Resumen El propósito de este estudio fue comparar los efectos de una sola sesión de estiramientos estático o dinámico en los isquiotibiales, y diez sesiones del programa de estiramiento en el rango de movimiento y rendimiento neuromuscular y funcional de individuos sanos. Cuarenta y cinco hombres activos y sanos fueron divididos en tres grupos: control, estiramiento estático y estiramiento dinámico. No hubo ninguna diferencia considerable entre los grupos experimentales y de control respecto a todas las variables (p >0,05). Se puede concluir que ni una sola sesión de estiramiento estático o dinámico de los isquiotibiales ni 10 sesiones del programa de estiramiento afectaron al rango de movimiento ni al rendimiento neuromuscular y funcional.

Low back pain and disability in military police: an epidemiological study / Dor lombar e incapacidade em policiais militares: um estudo epidemiológico / Dolor lumbar e incapacidad en policías militares: un estudio epidemiológico

Abstract Introduction: The low back pain is a major public health problem in industrialized societies, commonly affecting the adult population. The occupation is considered as a risk factor, especially those functions that require physical effort, we have as example the job of the military police, who are exposed to several risk factors, both those who perform administrative activities, and those who perform the ostensive policing. Objective: The aim of this study was to evaluate the prevalence of low back pain among military police, as well the presence of disability and associated factors. Methods: This is an analytical cross-sectional study. Was evaluated the level of disability, pain before and after the work shift, flexibility, postural alterations and anthropometric measures. It was used the regression analysis, considering 95% CI and p < 0.05. Were interviewed 97 military police with mean age of 39.30 (± 5.33), all males. Results: The complaint of low back pain was significantly larger after the work shift, and 82.5% reported difficulties in daily life activities due to low back pain. Conclusion: There is a high prevalence of low back pain and impairment in daily life activities because of military police. The data presented reinforce the need to consider low back pain as a public health problem that affects the whole population, especially the military police.

Resumo Introdução: A dor na região lombar é um importante problema de saúde pública nas sociedades industrializadas, acometendo comumente a população adulta. A ocupação é considerada como um fator de risco, principalmente aquelas funções que requerem esforço físico, temos como exemplo a ocupação do policial militar, que se encontram expostos a vários fatores de risco, tanto os que realizam atividades administrativas, quanto àqueles que realizam o policiamento ostensivo. Objetivo: Avaliar a prevalência de dor lombar entre policiais militares, bem como a presença de incapacidade e seus fatores associados. Métodos: Trata-se de um estudo transversal de caráter analítico. Foi avaliado o nível de incapacidade, dor antes e depois do turno de trabalho, flexibilidade, alterações posturais e medidas antropométricas. Utilizou-se a análise de regressão linear múltipla, considerando o IC 95% e p < 0,05. Foram entrevistados 97 policiais militares com média de idade de 39,30 (± 5,33), sendo todos do sexo masculino. Resultados: A queixa de dor lombar foi significativamente maior após o turno de trabalho e, 82,5% dos indivíduos relataram prejuízo na realização das atividades da vida diária decorrente de lombalgia. Conclusão: Há uma alta prevalência de dor lombar e prejuízo nas atividades da vida diária em sua decorrência entre os policiais militares. Os dados apresentados reforçam a necessidade de considerar a lombalgia como problema de saúde pública que afeta toda a população, em especial os policiais militares.

Resumen Introducción: El dolor en la región lumbar es un importante problema de salud pública en las sociedades industrializadas, afectando comúnmente a la población adulta. La ocupación es considerada como un factor de riesgo, principalmente aquellas funciones que requieren esfuerzo físico, tenemos como ejemplo la ocupación del policía militar, que se encuentran expuestos a varios factores de riesgo, tanto los que realizan actividades administrativas, como los que realizan el trabajo policial ostensible. Objetivo: El objetivo de este estudio fue evaluar la prevalencia de dolor lumbar entre policías militares, así como la presencia de incapacidad y sus factores asociados. Métodos: Se trata de un estudio transversal de carácter analítico. Se evaluó el nivel de incapacidad, dolor antes y después del turno de trabajo, flexibilidad, alteraciones posturales y medidas antropométricas. Se utilizó el análisis de regresión lineal múltiple considerando el IC 95% y p < 0,05. Se entrevistaron a 97 policías militares con una media de edad de 39,30 (± 5,33), siendo todos del sexo masculino. Resultados: La queja de dolor lumbar fue significativamente mayor después del turno de trabajo y el 82,5% de los individuos reportaron perjuicio en la realización de las actividades de la vida diaria derivada de la lumbalgia. Conclusión: Se concluye que hay una alta prevalencia de dolor lumbar y perjuicio en las actividades de la vida diaria en su consecuencia entre los policías militares. Los datos presentados refuerzan la necesidad de considerar la lumbalgia como problema de salud pública que afecta a toda la población, en especial a los policías militares.

Intra-rater and Inter-instrument Reliability on Range of Movement of Active Knee Extension

Abstract: The objective of the present study was to evaluate the reliability of intra-rater and inter-instrument measures during two flexibility programs. Fifty-three active and healthy males, aged between 18 and 28 years old, were randomly included in three groups: control (Cg, n = 18), static stretching (SSg, n = 17), and dynamic stretching (DSg, n = 18). All participants underwent measurements of their active range of knee extension using manual goniometry and computerized photogrammetry, measured in four separated assessments and analyzed using the SPSS, with ((5%. Both methodologies presented very strongintra-raterreliability (ICC: 0.91(0.99; P<0.001) at all four assessments in all the groups, and the instruments showed weak (r: 0.31-0.6) to strong(r: 0.61-0.9) correlation, in the Cg (P<0.05) and strong (r: 0.61-0.9) in the SSg and DSg (P<0.01), although without differences between groups, indicating that the measures are equally reliable, regardless of interventions.(AU)