Biomechanical properties of masseter muscle assessed through myotonometry in patients with temporomandibular disorder treated with ultrasound therapy: a randomized comparative study.

BACKGROUND: The aim of the study was to make an objective quantitative assessment of effectiveness of procedures with the use of a therapeutic dose of ultrasounds in this nosological entity, in connection with improved biomechanical properties and alleviation of pain experienced in masseter muscles. METHODS: The study included 40 patients with temporomandibular disorder. In group 1 (N.=20) ultrasound therapy (1.2 W/cm2) was carried out, while in group 2 (N.=20) sham therapy was applied. A total of 10 procedures were performed. Myotonometric measurements and assessment of pain intensity were carried out before treatment and after the completion of procedures. RESULTS: The analysis revealed a significant difference (P=0.011) between the values of decrement (D) measured on day 0 (2.08±0.45 [log]) and day 4 (1.80±0.55 [log]) in group 1. In group 2 no statistically significant differences were noted between the results obtained on consecutive days of the therapeutic cycle. A statistically significant difference in values of decrement (D) between group 1 (1.80±0.55 [log]) and group 2 (2.23±0.51 [log]) was noted on day 4 of the experiment (P=0.021). Both in group 1 and in group 2, a statistically significant reduction of pain intensity (VAS Scale) was obtained. CONCLUSIONS: The masseter muscle was more elastic during ultrasound therapy. However, the effect was transient. The analgesic effect was also observed in the control group; therefore, a placebo effect cannot be excluded.

Risk Factors for Injury in CrossFit®-A Retrospective Analysis.

CrossFit® is a physical activity program and sport which is based on functional movements performed at high intensity and with high variability of exercises. It develops all motor skills. The study included 424 athletes (266 men and 158 women) from twelve centers in Poland, actively practicing CrossFit® between 18 and 60 years of age. A questionnaire consisting of 25 questions was used, which was divided into four subsections concerning the characteristics of the sample, training routine, injuries, and information about environment. In total, 48% of respondents participating in the study suffered at least one injury during their entire training history. The injuries suffered most often involved shoulder joint and lumbar spine. Men were found to face a higher risk of injury than women, at 32.78% vs. 15.33% (p = 0.027). The shorter the training period, the smaller the number of injuries observed among the trainees. It was also noted that the shorter the training period, the lower the number of injuries that occurred (p = 0.041). An increase in the number of training sessions per week did not increase the incidence of injuries (p > 0.05). Performing isometric exercises during warm-up reduced the likelihood of injury during CrossFit® training itself (p = 0.012). Training despite of concomitant acute pain had a significant adverse effect on the incidence of injuries (p = 0.002). The most common risk factors for injury in the CrossFit® training process include, in particular: gender, training experience, and length of training sessions. Proper warm-up including isometric exercises and training conducted without accompanying pain symptoms reduces the risk of injury.

Are the mechanical properties of Achilles tendon altered in CrossFit athletes? Reliability and accuracy of myotonometry.

PURPOSE: Tendons adapt to loads affecting them by changing tendons' mechanical and morphological properties. The aim of the study was to investigate the influence of involvement in sport activities in the form of CrossFit training by individuals of different age upon the mechanical properties of Achilles tendon. METHODS: 231 people participated in the study. One group consisted of subjects who trained CrossFit as amateurs, the other group comprised subjects who were not physically active. Achilles tendon was studied for various positions of the ankle joint: 0° DF/PF, 10° DF, 20° DF, 20° PF and 40° PF. The following mechanical and viscoelastic tendon properties were measured using MyotonPRO: frequency [Hz], stiffness [N/m], decrement [log], relaxation time [ms] and creep [De]. The results have been compared in reference to physical activity, BMI, age and length of training history. RESULTS: Both the tension and stiffness increased with degree of Achilles tendon stretching and decreased as it contracted. Higher values have been noted in the group of people in training and with higher BMI values. The elasticity of Achilles tendon decreased with plantar flexion increase. Lower elasticity has been recorded in the group in training and with higher BMI. No significant influence of age and length of training history upon the parameters achieved has been noted. CONCLUSIONS: The specificity of CrossFit training and accompanying mechanical load result in development of adaptation changes in Achilles tendon, in the form of its higher tone/tension and stiffness, as well as lower elasticity.

The Impact of Coronavirus Infection on Health-Related Quality of Life in Amateur CrossFit Athletes.

BACKGROUND: The aim of this study was to assess how the disease, developing over the course of coronavirus infection, affects the quality of life of athletes practicing amateur sports who are not burdened with comorbidities. METHODS: The study included 102 amateur CrossFit athletes (54 (53%) women and 48 (47%) men) who had been infected with SARS-CoV-2, but were not hospitalized. The training experience of the respondents ranged from 1.5 to 15 years (average: 6.7 ± 3.8 years). The quality of life was assessed with EQ-5D-5L and Clinical COPD Questionnaire (CCQ), which was used to assess the quality of life specific to the respiratory system, and the severity of dyspnea was assessed using the MRC questionnaire. RESULTS: The training experience did not differ statistically significantly between men and women (p = 0.595). The quality of life in men according EQ-5D-5L was statistically significantly higher than in the case of women (0.979 ± 0.028 vs. 0.942 ± 0.073 (p < 0.001), respectively), and in EQ-VAS it was significantly higher in men than in women (85.64 ± 10.4 vs. 72.5 ± 19.36 points (p < 0.001)). The assessment of dyspnea by means of mMRC showed its higher intensity in women than in men. The differences were not statistically significant (p = 0.195). In men, a significantly lower result of the quality of life was noted in the CCQ questionnaire: 0.71 ± 0.57 vs. 1.14 ± 0.84 points (p = 0.009). CONCLUSIONS: The HRQOL, which surveyed amateur CrossFit after COVID-19, was higher in men than in women. People practicing strength- and strength-endurance-based sports rated their quality of life as the highest. Most of the subjects observed a slight intensification of dyspnea. The findings can be used for future healthcare measures to be applied in the population of CrossFit athletes.

Vojta method in the treatment of developmental hip dysplasia - a case report.

BACKGROUND: Developmental dysplasia of the hip joint is one of the most common congenital defects and often results in functional and structural disorders. Such cases particularly demand optimizing therapeutic effects and maximally reducing the duration of therapy. PURPOSE: The aim of this case report is to present the therapeutic process in a child with developmental hip dysplasia. CASE REPORT: This is a case report of a female child with a birth weight of 2,800 g and an Apgar score of 9 points born to a gravida 3 para 3 mother at 37 weeks. The child was delivered by cesarean section, and the pregnancy was complicated by oligohydramnios. Subluxation of the left hip joint was diagnosed by an orthopedist in the third month of life. The treatment followed was the Vojta method (the first phase of reflex turning and reflex crawling). RESULTS: During the 6 weeks of the Vojta treatment, the left half of the femoral head was centralized, and the process of formation of the hip joint acetabulum was influenced effectively enough to change the acetabulum's Graff type from the baseline D to IIb after 41 days of treatment. CONCLUSION: The diagnostic work-up of congenital hip joint dysplasia should involve a physiotherapist who will investigate the child's neuromuscular coordination, in addition to a neonatologist and a pediatrician. The therapy for a disorder of hip joint development of neuromotor origin should involve the application of global patterns according to Vojta. Children with congenital dysplasia of the hip joint should commence rehabilitation as early as possible.

Early detection of idiopathic scoliosis - analysis of three screening models.

INTRODUCTION: The prevalence of lateral curvatures of the spine ranges from 0.3% to 15.3% in the general population. The aim of the study was to develop and compare three different screening tests for idiopathic scoliosis (IS) with respect to their effectiveness and costs. MATERIAL AND METHODS: The Delphi method was used to assess the efficacy of each screening algorithm in detecting IS in the population. An economic analysis was also performed. RESULTS: Diagnostic Algorithm 1 for IS comprised a screening examination performed by nurses and a general practitioner (GP) with verification by specialists. The unit cost of carrying out diagnostic work-up for IS in Algorithm 1 was €94 per child. The second algorithm involved the use of the moiré computer method, followed by verification by a specialist. The lower unit cost of €86 per child of diagnostic work-up according to Algorithm 2 was due to fewer stages compared to Algorithm 1. The highest effectiveness with the highest costs were found for the third algorithm, with only one stage, a specialist's consultation (cost €153 per child). CONCLUSIONS: The number of stages in an algorithm does not correlate positively with its efficacy or cost. The recommended scheme is Algorithm 3, where children are examined by rehabilitation specialists or a physiotherapist using a scoliometer and an inclinometer. The use of the apparently most expensive scheme (Algorithm 3) should result in lowering the costs of treatment of established idiopathic scoliosis and, in the long term, prove to be the most cost-effective solution for the health care system.

Objective parallel-forms reliability assessment of 3 dimension real time body posture screening tests.

BACKGROUND: Screening tests play a significant role in rapid and reliable assessment of normal individual development in the entire population of children and adolescents. Body posture screening tests carried out at schools reveal that 50-60% of children and adolescents demonstrate body posture abnormalities, with 10% of this group at risk for progressive spinal deformities. This necessitates the search for effective and economically feasible forms of screening diagnosis. The aim of this study was to assess the reliability of clinical evaluation of body posture compared to objective assessment with the Zebris CMS-10 system (Zebris Medical GmbH). METHODS: The study enrolled 13-15-year-old pupils attending a junior secondary school (mean age 14.2 years). The study group consisted of 138 participants, including 71 girls and 67 boys, who underwent a clinical evaluation of the body posture and an examination with the Zebris CMS 10 system. RESULTS: Statistically significant discrepancies between the clinical and objective evaluation were noted with regard to lumbar lordosis in boys (n = 67) and thoracic kyphosis in girls (n = 71). No statistically significant differences in both groups were noted for pelvic rotation and trunk position in the frontal plane. CONCLUSIONS: 1. The finding of significant discrepancies between the results of assessment in the sagittal plane obtained in the clinical examination and Zebris CMS-10-based assessment suggests that clinical evaluation should be used to provide a general estimation of accentuation or reduction of spinal curvatures in the sagittal plane.2. The clinical evaluation of posture is reliable with regard to assessment in the frontal plane.3. The Zebris CMS-10 system makes the clinical examination significantly more objective with regard to assessment of the physiological curvatures and may be used to make screening tests more objective with regard to detecting postural defects.

Assessment of visual perception in adolescents with a history of central coordination disorder in early life - 15-year follow-up study.

INTRODUCTION: Central nervous system damage in early life results in both quantitative and qualitative abnormalities of psychomotor development. Late sequelae of these disturbances may include visual perception disorders which not only affect the ability to read and write but also generally influence the child's intellectual development. This study sought to determine whether a central coordination disorder (CCD) in early life treated according to Vojta's method with elements of the sensory integration (S-I) and neuro-developmental treatment (NDT)/Bobath approaches affects development of visual perception later in life. MATERIAL AND METHODS: The study involved 44 participants aged 15-16 years, including 19 diagnosed with moderate or severe CCD in the neonatal period, i.e. during the first 2-3 months of life, with diagnosed mild degree neonatal encephalopathy due to perinatal anoxia, and 25 healthy people without a history of developmental psychomotor disturbances in the neonatal period. The study tool was a visual perception IQ test comprising 96 graphic tasks. RESULTS: The study revealed equal proportions of participants (p < 0.05) defined as very skilled (94-96), skilled (91-94), aerage (71-91), poor (67-71), and very poor (0-67) in both groups. These results mean that adolescents with a history of CCD in the neonatal period did not differ with regard to the level of visual perception from their peers who had not demonstrated psychomotor development disorders in the neonatal period. CONCLUSIONS: Early treatment of children with CCD affords a possibility of normalising their psychomotor development early enough to prevent consequences in the form of cognitive impairments in later life.

Electromyographic and clinical evaluation of the efficacy of neuromobilization in patients with low back pain.

BACKGROUND: Evidence for the efficacy of therapeutic methods and procedures is being sought in accordance with the principles of Evidence Based Medicine. The choice of a physiotherapy method should be based on its documented efficacy. The purpose of the investigation was to analyse changes in functional disorders of resting muscle tone following neuromobilization treatment in patients with chronic low back pain. MATERIAL AND METHODS: The study involved 108 outpatients treated due to low back pain and neurogenic functional pain referred to the lower extremity. The treated group was subjected to two weeks of neuromobilization-based physiotherapy. The control group received standard physiotherapy, also over two weeks. RESULTS: The treated group demonstrated a statistically significant decrease in muscle tone in all muscles examined, clinical improvements (Laseque test and Bragard test results), decreased pain threshold estimated with a Visual Analogue Scale (VAS). In the control group, the only statistically significant change was a decrease in gastrocnemius muscle tone. CONCLUSIONS: 1. The results of the examinations appear to suggest that evaluation of resting muscle tone can be used to provide an objective assessment of the analgesic efficacy of physiotherapy, including neuromobilization. 2. In the treated group, neuromobilization therapy was superior to standard physiotherapy as regards eliminating or decreasing elevated resting muscle tone in response to pain in patients with low back pain. 3. Neuromobilization produced a significant improvement in clinical test results and clinical symptoms in the treated group as opposed to the control group, which demonstrates the efficacy of this therapy. 4. The results of the examinations show that tibialis anterior sEMG had the biggest diagnostic value for detecting changes in pain severity.

The correlation of selected physical examination findings and the efficacy of physiotherapy for chronic lumbosacral pain.

BACKGROUND: Lumbosacral pain is a significant social problem. Effective treatment of this ailment should be based on thorough diagnostic work-up. The goal of the present study was to determine which physical examination findings can help predict a positive outcome of physiotherapy, including kinesitherapy and physical therapy, aimed at symptomatic improvement. MATERIAL AND METHODS: The study group consisted of 50 patients with lumbosacral pain syndromes presenting as lumbalgia and ischialgia. RESULTS: Statistically significant correlations were ascertained between certain physical examination findings before the therapy and after the therapy. CONCLUSION: The crossed Lasegue sign was the only component of the physical examination that correlated with the dynamic efficacy of the rehabilitation treatment.

Principles of neuro mobilization for treating musculoskeletal disease.

Neuro mobilization is a method of conservative treatment of disorders of neural tissue. The rationale for using neuro mobilization in the treatment of musculoskeletal conditions is based on in vivo and in vitro studies which point to a high efficacy of neuro mobilization procedures. Appropriate use of neuro mobilization procedures depends on excellent knowledge of normal and pathological anatomy, differences between individual etiological factors, development of disease and symptom variability. The present paper familiarizes the reader with evidence-based conservative treatment of musculoskeletal conditions by neuro mobilization.

Effect of Kinesio Taping on bioelectrical activity of vastus medialis muscle. Preliminary report.

BACKGROUND: Kinesio Taping is currently regarded by physiotherapists as a method supporting rehabilitation and modulating some physiological processes. It is employed e.g. in orthopaedics and sport medicine. This sensory method supports joint function by exerting an effect on muscle function, enhancing activity of the lymphatic system and endogenous analgesic mechanisms as well as improving microcirculation. The aim of the study was to determine the effect of Kinesio Taping on changes in the tone of the vastus medialis muscle during isometric contractions. MATERIAL AND METHOD: The study group included 27 healthy persons. A Kinesio Tape was placed to support the function of the medial head of the quadriceps muscle of thigh. Transdermal EMG was used to assess bioelectrical activity of the muscle. A standardised protocol was employed for measurement of muscle tone, recorded as the peak torque of the muscle. RESULTS: An examination performed 24 hours after the placement of the Kinesio Tape revealed significantly increased recruitment of the muscle's motor units, as expressed by peak torque. An examination performed after 72 hours of kinesio taping showed a statistically significant increase in bioelectrical activity of the muscle. However, this was lower than the effect at 24 hours. In the group where the tapes were removed after 24 hours, high torque was still maintained. CONCLUSIONS: 1. Clinically significant effects of Kinesio Taping in this study included an increase in the bioelectrical activity of the muscle after 24 hours of kinesio taping and the maintenance of this effect for another 48 hours following removal of the tape. 2. The decrease in muscle tone to the baseline value, which was observed during the fourth day of Kinesio Taping use, may have resulted from the time of effective use of the KT tape being shorter than previously believed and may restrict Kinesio Taping use. 3. Kinesio Taping used shortly before the motor activity it is supposed to support may fail to fulfil its function.