New Guidelines for Electrical Stimulation Parameters in Adult Patients With Knee Osteoarthritis Based on a Systematic Review of the Current Literature.

OBJECTIVE: The goal of this systematic review was to provide guidelines for treatment parameters regarding electrical stimulation by investigating its efficacy in improving muscle strength and decreasing pain in patients with knee osteoarthritis. DESIGN: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard, three electronic databases (CINAHL, PubMed, and PEDro) and gray literature were used. Randomized control trials comparing electrical stimulation and conservative physical therapy were critically appraised using the 2005 University of Oxford standard. RESULTS: Nine randomized control trials were included in our review. First, our review confirmed that neuromuscular electrical stimulation is the most effective electrical stimulation treatment in the management of knee OA, and its efficiency is higher when combined with a strengthening program. Second, frequency of at least 50 Hz and no more than 75 Hz with a pulse duration between 200 and 400 µs and a treatment duration of 20 mins is necessary for successful treatment. CONCLUSIONS: For the first time, our review provides standardized clinical treatment parameters for neuromuscular electrical stimulation to be included in a strengthening program for the adult patient with knee OA. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Recall the impact of quadriceps femoris weakness on joint stability; (2) Summarize the mechanism of action of neuromuscular electrical stimulation (NMES) on reducing pain and increasing muscle strength; and (3) Plan the clinical treatment parameters of NMES to be included in a strengthening program for an adult patient with knee osteoarthritis. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Biomecánica del tiro de pistola de aire calibre 22 en deportistas de ambos sexos de pichincha / Biomechanics of 22-gauge air pistol shooting in Pichincha athletes, both sexes

Introducción: El tiro con pistola es una modalidad deportiva donde el componente técnico es fundamental para el logro de altos rendimientos deportivos. Por ende, los estudios biomecánicos posibilitan determinan los alcances y limitaciones del movimiento motriz en función de potenciar la efectividad del disparo. Objetivo: Comparar algunos indicadores biomecánicos en la técnica del tiro de pistola en deportistas de ambos sexos en Pichincha, tomando en cuenta características físicas y resultados obtenidos en diversas competiciones. Métodos: Se estudiaron a 11 deportistas de tiro de pistola (4 mujeres y 7 hombres) a través de un análisis técnico del aspecto postural y los movimientos realizados en la ejecución del disparo. Los movimientos se analizaron con el programa Kinovea, estudiando las variables ángulos de abertura inicial y final del brazo, centro de gravedad y ángulos de cabeza y tronco con respecto al centro de gravedad. Resultados: Se estableció una correlación lineal positiva de carácter fuerte, pues cuando menor fue el ángulo del brazo para apuntar al blanco mayor fue la estatura del sujeto (r= 0,894) en el eje X, y una correlación positiva moderada (r= 0,324) en el eje Y. En la comparación de las variables biomecánicas entre sexos solo evidenció diferencias significativas en el indicador puntaje (p= 0,006), aunque existieron variaciones en los rangos promedios a tener en cuenta para el análisis integral del rendimiento técnico en ambos sexos. Conclusiones: Al tener el rendimiento deportivo un carácter multifactorial, se consideró tener presente las potencialidades evidenciadas en el presente estudio y en otros trabajos consultados para perfeccionar la efectividad del tirador según las características individuales y del sexo estudiado(AU)

Introduction: Pistol shooting is a sport where the technical component is essential in high sporting performance. Therefore, biomechanical studies make it possible to determine the scope and limitations of motor movement in order to enhance the shot effectiveness. Objective: To compare some biomechanical indicators for pistol shooting technique in both sexes' athletes into Pichincha, taking into account physical characteristics and results obtained in various competitions. Methods: Eleven pistol-shooting athletes (4 women and 7 men) were studied through a technical analysis of postural aspect and movements made in shot execution. The movements were analyzed with Kinovea program, studying the variables initial and final opening angles of arm, gravity center & head and trunk angles with respect to gravity center. Results: A positive linear correlation of strong character was established, because the smaller arm angle to target the greater the subject height (r = 0,894) on X axis, and a moderate positive correlation (r = 0,324) in Y axis. The comparison of biomechanical variables between sexes only showed significant differences in score indicator (p = 0.006), although there were variations in average ranges to be taken into account for comprehensive analysis in technical performance to both sexes. Conclusions: Given that sports performance has a multifactorial character, it was considered to take into account the potentials achieved in this study and other studies consulted, to improve the shooter effectiveness to according individual characteristics and sex studied(AU)