Immediate Effects of Spinal Manipulative Therapy on the Performance of Elite Brazilian Soccer Players: A Pilot Randomized Controlled Trial With an Internally Validated Sham Treatment.

Objective: The purpose of this study was to assess the feasibility of the procedures' routine, the recruiting rate, the presence of any significant detrimental impact on the players' training routine, and the sham efficacy in achieving blinding. Methods: A parallel randomized controlled clinical trial was performed with 20 elite soccer players who were randomly assigned to 1 of 2 groups: spinal manipulative therapy (SMT) and sham SMT. All players were from the same team, were injury free, and were naive to SMT. Measured outcome tests (30-m sprint run with a 10-m split and change of direction [COD] test) were performed at the same time by all participants immediately before and after interventions. Photocell devices were used for data acquisition. Results: Twenty participants were analyzed (10 in each group). There were no changes to the sprint (10 m and 30 m) and COD test results immediately after either of the interventions. All participants in both groups (SMT and sham SMT) answered "yes" to a question after the intervention asking if they were treated by SMT. No adverse effects or training routine impairment were reported. Conclusion: This pilot study protocol showed it was an appropriate design for a confirmatory clinical trial. The study had minimal effect on the team training routine, and the recruitment rate was excellent. The proposed sham SMT strategy was successful in blinding the players. In this sample, SMT did not have any immediate effect on the performance of these elite soccer players, as measured by 10- and 30-m sprint times and COD sprint times.

Evaluation of Upper Limb Joint Contribution to Racket Head Speed in Elite Tennis Players Using IMU Sensors: Comparison between the Cross-Court and Inside-Out Attacking Forehand Drive.

This study aimed to quantify and compare the upper limb angular kinematics and its contributions to the racket head speed between the cross-court (CC) and inside-out (IO) attacking tennis forehand of elite tennis players in a competitive environment. A new approach was used to study the forehand drive with mini-inertial sensors of motion capture to record the kinematic data. Six strokes in each direction per participant (72 shots in total) were chosen for analysis. Upper limb kinematics were calculated in the Visual 3D platform (Visual 3D Professional V5.01.21, C-motion, Germantown, MD, USA). The method used to calculate the upper limb's contributions was performed with MATLAB software and used the segment's (upper arm, forearm and hand) angular velocities and their respective displacement vectors obtained through the inertial sensors. Upper limb kinematics demonstrated a higher shoulder rotation in the IO direction with significant differences at the end of the backswing, which could be a key factor in distinguishing the two directions of the shot. Results also demonstrated that the horizontal flexion of the upper arm (around the shoulder joint) was primarily responsible for the racket velocity in the anteroposterior direction (48.1% CC and 45.2% IO), followed by the extension of the forearm (around the elbow joint) (17.3% CC and 20.9% IO) and the internal rotation of the upper arm (around the shoulder joint) (15.6% CC and 14.2% IO). No significant differences were shown in the contributions of upper limbs to the racket head velocity between the two directions of the shot. Tennis coaches and players should develop a specific training programme to perform higher angular velocities in these specific joint rotations.

Methodological tools used for tripping gait analysis of elderly and prosthetic limb users: a systematic review.

BACKGROUND: Tripping during walking is known to be the predominant cause of falls in elderly and prosthetic limb users. To standardise measurements and analysis of trips, it is critical to summarise the methods used in laboratory-controlled trials. AIM: The aim of this study was to reach a clearer standardisation measurement and analysis of trips during elderly and prosthetic gait through a systematic review. METHODS: Studies that assessed elderly and prosthetic tripping gait characteristics were included in this review. The search resulted in an initial yield of 2493 unique articles after duplicates were removed (PubMed, Scopus and Science Direct). Title analysis resulted in 1697 articles excluded and 659 articles were assessed for further eligibility on the basis of the abstract. 174 articles were excluded based on a full-text appraisal. The final yield was 21 unique articles that met all the inclusion criteria. RESULTS: The findings revealed a number of inconsistencies among the studies, namely ambiguity in relation to gait speed, differences in overground and treadmill locomotion. Subsequently, different experimental setups such as trip inducement strategies may influence the collected data, and thus have implications for study outcomes. CONCLUSION: A gold standard should be set to have better standardised results, thus creating a more robust and holistic approach towards the rehabilitation of prosthetic gait and in the elderly.

The effects of a single session of lumbar spinal manipulative therapy in terms of physical performance test symmetry in asymptomatic athletes: a single-blinded, randomised controlled study.

BACKGROUND AND AIM: Musculoskeletal disorders in athletes, including spinal biomechanical dysfunctions, are believed to negatively influence symmetry. Spinal manipulative therapy (SMT) is recognised as a safe and effective treatment for musculoskeletal disorders, but there is little evidence about whether it can be beneficial in symmetry. Therefore, this study aimed to measure the effects of lumbar SMT in symmetry. METHODS: Forty asymptomatic athletes participated in the study. The randomisation procedure was performed according to the following group allocation: group 1 (SMT) and group 2 (SHAM). Each participant completed a physical activity questionnaire, and also underwent clinical and physical evaluation for inclusion according to eligibility criteria. Statistical significance (P<0.05) between groups and types of therapy were calculated by physical performance tests symmetry (static position, squat and counter movement jump (CMJ), pre- and post-SMT and SHAM. There were 14 trials of three symmetry tests for each participant, for a total of 560 trials. RESULTS: Lumbar SMT produced immediate effects in symmetry in the static position; however, the same effects were not found in squat and CMJ on symmetry 1. Therefore, our results showed a significant difference in pre- (mean 16.3%) and post-lumbar SMT (mean 3.7%) in static symmetry. However, symmetry 2 showed no statistical significant differences for any of the tests and intervention groups. No statistically significant effects in symmetry pre- to post-SHAM were found in any of the tests. CONCLUSIONS: Statistically significant differences were found in lumbar SMT, but only for static symmetry. These findings suggest that SMT was effective in producing immediate effects in symmetry in the static position, but none in dynamic tests. Future studies could address our study's limitations. CLINICAL TRIALS REGISTER NUMBER: NCT03361592.