Psychological factors show limited association with the severity of Achilles tendinopathy.

BACKGROUND: This study aimed to investigate the association between psychosocial factors and the severity of Achilles tendinopathy, along with exploring their potential link to the pain's duration. METHODS: A cross-sectional study involving 111 individuals with Achilles tendon pain was conducted. METHODS: A cross-sectional study involving 111 individuals with Achilles tendon pain was conducted. Various psychological factors were assessed using the Pain Catastrophizing Scale, Chronic Pain Self-Efficacy Scale (CPSS), Tampa Scale for Kinesiophobia, and Hospital Anxiety and Depression Scale (HAD). Additionally, the severity of Achilles tendon pain was evaluated using the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A-Br). Regression analyses were employed to determine the association of these psychosocial factors with pain severity and duration. RESULTS: Self-efficacy for chronic pain showed a slight association with Achilles tendon pain severity (ß = 0.42 [95% CI: 0.06 to 0.16], p = 0.001), explaining only 19% of the dependent variable. The other variables, including anxiety, depression, pain catastrophizing, and fear of movement, did not exhibit significant associations. CONCLUSION: The study suggests that psychological factors demonstrate limited association with the severity of Achilles tendinopathy. While self-efficacy for chronic pain was weakly associated, its clinical relevance remains uncertain. Future research, particularly longitudinal studies, should explore the influence of psychosocial factors on treatment adherence and response to enhance management strategies for Achilles tendon pain.

How are hamstring strain injuries managed in elite men's football clubs? A survey with 62 Brazilian physical therapists.

OBJECTIVE: To describe perceptions and practices of physical therapists from elite men's football clubs on the management of athletes with hamstring strain injury (HSI). DESIGN: Cross-sectional study. SETTING: Online survey. PARTICIPANTS: Physical therapists from clubs engaged in the two main divisions of Brazilian men's football. MAIN OUTCOME MEASURES: Practices for assessment and rehabilitation of athletes with HSI. RESULTS: This survey had 62 physical therapists from 35 of the 40 eligible clubs (87.5% representativeness). Despite heterogeneity on assessment practices, all respondents use imaging exams, adopt injury classification scales, and evaluate aspects related to pain, range of motion, muscle strength, and functional status of athletes with HSI. Rehabilitation programs are usually divided into 3 to 4 phases. All respondents usually apply electrophysical agents and stretching in HSI rehabilitation programs, 98.4% apply strengthening exercises (93.5% include eccentrics), 96.8% manual therapy, 95.2% exercises that mimic the functional demands of football, and 93.5% lumbopelvic stabilization exercises. Muscle strength was the most reported return to play criterion (71% of respondents). CONCLUSION: The present study allowed the sports physical therapy community to become aware of the approaches usually adopted for management of athletes with HSI who play in the highest level of Brazilian men's football.

Preventive effect of tailored exercises on patellar tendinopathy in elite youth athletes: A cohort study.

OBJECTIVE: To investigate the effects of an intervention with tailored exercises on the incidence of patellar tendinopathy (PT) in elite youth jumping athletes. DESIGN: Prospective crossover cohort. SETTING: One sport club facility. PARTICIPANTS: 271 elite youth basketball and volleyball player were followed in the first year of the study (Observation year) and 270 athletes were followed in the second year (intervention year). MAIN OUTCOME MEASURE: Incidence rates of PT per 1,000h of exposure. Cox survival analysis was used to verify the effects of the intervention (exercises implemented according to the findings of a preseason assessment) on PT incidence. RESULTS: The exercise prevention program significantly reduced the number of cases of PT, with athletes submitted to the intervention showing 51% less risk of developing PT. The overall PT incidence in the Observation year (5.9 per 1,000h of exposure) was significantly higher than that in the intervention year (2.8 per 1,000h of exposure) (P = .037). Twenty-six athletes developed PT in the observation year, whereas 13 athletes developed PT in the intervention year. CONCLUSIONS: A tailored preventive program may be able to reduce the incidence of patellar tendinopathy, especially in male youth volleyball athletes. Randomized controlled trials are encouraged to confirm these findings.

Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report. / Uso da ventilação não invasiva em síndrome do desconforto respiratório agudo grave por inalação acidental de cloro: um relato de caso.

Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case. We classified severe acute respiratory distress syndrome based on an oxygen partial pressure/oxygen inspired fraction ratio <100, although the Berlin classification is limited in considering patients with severe hypoxemia managed exclusively with noninvasive ventilation. The failure rate of noninvasive ventilation in cases of acute respiratory distress syndrome is approximately 52% and is associated with higher mortality. The possible complications of using noninvasive positive-pressure mechanical ventilation in cases of acute respiratory distress syndrome include delays in orotracheal intubation, which is performed in cases of poor clinical condition and with high support pressure levels, and deep inspiratory efforts, generating high tidal volumes and excessive transpulmonary pressures, which contribute to ventilation-related lung injury. Despite these complications, some studies have shown a decrease in the rates of orotracheal intubation in patients with acute respiratory distress syndrome with low severity scores, hemodynamic stability, and the absence of other organ dysfunctions.

Uso da ventilação não invasiva em síndrome do desconforto respiratório agudo grave por inalação acidental de cloro: um relato de caso / Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report

RESUMO A síndrome do desconforto respiratório agudo é caracterizada por lesão pulmonar inflamatória difusa, classificada em leve, moderada e grave. Clinicamente observam-se hipoxemia, opacidades bilaterais na imagem pulmonar e diminuição da complacência pulmonar. A sepse está entre as causas mais prevalentes (30 - 50%). Dentre as causas diretas de síndrome do desconforto respiratório agudo, a inalação de cloro é uma causa incomum, gerando, na maior parte dos casos, irritação de mucosas e vias aéreas. Apresentamos um caso de síndrome do desconforto respiratório agudo grave após inalação acidental de cloro em piscina, sendo utilizada ventilação não invasiva como tratamento com boa resposta neste caso. Classificamos como síndrome do desconforto respiratório agudo grave baseado na relação pressão parcial de oxigênio/fração inspirada de oxigênio < 100, embora a classificação de Berlin seja limitada em considerar pacientes com hipoxemia grave manejados exclusivamente com ventilação não invasiva. A taxa de falha da ventilação não invasiva nos casos de síndrome do desconforto respiratório agudo está em torno de 52%, estando associada à maior mortalidade. As possíveis complicações do uso da ventilação mecânica não invasiva com pressão positiva na síndrome do desconforto respiratório agudo seriam o atraso para a intubação orotraqueal sendo a mesma realizada em uma condição clínica pior e um alto nível de pressões de suporte, somados a esforços inspiratórios profundos, gerando elevados volumes correntes e pressões transpulmonares excessivas, que contribuem para injúria pulmonar associada à ventilação. Apesar disto, alguns estudos mostraram diminuição nas taxas de intubação orotraqueal em pacientes com síndrome do desconforto respiratório Agudo com baixos escores de gravidade, estabilidade hemodinâmica e ausência de outras disfunções orgânicas.

ABSTRACT Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case. We classified severe acute respiratory distress syndrome based on an oxygen partial pressure/oxygen inspired fraction ratio <100, although the Berlin classification is limited in considering patients with severe hypoxemia managed exclusively with noninvasive ventilation. The failure rate of noninvasive ventilation in cases of acute respiratory distress syndrome is approximately 52% and is associated with higher mortality. The possible complications of using noninvasive positive-pressure mechanical ventilation in cases of acute respiratory distress syndrome include delays in orotracheal intubation, which is performed in cases of poor clinical condition and with high support pressure levels, and deep inspiratory efforts, generating high tidal volumes and excessive transpulmonary pressures, which contribute to ventilation-related lung injury. Despite these complications, some studies have shown a decrease in the rates of orotracheal intubation in patients with acute respiratory distress syndrome with low severity scores, hemodynamic stability, and the absence of other organ dysfunctions.

Experimental Diabetes Alters the Morphology and Nano-Structure of the Achilles Tendon.

Although of several studies that associate chronic hyperglycemia with tendinopathy, the connection between morphometric changes as witnessed by magnetic resonance (MR) images, nanostructural changes, and inflammatory markers have not yet been fully established. Therefore, the present study has as a hypothesis that the Achilles tendons of rats with diabetes mellitus (DM) exhibit structural changes. The animals were randomly divided into two experimental groups: Control Group (n = 06) injected with a vehicle (sodium citrate buffer solution) and Diabetic Group (n = 06) consisting of rats submitted to intraperitoneal administration of streptozotocin. MR was performed 24 days after the induction of diabetes and images were used for morphometry using ImageJ software. Morphology of the collagen fibers within tendons was examined using Atomic Force microscopy (AFM). An increase in the dimension of the coronal plane area was observed in the diabetic group (8.583 ± 0.646 mm2/100g) when compared to the control group (4.823 ± 0.267 mm2/100g) resulting in a significant difference (p = 0.003) upon evaluating the Achilles tendons. Similarly, our analysis found an increase in the size of the transverse section area in the diabetic group (1.328 ± 0.103 mm2/100g) in comparison to the control group (0.940 ± 0.01 mm2/100g) p = 0.021. The tendons of the diabetic group showed great irregularity in fiber bundles, including modified grain direction and jagged junctions and deformities in the form of collagen fibrils bulges. Despite the morphological changes observed in the Achilles tendon of diabetic animals, IL1 and TNF-α did not change. Our results suggest that DM promotes changes to the Achilles tendon with important structural modifications as seen by MR and AFM, excluding major inflammatory changes.

Evaluation of quantitative parameters of Leydig cell in diabetic adults rats / Avaliação de parâmetros quantitativos de células de Leydig em ratos diabéticos adultos

The goal of present study was to evaluate the effects of diabetes on quantitative parameters of Leydig cells. Twelve adults Wistar rats were divided in: 1) Diabetic Group (DG), which was induced by a single intraperitoneal injection of streptozotocin (60 mg kg-1 of body weight); and 2) Control Group (CG), which received citrate buffer intraperitoneal. After eight weeks of diabetic induction, the animals were weighted, anesthetized and testicles were removed and routinely processed to paraffin embedded. Body weight (40%) and testicular weight (18%) of diabetic rats were significantly lower than control group. Diabetic rats showed an increase in interstitial compartment but the tubular compartment did not differ. The individual volume of Leydig cells and nuclear diameter were lower in DG. However, the population of these cells was increased. In conclusion, diabetes induced by streptozotocin in adult rats promoted alterations in testicular compartments and changes on volume, nuclear diameter and population of Leydig cells, compromising the testicular function.

O objetivo do presente estudo foi avaliar os efeitos do 'diabetes' nos parâmetros quantitativos de células de Leydig. Doze ratos machos adultos foram divididos em: 1) Grupo Diabético (GD) induzidos por injeção intraperitoneal única de estreptozotocina (60 mg kg-1 de peso corporal); e 2) Grupo Controle (GC) receberam tampão citrato, via intraperitoneal. Após oito semanas da indução, os animais foram pesados, anestesiados, os testículos foram removidos e processados rotineiramente em parafina. O peso corporal (40%) e testicular (18%) dos ratos diabéticos reduziu significativamente em relação ao grupo controle. Ratos diabéticos mostraram aumento no compartimento intersticial, mas o compartimento tubular não apresentou diferença significativa. O volume individual e o diâmetro nuclear de células de Leydig reduziram em GD. No entanto, a população dessas células aumentou. Em conclusão, o 'diabetes' induzido por estreptozotocina, em ratos adultos, promoveu alterações nos compartimentos testiculares e mudanças no volume, diâmetro nuclear e população das células de Leydig, comprometendo a função testicular.

Treino moderado de corrida causa alterações nas propriedades biomecânicas do tendão do calcâneo? / Do moderate running training changes the biomechanical properties of the achilles tendon? / ¿Entrenamiento físico moderado causan cambios en las propiedades biomecánicas del tendón de aquiles?

O efeito do treinamento aeróbio ainda apresenta resultados conflitantes com relação às respostas biomecânicas apresentadas pelo tendão após um período de treinamento aeróbio moderado, como a corrida. Este estudo tem como objetivo avaliar o efeito de um protocolo de corrida de intensidade moderada em esteira sobre as propriedades mecânicas dos tendões do calcâneo de ratos. Para o ensaio mecânico os tendões foram tracionados até o ponto de fracasso do espécime. O treinamento aeróbiode intensidade moderada em ratos não causa alterações nas propriedades biomecânicas do tendão de calcâneo, desta forma, parece não representar risco podendo ser eficaz por não levar o tendão do Calcâneo ao estresse e a fadiga mecânica.

The effect of aerobic training has presented conflicting results regarding the biomechanical responses submitted by the tendon after a period of moderate aerobic training such as running. This study aims to evaluate the effect of a protocol running on a treadmill at moderate intensity on the mechanical properties of the Achilles tendons of rats. For mechanical test the tendons were pulled to the point of failure of the specimen. The moderate-intensity aerobic training in rats does not changes in the biomechanical properties of the Achilles tendon, thus, does not seem to pose a risk can be effective for not taking the Achilles tendon to mechanical stress and fatigue.

El efecto de entrenamiento aerobio ha presentado resultados contradictorios respecto a las respuestas biomecánicas presentado por el tendón después de un período de entrenamiento aerobio moderado, como correr. Este estudio pretende evaluar el efecto de un protocolo de correr en una cinta a una intensidad moderada en las propiedades mecánicas de los tendones de Aquiles de las ratas. Para pruebas mecánicas de los tendones se retiraron hasta el punto de fracaso de la muestra. El entrenamiento aerobio de intensidad moderada en las ratas no provoca cambios en las propiedades biomecánicas del tendón de Aquiles, por lo tanto, no parece representar un riesgo puede ser eficaz para no tomar el tendón de Aquiles a la tensión mecánica y la fatiga.

Perfil da Fisioterapia Esportiva nas Instituições de Ensino Superior do Brasil / Profile of Sports Physiotherapy in colleges and universities in Brazil / Perfil de la Fisioterapia Deportiva en las Instituciones de Enseñanza Superior del Brasil

O I Fórum Nacional dos Docentes da Fisioterapia Esportiva descreve diretrizes para normatização do ensino de graduação e pós-graduação referente à Fisioterapia Esportiva, as quais fundamentam orientações para Instituições do Ensino Superior (IES). O objetivo do estudo foi descrever o perfil da disciplina/do módulo de Fisioterapia Esportiva nas IES do Brasil. Foi realizado um estudo transversal entre os meses janeiro a outubro de 2011 e buscou-se no sistema de informação e-MEC a identificação das 439 instituições que ofertam o curso de graduação em Fisioterapia. Posteriormente, houve um levantamento de informações nos planos pedagógicos dessas IES, observando-se grade curricular do curso, especificamente a existência da disciplina/do módulo de Fisioterapia Esportiva, carga horária e estágio supervisionado. Em seguida, foi aplicado um questionário aos coordenadores de 33% das IES que ofertam a disciplina/o módulo de Fisioterapia Esportiva. A disciplina de Fisioterapia Esportiva é ofertada em 56% das IES brasileiras com graduação em Fisioterapia; destas, 97% oferecem em caráter obrigatório e em 62% o conteúdo é ofertado unido a outra disciplina. Com base na resposta aos questionários, 31% dos cursos apresentam carga horária total da disciplina entre 30 a 45 horas/aula, 50% oferecem estágio supervisionado e apenas 20% das instituições oferecem pós-graduação lato sensu na área. Foi investigada também a titulação dos professores ministrantes: 24% deles são especialistas, 31% são mestres, apenas 3% são doutores e 34% obtiveram o título de sócio-especialista da Sociedade Nacional de Fisioterapia Esportiva (SONAFE). Observa-se que a Fisioterapia Esportiva nas IES do Brasil ainda não está de acordo com as diretrizes que normatizam o ensino de graduação e pós-graduação na área...

The first Brazilian Forum of Professors in Sports Physiotherapy describes guidelines to standardize the education in undergraduate and graduate courses in relation to Sports Physiotherapy, justifying an orientation for Institutions of Higher Education (IHE). The aim of this study was to describe the profile of the Sports Physiotherapy in Brazilian IHE. A cross sectional study was conducted from January to October, 2011. In the research on the e-MEC information system, 439 institutions that offer undergraduate Physiotherapy courses were identified. Subsequently, it was collected information from pedagogical plans of these IHE, about core curriculum, specifically the existence or absence of the discipline of Sports Physiotherapy, workload and traineeship. A questionnaire was given to the coordinators of 33% of IHE that offer the discipline of Sports Physiotherapy. This discipline is offered in 56% of the Brazilian IHE with Physiotherapy course, obligatorily in 97% and, in 62%, the content is offered together with another discipline. Based in the response to the questionnaires, 31% of the courses have a total discipline workload within 30 to 45 hours/class, 50% of the courses offer traineeship, and only 20% of the IHE offer graduate courses in the area. It was also investigated the teachers' titration: 24% of them are specialists, 31% have a master degree, only 3% have a PhD degree, and 34% achieved the specialist degree of Sociedade Nacional de Fisioterapia Esportiva (SONAFE). It is observed that Sports Physiotherapy in the Brazilian IHE is not in accordance with the guidelines that regulate the teaching in undergraduate and graduate courses in the area...

El I Foro Nacional de los Docentes de Fisioterapia Deportiva describe directrices para normatización de la enseñanza de graduación y postgrado referente a la Fisioterapia Deportiva, las cuales fundamentan orientaciones para Instituciones de Enseñanza Superior (IES). El objetivo del estudio fue describir el perfil de la disciplina/del módulo de Fisioterapia Deportiva en las IES del Brasil. Fue realizado un estudio transversal entre los meses de enero a octubre de 2011 y se buscó en el sistema de información e-MEC la identificación de las 439 instituciones que ofertan el curso de graduación en Fisioterapia. Posteriormente, hubo un levantamiento de informaciones en los planes pedagógicos de esas IES, observándose el programa curricular del curso, específicamente la existencia de la disciplina/del módulo de Fisioterapia Deportiva, carga horaria y pasantía supervisada. Enseguida, les fue aplicado un cuestionario a los coordinadores de 33% de las IES que ofertan la disciplina/el módulo de Fisioterapia Deportiva. La disciplina de Fisioterapia Deportiva es ofertada en 56% de las IES brasileñas con graduación en Fisioterapia; de estas, 97% la ofrecen en carácter obligatorio y en 62% el contenido es ofertado unido a otra disciplina. Basándonos en la respuesta a los cuestionarios, 31% de los cursos presentan carga horaria total de la disciplina entre 30 a 45 horas/clase, 50% ofrecen pasantía supervisada y apenas 20% de las instituciones ofrecen postgrado lato sensu en el área. Fue investigada también la titulación de los profesores actuantes: 24% de ellos son especialistas, 31% son másters, apenas 3% son doctores y 34% obtuvieron el título de socio especialista de la Sociedade Nacional de Fisioterapia Esportiva (SONAFE). Se observa que la Fisioterapia Deportiva en las IES del Brasil aun no está de acuerdo con las directrices que regulan la enseñanza de graduación y postgrado en el área...

Incidência de atitudes escolióticas em atletas de judô com idade a partir de 18 anos / Incidence of scoliosis in judo athletes from 18 years old

A escoliose é um desvio postural causado por desequilíbrios da musculatura paravertebral. É caracterizada pela flexão lateral e rotação das vértebras, ou seja, é uma deformidade tridimensional. Estas curvaturas anormais são freqüentemente encontradas em atletas de judô devido aos movimentos de flexão e rotação da coluna vertebral realizados nos golpes. Os desvios posturais aumentam a tensão das fibras musculares acarretando em mais lesões ao atleta reduzindo seu potencial físico. O presente estudo tem caráter prospectivo, avaliativo, epidemiológico e informativo e tem como objetivo analisar a incidência das escolioses em atletas competidores de judô do Estado de Alagoas. O estudo possui uma amostra de 31 atletas do sexo masculino com 23,3 ± 1,6 anos, no qual, após análise de dados, observou-se uma alta incidência de escoliose.

Scoliosis is a postural shunting line caused by alterations of the spinal cord. It is characterized by the lateral bend and rotation of the vertebrae, so is a three-dimensional deformity. These abnormal curves frequently are found in judo athletes, by the movements of bend and carried through rotation of the vertebral column in the blows. The postural shunting lines increase the tension of muscular staple fibers causing more injuries to the athlete reducing its physical potential. This study has a prospective, evaluative, epidemiologist and informative approach and has as objective to analyze the incidence of scoliosis in competitive judo athletes of Alagoas city. The sample was composed by 31 males athletes, with 23,3 ± 1,6 years old, which, after data analysis it was observed a high incidence of scoliosis.