Effects of low-load blood flow restriction training in healthy adult tendons: A systematic review and meta-analysis.

OBJECTIVE: To systematically review the effects of low-load blood flow restriction training (LL-BFR) on healthy adult tendons. DESIGN: A systematic review with meta-analysis. LITERATURE SEARCH: Six electronic databases were searched by two researchers. STUDY SELECTION CRITERIA: Clinical trials comparing the effects of LL-BFR to high-load resistance training (HL-RT) or low-load resistance training (LL-RT) in healthy adult tendons. DATA SYNTHESIS: Two reviewers selected the eligible clinical trials, and one reviewer exported the data. Two reviewers evaluated the study quality and risk of bias using the PEDro scale and the ROB2 scale. We performed meta-analysis where appropriate using a random-effects model. We rated the quality of evidence using GRADE. RESULTS: Six studies were eligible. We analyzed tendon cross-sectional area (CSA) and tendon stiffness as the outcomes. Across all comparisons, there was low-to moderate-quality evidence of a difference between LL-BFR and LL-RT immediately after exercise. There was high-quality evidence of no difference between LL-BFR and HL-RT in the long term. CONCLUSION: The effects of LL-BFR on the tendons depends on the time and dose of the intervention. LL-BFR could be useful to increase the CSA of the tendons in a similar or superior way to HL-RT after 8 weeks of intervention.

Relationship between spatiotemporal parameters and clinical outcomes in children with bilateral spastic cerebral palsy: Clinical interpretation proposal.

BACKGROUND: Understanding the links between gait disorders, impairments, and activity limitations is essential for correctly interpreting the instrumented gait analysis. We aimed to evaluate the relationships between spatiotemporal parameters and clinical outcomes in children with bilateral spastic cerebral palsy, and find out whether spatiotemporal parameters provide clinical information regarding gait pattern and walking. METHODS: Data from 19 children with bilateral spastic cerebral palsy (nine males, ten females, 9.6 ± 2.8 years old) were collected retrospectively. All children underwent an instrumented gait analysis and a standardized clinical assessment. Seven spatiotemporal parameters were calculated: non-dimensional cadence, stride length, step width, gait speed, first double support, single support, and time of toe off. Clinical outcomes included measures of two different components of the International Classification of Functioning, Disability and Health - Children and Youth version: body functions and structures (spasticity, contractures and range of motion, and deformities), and activities and participation (gross motor function, and walking capacity). Pearson correlation, ANOVA, Student's t, Mann-Whitney U, and Kruskal-Wallis tests were used to analyze relationships. Spatiotemporal parameters related to clinical outcomes of body functions and structures were interpreted as outcome measures of gait pattern, while those related to clinical outcomes of activities and participation were interpreted as outcome measures of walking. RESULTS: Non-dimensional cadence, stride length, and gait speed showed relationships (p < 0.05) with hip flexors spasticity and hindfoot deformity, ankle plantar flexors spasticity, and hindfoot deformity, respectively. All spatiotemporal parameters except non-dimensional cadence showed correlation (p < 0.05) with gross motor function and walking capacity. CONCLUSIONS: Spatiotemporal parameters provide clinical information regarding both gait pattern and walking.

Gait event detection using kinematic data in children with bilateral spastic cerebral palsy.

BACKGROUND: Ground reaction forces are the gold standard for detecting gait events, but they are not always applicable in cerebral palsy. Ghoussayni's algorithm is an event detection method based on the sagittal plane velocity of heel and toe markers. We aimed to evaluate whether Ghoussayni's algorithm, using two different thresholds, was a valid event detection method in children with bilateral spastic cerebral palsy. We also aimed to define a new adaptation of Ghoussayni's algorithm for detecting foot strike in cerebral palsy, and study the effect of event detection methods on spatiotemporal parameters. METHODS: Synchronized kinematic and kinetic data were collected retrospectively from 16 children with bilateral spastic cerebral palsy (7 males and 9 females; age 8.9 ± 2.7 years) walking barefoot at self-selected speed. Gait events were detected using methods: 1) ground reaction forces, 2) Ghoussayni's algorithm with a threshold of 0.5 m/s, and 3) Ghoussayni's algorithm with a walking speed dependent threshold. The new adaptation distinguished how foot strikes were performed (heel and/or toe) comparing the timing when the foot markers velocities fell below the threshold. Differences between the three methods, and between spatiotemporal parameters calculated from the two Ghoussayni's thresholds were analyzed. FINDINGS: There were statistically significant (P < 0.05) differences between methods 1 and 3, and between some spatiotemporal parameters calculated from methods 2 and 3. Ghoussayni's algorithm showed better performance for foot strike than for toe off. INTERPRETATION: Ghoussayni's algorithm using 0.5 m/s is valid in children with bilateral spastic cerebral palsy. Event detection methods affect spatiotemporal parameters.

Validity and reliability of the Kinovea program in obtaining angles and distances using coordinates in 4 perspectives.

An objective analysis of the human movement can help both clinical assessment and sports performance. Kinovea is a free 2D motion analysis software that can be used to measure kinematic parameters. This low-cost technology has been used in sports sciences, as well as in the clinical and research fields. One interesting tool is that it can measure an object (or person) passing in front of the camera, taking into account the perspective between the camera and the recorded object. Although it has been validated as a tool to assess time-related variables, few studies assessed its validity compared to a Gold Standard; furthermore, its reliability in different perspectives has not been previously assessed. The main objective of this study is to determine the validity of the Kinovea software compared to AutoCAD, and its intra and inter-rater reliability in obtaining coordinates data; a second objective is to compare their results at 4 different perspectives (90°, 75°, 60° and 45°) and to assess the inter and intra rater reliability at each perspective. For this purpose, a wire structure figure in the shape of a human lower limb was designed and measured in AutoCAD; it was then recorded during a pendular motion with a video-camera placed at distance of 5 m and analyzed with Kinovea in the 4 perspectives (90°, 75°, 60° and 45°). Each frame was examined by three observers who made two attempts. A multiple approach was applied involving the analysis of the systematic error, with a two-way ANOVA 2x4; the relative reliability with Intraclass Correlation Coefficient (ICC) and the Coefficient of Variance (CV) (95% confidence interval); and the absolute reliability with the Standard Error (SE). The results indicate that the Kinovea software is a valid and reliable tool that is able to measure accurately at distances up to 5 m from the object and at an angle range of 90°-45°. Nevertheless, for optimum results an angle of 90° is suggested.