Therapeutic Exercise Intervention Using Vibration Platforms for Glycemic Control in Type 2 Diabetes: A Pilot Study.

Diabetes generates a great impact on society, as well as a concern for health professionals due to its high and increasing prevalence; there are several studies that demonstrate the effectiveness of vibration platforms and their benefits at a physiological level. The aim of this study will be to analyze the decrease in glycosylated hemoglobin and glycemia levels after the use of whole-body vibration platforms and the possible inclusion of this therapeutic option within the usual treatments. This is a double-blind, randomized controlled trial with parallel group design in a 1:1 ratio. The sample will be composed of people diagnosed with type 2 diabetes mellitus in in the Plasencia area (Cáceres, Extremadura). Participants will be randomly assigned to the intervention or control group using a randomization list and will follow the inclusion criteria: type 2 diabetics between 50 and 60 years of age and not taking diabetes medication. All participants will undergo a determination of glycosylated hemoglobin, blood pressure, lipid profile, weight and height, and different functional tests such as Time Up and Go, 10 Meters Walk Test, and 5 Sit To Stand. The experimental group will perform a whole-body vibration intervention on an oscillating platform for 12 weeks with a weekly frequency of three nonconsecutive days and a duration of 12 min. The exercises will consist of 60 s of work and 60 s with rest. The control group will carry out their normal life insisting on the importance of glycemic controls before and after their daily physical exercise. This study has been registered at clinical.trial.org, ID: NCT05968222. Whole-body vibration platforms have demonstrated their effectiveness in different pathologies such as stroke, fibromyalgia, sclerosis multiple, or Parkinson's. For that reason, an improvement in glycemic and lipid values and body composition are expected in people with diabetes after a whole-body vibration intervention for 12 weeks' duration. In addition, whole-body vibration platforms could be postulated as an alternative to usual treatments.

Effect of Hip Muscle Strengthening Exercises on Pain and Disability in Patients with Non-Specific Low Back Pain-A Systematic Review.

Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of this study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from the PubMed, PEDro, and Scopus databases published up to September 2022. Based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASP and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as "good". In conclusion, the addition of hip muscle strengthening exercises iterating interacted with LBP, effectively improving pain and disability.

Musculoskeletal Injuries and Risk Factors in Spanish CrossFit® Practitioners.

CrossFit® Training is a physical and sports-conditioning system based on constantly varied functional movements performed at high intensity. CrossFit® has been shown to significantly improve general physical performance and body composition. Although there seems to be an association between the practice of CrossFit® and musculoskeletal injuries, the relationship between CrossFit® and injury risks has been poorly studied. The main objective of this study was to establish the relationship between CrossFit® and musculoskeletal injuries. Secondary objectives were the analysis of various risk factors and injury and the comparison of the incidence of CrossFit® injuries to that of other sports. An online questionnaire was distributed to gyms affiliated with CrossFit®, Inc. in the Principality of Asturias, Spain in order to carry out a retrospective transversal descriptive study. The frequency of injuries in CrossFit® is similar to most sports. Injuries are often minor and of short duration, with the shoulder being the most affected joint complex.

Immediate Effects of Whole-Body versus Local Dynamic Electrostimulation of the Abdominal Muscles in Healthy People Assessed by Ultrasound: A Randomized Controlled Trial.

Dynamic electrostimulation consists of the application of local or global electrostimulation together with physical exercise. This study aimed to investigate the immediate effects of a dynamic electrostimulation session on the thickness of the abdominal musculature, inter-rectus distance, heart rate, blood pressure, and body temperature, and to identify possible differences in its form of application. A total of 120 healthy participants were divided into three groups: the whole-body electrostimulation group, the local electrostimulation group, and the control group without electrical stimulation. All groups performed a single session with the same dynamic exercise protocol. Muscle thickness and inter-rectus distance were evaluated ultrasonographically using the Rehabilitative Ultrasound Imaging technique both at rest and in muscle contraction (the active straight leg raise test) to find the post-intervention differences. The results showed significant differences in immediate post-intervention heart rate, with a smaller increase in the local electrostimulation group compared to the control and whole-body electrostimulation groups. No significant differences were identified between the groups after the interventions in the rest of the variables analyzed. Therefore, a local application, with the same effects as a global application on the abdominal musculature, has fewer contraindications, which makes its use more advisable, especially in populations with cardiorespiratory disorders, for which more research is needed.

Duchenne de Boulogne: el camino de la ciencia al arte / Duchenne de Boulogne: the road from science to art

La obra de Guillaume Benjamín Amand Duchenne (1806-1871) ha sido ampliamente recogida y analizada. La mayoría de sus biógrafos destacan a un extraordinario científico y clínico, que revolucionó el campo de la neurología y la electroterapia. Sin embargo, se considera que no ha sido suficientemente destacada su mayor aportación: ser el nexo entre dos campos que habían sido independientes hasta ese momento, la electrofisiología y la fotografía artística. La culminación de esta simbiosis sería la publicación de Mécanisme De La Physionomie Humaine: Où, Analyse Électro-Physiologique De L’expression Des Passions, publicada en 1862. Para los autores del presente trabajo, el objetivo final de la obra de Duchenne no fue solo el de un científico y clínico, fue también el de un artista, empeñado en reflejar y desentrañar los mecanismos de la emoción y del sentimiento. Incluso, pretendió establecer un canon estético en la pintura y escultura en la expresión facial, que reflejase su ideal de belleza. Su obra, tuvo importantes repercusiones en la neurología y la electroterapia, en la fotografía médica y en el desarrollo de un nuevo espacio escénico: la representación del movimiento corporal provocado por corrientes eléctricas, el denominado Electric Performance Art.(AU)

The work of Guillaume Benjamin Amand Duchenne (1806-1871) has been widely collected and analyzed. Most of his biographers highlight an extraordinary scientific and clinician, who revolutionized the field of neurology and electrotherapy. It is considered though that his most important contribution has not been sufficiently highlighted: he was the nexus of union between two fields independent until then, electrophysiology and artistic photograph. The culmination of this symbiosis is the publication of Mécanisme De La Physionomie Humaine: Où, Analyse Électro-Physiologique De L’expression Des Passions published in 1862. To the authors of the present study, the goal of Duchenne’s work was not only that of a scientific and clinician but also that of an artist, determined to reflect and unravel the mechanisms of emotion and feeling. He even intended to establish an aesthetic canon in painting and sculpture in facial expression, reflecting his ideal of beauty. His work had important repercussions in neurology and electrotherapy, in medical photography and in the development of a new scenic space: the representation of body movement provoked by electric currents, named Electric Performance Art.(AU)

The Effect of Combining Transcranial Direct Current Stimulation Treatment and an Exercise Program on Fragility in a Population with Multiple Sclerosis: Cross-Over Design Trial.

BACKGROUND: The relationship between fragility and neurological diseases is extensive and affects many patients with multiple sclerosis (MS), whose risk factors are related to fragility. OBJECTIVE: To study the effects of exercise and transcranial direct current stimulation (tDCS) in MS patients with fatigue from four dimensions: functional mobility, balance, fatigue, and depression. METHODS: A total of 12 patients who belonged to two associations of people with physical disabilities participated. Functional mobility, depression, balance, and fatigue were assessed before and after the intervention. Transcranial direct current stimulation and the exercise program were carried out over a 4-week period with a wash-out period of 5 months. RESULTS: After the application of tDCS, we found significant improvements in balance (p < 0.05, g = 0.632), depression (p < 0.05, g = 0.402), functional mobility (p < 0.05, g = 0.297), and fatigue (p < 0.05, g = 0.526). After the exercise program, significant improvements were shown in balance (p < 0.01, g = 0.418), depression (p < 0.001, g = 0.540), functional mobility (p < 0.01, g = 0.262), and fatigue (p < 0.01, g = 0.742). Two-way mixed-measures ANOVA showed that all variables improved in both groups, with significant differences over time but not between groups. Secondary analysis showed significant correlations between balance and functional mobility (r = 0.671, p = 0.017), depression and fatigue (r = 0.586, p = 0.044) and between intensity of rehabilitation and balance (r = 0.622, p = 0.031). CONCLUSION: Participating in an exercise program and receiving tDCS separately improved the variables of depression, balance, mobility, and fatigue.

The Role of Hip Joint Clearance Discrepancy as Other Clinical Predictor of Reinjury and Injury Severity in Hamstring Tears in Elite Athletes.

Hamstring tear injuries (HTI) are the most prevalent injuries in athletes, with high reinjury rates. To prevent reinjury and reduce the severity of injuries, it is essential to identify potential risk factors. Hip characteristics are fundamental to optimal hamstring function. We sought to investigate the role of hip joint clearance discrepancy (JCD) as a risk factor for HTI and a clinical predictor of risk of reinjury and injury severity. A cross-sectional, retrospective study was performed with elite athletes (n = 100) who did (n = 50) and did not (n = 50) have a history of injury. X-rays were taken to assess JCD. We reviewed muscular lesions historial, and health records for the previous 5 years. Significant differences were found in injury severity (p = 0.026; ŋ2p = 0.105) and a number of injuries (p = 0.003; ŋ2p = 0.172). The multivariate analysis data indicated that JCD was significantly associated with the number of injuries and their severity (p < 0.05). In the stepwise regression model, JCD variability explained 60.1% of the number of injuries (R2 0.601) and 10.5% of injury severity (R2 0.0105). These results suggest that JCD could play an important role as a risk factor for HTI and also as a clinical predictor of reinjury and injury severity.

Effects of progressive resistance exercise in akinetic-rigid Parkinson's disease patients: a randomized controlled trial.

BACKGROUND: Progressive resistance exercise (PRE) can have a positive effect in individuals with Parkinson's disease (PD). However, the effect of PRE may vary with the clinical subtype of PD. To date, no study has assessed the effects of PRE in the different subtypes of PD. AIM: The aim of the present study was to assess the effects of PRE in PD patients with akinesia and rigidity (AR-subtype). DESIGN: A randomized controlled trial was conducted. SETTING: Outpatients clinics of the Bierzo Parkinson Association (Ponferrada, Spain) and the Asturias Parkinson Association (Oviedo, Spain). POPULATION: Twenty-eight patients with AR-subtype PD were randomized into an Experimental Group (EG, N.=13) and Control Group (CG, N.=15). METHODS: Static posturography (Centre of Pressure -CoP- parameters), gait (the Ten-Meter Walk Test [TMWT]), freezing of gait (the Freezing of Gait Questionnaire [FOG-Q]), the motor portion of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and patient-perceived quality of life (the 39-item Parkinson's disease Questionnaire [PDQ39]), were assessed at pre-test, post-test, and re-test. Ratings of perceived exertion (RPE) (Borg >6-20 Scale) were recorded at the end of each PRE training session. RESULTS: The EG displayed significant ameliorations in Length (CoP parameters) from pre- to post-test (P=0.048), in speed of fast rhythm walking (TMWT) from pre- to post-test (P=0.000), and from pre- to re-test (P=0.027), and in the PDQ39 Score from pre- to post-test (P=0.024). No significant differences were detected in Area or Speed (CoP parameters), speed of preferred rhythm walking (TMWT), FOG-Q scores, or the motor portion of the MDS-UPDRS scores. The EG reported a mean RPE of 9.95 (between "very light" and "fairly light") for the whole training program. CONCLUSIONS: These findings provide support for the use of PRE training in the rehabilitation of individuals with AR-subtype PD, as it can improve static posturography, gait, and quality of life. Furthermore, RPE scores showed that individuals with AR-subtype PD consider that PRE training require only light efforts. CLINICAL REHABILITATION IMPACT: The PRE training can be a helpful and fruitful rehabilitation tool for AR-subtype PD patients.

Effects of supervised slackline training on postural instability, freezing of gait, and falls efficacy in people with Parkinson's disease.

PURPOSE: The aim of this study was to assess whether supervised slackline training reduces the risk of falls in people with Parkinson's disease (PD). METHODS: Twenty-two patients with idiopathic PD were randomized into experimental (EG, N = 11) and control (CG, N = 11) groups. Center of Pressure (CoP), Freezing of Gait (FOG), and Falls Efficacy Scale (FES) were assessed at pre-test, post-test and re-test. Rate perceived exertion (RPE, Borg's 6-20 scale) and local muscle perceived exertion (LRPE) were also assessed at the end of the training sessions. RESULTS: The EG group showed significant improvements in FOG and FES scores from pre-test to post-test. Both decreased at re-test, though they did not return to pre-test levels. No significant differences were detected in CoP parameters. Analysis of RPE and LRPE scores revealed that slackline was associated with minimal fatigue and involved the major lower limb and lumbar muscles. CONCLUSIONS: These findings suggest that slacklining is a simple, safe, and challenging training and rehabilitation tool for PD patients. It could be introduced into their physical activity routine to reduce the risk of falls and improve confidence related to fear of falling. Implications for Rehabilitation Individuals with Parkinson's disease (PD) are twice as likely to have falls compared to patients with other neurological conditions. This study support slackline as a simple, safe, and challenging training and rehabilitation tool for people with PD, which reduce their risk of falls and improve confidence related to fear of falling. Slackline in people with PD yields a low tiredness or fatigue impact and involves the major lower limb and lumbar muscles.

Patients with neck pain are less likely to improve if they experience poor sleep quality: a prospective study in routine practice.

OBJECTIVE: To assess whether sleep quality (SQ) at baseline is associated with improvement in pain and disability at 3 months. MATERIALS AND METHODS: Four hundred twenty-two subacute and chronic patients with neck pain (NP) were recruited in 32 physiotherapy, primary care, and specialized centers. NP, referred pain, disability, catastrophizing, depression, and SQ were assessed through validated questionnaires, upon recruitment and 3 months later. Correlations between baseline scores were calculated through the Spearman coefficient. Improvements in NP, disability, and SQ were defined as a reduction of ≥30% of baseline score. Six estimative logistic regression models were developed to assess the association between baseline SQ and improvement of NP, baseline SQ and improvement of disability, baseline NP and improvement of SQ, baseline disability and improvement of SQ, the evolutions of NP and SQ, and the evolutions of disability and SQ. RESULTS: Most patients were subacute and mildly impaired. Regression models showed that better SQ at baseline was associated with improvement of NP (odds ratio=0.91 [95% confidence interval, 0.83-0.99]), but not disability (1.04 [0.95-1.13]); the improvement of SQ was associated with more severe NP at baseline (1.26 [1.07-1.49)], but not with baseline disability (0.99 [0.97-1.02]); and that improvement in SQ was associated with improvements in NP (3.48 [1.68-7.20]), and disability (5.02 [2.39-10.11]). DISCUSSION: NP is less likely to improve in patients with poorer SQ, irrespective of age, sex, catastrophizing, depression, or treatments prescribed for NP. Future studies should confirm these results with more severely impaired patients.