Comparing exercises with and without electromyographic biofeedback in subacromial pain syndrome: A randomized controlled trial.

BACKGROUND: Deficits in movement and muscle activation of scapulohumeral joint are related to Subacromial Pain Syndrome. Electromyography biofeedback during exercise may enhance muscle activation and coordination, and consequently improve pain and shoulder function. METHODS: This study compared the effects of an exercise protocol with and without using electromyographic biofeedback on pain, function and movement of the shoulder complex in subjects with Subacromial Pain Syndrome. A total of 24 patients with subacromial pain (mean age = 46.2 + 8.1;18 women) were randomized to either therapeutic exercise or exercise plus biofeedback to the trapezius and serratus muscles. Pain and shoulder function were evaluated as the primary outcome and range of motion, muscle strength, electromyographic activity and scapulohumeral kinematics as secondary outcomes. The subjects underwent eight weeks of intervention and comparisons were made between groups in baseline, at 4 weeks, 8 weeks, and at 4 weeks post intervention. FINDINGS: There were differences between groups for pain [mean difference = 1.5 (CI 0.3, 3.2) p = 0.01] at 8 weeks in the Exercise group and scapular upward rotation at 60° of arm elevation [mean difference = 13.9 (CI 0.9, 9.3), p = 0.006] in the Biofeedback group. There was no difference for the other variables of scapular kinematics as well as for shoulder function (DASH), muscle strength, range of motion and electromyographic variables. INTERPRETATION: The addition of Biofeedback to the exercise protocol increased upward rotation of the scapula. However, the volunteers who performed only the Exercises had a better response in reducing pain.

Reliability and concurrent validity of a mobile application to measure thoracolumbar range of motion in low back pain patients.

BACKGROUND: Smartphone devices have been used to measure range of motion (ROM) in different joints. OBJECTIVE: To verify the concurrent validity of thoracolumbar ROM using a mobile application and a digital inclinometer, as well as the intrarater reliability of individuals with and without back pain. METHODS: One investigator was responsible for measuring the ROM during the evaluations performed on 20 asymptomatic subjects and 20 symptomatic subjects in two consecutive days. RESULTS: Regarding to the concurrent validity, the Intraclass Correlation Coefficients (ICC) were classified as very good for all analyzed movements. For intrarater reliability, the mobile application had ICC varying between good and very good for the symptomatic subjects and very good for asymptomatic subjects. CONCLUSIONS: The mobile application may be considered a valid and reliable tool to assess thoracolumbar ROM for both asymptomatic and chronic low back pain subjects.

Whole-Body Vibration on Performance of Quadriceps After ACL Reconstruction: A Blinded Randomized Controlled Trial.

CONTEXT: Whole-body vibration (WBV) has been widely used in clinical and sport practice. These devices produce constant vibrations, originating symmetrical waves that move along the vertical axis. It is suggested that mechanical stimuli produced by high vibration can be an alternative to improve neuromuscular performance and balance in different populations. However, there is still a lack of consensus in the literature regarding neurophysiological responses in the skeletal muscle immediately after the use of WBV, specifically in individuals subjected to anterior cruciate ligament reconstruction. OBJECTIVE: To investigate the immediate effects of WBV on neuromuscular performance of the quadriceps femoris and postural oscillation of individuals subjected to anterior cruciate ligament reconstruction. DESIGN: This is a blinded randomized controlled trial. SETTING: University laboratory. PARTICIPANTS: Forty-four men. INTERVENTION: Participants were randomized into 2 groups: control group (n = 22, exercise protocol on the vibrating platform turned off) and WBV group (n = 22, exercises on the vibrating platform turned on, at a frequency of 50 Hz and amplitude of 4 mm). MAIN OUTCOME MEASURES: The volunteers underwent a dynamometric evaluation of the quadriceps femoris and electromyographic activity of vastus lateralis and vastus medialis muscles, in addition to oscillation of the center of pressure at 2 different moments: before and immediately after the intervention protocol. RESULTS: The intragroup comparison evidenced differences between preassessments and postassessments for the variables of laterolateral amplitude, peak torque, and total work. However, no significant difference was observed in the intergroup comparison after WBV protocol. CONCLUSION: The use of WBV did not immediately alter the performance of the quadriceps femoris and the electromyographic activity of vastus lateralis and vastus medialis muscles. In addition, it also did not interfere with pressure center oscillation of individuals subjected to anterior cruciate ligament reconstruction.