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Sacco ICN, Trombini-Souza F, Suda EY. Impact of biomechanics on therapeutic interventions and rehabilitation for major chronic musculoskeletal conditions: A 50-year perspective. J Biomech 2023; 154:111604. [PMID: 37159980 DOI: 10.1016/j.jbiomech.2023.111604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
The pivotal role of biomechanics in the past 50 years in consolidating the basic knowledge that underpins prevention and rehabilitation measures has made this area a great spotlight for health practitioners. In clinical practice, biomechanics analysis of spatiotemporal, kinematic, kinetic, and electromyographic data in various chronic conditions serves to directly enhance deeper understanding of locomotion and the consequences of musculoskeletal dysfunctions in terms of motion and motor control. It also serves to propose straightforward and tailored interventions. The importance of this approach is supported by myriad biomechanical outcomes in clinical trials and by the development of new interventions clearly grounded on biomechanical principles. Over the past five decades, therapeutic interventions have been transformed from fundamentally passive in essence, such as orthoses and footwear, to emphasizing active prevention, including exercise approaches, such as bottom-up and top-down strengthening programs for runners and people with osteoarthritis. These approaches may be far more effective inreducing pain, dysfunction, and, ideally, incidence if they are based on the biomechanical status of the affected person. In this review, we demonstrate evidence of the impact of biomechanics and motion analysis as a foundation for physical therapy/rehabilitation and preventive strategies for three chronic conditions of high worldwide prevalence: diabetes and peripheral neuropathy, knee osteoarthritis, and running-related injuries. We conclude with a summary of recommendations for future studies needed to address current research gaps.
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Affiliation(s)
- Isabel C N Sacco
- Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Francis Trombini-Souza
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil; Master's and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | - Eneida Yuri Suda
- Postgraduate Program in Physiotherapy, Universidade Ibirapuera, São Paulo, Brazil
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2
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Tuominen J, Leppänen M, Jarske H, Pasanen K, Vasankari T, Parkkari J. Test-Retest Reliability of Isokinetic Ankle, Knee and Hip Strength in Physically Active Adults Using Biodex System 4 Pro. Methods Protoc 2023; 6:mps6020026. [PMID: 36961046 PMCID: PMC10037623 DOI: 10.3390/mps6020026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND The isokinetic dynamometry is considered a gold standard in muscle strength testing. The reliability of lower limb isokinetic strength measurements has not been thoroughly evaluated. OBJECTIVE To examine the test-retest reliability of isokinetic ankle plantar and dorsiflexion, ankle inversion and eversion, knee extension and flexion and hip abduction and adduction strength in physically active adults using Biodex System 4 Pro. METHODS Peak torques (PTs) and average peak torques (APTs) of the dominant and nondominant lower limbs were tested twice in 19 physically active adults 7 to 14 days apart. RESULTS The intraclass correlation coefficients (ICC) values varied from excellent to moderate and coefficient of variation of typical error (CVTE) values were 6.6-19.5%. Change in the mean expressed as a percent varied from -3.1% to 9.6%. There was no difference in the reliability between PT and APT values. Dominant lower limb was more reliable in every case if there was difference between limbs. CONCLUSION Test-retest reliability of isokinetic ankle, knee and hip strength in physically active adults using Biodex System 4 is mostly good or excellent. However, the observed range of the random variation has to be noted when using it in scientific follow-up studies or evaluation of patient progress in clinical settings.
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Affiliation(s)
- Juho Tuominen
- Facualty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
| | - Heidi Jarske
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Tommi Vasankari
- Facualty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyvaskyla, Finland
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3
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Rice PE, Nishikawa K, Nimphius S. Isolated Joint Block Progression Training Improves Leaping Performance in Dancers. Front Sports Act Living 2022; 3:779824. [PMID: 34970645 PMCID: PMC8712483 DOI: 10.3389/fspor.2021.779824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to investigate the effect of a 12-week ankle-specific block progression training program on saut de chat leaping performance [leap height, peak power (PP), joint kinetics and kinematics], maximal voluntary isometric plantar flexion (MVIP) strength, and Achilles tendon (AT) stiffness. Dancers (training group n = 7, control group n = 7) performed MVIP at plantarflexed (10◦) and neutral ankle positions (0◦) followed by ramping isometric contractions equipped with ultrasound to assess strength and AT stiffness, respectively. Dancers also performed saut de chat leaps surrounded by 3-D motion capture atop force platforms to determine center of mass and joint kinematics and kinetics. The training group then followed a 12-week ankle-focused program including isometric, dynamic constant external resistance, accentuated eccentric loading, and plyometric training modalities, while the control group continued dancing normally. We found that the training group's saut de chat ankle PP (59.8%), braking ankle stiffness (69.6%), center of mass PP (11.4%), and leap height (12.1%) significantly increased following training. We further found that the training group's MVIP significantly increased at 10◦ (17.0%) and 0◦ (12.2%) along with AT stiffness (29.6%), while aesthetic leaping measures were unchanged (peak split angle, mean trunk angle, trunk angle range). Ankle-specific block progression training appears to benefit saut de chat leaping performance, PP output, ankle-joint kinetics, maximal strength, and AT stiffness, while not affecting kinematic aesthetic measures. We speculate that the combined training blocks elicited physiological changes and enhanced neuromuscular synchronization for increased saut de chat leaping performance in this cohort of dancers.
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Affiliation(s)
- Paige E Rice
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, United States.,Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Kiisa Nishikawa
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Sophia Nimphius
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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4
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Stretch-Shortening Cycle Performance and Muscle-Tendon Properties in Dancers and Runners. J Appl Biomech 2021; 37:547-555. [PMID: 34788742 DOI: 10.1123/jab.2021-0094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/24/2021] [Accepted: 09/02/2021] [Indexed: 11/18/2022]
Abstract
The purpose of this investigation was to elucidate whether ankle joint stretch-shortening cycle performance, isometric and isokinetic plantarflexion strength, and maximal Achilles tendon force and elongation differ between dancers, endurance runners, and untrained controls. To differentiate between dancers, endurance runners, and controls, the authors measured maximal Achilles tendon force and elongation during isometric ramp contractions with ultrasonic imaging, maximal isometric and isokinetic plantarflexion strength with dynamometry, and stretch-shortening cycle function during countermovement hopping and 30-cm drop hopping with a custom-designed sled. The Achilles tendon of dancers elongated significantly (P ≤ .05) more than runners and controls. Dancers were significantly stronger than controls during isometric contractions at different ankle angles. Concentric and eccentric strength during isokinetic contractions at 60°·s-1 and 120°·s-1 was significantly higher in dancers and runners than controls. Dancers hopped significantly higher than runners and controls during hopping tasks. Dancers also possessed significantly greater countermovement hop relative peak power, drop hop relative impulse, and drop hop relative peak power than controls. Finally, dancers reached significantly greater velocities during countermovement hops than runners and controls. Our findings suggest dancing and running require or likely enhance plantarflexion strength. Furthermore, dancing appears to require and enhance ankle joint stretch-shortening cycle performance and tendon elongation.
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Grazioli R, Sobieski N, Wilhelm EN, Brusco CM, Rech A. Divergent isokinetic muscle strength deficits in street running athletes. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00856-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Almeida CHSD, Reis LFDF, Nascimento LPADS, Soares AR, Maioli MCP, Lopes AJ. Therapist-oriented home rehabilitation for adults with sickle cell anemia: effects on muscle strength, functional capacity, and quality of life. ACTA ACUST UNITED AC 2021; 26:612-619. [PMID: 34411499 DOI: 10.1080/16078454.2021.1965736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Considering the advances in functional rehabilitation in recent decades, therapist-oriented home rehabilitation (TOHR) has been increasingly used in the field of physical therapy because it increases patient compliance and reduces health system costs. The objective of this study was to investigate the effects of TOHR on functional capacity, muscle strength, and quality of life (QoL) in adults with sickle cell anemia (SCA). METHODS Forty adults with SCA underwent manually guided TOHR for 12 weeks. Before and at the end of training, the following variables were assessed in the participants: distance covered in the 6-min walk test (6MWD); maximal inspiratory pressure (MIP); maximal expiratory pressure (MEP); handgrip strength (HGS); quadriceps strength (QS); and QoL using the Short Form-36 physical component summary (SF-36PCS) and the Short Form-36 mental component summary (SF-36MCS). RESULTS After TOHR, significant increases were observed in the mean values for the 6MWD, MIP, MEP, HGS, QS, and SF-36PCS and SF-36MCS scores. The relative delta between the pre- and post-TOHR 6MWDs correlated significantly with the relative deltas of MIP (rs = 0.640, p < 0.0001), MEP (rs = 0.587, p < 0.0001), HGS (rs = 0.360, p = 0.022), and QS (rs = 0.351, p = 0.026). When the participants were separated according to their use of hydroxyurea, significant increases were observed in the relative deltas of the 6MWD, MIP and MEP values. CONCLUSIONS This study shows that TOHR can potentially increase functional capacity, muscle strength, and QoL in adults with SCA. Furthermore, there appears to be a relationship between 6MWD gains and muscle strength gains with TOHR.Trial registration: ClinicalTrials.gov identifier: NCT04705792.
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Affiliation(s)
| | - Luis Felipe da Fonseca Reis
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ, Brasil
| | | | - Andrea Ribeiro Soares
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil.,Disciplina de Hematologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Maria Christina Paixão Maioli
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil.,Disciplina de Hematologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Agnaldo José Lopes
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ, Brasil.,Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil
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The Protective Effect of Neuromuscular Training on the Medial Tibial Stress Syndrome in Youth Female Track-and-Field Athletes: A Clinical Trial and Cohort Study. J Sport Rehabil 2021; 30:1019-1027. [PMID: 33883301 DOI: 10.1123/jsr.2020-0376] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/03/2021] [Accepted: 02/05/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Few reports have analyzed the effects of neuromuscular (NM) training programs on the injury incidence among youth female track-and-field athletes. OBJECTIVE To determine the effects of NM training on reducing lower limb injury incidence and to establish its effects on countermovement jump performance, balance, 30-m sprint, and joint position sense in youth female track-and-field athletes. DESIGN Single-blind, randomized controlled clinical trial. SETTING Sports research laboratory. PARTICIPANTS Twenty-two female athletes were allocated into 2 groups: Conventional (CONV) training (n = 11; age = 15.3 [2.1] y) and NM training (n = 11; age = 15.0 [2.7] y). INTERVENTIONS Interventions were performed during the preseason of 6 weeks. The CONV training included anaerobic, strength, and aerobic training. The NM training consisted of a multicomponent program that integrated jumps, landings, and running with strength, endurance, agility, balance, and CORE training. MAIN OUTCOME MEASURES A follow-up of the cohorts was carried out through the evaluation of lower limb injuries (main outcome) during a regular season (weeks 7-18). Secondary outcomes were measured before and after the intervention: Y-balance test, active joint repositioning, ground reaction force, and countermovement jump height. RESULTS The injury incidence rate was 17.89 injuries per 1000 hours athlete-exposure in CONV training, and 6.58 in NM training (relative risk = 0.38; 95% confidence interval, 0.18 to 0.82; P = .044). Particularly, the medial tibial stress syndrome incidence rate was 5.96 injuries per 1000 hours athlete-exposure in CONV training and 0.82 in NM training (relative risk = 0.17; 95% confidence interval, 0.02 to 1.12; P = .012). In addition, a significant training × time interaction was noted, favoring improvements in 30-m sprint and countermovement jump height after NM. CONCLUSION The NM training may improve youth female athlete's physical fitness and reduce their injury relative risk of medial tibial stress syndrome injury.
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Hoitz F, von Tscharner V, Baltich J, Nigg BM. Individuality decoded by running patterns: Movement characteristics that determine the uniqueness of human running. PLoS One 2021; 16:e0249657. [PMID: 33793671 PMCID: PMC8016321 DOI: 10.1371/journal.pone.0249657] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/22/2021] [Indexed: 11/18/2022] Open
Abstract
Human gait is as unique to an individual as is their fingerprint. It remains unknown, however, what gait characteristics differentiate well between individuals that could define the uniqueness of human gait. The purpose of this work was to determine the gait characteristics that were most relevant for a neural network to identify individuals based on their running patterns. An artificial neural network was trained to recognize kinetic and kinematic movement trajectories of overground running from 50 healthy novice runners (males and females). Using layer-wise relevance propagation, the contribution of each variable to the classification result of the neural network was determined. It was found that gait characteristics of the coronal and transverse plane as well as medio-lateral ground reaction forces provided more information for subject identification than gait characteristics of the sagittal plane and ground reaction forces in vertical or anterior-posterior direction. Additionally, gait characteristics during the early stance were more relevant for gait recognition than those of the mid and late stance phase. It was concluded that the uniqueness of human gait is predominantly encoded in movements of the coronal and transverse plane during early stance.
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Affiliation(s)
- Fabian Hoitz
- Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - Vinzenz von Tscharner
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer Baltich
- Brooks Sports Inc., Seattle, Washington, United States of America
| | - Benno M. Nigg
- Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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9
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Relationship Between Training Factors and Injuries in Stand-Up Paddleboarding Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030880. [PMID: 33498553 PMCID: PMC7908629 DOI: 10.3390/ijerph18030880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 01/10/2023]
Abstract
Stand-up paddleboarding (SUP) is an increasingly popular sport but, as in other sports, there is an injury ratio associated with practicing it. In other types of sport, some factors have been linked to the likelihood of suffering an injury, among which stretching, core training and resistance training may be considered the most significant. Therefore, the main aim of this study was to identify the training factors that could influence injuries suffered by participants in international SUP competitions. Ninety-seven questionnaires were collected from paddlers who participated in an international SUP circuit, with epidemiological data being gathered about injuries and different questions related to the training undertaken. A multi-factor ANOVA test was used to identify the factors which influence the state of injury. Results showed that almost 60% of injuries occurred in the arms or in the upper thoracic region, around 65% of which were in tendons or muscles and, in almost half of cases, were related to overuse. Likewise, the results showed that athletes with injury performed fewer resistance training sessions per week (p = 0.028), over fewer months per year (p = 0.001), more weekly training sessions (p = 0.004) and, lastly, a greater volume of weekly training (p = 0.003) than athletes without injury. Moreover, the most important training factors that reduce the likelihood of suffering an injury were taken into account-in. particular, resistance training alone (p = 0.011) or together with CORE training (p = 0.006) or stretching (p = 0.012), and the dominant side of paddling (p = 0.032). In conclusion, resistance training would seem to reduce the likelihood of injury among SUP practitioners, and such benefits could be obtained by resistance training alone or in combination with CORE training or stretching.
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10
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Vera AM, Barrera BD, Peterson LE, Yetter TR, Dong D, Delgado DA, McCulloch PC, Varner KE, Harris JD. An Injury Prevention Program for Professional Ballet: A Randomized Controlled Investigation. Orthop J Sports Med 2020; 8:2325967120937643. [PMID: 32782904 PMCID: PMC7388110 DOI: 10.1177/2325967120937643] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/09/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Few investigations have examined dance-specific injury prevention programs (IPPs), and no published randomized controlled trials are available that evaluate IPPs for dance. HYPOTHESIS The implementation of an IPP will significantly reduce the risk of injury in professional ballet dancers. STUDY DESIGN Randomized controlled trial; Level of evidence, 2. METHODS A randomized controlled trial was designed that entailed a superiority model for the intervention group. All professional dancers from a single ballet company were eligible to participate. Randomization and allocation were performed before the start of the season. The control group practiced and performed without change to preexisting standard operating practice. The IPP group was instructed to perform a 30-minute exercise program 3 times per week over the 52-week study period. Injuries were recorded. Standard continuous and categorical data comparisons and correlations were used. Cox proportional hazards regression models for recurrent failures were used wherein the hazard ratio indicates the relative likelihood of injury in the control versus intervention groups. RESULTS Of the 52 eligible dancers, 75% (n = 39) participated. Of these 39 dancers, 19 (9 males, 10 females; mean age, 26.6 ± 4.0 years) were randomized to the control group and 20 (11 males, 9 females; mean age, 25.1 ± 5.1 years) to the IPP group. No significant (P > .05) difference was found in baseline demographics between groups. A total of 116 injuries were recorded for the entire study population (49 IPP; 67 control). Traumatic and chronic injuries accounted for 54% and 46% of injuries, respectively. The injury rate was 82% less (IPP hazard ratio, 0.18; z = -2.29; P = .022) in the IPP group after adjustment for confounding variables, and time between injuries was 45% longer (IPP hazard ratio, 0.55; z = -2.20; P = .028) than for controls. CONCLUSION The present study is the first prospective randomized controlled investigation of an IPP for professional ballet. The results showed an 82% decrease in injury rate for the intervention group and an extended period from previous injury to subsequent injury. REGISTRATION NCT04110002 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Angelina M. Vera
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - Bene D. Barrera
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - Leif E. Peterson
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - Thomas R. Yetter
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - David Dong
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | | | | | - Kevin E. Varner
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
| | - Joshua D. Harris
- Houston Methodist Orthopedics and Sports Medicine, Houston, Texas,
USA
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Effect of neuromuscular training augmented with knee valgus control instructions on lower limb biomechanics of male runners. Phys Ther Sport 2020; 43:89-99. [PMID: 32135451 DOI: 10.1016/j.ptsp.2020.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine if combining neuromuscular training (NMT) with knee valgus control instructions (VCIs) can affect lower limb biomechanics and injury incidence in male novice runners and assess over 1-year follow-up. DESIGN Controlled laboratory Study. SETTING University research laboratory. PARTICIPANTS 60 male novice runners randomly assigned into NMT (n = 20), NMT plus VCIs (n = 20), and sham (n = 20). MAIN OUTCOME MEASURES Kinematic and kinetic were measured at pre- and post-test and 1-year follow-up. Injury incidence assessed at pre-test and 1-year follow up. RESULTS There were significant between-group differences in kinetics after 6 weeks in NMT plus VCIs group. No significant differences were observed between NMT and NMT plus VCIs in kinematic variables. No significant change was seen in the sham in all variables. At 1-year follow-up, the minimal changes were seen in kinetic variables. Reduction reported running-related injuries were 31.58% in the NMT alone group, 65.52% in NMT plus VCIs group. In sham, it increased to 13.46%. CONCLUSIONS NMT plus VCIs was effective to reduce kinetics and improve kinematics in novice runners. Also, it could reduce injury incidence. This protocol may be an option for both athletic trainers and coaches for preventing of lower limbs' injury in male runners.
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Letafatkar A, Rabiei P, Farivar N, Alamouti G. Long‐term efficacy of conditioning training program combined with feedback on kinetics and kinematics in male runners. Scand J Med Sci Sports 2019; 30:429-441. [DOI: 10.1111/sms.13587] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 10/21/2019] [Accepted: 10/28/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Amir Letafatkar
- Sports Injury and Corrective Exercises Faculty of Physical Education and Sports Sciences Kharazmi University Tehran Iran
| | - Pouya Rabiei
- Department of Physical Education and Sports Sciences Islamic Azad University Karaj Iran
| | - Niloufar Farivar
- Sports Injury and Corrective Exercises Faculty of Physical Education and Sports Sciences Kharazmi University Tehran Iran
| | - Gelareh Alamouti
- Sports Injury and Corrective Exercises Faculty of Physical Education and Sports Sciences Kharazmi University Tehran Iran
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Lima TRL, Kasuki L, Gadelha M, Lopes AJ. Physical exercise improves functional capacity and quality of life in patients with acromegaly: a 12-week follow-up study. Endocrine 2019; 66:301-309. [PMID: 31317523 DOI: 10.1007/s12020-019-02011-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 07/09/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although the focus of acromegaly treatment is the hormonal control of the disease, a new perspective must be given to the functional rehabilitation of these patients, especially when considering the recent increase in survival. The aim of this study was to evaluate the effects of therapist-oriented home rehabilitation (TOHR) on patients with acromegaly. PATIENTS AND METHODS Seventeen adults with acromegaly followed an exercise programme from a booklet with instructions for each exercise prescribed, for 2 months, and were reassessed after 1 month of washout. At each of the 3 timepoints (before and after the intervention and at the 1-month follow-up), the participants were subjected to the following assessments: body composition through bioimpedance, health-related quality of life (HRQoL) using the Acromegaly Quality of Life (AcroQoL) questionnaire, general fatigue through the Functional Assessment of Chronic Illness Therapy-Fatigue scale, handgrip strength, lower extremity functionality using isometric dynamometry and the Lower Extremity Functional Scale (LEFS), body balance through stabilometry, and functional capacity through 6-minute walking distance (6MWD). RESULTS After performing TOHR, improvements in general fatigue, quadriceps muscle strength, LEFS, 6MWD, balance control and all AcroQoL dimensions were observed (all P < 0.05). After 1 month of washout, however, these gains were lost for all parameters, except the LEFS and balance control. CONCLUSIONS In acromegaly, TOHR results in improvements in muscle function, functional capacity, general fatigue, body balance, and HRQoL. Large randomized controlled trials are needed to replicate these benefits and to recommend rehabilitation, especially for those with long-term illness.
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Affiliation(s)
- Tatiana Rafaela Lemos Lima
- Rehabilitation Sciences Post-graduate Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Leandro Kasuki
- Neuroendocrinology Research Centre/Endocrinology Section, Medical School and Clementino Fraga Filho University Hospital, Federal University of the Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Neuroendocrine Unit, Paulo Niemeyer State Brain Institute, Secretary of State for Health of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Monica Gadelha
- Neuroendocrinology Research Centre/Endocrinology Section, Medical School and Clementino Fraga Filho University Hospital, Federal University of the Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Neuroendocrine Unit, Paulo Niemeyer State Brain Institute, Secretary of State for Health of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-graduate Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
- Post-graduate Programme in Medical Sciences, School of Medical Sciences, State University of the Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
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Besomi M, Leppe J, Martínez MJ, Enríquez MI, Mauri-Stecca MV, Sizer PS. Running motivations within different populations of Chilean urban runners. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1381317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Besomi
- School of Physical Therapy, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - J. Leppe
- School of Physical Therapy, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - M. J. Martínez
- School of Physical Therapy, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - M. I. Enríquez
- School of Physical Therapy, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - M. V. Mauri-Stecca
- School of Physical Therapy, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P. S. Sizer
- School of Physical Therapy, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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15
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Liew BXW, Morris S, Keogh JWL, Appleby B, Netto K. Effects of two neuromuscular training programs on running biomechanics with load carriage: a study protocol for a randomised controlled trial. BMC Musculoskelet Disord 2016; 17:445. [PMID: 27770784 PMCID: PMC5075409 DOI: 10.1186/s12891-016-1271-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background In recent years, athletes have ventured into ultra-endurance and adventure racing events, which tests their ability to race, navigate, and survive. These events often require race participants to carry some form of load, to bear equipment for navigation and survival purposes. Previous studies have reported specific alterations in biomechanics when running with load which potentially influence running performance and injury risk. We hypothesize that a biomechanically informed neuromuscular training program would optimize running mechanics during load carriage to a greater extent than a generic strength training program. Methods This will be a two group, parallel randomized controlled trial design, with single assessor blinding. Thirty healthy runners will be recruited to participate in a six weeks neuromuscular training program. Participants will be randomized into either a generic training group, or a biomechanically informed training group. Primary outcomes include self-determined running velocity with a 20 % body weight load, jump power, hopping leg stiffness, knee extensor and triceps-surae strength. Secondary outcomes include running kinetics and kinematics. Assessments will occur at baseline and post-training. Discussion To our knowledge, no training programs are available that specifically targets a runner’s ability to carry load while running. This will provide sport scientists and coaches with a foundation to base their exercise prescription on. Trial registration ANZCTR (ACTRN12616000023459) (14 Jan 2016) Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-1271-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bernard X W Liew
- School of Physiotherapy and Exercise Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Susan Morris
- School of Physiotherapy and Exercise Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University, QLD 4229, Robina, Australia.,Sports Performance Research Centre New Zealand, AUT University, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
| | - Brendyn Appleby
- Strength and Conditioning, Australian Institute of Sport, Canberra, Australia.,High Performance Unit, Hockey Australia, Perth, Australia
| | - Kevin Netto
- School of Physiotherapy and Exercise Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
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16
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Baltich J, Emery CA, Whittaker JL, Nigg BM. Running injuries in novice runners enrolled in different training interventions: a pilot randomized controlled trial. Scand J Med Sci Sports 2016; 27:1372-1383. [DOI: 10.1111/sms.12743] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 12/15/2022]
Affiliation(s)
- J. Baltich
- Human Performance Laboratory (HPL); Faculty of Kinesiology; University of Calgary; Calgary Alberta Canada
| | - C. A. Emery
- Sport Injury Prevention Research Centre; Faculty of Kinesiology; University of Calgary; Calgary Alberta Canada
- The Alberta Children's Hospital Research Institute for Child and Maternal Health; Cumming School of Medicine; University of Calgary; Calgary Alberta Canada
| | - J. L. Whittaker
- Department of Physical Therapy; Faculty of Rehabilitation Medicine; Glen Sather Sports Medicine Clinic; University of Alberta; Edmonton Alberta Canada
| | - B. M. Nigg
- Human Performance Laboratory (HPL); Faculty of Kinesiology; University of Calgary; Calgary Alberta Canada
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17
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Matias AB, Taddei UT, Duarte M, Sacco ICN. Protocol for evaluating the effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: a randomized controlled trial. BMC Musculoskelet Disord 2016; 17:160. [PMID: 27075480 PMCID: PMC4831173 DOI: 10.1186/s12891-016-1016-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 04/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overall performance, particularly in a very popular sports activity such as running, is typically influenced by the status of the musculoskeletal system and the level of training and conditioning of the biological structures. Any change in the musculoskeletal system's biomechanics, especially in the feet and ankles, will strongly influence the biomechanics of runners, possibly predisposing them to injuries. A thorough understanding of the effects of a therapeutic approach focused on feet biomechanics, on strength and functionality of lower limb muscles will contribute to the adoption of more effective therapeutic and preventive strategies for runners. METHODS/DESIGN A randomized, prospective controlled and parallel trial with blind assessment is designed to study the effects of a "ground-up" therapeutic approach focused on the foot-ankle complex as it relates to the incidence of running-related injuries in the lower limbs. One hundred and eleven (111) healthy long-distance runners will be randomly assigned to either a control (CG) or intervention (IG) group. IG runners will participate in a therapeutic exercise protocol for the foot-ankle for 8 weeks, with 1 directly supervised session and 3 remotely supervised sessions per week. After the 8-week period, IG runners will keep exercising for the remaining 10 months of the study, supervised only by web-enabled software three times a week. At baseline, 2 months, 4 months and 12 months, all runners will be assessed for running-related injuries (primary outcome), time for the occurrence of the first injury, foot health and functionality, muscle trophism, intrinsic foot muscle strength, dynamic foot arch strain and lower-limb biomechanics during walking and running (secondary outcomes). DISCUSSION This is the first randomized clinical trial protocol to assess the effect of an exercise protocol that was designed specifically for the foot-and-ankle complex on running-related injuries to the lower limbs of long-distance runners. We intend to show that the proposed protocol is an innovative and effective approach to decreasing the incidence of injuries. We also expect a lengthening in the time of occurrence of the first injury, an improvement in foot function, an increase in foot muscle mass and strength and beneficial biomechanical changes while running and walking after a year of exercising. TRIAL REGISTRATION Clinicaltrials.gov Identifier NCT02306148 (November 28, 2014) under the name "Effects of Foot Strengthening on the Prevalence of Injuries in Long Distance Runners". Committee of Ethics in Research of the School of Medicine of the University of Sao Paulo (18/03/2015, Protocol # 031/15).
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Affiliation(s)
- Alessandra B. Matias
- />Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, 05360-160 São Paulo, São Paulo Brazil
| | - Ulisses T. Taddei
- />Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, 05360-160 São Paulo, São Paulo Brazil
| | - Marcos Duarte
- />Federal University of ABC, Biomedical Engineering, São Bernardo, São Paulo Brazil
| | - Isabel C. N. Sacco
- />Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea, 51 - Cidade Universitária, 05360-160 São Paulo, São Paulo Brazil
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Abstract
AbstractPurpose. The purpose of the study was to find the rate of musculoskeletal injuries in ultra-trail runners, investigate the most sensitive anatomical areas, and discover associated predicting factors to aid in the effective prevention and rapid rehabilitation of trail running injuries. Methods. Forty ultra trail runners responded to an epidemiological questionnaire. Results. At least one running injury was reported by 90% of the sample, with a total of 135 injuries were reported (111 overuse injuries, 24 appeared during competing). Lower back pain was the most common source of injury (42.5%). Running in the mountains (p = 0.0004) and following a personalized training schedule (p = 0.0995) were found to be protective factors. Runners involved in physical labor are associated with more injuries (p = 0.058). Higher-level runners are associated with more injuries than lower-level cohorts (p = 0.067), with symptoms most commonly arising in the lower back (p = 0.091), hip joint (p = 0.083), and the plantar surface of the foot (p = 0.054). Experienced runners (> 6 years) are at greater risk of developing injuries (p = 0.001), especially in the lower back (p = 0.012), tibia (p = 0.049), and the plantar surface of the foot (p = 0 .028). Double training sessions could cause hip joint injury (p = 0.060). Conclusions. In order to avoid injury, it is recommended to train mostly on mountain trails and have a training program designed by professionals.
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